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Ding X, Jiang X, Zheng H, Shi H, Wang B, Chan S. MARes-Net: multi-scale attention residual network for jaw cyst image segmentation. Front Bioeng Biotechnol 2024; 12:1454728. [PMID: 39161348 PMCID: PMC11330813 DOI: 10.3389/fbioe.2024.1454728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Accepted: 07/25/2024] [Indexed: 08/21/2024] Open
Abstract
Jaw cyst is a fluid-containing cystic lesion that can occur in any part of the jaw and cause facial swelling, dental lesions, jaw fractures, and other associated issues. Due to the diversity and complexity of jaw images, existing deep-learning methods still have challenges in segmentation. To this end, we propose MARes-Net, an innovative multi-scale attentional residual network architecture. Firstly, the residual connection is used to optimize the encoder-decoder process, which effectively solves the gradient disappearance problem and improves the training efficiency and optimization ability. Secondly, the scale-aware feature extraction module (SFEM) significantly enhances the network's perceptual abilities by extending its receptive field across various scales, spaces, and channel dimensions. Thirdly, the multi-scale compression excitation module (MCEM) compresses and excites the feature map, and combines it with contextual information to obtain better model performance capabilities. Furthermore, the introduction of the attention gate module marks a significant advancement in refining the feature map output. Finally, rigorous experimentation conducted on the original jaw cyst dataset provided by Quzhou People's Hospital to verify the validity of MARes-Net architecture. The experimental data showed that precision, recall, IoU and F1-score of MARes-Net reached 93.84%, 93.70%, 86.17%, and 93.21%, respectively. Compared with existing models, our MARes-Net shows its unparalleled capabilities in accurately delineating and localizing anatomical structures in the jaw cyst image segmentation.
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Affiliation(s)
- Xiaokang Ding
- College of Mechanical Engineering, Quzhou University, Quzhou, China
| | - Xiaoliang Jiang
- College of Mechanical Engineering, Quzhou University, Quzhou, China
| | - Huixia Zheng
- Department of Stomatology, Quzhou People’s Hospital, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou, China
| | - Hualuo Shi
- College of Mechanical Engineering, Quzhou University, Quzhou, China
- School of Mechanical Engineering, Hangzhou Dianzi University, Hangzhou, China
| | - Ban Wang
- School of Mechanical Engineering, Hangzhou Dianzi University, Hangzhou, China
| | - Sixian Chan
- College of Computer Science and Technology, Zhejiang University of Technology, Hangzhou, China
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2
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Shrivastava PK, Hasan S, Abid L, Injety R, Shrivastav AK, Sybil D. Accuracy of machine learning in the diagnosis of odontogenic cysts and tumors: a systematic review and meta-analysis. Oral Radiol 2024; 40:342-356. [PMID: 38530559 DOI: 10.1007/s11282-024-00745-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/06/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND The recent impact of artificial intelligence in diagnostic services has been enormous. Machine learning tools offer an innovative alternative to diagnose cysts and tumors radiographically that pose certain challenges due to the near similar presentation, anatomical variations, and superimposition. It is crucial that the performance of these models is evaluated for their clinical applicability in diagnosing cysts and tumors. METHODS A comprehensive literature search was carried out on eminent databases for published studies between January 2015 and December 2022. Studies utilizing machine learning models in the diagnosis of odontogenic cysts or tumors using Orthopantomograms (OPG) or Cone Beam Computed Tomographic images (CBCT) were included. QUADAS-2 tool was used for the assessment of the risk of bias and applicability concerns. Meta-analysis was performed for studies reporting sufficient performance metrics, separately for OPG and CBCT. RESULTS 16 studies were included for qualitative synthesis including a total of 10,872 odontogenic cysts and tumors. The sensitivity and specificity of machine learning in diagnosing cysts and tumors through OPG were 0.83 (95% CI 0.81-0.85) and 0.82 (95% CI 0.81-0.83) respectively. Studies utilizing CBCT noted a sensitivity of 0.88 (95% CI 0.87-0.88) and specificity of 0.88 (95% CI 0.87-0.89). Highest classification accuracy was 100%, noted for Support Vector Machine classifier. CONCLUSION The results from the present review favoured machine learning models to be used as a clinical adjunct in the radiographic diagnosis of odontogenic cysts and tumors, provided they undergo robust training with a huge dataset. However, the arduous process, investment, and certain ethical concerns associated with the total dependence on technology must be taken into account. Standardized reporting of outcomes for diagnostic studies utilizing machine learning methods is recommended to ensure homogeneity in assessment criteria, facilitate comparison between different studies, and promote transparency in research findings.
