Automated detection and segmentation of chondromalacia patella on axial knee MRI using YOLOv11 and a custom CNN: a deep learning-based diagnostic model

Objective To evaluate a deep learning pipeline using YOLOv11 for segmentation and a custom CNN for classification to automatically detect and assess chondromalacia patella on axial knee MRI, aligning with expert clinical evaluation. Materials and methods A dataset of 650 axial knee MRIs was analyzed. YOLOv11 segmented the patellofemoral region, and a custom CNN classified chondromalacia. Performance was assessed using segmentation accuracy, classification accuracy, confidence scoring, and Grad-CAM-based visual explainability. Results The CNN achieved a test accuracy of 82.30% on 113 images, with an AUC of 0.87, indicating promising but preliminary discriminative ability. Grad-CAM maps showed reasonable agreement with expert interpretation. Conclusion The proposed YOLOv11-CNN pipeline demonstrated promising accuracy and may provide a potentially useful and interpretable solution for the detection and segmentation of chondromalacia patella on MRI, with the possibility of enhancing efficiency and consistency in orthopedic radiology workflows after further validation.