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Vinayahalingam S, van Nistelrooij N, Rothweiler R, Tel A, Verhoeven T, Tröltzsch D, Kesting M, Bergé S, Xi T, Heiland M, Flügge T. Advancements in diagnosing oral potentially malignant disorders: leveraging Vision transformers for multi-class detection. Clin Oral Investig 2024; 28:364. [PMID: 38849649 PMCID: PMC11161543 DOI: 10.1007/s00784-024-05762-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 06/01/2024] [Indexed: 06/09/2024]
Abstract
OBJECTIVES Diagnosing oral potentially malignant disorders (OPMD) is critical to prevent oral cancer. This study aims to automatically detect and classify the most common pre-malignant oral lesions, such as leukoplakia and oral lichen planus (OLP), and distinguish them from oral squamous cell carcinomas (OSCC) and healthy oral mucosa on clinical photographs using vision transformers. METHODS 4,161 photographs of healthy mucosa, leukoplakia, OLP, and OSCC were included. Findings were annotated pixel-wise and reviewed by three clinicians. The photographs were divided into 3,337 for training and validation and 824 for testing. The training and validation images were further divided into five folds with stratification. A Mask R-CNN with a Swin Transformer was trained five times with cross-validation, and the held-out test split was used to evaluate the model performance. The precision, F1-score, sensitivity, specificity, and accuracy were calculated. The area under the receiver operating characteristics curve (AUC) and the confusion matrix of the most effective model were presented. RESULTS The detection of OSCC with the employed model yielded an F1 of 0.852 and AUC of 0.974. The detection of OLP had an F1 of 0.825 and AUC of 0.948. For leukoplakia the F1 was 0.796 and the AUC was 0.938. CONCLUSIONS OSCC were effectively detected with the employed model, whereas the detection of OLP and leukoplakia was moderately effective. CLINICAL RELEVANCE Oral cancer is often detected in advanced stages. The demonstrated technology may support the detection and observation of OPMD to lower the disease burden and identify malignant oral cavity lesions earlier.
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Affiliation(s)
- Shankeeth Vinayahalingam
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands
- Department of Artificial Intelligence, Radboud University, Nijmegen, the Netherlands
- Department of Oral and Maxillofacial Surgery, Universitätsklinikum Münster, Münster, Germany
| | - Niels van Nistelrooij
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - René Rothweiler
- Department of Oral and Maxillofacial Surgery, Translational Implantology, Medical Center, Faculty of Medicine, University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Alessandro Tel
- Clinic of Maxillofacial Surgery, Head&Neck and Neuroscience Department, University Hospital of Udine, Udine, Italy
| | - Tim Verhoeven
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Daniel Tröltzsch
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Marco Kesting
- Department of Oral and Cranio-Maxillofacial Surgery, Friedrich-Alexander-University Erlangen- Nuremberg (FAU), Erlangen, Germany
| | - Stefaan Bergé
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Tong Xi
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Tabea Flügge
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany.
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Flores dos Santos LC, Fernandes JR, Lima IFP, Bittencourt LDS, Martins MD, Lamers ML. Applicability of autofluorescence and fluorescent probes in early detection of oral potentially malignant disorders: a systematic review and meta-data analysis. Photodiagnosis Photodyn Ther 2022; 38:102764. [DOI: 10.1016/j.pdpdt.2022.102764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/10/2022] [Accepted: 02/14/2022] [Indexed: 12/24/2022]
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