{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T13:06:47Z","timestamp":1789218407283,"version":"build-2803163510"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81930045"],"award-info":[{"award-number":["81930045"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82371938"],"award-info":[{"award-number":["82371938"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["nyaspubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann NY Acad Sci"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Accurate diagnosis of early\u2010stage osteonecrosis of the femoral head (ONFH) remains challenging due to reliance on subjective radiological interpretation. This multicenter retrospective study developed an automated, multi\u2010sequence MRI\u2010based diagnostic model for early ONFH using data from 342 ONFH\u2010affected femoral heads (FHs) from 282 patients and 265 healthy FHs from 233 healthy individuals obtained from two geographically distinct institutions. The dataset comprised three MRI sequences (T1WI, FS\u2010T2WI, and Cor STIR) and 7844 annotated FH instances labeled as normal or abnormal. A You Only Look Once (YOLO) segmentation model was trained on both single\u2010sequence and multi\u2010sequence datasets, and a global attention mechanism (GAM) was integrated to enhance diagnostic performance, yielding the GAM\u2010YOLO model. Model performance was compared with that of radiology residents using Fisher's exact test. The multi\u2010sequence YOLO model achieved superior diagnostic accuracy (sensitivity 93.19%, specificity 94.65%, accuracy 94.04%) compared to single\u2010sequence models. Incorporation of GAM further improved performance (sensitivity 97.00%, specificity 97.52%, accuracy 97.30%;\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.05). When applied to entire FH images, the GAM\u2010YOLO model achieved sensitivity, specificity, and accuracy of 99.03%, 98.51%, and 98.82%, respectively, showing higher diagnostic performance than residents (\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.01). These findings suggest that the GAM\u2010YOLO model offers a promising and objective tool for early ONFH diagnosis, demonstrating potential for clinical application.\n                  <\/jats:p>","DOI":"10.1111\/nyas.70354","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T10:42:46Z","timestamp":1787136166000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Global Attention Mechanism\u2013Enhanced Deep Learning for Multi\u2010Sequence MRI Diagnosis of Early Femoral Head Osteonecrosis"],"prefix":"10.1111","volume":"1562","author":[{"given":"Yi","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Radiology Renmin Hospital of Wuhan University  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Radiology Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donglin","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Radiology Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huasheng","family":"Zhuo","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Intelligent Manufacturing Equipment and Technology Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyong","family":"Liu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Intelligent Manufacturing Equipment and Technology Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuanxuan","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Radiology First Affiliated Hospital of Shihezi University School of Medicine  Shihezi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9581-5322","authenticated-orcid":false,"given":"Baojun","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Radiology Renmin Hospital of Wuhan University  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongyichen","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Radiology Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bowen","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Radiology Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yitong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiology Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John N.","family":"Morelli","sequence":"additional","affiliation":[{"name":"The Russell H. Morgan Department of Radiology and Radiological Science The Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0545-6782","authenticated-orcid":false,"given":"Xiaoming","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiology Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018\u2010020\u20101565\u20103"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.revmed.2019.10.332"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocl.2018.10.001"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264\u2010018\u20103917\u20108"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2019.11.029"},{"key":"e_1_2_10_7_1","first-page":"33e9","article-title":"The Discrepancy in the Posterior Boundary of Necrotic Lesion Between Axial and Oblique Axial Slices of MRI in Patients With Osteonecrosis of the Femoral Head","volume":"104","author":"Ikemura S.","year":"2022","journal-title":"Journal of Bone and Joint Surgery American"},{"key":"e_1_2_10_8_1","first-page":"34","article-title":"A Quantitative System for Staging Avascular Necrosis","volume":"77","author":"Steinberg M. 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