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Included patients had confirmed diagnoses of CAI through arthroscopy, as well as individuals who had undergone MRI and physical examinations that ruled out ligament injuries. DL models were constructed based on a multilabel paradigm. A transformer\u2010based multilabel DL model (AnkleNet) was developed and compared with 4 convolution neural network (CNN) models. Subsequently, a reader study was conducted to evaluate the impact of model assistance on clinicians when diagnosing challenging cases: identifying rotational CAI (RCAI). Diagnostic performance was assessed using area under the receiver operating characteristic curve (AUC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Our transformer\u2010based model achieved AUCs of 0.910 and 0.892 for detecting lateral and medial collateral ligament injury, respectively, both of which were significantly higher than those of CNN\u2010based models (all\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). In terms of further CAI diagnosis, there was a macro\u2010average AUC of 0.870 and a balanced accuracy of 0.805. The reader study indicated that incorporation with our model significantly enhanced the diagnostic accuracy of clinicians (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .042), particularly junior clinicians, and led to a reduction in diagnostic variability. The code of the model can be accessed at\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/github.com\/ChiariRay\/AnkleNet\">https:\/\/github.com\/ChiariRay\/AnkleNet<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our transformer\u2010based model was able to detect lateral and medial collateral ligament injuries based on MRI and outperformed CNN\u2010based models, demonstrating a promising performance in diagnosing CAI, especially patients with RCAI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>Developing such an algorithm can improve the diagnostic performance of clinicians, aiding in identifying patients who would benefit from arthroscopy, such as patients with RCAI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2024.05.027","type":"journal-article","created":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T13:13:37Z","timestamp":1718198017000},"page":"574","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":10,"title":["Transformer\u2010Based Multilabel Deep Learning Model Is Efficient for Detecting Ankle Lateral and Medial Ligament Injuries on Magnetic Resonance Imaging and Improving Clinicians\u2019 Diagnostic Accuracy for Rotational Chronic Ankle Instability"],"prefix":"10.1002","volume":"41","author":[{"given":"Rui","family":"Yin","sequence":"first","affiliation":[{"name":"Department of Sports Medicine and Joint Surgery Nanjing First Hospital Nanjing Medical University Nanjing 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Nanjing Medical University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunjia","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine and Joint Surgery Nanjing First Hospital Nanjing Medical University Nanjing China"},{"name":"Department of Hand and Foot Microsurgery Xuzhou Central Hospital Xuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine and Joint Surgery Nanjing First Hospital Nanjing Medical University Nanjing China"},{"name":"Department of Orthopedics The Second People\u2019s Hospital of Lianyungang Lianyungang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiqiu","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine and Joint Surgery Nanjing First Hospital Nanjing Medical University Nanjing 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