Imputation methods for temporal radiographic texture analysis in the detection of periprosthetic osteolysis

Periprosthetic osteolysis is a disease triggered by the body's response to tiny wear fragments from total hip replacements (THR), which leads to localized bone loss and disappearance of the trabecular bone texture. We have been investigating methods of temporal radiographic texture analysis (tRTA) to help detect periprosthetic osteolysis. One method involves merging feature measurements at multiple time points using an LDA or BANN. The major drawback of this method is that several cases do not meet the inclusion criteria because of missing data, i.e., missing image data at the necessary time intervals. In this research, we investigated imputation methods to fill in missing data points using feature averaging, linear interpolation, and first and second order polynomial fitting. The database consisted of 101 THR cases with full data available from four follow-up intervals. For 200 iterations, missing data were randomly created to simulate a typical THR database, and the missing points were then filled in using the imputation methods. ROC analysis was used to assess the performance of tRTA in distinguishing between osteolysis and normal cases for the full database and each simulated database. The calculated values from the 200 iterations showed that the imputation methods produced negligible bias, and substantially decreased the variance of the AUC estimator, relative to excluding incomplete cases. The best performing imputation methods were those that heavily weighted the data points closest to the missing data. The results suggest that these imputation methods appear to be acceptable means to include cases with missing data for tRTA.