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Research on knee osteoarthritis grading based on multidimensional feature fusion

He Ren*, Yina Zhang*, Yutong Xie*, Anqi Wu, Xianglun Kong, Chenxiao Bai, Miao Yu, Yimeng Wang, Ping Li


Faculty of Medical Instrumentation, Shanghai University of Medicine and Health Sciences, Shanghai 201318,  China. 

*The authors contribute equally.

 

Address correspondence to: Ping Li, Faculty of Medical Instrumentation, Shanghai University of Medicine and Health Sciences, No. 279, Zhouzhu Highway, Pudong New Area, Shanghai 201318, China. Tel: +86-13764055848. E-mail: lip@sumhs.edu.cn.


DOI: https://doi.org/10.61189/517419bnpxap


Received July 17, 2025; Accepted September 29, 2025; Published December 31, 2025


Highlights

● Based on 8,110 OAI X-ray images, 18 radiomic features were processed and selected, with SMOTE combined with category weight balancing employed to address data imbalance. 

● Among eight machine learning models, the SVM achieved the best performance. 

● SHAP and LIME analyses enhanced model interpretability by identifying key radiomic features influencing predictions.

Abstract

Objective: This study aimed to apply machine learning approaches to the Kellgren-Lawrence (KL) grading of knee osteoarthritis, develop an effective automatic KL grading technique, and provide a methodological reference for clinical diagnosis and research. Methods: Data were obtained from the Osteoarthritis Initiative (OAI) knee X-ray image dataset, comprising 8,110 images from the folders of auto_test, train, and val. All images were first subjected to inversion processing, followed by extraction of two-dimensional radiomic features. Feature selection was then conducted using a combination of variance thresholding and analysis of variance (ANOVA), yielding 18 key features. To address class imbalance in the original dataset, this synthetic minority over-sampling technique (SMOTE)  and class weight balancing were jointly applied. Eight machine learning models-Decision Trees (DT), Logistic Regression (LR), Random Forests (RF), K-Nearest Neighbors (KNN), Support Vector Machine (SVM), Extreme Gradient Boosting (XGBoost), Categorical Boosting (CatBoost), and Light Gradient Boosting Machine (LightGBM)-were trained for KL grading of knee osteoarthritis. Model performance was evaluated using accuracy, precision, recall, F1-score, and the area under the curve (AUC). For the optimal SVM model, global and local interpretability analy-ses were further conducted using SHapley Additive exPlanations (SHAP) and Local Interpretable Model-agnostic Explanations (LIME) to identify the key factors influencing model decisions. Results: The support vector machine  (SVM) model achieves the best performance. Conclusion: This study establishes an effective machine learningbased method for automatic KL grading of knee osteoarthritis, providing valuable support for clinical diagnosis and research applications.

Keywords: Osteoarthritis, knee osteoarthritis, Kellgren-Lawrence (KL) grading, machine learning, interpretability

Cite

Ren H, Zhang YA, Xie YT, Wu AQ, Kong XL, Bai CX, Yu M, Wang YM, Li P. Research on knee osteoarthritis grading based on  multidimensional feature fusion. Prog in Med Devices. 2025 Dec; 3 (4): 211-222. doi: 10.61189/517419bnpxap

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