Vision transformer and deep learning based weighted ensemble model for automated spine fracture type identification with GAN generated CT images

The most common causes of spine fractures, or vertebral column fractures (VCF), are traumas like falls, injuries from sports, or accidents. CT scans are affordable and effective at detecting VCF types in an accurate manner. VCF type identification in cervical, thoracic, and lumbar (C3-L5) regions is limited and sensitive to inter-observer variability. To solve this problem, this work introduces an autonomous approach for identifying VCF type by developing a novel ensemble model of Vision Transformers (ViT) and best-performing deep learning (DL) models. It assists orthopaedicians in easy and early identification of VCF types. The performance of numerous fine-tuned DL architectures, including VGG16, ResNet50, and DenseNet121, was investigated, and an ensemble classification model was developed to identify the best-performing combination of DL models. A ViT model is also trained to identify VCF. Later, the best-performing DL models and ViT were fused by weighted average technique for type identification. To overcome data limitations, an extended Deep Convolutional Generative Adversarial Network (DCGAN) and Progressive Growing Generative Adversarial Network (PGGAN) were developed. The VGG16-ResNet50-ViT ensemble model outperformed all ensemble models and got an accuracy of 89.98%. Extended DCGAN and PGGAN augmentation increased the accuracy of type identification to 90.28% and 93.68%, respectively. This demonstrates efficacy of PGGANs in augmenting VCF images. The study emphasizes the distinctive contributions of the ResNet50, VGG16, and ViT models in feature extraction, generalization, and global shape-based pattern capturing in VCF type identification. CT scans collected from a tertiary care hospital are used to validate these models.