Automated detection and classification of osteolytic lesions in panoramic radiographs using CNNs and vision transformers.
Authors
Affiliations (6)
Affiliations (6)
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, P.O. Box 9101, Nijmegen, 6500 HB, the Netherlands.
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Augustenburger Platz 1, Berlin, 13353, Germany.
- Department of Hand, Plastic and Reconstructive Surgery, BG Trauma Center Ludwigshafen, University of Heidelberg, Burn CenterLudwig-Guttmann-Strasse 13, Ludwigshafen, 67071, Germany.
- Department of Oral and Maxillofacial Surgery, University Medical Centre, Johannes Gutenberg University Mainz, Augustusplatz 2, Mainz, 55131, Germany.
- Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstrasse 124, Krems an Der Donau, 3500, Austria.
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Augustenburger Platz 1, Berlin, 13353, Germany. [email protected].
Abstract
Diseases underlying osteolytic lesions in jaws are characterized by the absorption of bone tissue and are often asymptomatic, delaying their diagnosis. Well-defined lesions (benign cyst-like lesions) and ill-defined lesions (osteomyelitis or malignancy) can be detected early in a panoramic radiograph (PR) by an experienced examiner, but most dentists lack appropriate training. To support dentists, this study aimed to develop and evaluate deep learning models for the detection of osteolytic lesions in PRs. A dataset of 676 PRs (165 well-defined, 181 ill-defined, 330 control) was collected from the Department of Oral and Maxillofacial Surgery at Charité Berlin, Germany. The osteolytic lesions were pixel-wise segmented and labeled as well-defined or ill-defined. Four model architectures for instance segmentation (Mask R-CNN with a Swin-Tiny or ResNet-50 backbone, Mask DINO, and YOLOv5) were employed with five-fold cross-validation. Their effectiveness was evaluated with sensitivity, specificity, F1-score, and AUC and failure cases were shown. Mask R-CNN with a Swin-Tiny backbone was most effective (well-defined F1 = 0.784, AUC = 0.881; ill-defined F1 = 0.904, AUC = 0.971) and the model architectures including vision transformer components were more effective than those without. Model mistakes were observed around the maxillary sinus, at tooth extraction sites, and for radiolucent bands. Promising deep learning models were developed for the detection of osteolytic lesions in PRs, particularly those with vision transformer components (Mask R-CNN with Swin-Tiny and Mask DINO). These results underline the potential of vision transformers for enhancing the automated detection of osteolytic lesions, offering a significant improvement over traditional deep learning models.