SCOPE-MRI: Bankart Lesion Detection as a Case Study in Data Curation and Deep Learning for Challenging Diagnoses

While deep learning has shown strong performance in musculoskeletal imaging, existing work has largely focused on pathologies where diagnosis is not a clinical challenge, leaving more difficult problems underexplored, such as detecting Bankart lesions (anterior-inferior glenoid labral tears) on standard MRIs. Diagnosing these lesions is challenging due to their subtle imaging features, often leading to reliance on invasive MRI arthrograms (MRAs). This study introduces ScopeMRI, the first publicly available, expert-annotated dataset for shoulder pathologies, and presents a deep learning (DL) framework for detecting Bankart lesions on both standard MRIs and MRAs. ScopeMRI includes 586 shoulder MRIs (335 standard, 251 MRAs) from 558 patients who underwent arthroscopy. Ground truth labels were derived from intraoperative findings, the gold standard for diagnosis. Separate DL models for MRAs and standard MRIs were trained using a combination of CNNs and transformers. Predictions from sagittal, axial, and coronal views were ensembled to optimize performance. The models were evaluated on a 20% hold-out test set (117 MRIs: 46 MRAs, 71 standard MRIs). The models achieved an AUC of 0.91 and 0.93, sensitivity of 83% and 94%, and specificity of 91% and 86% for standard MRIs and MRAs, respectively. Notably, model performance on non-invasive standard MRIs matched or surpassed radiologists interpreting MRAs. External validation demonstrated initial generalizability across imaging protocols. This study demonstrates that DL models can achieve radiologist-level diagnostic performance on standard MRIs, reducing the need for invasive MRAs. By releasing ScopeMRI and a modular codebase for training and evaluating deep learning models on 3D medical imaging data, we aim to accelerate research in musculoskeletal imaging and support the development of new datasets for clinically challenging diagnostic tasks.

ProtoECGNet: Case-Based Interpretable Deep Learning for Multi-Label ECG Classification with Contrastive Learning

Deep learning-based electrocardiogram (ECG) classification has shown impressive performance but clinical adoption has been slowed by the lack of transparent and faithful explanations. Post hoc methods such as saliency maps may fail to reflect a model's true decision process. Prototype-based reasoning offers a more transparent alternative by grounding decisions in similarity to learned representations of real ECG segments, enabling faithful, case-based explanations. We introduce ProtoECGNet, a prototype-based deep learning model for interpretable, multi-label ECG classification. ProtoECGNet employs a structured, multi-branch architecture that reflects clinical interpretation workflows: it integrates a 1D CNN with global prototypes for rhythm classification, a 2D CNN with time-localized prototypes for morphology-based reasoning, and a 2D CNN with global prototypes for diffuse abnormalities. Each branch is trained with a prototype loss designed for multi-label learning, combining clustering, separation, diversity, and a novel contrastive loss that encourages appropriate separation between prototypes of unrelated classes while allowing clustering for frequently co-occurring diagnoses. We evaluate ProtoECGNet on all 71 diagnostic labels from the PTB-XL dataset, demonstrating competitive performance relative to state-of-the-art black-box models while providing structured, case-based explanations. To assess prototype quality, we conduct a structured clinician review of the final model's projected prototypes, finding that they are rated as representative and clear. ProtoECGNet shows that prototype learning can be effectively scaled to complex, multi-label time-series classification, offering a practical path toward transparent and trustworthy deep learning models for clinical decision support.

Toward Non-Invasive Diagnosis of Bankart Lesions with Deep Learning

Bankart lesions, or anterior-inferior glenoid labral tears, are diagnostically challenging on standard MRIs due to their subtle imaging features-often necessitating invasive MRI arthrograms (MRAs). This study develops deep learning (DL) models to detect Bankart lesions on both standard MRIs and MRAs, aiming to improve diagnostic accuracy and reduce reliance on MRAs. We curated a dataset of 586 shoulder MRIs (335 standard, 251 MRAs) from 558 patients who underwent arthroscopy. Ground truth labels were derived from intraoperative findings, the gold standard for Bankart lesion diagnosis. Separate DL models for MRAs and standard MRIs were trained using the Swin Transformer architecture, pre-trained on a public knee MRI dataset. Predictions from sagittal, axial, and coronal views were ensembled to optimize performance. The models were evaluated on a 20% hold-out test set (117 MRIs: 46 MRAs, 71 standard MRIs). Bankart lesions were identified in 31.9% of MRAs and 8.6% of standard MRIs. The models achieved AUCs of 0.87 (86% accuracy, 83% sensitivity, 86% specificity) and 0.90 (85% accuracy, 82% sensitivity, 86% specificity) on standard MRIs and MRAs, respectively. These results match or surpass radiologist performance on our dataset and reported literature metrics. Notably, our model's performance on non-invasive standard MRIs matched or surpassed the radiologists interpreting MRAs. This study demonstrates the feasibility of using DL to address the diagnostic challenges posed by subtle pathologies like Bankart lesions. Our models demonstrate potential to improve diagnostic confidence, reduce reliance on invasive imaging, and enhance accessibility to care.