Skip to main content
Erschienen in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie 1/2020

18.12.2019 | Arnold-Biber Research Award

Artificial intelligence in orthodontics

Evaluation of a fully automated cephalometric analysis using a customized convolutional neural network

verfasst von: Dr. med. dent. Felix Kunz, Prof. Dr. med. dent. Angelika Stellzig-Eisenhauer, Florian Zeman, M.Sc., Dr. med. dent. Julian Boldt

Erschienen in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie | Ausgabe 1/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The aim of this investigation was to create an automated cephalometric X‑ray analysis using a specialized artificial intelligence (AI) algorithm. We compared the accuracy of this analysis to the current gold standard (analyses performed by human experts) to evaluate precision and clinical application of such an approach in orthodontic routine.

Methods

For training of the network, 12 experienced examiners identified 18 landmarks on a total of 1792 cephalometric X‑rays. To evaluate quality of the predictions of the AI, both AI and each examiner analyzed 12 commonly used orthodontic parameters on a basis of 50 cephalometric X‑rays that were not part of the training data for the AI. Median values of the 12 examiners for each parameter were defined as humans’ gold standard and compared to the AI’s predictions.

Results

There were almost no statistically significant differences between humans’ gold standard and the AI’s predictions. Differences between the two analyses do not seem to be clinically relevant.