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Affiliation(s)
| | - Shamimul Hasan
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Laraib Abid
- Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Ranjit Injety
- Department of Neurology, Christian Medical College & Hospital, Ludhiana, Punjab, India
| | - Ayush Kumar Shrivastav
- Computer Science and Engineering, Centre for Development of Advanced Computing, Noida, Uttar Pradesh, India
| | - Deborah Sybil
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India.
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Shi YJ, Li JP, Wang Y, Ma RH, Wang YL, Guo Y, Li G. Deep learning in the diagnosis for cystic lesions of the jaws: a review of recent progress. Dentomaxillofac Radiol 2024; 53:271-280. [PMID: 38814810 PMCID: PMC11211683 DOI: 10.1093/dmfr/twae022] [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: 12/13/2023] [Revised: 05/06/2024] [Accepted: 05/09/2024] [Indexed: 06/01/2024] Open
Abstract
Cystic lesions of the gnathic bones present challenges in differential diagnosis. In recent years, artificial intelligence (AI) represented by deep learning (DL) has rapidly developed and emerged in the field of dental and maxillofacial radiology (DMFR). Dental radiography provides a rich resource for the study of diagnostic analysis methods for cystic lesions of the jaws and has attracted many researchers. The aim of the current study was to investigate the diagnostic performance of DL for cystic lesions of the jaws. Online searches were done on Google Scholar, PubMed, and IEEE Xplore databases, up to September 2023, with subsequent manual screening for confirmation. The initial search yielded 1862 titles, and 44 studies were ultimately included. All studies used DL methods or tools for the identification of a variable number of maxillofacial cysts. The performance of algorithms with different models varies. Although most of the reviewed studies demonstrated that DL methods have better discriminative performance than clinicians, further development is still needed before routine clinical implementation due to several challenges and limitations such as lack of model interpretability, multicentre data validation, etc. Considering the current limitations and challenges, future studies for the differential diagnosis of cystic lesions of the jaws should follow actual clinical diagnostic scenarios to coordinate study design and enhance the impact of AI in the diagnosis of oral and maxillofacial diseases.
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Affiliation(s)
- Yu-Jie Shi
- School of Electronics and Information Engineering, Beijing Jiaotong University, Beijing, 100044, China
| | - Ju-Peng Li
- School of Electronics and Information Engineering, Beijing Jiaotong University, Beijing, 100044, China
| | - Yue Wang
- School of Electronics and Information Engineering, Beijing Jiaotong University, Beijing, 100044, China
| | - Ruo-Han Ma
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing, 100081, China
| | - Yan-Lin Wang
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing, 100081, China
| | - Yong Guo
- School of Electronics and Information Engineering, Beijing Jiaotong University, Beijing, 100044, China
| | - Gang Li
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing, 100081, China
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Liang B, Qin H, Nong X, Zhang X. Classification of Ameloblastoma, Periapical Cyst, and Chronic Suppurative Osteomyelitis with Semi-Supervised Learning: The WaveletFusion-ViT Model Approach. Bioengineering (Basel) 2024; 11:571. [PMID: 38927807 PMCID: PMC11200596 DOI: 10.3390/bioengineering11060571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 05/31/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024] Open
Abstract
Ameloblastoma (AM), periapical cyst (PC), and chronic suppurative osteomyelitis (CSO) are prevalent maxillofacial diseases with similar imaging characteristics but different treatments, thus making preoperative differential diagnosis crucial. Existing deep learning methods for diagnosis often require manual delineation in tagging the regions of interest (ROIs), which triggers some challenges in practical application. We propose a new model of Wavelet Extraction and Fusion Module with Vision Transformer (WaveletFusion-ViT) for automatic diagnosis using CBCT panoramic images. In this study, 539 samples containing healthy (n = 154), AM (n = 181), PC (n = 102), and CSO (n = 102) were acquired by CBCT for classification, with an additional 2000 healthy samples for pre-training the domain-adaptive network (DAN). The WaveletFusion-ViT model was initialized with pre-trained weights obtained from the DAN and further trained using semi-supervised learning (SSL) methods. After five-fold cross-validation, the model achieved average sensitivity, specificity, accuracy, and AUC scores of 79.60%, 94.48%, 91.47%, and 0.942, respectively. Remarkably, our method achieved 91.47% accuracy using less than 20% labeled samples, surpassing the fully supervised approach's accuracy of 89.05%. Despite these promising results, this study's limitations include a low number of CSO cases and a relatively lower accuracy for this condition, which should be addressed in future research. This research is regarded as an innovative approach as it deviates from the fully supervised learning paradigm typically employed in previous studies. The WaveletFusion-ViT model effectively combines SSL methods to effectively diagnose three types of CBCT panoramic images using only a small portion of labeled data.
