-Diagnosis of Nasopalatine Duct and Nasopalatine Duct Cyst in CBCT Images: A Radiomics-Based Machine Learning Approach.
Authors
Affiliations (3)
Affiliations (3)
- DDS, Dental Specialist, Assist. Prof. Dr Oral Diagnosis and Maxillofacial Radiology, Çukurova University Faculty of Dentistry, Adana, Türkiye.
- DDS, Research Assist. Oral Diagnosis and Maxillofacial Radiology, Çukurova University Faculty of Dentistry, Adana, Türkiye.
- DDS, PhD, Assoc. Prof. Dr Oral Diagnosis and Maxillofacial Radiology, Çukurova University Faculty of Dentistry, Adana, Türkiye.
Abstract
This study aimed to evaluate the diagnostic performance of machine learning (ML) algorithms based on radiomic features extracted from cone-beam computed tomography (CBCT) images in differentiating the nasopalatine duct (NPD) from the nasopalatine duct cyst (NPDC), and to compare their performance with that of a dentomaxillofacial radiologist. CBCT scans from 101 histopathologically confirmed NPDC cases and 101 age- and sex-matched controls with normal NPD were retrospectively analyzed. Manual segmentation was performed to extract 1037 radiomic features (original, Laplacian of Gaussian, and wavelet-transformed). After dimensionality reduction, five ML models (support vector machine (SVM), random forest (RF), decision tree (DT), k-nearest neighbors (KNN), and logistic regression (LR)) were trained using 5-fold cross-validation. Performance was evaluated using the area under the ROC curve (AUC), sensitivity, specificity, precision, recall, and F1-score. Among the 11 optimal features identified through feature selection, large area high gray level emphasis and zone variance from the gray level size zone matrix (GLSZM) class were the most prominent. SVM achieved the highest performance in the test set (AUC and all other metrics = 1.00). The radiologist showed comparable but slightly lower overall performance than SVM (AUC = 0.94, with other metrics between 0.93 and 0.95). Machine learning algorithms based on radiomic features extracted from CBCT images can effectively differentiate NPD from NPDC. Unlike standard visual interpretation, this approach analyzes quantitative image features via mathematical models, yielding objective and reproducible results. It may serve as a non-invasive, complementary decision-support tool, particularly in diagnostically challenging cases.