A Deep Learning-Based Approach for the Diagnostic of Brucellar Spondylitis in Magnetic Resonance Images

Brucellar spondylitis (BS), a prevalent zoonotic disease caused by Brucella, poses a significant global health threat. Accurate and timely diagnosis of BS is crucial for effective treatment; however, no specialized deep learning model has been developed for detecting BS in MR images. In this study, we proposed Brucella Spondylitis MRI Diagnosis Network (BSMRINet), a fully automated diagnostic framework designed for the detection of BS from T2-weighted (T2W) MR images. The model was developed and validated using 582 cohorts collected from four hospitals between January 2018 and August 2023. The BSMRINet architecture comprised two key modules. The vertebral body lesion detection module was designed to detect BS in intact vertebral bodies by integrating a corner detection algorithm with a ResNet-based deep learning model. This module provided accurate identification and localization of potential lesions of Brucella and calculated intervertebral disc height (DH) values. The spine lesion detection module was specifically designed to detect BS in damaged vertebral bodies by utilizing a DenseNet architecture with modified squeeze-and-excitation (scSE) networks. This module further evaluated paravertebral injuries, including abscess formation, soft tissue swelling, and joint involvement. BSMRINet demonstrated strong robustness and generalization across both internal and external validation phases. Additionally, it outperformed two radiologists with 10 to 15 years of experience in diagnosing spinal MR images. The results suggested that BSMRINet can assist in the diagnostic process of BS and enhance the diagnostic capabilities of radiologists.