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Affiliation(s)
- Bohui Liang
- School of Computer, Electronics and Information, Guangxi University, Nanning 530004, China;
| | - Hongna Qin
- School of Information and Management, Guangxi Medical University, Nanning 530021, China;
| | - Xiaolin Nong
- College & Hospital of Stomatology, Guangxi Medical University, Nanning 530021, China
| | - Xuejun Zhang
- School of Computer, Electronics and Information, Guangxi University, Nanning 530004, China;
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Chen S, Yang Y, Wu W, Wei R, Wang Z, Tay FR, Hu J, Ma J. Classification of Caries Based on CBCT: A Deep Learning Network Interpretability Study. JOURNAL OF IMAGING INFORMATICS IN MEDICINE 2024:10.1007/s10278-024-01143-5. [PMID: 38806951 DOI: 10.1007/s10278-024-01143-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 04/16/2024] [Accepted: 05/16/2024] [Indexed: 05/30/2024]
Abstract
This study aimed to create a caries classification scheme based on cone-beam computed tomography (CBCT) and develop two deep learning models to improve caries classification accuracy. A total of 2713 axial slices were obtained from CBCT images of 204 carious teeth. Both classification models were trained and tested using the same pretrained classification networks on the dataset, including ResNet50_vd, MobileNetV3_large_ssld, and ResNet50_vd_ssld. The first model was used directly to classify the original images (direct classification model). The second model incorporated a presegmentation step for interpretation (interpretable classification model). Performance evaluation metrics including accuracy, precision, recall, and F1 score were calculated. The Local Interpretable Model-agnostic Explanations (LIME) method was employed to elucidate the decision-making process of the two models. In addition, a minimum distance between caries and pulp was introduced for determining the treatment strategies for type II carious teeth. The direct model that utilized the ResNet50_vd_ssld network achieved top accuracy, precision, recall, and F1 score of 0.700, 0.786, 0.606, and 0.616, respectively. Conversely, the interpretable model consistently yielded metrics surpassing 0.917, irrespective of the network employed. The LIME algorithm confirmed the interpretability of the classification models by identifying key image features for caries classification. Evaluation of treatment strategies for type II carious teeth revealed a significant negative correlation (p < 0.01) with the minimum distance. These results demonstrated that the CBCT-based caries classification scheme and the two classification models appeared to be acceptable tools for the diagnosis and categorization of dental caries.
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Affiliation(s)
- Surong Chen
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Yan Yang
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Weiwei Wu
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Ruonan Wei
- School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Zezhou Wang
- West China School of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Franklin R Tay
- Department of Endodontics, Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Jingyu Hu
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China.
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China.
| | - Jingzhi Ma
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China.
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China.
