{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T12:40:28Z","timestamp":1792586428209,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Accurate and reproducible Kellgren\u2013Lawrence grading of radiographic knee osteoarthritis remains challenging, particularly for intermediate grades and anatomically heterogeneous compartments. We present X\u2010VIG, an interpretable deep learning framework integrating paired anteroposterior and lateral knee radiographs via view\u2010specific backbones with deformable convolutions, attention\u2010based feature fusion, and dual classification\u2013regression optimization aligned with five\u2010grade clinical practice. Grad\u2010CAM++ visualizations enhance model transparency and support clinical interpretation. In a retrospective cohort (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009229) with consensus reference\u2010standard KL labels established by double\u2010blinded expert review and patient\u2010level splitting (70%\/30%), X\u2010VIG achieved AUCs of 0.9646\u20130.9945 across five anatomical subregions. Multimodal fusion yielded a mean AUC gain of 5.6 percentage points over single\u2010view models. In a reader study of 50 held\u2010out patients comprising 100 individual radiographs, X\u2010VIG outperformed junior radiologists, matched or surpassed senior performance in most subregions, and reduced reading time by 82% (27\u2009s per case). These results position X\u2010VIG as a credible second reader for standardizing the reporting of knee osteoarthritis in routine clinical workflows.\n                  <\/jats:p>","DOI":"10.1002\/jor.70276","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T08:42:51Z","timestamp":1791448971000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and Validation of an Interpretable Deep Learning Model for Automated Kellgren\u2013Lawrence Grading of Knee Osteoarthritis Using X\u2010Ray Imaging"],"prefix":"10.1002","volume":"44","author":[{"given":"Zhen","family":"Dai","sequence":"first","affiliation":[{"name":"Department of Orthopedics The First Affiliated Hospital of AnhuiMedical University Hefei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengcheng","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The First Affiliated Hospital of AnhuiMedical University Hefei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Ni","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The First Affiliated Hospital of AnhuiMedical University Hefei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The First Affiliated Hospital of AnhuiMedical University Hefei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangyue","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Rheumatology The First Affiliated Hospital of AnhuiMedical University Hefei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8710-7559","authenticated-orcid":false,"given":"Jinling","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The First Affiliated Hospital of AnhuiMedical University Hefei China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.28251"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10278-018-0098-3"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1109\/ISBI.2018.8363705"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1109\/IISA.2019.8900714"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-024-10928-9"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-85945-9"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-97565-4"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.792900"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.598897"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s42836-022-00118-7"},{"key":"e_1_2_9_12_1","volume-title":"Proceedings of the First International Conference on Innovative Computing, Information and Control (ICICIC'06), vol. 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