Conclusions

We created an AI algorithm able to analyze unknown cephalometric X‑rays at almost the same quality level as experienced human examiners (current gold standard). This study is one of the first to successfully enable implementation of AI into dentistry, in particular orthodontics, satisfying medical requirements.
Literatur
1.
Zurück zum Zitat Arik SO, Ibragimov B, Xing L (2017) Fully automated quantitative cephalometry using convolutional neural networks. J Med Imaging 4:14501CrossRef Arik SO, Ibragimov B, Xing L (2017) Fully automated quantitative cephalometry using convolutional neural networks. J Med Imaging 4:14501CrossRef
2.
Zurück zum Zitat Bland JM, Altman DG (1999) Measuring agreement in method comparison studies. Stat Methods Med Res 8:135–160CrossRef Bland JM, Altman DG (1999) Measuring agreement in method comparison studies. Stat Methods Med Res 8:135–160CrossRef
3.
Zurück zum Zitat Bland JM, Altman DG (2003) Applying the right statistics: analyses of measurement studies. Ultrasound Obstet Gynecol 22:85–93CrossRef Bland JM, Altman DG (2003) Applying the right statistics: analyses of measurement studies. Ultrasound Obstet Gynecol 22:85–93CrossRef
4.
Zurück zum Zitat Broadbent B (1931) A new X‑ray technique and its application to orthodontia. Angle Orthod 1:45–66 Broadbent B (1931) A new X‑ray technique and its application to orthodontia. Angle Orthod 1:45–66
5.
Zurück zum Zitat Cardillo J, Sid-Ahmed MA (1994) An image processing system for locating craniofacial landmarks. IEEE Trans Med Imaging 13:275–289CrossRef Cardillo J, Sid-Ahmed MA (1994) An image processing system for locating craniofacial landmarks. IEEE Trans Med Imaging 13:275–289CrossRef
6.
Zurück zum Zitat Ciresan DC, Meier U, Masci J, Gambardella LM, Schmidhuber J (2011) Flexible, high performance convolutional neural networks for image classification. Paper presented at the Proceedings of the Twenty-Second international joint conference on Artificial Intelligence, Barcelona. vol 2 Ciresan DC, Meier U, Masci J, Gambardella LM, Schmidhuber J (2011) Flexible, high performance convolutional neural networks for image classification. Paper presented at the Proceedings of the Twenty-Second international joint conference on Artificial Intelligence, Barcelona. vol 2
7.
Zurück zum Zitat Desvignes M, Romaniuk B, Clouard R, Demoment R, Revenu M, Deshayes MJ (2000) First steps toward automatic location of landmarks on X‑ray images. In: Proceedings 15th International Conference on Pattern Recognition ICPR-2000, 3–7 Sept. 2000, pp 275–278 Desvignes M, Romaniuk B, Clouard R, Demoment R, Revenu M, Deshayes MJ (2000) First steps toward automatic location of landmarks on X‑ray images. In: Proceedings 15th International Conference on Pattern Recognition ICPR-2000, 3–7 Sept. 2000, pp 275–278
8.
Zurück zum Zitat Ding Y, Sohn JH, Kawczynski MG, Trivedi H, Harnish R, Jenkins NW, Lituiev D, Copeland TP, Aboian MS, Aparici CM, Behr SC, Flavell RR, Huang S‑Y, Zalocusky KA, Nardo L, Seo Y, Hawkins RA, Pampaloni MH, Hadley D, Franc BL (2019) A deep learning model to predict a diagnosis of alzheimer disease by using 18F-FDG PET of the brain. Radiology 290:456–464CrossRef Ding Y, Sohn JH, Kawczynski MG, Trivedi H, Harnish R, Jenkins NW, Lituiev D, Copeland TP, Aboian MS, Aparici CM, Behr SC, Flavell RR, Huang S‑Y, Zalocusky KA, Nardo L, Seo Y, Hawkins RA, Pampaloni MH, Hadley D, Franc BL (2019) A deep learning model to predict a diagnosis of alzheimer disease by using 18F-FDG PET of the brain. Radiology 290:456–464CrossRef
9.
Zurück zum Zitat Dreyer KJ, Geis JR (2017) When machines think: radiology’s next frontier. Radiology 285:713–718CrossRef Dreyer KJ, Geis JR (2017) When machines think: radiology’s next frontier. Radiology 285:713–718CrossRef
10.
Zurück zum Zitat El-Feghi I, Sid-Ahmed MA, Ahmadi M (2004) Automatic localization of craniofacial landmarks for assisted cephalometry. Pattern Recognit 37:609–621CrossRef El-Feghi I, Sid-Ahmed MA, Ahmadi M (2004) Automatic localization of craniofacial landmarks for assisted cephalometry. Pattern Recognit 37:609–621CrossRef