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Delamare E, Fu X, Huang Z, Kim J. Panoramic imaging errors in machine learning model development: a systematic review. Dentomaxillofac Radiol 2024; 53:165-172. [PMID: 38273661 PMCID: PMC11003661 DOI: 10.1093/dmfr/twae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 12/11/2023] [Accepted: 01/01/2024] [Indexed: 01/27/2024] Open
Abstract
OBJECTIVES To investigate the management of imaging errors from panoramic radiography (PAN) datasets used in the development of machine learning (ML) models. METHODS This systematic literature followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and used three databases. Keywords were selected from relevant literature. ELIGIBILITY CRITERIA PAN studies that used ML models and mentioned image quality concerns. RESULTS Out of 400 articles, 41 papers satisfied the inclusion criteria. All the studies used ML models, with 35 papers using deep learning (DL) models. PAN quality assessment was approached in 3 ways: acknowledgement and acceptance of imaging errors in the ML model, removal of low-quality radiographs from the dataset before building the model, and application of image enhancement methods prior to model development. The criteria for determining PAN image quality varied widely across studies and were prone to bias. CONCLUSIONS This study revealed significant inconsistencies in the management of PAN imaging errors in ML research. However, most studies agree that such errors are detrimental when building ML models. More research is needed to understand the impact of low-quality inputs on model performance. Prospective studies may streamline image quality assessment by leveraging DL models, which excel at pattern recognition tasks.
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Affiliation(s)
- Eduardo Delamare
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2050, Australia
- Digital Health and Data Science, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2050, Australia
| | - Xingyue Fu
- School of Computer Science, Faculty of Engineering, The University of Sydney, Camperdown, NSW, 2050, Australia
| | - Zimo Huang
- School of Computer Science, Faculty of Engineering, The University of Sydney, Camperdown, NSW, 2050, Australia
| | - Jinman Kim
- School of Computer Science, Faculty of Engineering, The University of Sydney, Camperdown, NSW, 2050, Australia
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Farajollahi M, Safarian MS, Hatami M, Esmaeil Nejad A, Peters OA. Applying artificial intelligence to detect and analyse oral and maxillofacial bone loss-A scoping review. AUST ENDOD J 2023; 49:720-734. [PMID: 37439465 DOI: 10.1111/aej.12775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/14/2023]
Abstract
Radiographic evaluation of bone changes is one of the main tools in the diagnosis of many oral and maxillofacial diseases. However, this approach to assessment has limitations in accuracy, inconsistency and comparatively low diagnostic efficiency. Recently, artificial intelligence (AI)-based algorithms like deep learning networks have been introduced as a solution to overcome these challenges. Based on recent studies, AI can improve the detection accuracy of an expert clinician for periapical pathology, periodontal diseases and their prognostication, as well as peri-implant bone loss. Also, AI has been successfully used to detect and diagnose oral and maxillofacial lesions with a high predictive value. This study aims to review the current evidence on artificial intelligence applications in the detection and analysis of bone loss in the oral and maxillofacial regions.
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Affiliation(s)
- Mehran Farajollahi
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Sadegh Safarian
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Hatami
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azadeh Esmaeil Nejad
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ove A Peters
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
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Cuschieri LA, Schembri-Higgans R, Bezzina N, Betts A, Cortes ARG. Importance of 3-dimensional imaging in the early diagnosis of chondroblastic osteosarcoma. Imaging Sci Dent 2023; 53:247-256. [PMID: 37799747 PMCID: PMC10548150 DOI: 10.5624/isd.20220223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 05/30/2023] [Accepted: 06/15/2023] [Indexed: 10/07/2023] Open
Abstract
The aim of this report is to present a case of chondroblastic osteosarcoma located in the right maxillary premolar region of a 17-year-old female patient. The initial clinical presentation and 2-dimensional (2D) radiographic methods proved inadequate for a definitive diagnosis. However, a cone-beam computed tomography scan revealed a hyperdense, heterogeneous lesion in the right maxillary premolar region, exhibiting a characteristic "sun-ray" appearance. To assess soft tissue involvement, a medical computed tomography scan was subsequently conducted. A positron emission tomography scan detected no metastasis or indications of secondary tumors. T1- and T2-weighted magnetic resonance imaging showed signal heterogeneity within the lesion, including areas of low signal intensity at the periphery. A histological examination conducted after an incisional biopsy confirmed the diagnosis of high-grade chondroblastic osteosarcoma. The patient was then referred to an oncology department for chemotherapy before surgery. In conclusion, these findings suggest that early diagnosis using 3-dimensional imaging can detect chondroblastic osteosarcoma in its early stages, such as before metastasis occurs, thereby improving the patient's prognosis.
