Tracking temporal progression of benign bone tumors through X-ray based detection and segmentation

Abstract

X-ray is the most widely used imaging modality for the initial diagnosis of bone tumors due to its accessibility and cost-effectiveness. However, the longitudinal comparison of benign bone tumors, particularly for assessing size and shape progression over time, remains largely manual and subjective. In this study, we propose FusionX-BBTNet, a deep learning-based framework that enables automated detection, segmentation, and time-sequential analysis of BBTs from X-ray images. The framework combines YOLO-based object detection with U-Net segmentation, and utilizes a novel wavelet-enhanced dataset to improve contour accuracy. To enable real-world quantification, an OCR-based module is used to extract the X-ray scale bar and compute the pixel-to-length conversion ratio. With this, tumor size and area are calculated in millimeters, and their changes over time are visualized through centroid-based alignment. The proposed method was validated on a dataset of 466 expert-annotated X-ray images, achieving a mean IoU of 0.9376 and a boundary F1 score of 0.9827. In addition to providing reliable tumor localization and measurement, the system supports clinical decision-making by offering intuitive shape and area comparisons. This approach has the potential to complement expert interpretation and improve diagnostic efficiency, especially in environments with limited radiological expertise.