11.
Zurück zum Zitat Forsyth DB, Davis DN (1996) Assessment of an automated cephalometric analysis system. Eur J Orthod 18:471–478CrossRef Forsyth DB, Davis DN (1996) Assessment of an automated cephalometric analysis system. Eur J Orthod 18:471–478CrossRef
12.
Zurück zum Zitat Fu Jie H, LeCun Y (2006) Large-scale learning with SVM and convolutional for generic object categorization. In: 2006 IEEE Computer Society Conference on Computer Vision and Pattern Recognition (CVPR′06) 17–22 June 2006, pp 284–291 Fu Jie H, LeCun Y (2006) Large-scale learning with SVM and convolutional for generic object categorization. In: 2006 IEEE Computer Society Conference on Computer Vision and Pattern Recognition (CVPR′06) 17–22 June 2006, pp 284–291
13.
Zurück zum Zitat Fukushima K (1975) Cognitron: a self-organizing multilayered neural network. Biol Cybern 20:121–136CrossRef Fukushima K (1975) Cognitron: a self-organizing multilayered neural network. Biol Cybern 20:121–136CrossRef
14.
Zurück zum Zitat Gonçalves FA, Schiavon L, Pereira Neto JS, Nouer DF (2006) Comparison of cephalometric measurements from three radiological clinics. Braz Oral Res 20:162–166CrossRef Gonçalves FA, Schiavon L, Pereira Neto JS, Nouer DF (2006) Comparison of cephalometric measurements from three radiological clinics. Braz Oral Res 20:162–166CrossRef
15.
Zurück zum Zitat Hinton G, Sejnowski TJ (1999) Unsupervised learning: foundations of neural computation. MIT Press, Cambridge, MACrossRef Hinton G, Sejnowski TJ (1999) Unsupervised learning: foundations of neural computation. MIT Press, Cambridge, MACrossRef
16.
Zurück zum Zitat Kahn CE Jr. (2017) From images to actions: opportunities for artificial intelligence in radiology. Radiology 285:719–720CrossRef Kahn CE Jr. (2017) From images to actions: opportunities for artificial intelligence in radiology. Radiology 285:719–720CrossRef
17.
Zurück zum Zitat Kamoen A, Dermaut L, Verbeeck R (2001) The clinical significance of error measurement in the interpretation of treatment results. Eur J Orthod 23:569–578CrossRef Kamoen A, Dermaut L, Verbeeck R (2001) The clinical significance of error measurement in the interpretation of treatment results. Eur J Orthod 23:569–578CrossRef
18.
Zurück zum Zitat Kaur A, Singh C (2013) Automatic cephalometric landmark detection using Zernike moments and template matching vol 9 Kaur A, Singh C (2013) Automatic cephalometric landmark detection using Zernike moments and template matching vol 9
19.
Zurück zum Zitat Krizhevsky A, Sutskever I, Hinton G (2012) ImageNet classification with deep convolutional neural networks. Paper presented at the Proceedings of the 25th International Conference on Neural Information Processing Systems, Lake Tahoe. vol 1 Krizhevsky A, Sutskever I, Hinton G (2012) ImageNet classification with deep convolutional neural networks. Paper presented at the Proceedings of the 25th International Conference on Neural Information Processing Systems, Lake Tahoe. vol 1
20.
Zurück zum Zitat LeCun Y, Bengio Y, Hinton G (2015) Deep learning. Nature 521:436–444CrossRef LeCun Y, Bengio Y, Hinton G (2015) Deep learning. Nature 521:436–444CrossRef
21.
Zurück zum Zitat Lee JH, Kim DH, Jeong SN, Choi SH (2018) Detection and diagnosis of dental caries using a deep learning-based convolutional neural network algorithm. J Dent 77:106–111CrossRef Lee JH, Kim DH, Jeong SN, Choi SH (2018) Detection and diagnosis of dental caries using a deep learning-based convolutional neural network algorithm. J Dent 77:106–111CrossRef
22.
Zurück zum Zitat Levy-Mandel AD, Venetsanopoulos AN, Tsotsos JK (1986) Knowledge-based landmarking of cephalograms. Comput Biomed Res 19:282–309CrossRef Levy-Mandel AD, Venetsanopoulos AN, Tsotsos JK (1986) Knowledge-based landmarking of cephalograms. Comput Biomed Res 19:282–309CrossRef
23.
Zurück zum Zitat Liu JK, Chen YT, Cheng KS (2000) Accuracy of computerized automatic identification of cephalometric landmarks. Am J Orthod Dentofacial Orthop 118:535–540CrossRef Liu JK, Chen YT, Cheng KS (2000) Accuracy of computerized automatic identification of cephalometric landmarks. Am J Orthod Dentofacial Orthop 118:535–540CrossRef