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Affiliation(s)
- Laura Althea Cuschieri
- Department of Dental Surgery, Faculty of Dental Surgery, University of Malta, Msida, Malta
| | | | - Nicholas Bezzina
- Department of Dental Surgery, Faculty of Dental Surgery, University of Malta, Msida, Malta
| | - Alexandra Betts
- Department of Dental Surgery, Faculty of Dental Surgery, University of Malta, Msida, Malta
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Sivari E, Senirkentli GB, Bostanci E, Guzel MS, Acici K, Asuroglu T. Deep Learning in Diagnosis of Dental Anomalies and Diseases: A Systematic Review. Diagnostics (Basel) 2023; 13:2512. [PMID: 37568875 PMCID: PMC10416832 DOI: 10.3390/diagnostics13152512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Deep learning and diagnostic applications in oral and dental health have received significant attention recently. In this review, studies applying deep learning to diagnose anomalies and diseases in dental image material were systematically compiled, and their datasets, methodologies, test processes, explainable artificial intelligence methods, and findings were analyzed. Tests and results in studies involving human-artificial intelligence comparisons are discussed in detail to draw attention to the clinical importance of deep learning. In addition, the review critically evaluates the literature to guide and further develop future studies in this field. An extensive literature search was conducted for the 2019-May 2023 range using the Medline (PubMed) and Google Scholar databases to identify eligible articles, and 101 studies were shortlisted, including applications for diagnosing dental anomalies (n = 22) and diseases (n = 79) using deep learning for classification, object detection, and segmentation tasks. According to the results, the most commonly used task type was classification (n = 51), the most commonly used dental image material was panoramic radiographs (n = 55), and the most frequently used performance metric was sensitivity/recall/true positive rate (n = 87) and accuracy (n = 69). Dataset sizes ranged from 60 to 12,179 images. Although deep learning algorithms are used as individual or at least individualized architectures, standardized architectures such as pre-trained CNNs, Faster R-CNN, YOLO, and U-Net have been used in most studies. Few studies have used the explainable AI method (n = 22) and applied tests comparing human and artificial intelligence (n = 21). Deep learning is promising for better diagnosis and treatment planning in dentistry based on the high-performance results reported by the studies. For all that, their safety should be demonstrated using a more reproducible and comparable methodology, including tests with information about their clinical applicability, by defining a standard set of tests and performance metrics.
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Affiliation(s)
- Esra Sivari
- Department of Computer Engineering, Cankiri Karatekin University, Cankiri 18100, Turkey
| | | | - Erkan Bostanci
- Department of Computer Engineering, Ankara University, Ankara 06830, Turkey
| | | | - Koray Acici
- Department of Artificial Intelligence and Data Engineering, Ankara University, Ankara 06830, Turkey
| | - Tunc Asuroglu
- Faculty of Medicine and Health Technology, Tampere University, 33720 Tampere, Finland
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Feher B, Kuchler U, Schwendicke F, Schneider L, Cejudo Grano de Oro JE, Xi T, Vinayahalingam S, Hsu TMH, Brinz J, Chaurasia A, Dhingra K, Gaudin RA, Mohammad-Rahimi H, Pereira N, Perez-Pastor F, Tryfonos O, Uribe SE, Hanisch M, Krois J. Emulating Clinical Diagnostic Reasoning for Jaw Cysts with Machine Learning. Diagnostics (Basel) 2022; 12:diagnostics12081968. [PMID: 36010318 PMCID: PMC9406703 DOI: 10.3390/diagnostics12081968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 11/24/2022] Open
Abstract
The detection and classification of cystic lesions of the jaw is of high clinical relevance and represents a topic of interest in medical artificial intelligence research. The human clinical diagnostic reasoning process uses contextual information, including the spatial relation of the detected lesion to other anatomical structures, to establish a preliminary classification. Here, we aimed to emulate clinical diagnostic reasoning step by step by using a combined object detection and image segmentation approach on panoramic radiographs (OPGs). We used a multicenter training dataset of 855 OPGs (all positives) and an evaluation set of 384 OPGs (240 negatives). We further compared our models to an international human control group of ten dental professionals from seven countries. The object detection model achieved an average precision of 0.42 (intersection over union (IoU): 0.50, maximal detections: 100) and an average recall of 0.394 (IoU: 0.50–0.95, maximal detections: 100). The classification model achieved a sensitivity of 0.84 for odontogenic cysts and 0.56 for non-odontogenic cysts as well as a specificity of 0.59 for odontogenic cysts and 0.84 for non-odontogenic cysts (IoU: 0.30). The human control group achieved a sensitivity of 0.70 for odontogenic cysts, 0.44 for non-odontogenic cysts, and 0.56 for OPGs without cysts as well as a specificity of 0.62 for odontogenic cysts, 0.95 for non-odontogenic cysts, and 0.76 for OPGs without cysts. Taken together, our results show that a combined object detection and image segmentation approach is feasible in emulating the human clinical diagnostic reasoning process in classifying cystic lesions of the jaw.
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Affiliation(s)
- Balazs Feher
- Department of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
- Competence Center Oral Biology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
- Correspondence: ; Tel.: +43-1-40070-2623
| | - Ulrike Kuchler
- Department of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Falk Schwendicke
- Department of Oral Diagnostics, Digital Health, and Health Services Research, Charité—University Medicine Berlin, 14197 Berlin, Germany
| | - Lisa Schneider
- Department of Oral Diagnostics, Digital Health, and Health Services Research, Charité—University Medicine Berlin, 14197 Berlin, Germany
| | - Jose Eduardo Cejudo Grano de Oro
- Department of Oral Diagnostics, Digital Health, and Health Services Research, Charité—University Medicine Berlin, 14197 Berlin, Germany
| | - Tong Xi
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, 6525 GA Nijmegen, The Netherlands
| | - Shankeeth Vinayahalingam
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, 6525 GA Nijmegen, The Netherlands
| | - Tzu-Ming Harry Hsu
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Janet Brinz
- Department of Restorative Dentistry, Ludwig-Maximilians-University of Munich, 80336 Munich, Germany
| | - Akhilanand Chaurasia
- Department of Oral Medicine and Radiology, Faculty of Dental Sciences, King George’s Medical University, Lucknow 226003, India
| | - Kunaal Dhingra
- Periodontics Division, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Robert Andre Gaudin
- Department of Oral and Maxillofacial Surgery, Charité—University Medicine Berlin, 14197 Berlin, Germany
- Berlin Institute of Health, 10178 Berlin, Germany
| | - Hossein Mohammad-Rahimi
- Dentofacial Deformities Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran 1416634793, Iran
| | - Nielsen Pereira
- Private Practice in Oral and Maxillofacial Radiology, Rio de Janeiro 22430-000, Brazil
| | - Francesc Perez-Pastor
- Servei Salut Dental, Gerencia Atencio Primaria, Institut Balear de la Salut, 07003 Palma, Spain
| | - Olga Tryfonos
- Department of Periodontology and Oral Biochemistry, Academic Centre for Dentistry Amsterdam, 1081 LA Amsterdam, The Netherlands
| | - Sergio E. Uribe
- Department of Conservative Dentistry & Oral Health, Riga Stradins University, LV-1007 Riga, Latvia
- School of Dentistry, Universidad Austral de Chile, Valdivia 5110566, Chile
- Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, LV-1658 Riga, Latvia
| | - Marcel Hanisch
- Department of Oral and Maxillofacial Surgery, University Clinic Münster, 48143 Münster, Germany
| | - Joachim Krois
- Department of Oral Diagnostics, Digital Health, and Health Services Research, Charité—University Medicine Berlin, 14197 Berlin, Germany
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