24.
Zurück zum Zitat Mohri M, Rostamizadeh A, Talwalkar A (2012) Foundations of machine learning. MIT Press, Cambridge, MA Mohri M, Rostamizadeh A, Talwalkar A (2012) Foundations of machine learning. MIT Press, Cambridge, MA
25.
Zurück zum Zitat Nebauer C (1998) Evaluation of convolutional neural networks for visual recognition. IEEE Trans Neural Netw 9:685–696CrossRef Nebauer C (1998) Evaluation of convolutional neural networks for visual recognition. IEEE Trans Neural Netw 9:685–696CrossRef
26.
Zurück zum Zitat Nishimoto S, Sotsuka Y, Kawai K, Ishise H, Kakibuchi M (2019) Personal computer-based cephalometric landmark detection with deep learning, using cephalograms on the internet. J Craniofac Surg 30:91–95CrossRef Nishimoto S, Sotsuka Y, Kawai K, Ishise H, Kakibuchi M (2019) Personal computer-based cephalometric landmark detection with deep learning, using cephalograms on the internet. J Craniofac Surg 30:91–95CrossRef
27.
Zurück zum Zitat Parthasarathy S, Nugent ST, Gregson PG, Fay DF (1989) Automatic landmarking of cephalograms. Comput Biomed Res 22:248–269CrossRef Parthasarathy S, Nugent ST, Gregson PG, Fay DF (1989) Automatic landmarking of cephalograms. Comput Biomed Res 22:248–269CrossRef
28.
Zurück zum Zitat Ronneberger O, Fischer P, Brox T (2015) U‑net: convolutional networks for biomedical image segmentation. In: Medical image computing and computer-assisted intervention MICCAI 2015. Springer, Cham, pp 234–241 Ronneberger O, Fischer P, Brox T (2015) U‑net: convolutional networks for biomedical image segmentation. In: Medical image computing and computer-assisted intervention MICCAI 2015. Springer, Cham, pp 234–241
29.
Zurück zum Zitat Russell S, Norvig P (2010) Artificial intelligence: a modern approach, 3rd edn. Prentice Hall, Upper Saddle River, NJ Russell S, Norvig P (2010) Artificial intelligence: a modern approach, 3rd edn. Prentice Hall, Upper Saddle River, NJ
30.
Zurück zum Zitat Srivastava N, Hinton G, Krizhevsky A, Sutskever I, Salakhutdinov R (2014) Dropout: a simple way to prevent neural networks from overfitting vol 15 Srivastava N, Hinton G, Krizhevsky A, Sutskever I, Salakhutdinov R (2014) Dropout: a simple way to prevent neural networks from overfitting vol 15
32.
Zurück zum Zitat Vial A, Stirling D, Field M, Ros M, Ritz C, Carolan M, Holloway L, Miller AA (2018) The role of deep learning and radiomic feature extraction in cancer-specific predictive modelling: a review. Transl Cancer Res 7:803–816CrossRef Vial A, Stirling D, Field M, Ros M, Ritz C, Carolan M, Holloway L, Miller AA (2018) The role of deep learning and radiomic feature extraction in cancer-specific predictive modelling: a review. Transl Cancer Res 7:803–816CrossRef
33.
Zurück zum Zitat Wang CW, Huang CT, Hsieh MC, Li CH, Chang SW, Li WC, Vandaele R, Maree R, Jodogne S, Geurts P, Chen C, Zheng G, Chu C, Mirzaalian H, Hamarneh G, Vrtovec T, Ibragimov B (2015) Evaluation and comparison of anatomical landmark detection methods for cephalometric X‑Ray images: a grand challenge. IEEE Trans Med Imaging 34:1890–1900CrossRef Wang CW, Huang CT, Hsieh MC, Li CH, Chang SW, Li WC, Vandaele R, Maree R, Jodogne S, Geurts P, Chen C, Zheng G, Chu C, Mirzaalian H, Hamarneh G, Vrtovec T, Ibragimov B (2015) Evaluation and comparison of anatomical landmark detection methods for cephalometric X‑Ray images: a grand challenge. IEEE Trans Med Imaging 34:1890–1900CrossRef
34.
Zurück zum Zitat Yang X, Wu N, Cheng G, Zhou Z, Yu DS, Beitler JJ, Curran WJ, Liu T (2014) Automated segmentation of the parotid gland based on atlas registration and machine learning: a longitudinal MRI study in head-and-neck radiation therapy. Int J Radiat Oncol Biol Phys 90:1225–1233CrossRef Yang X, Wu N, Cheng G, Zhou Z, Yu DS, Beitler JJ, Curran WJ, Liu T (2014) Automated segmentation of the parotid gland based on atlas registration and machine learning: a longitudinal MRI study in head-and-neck radiation therapy. Int J Radiat Oncol Biol Phys 90:1225–1233CrossRef
35.
Zurück zum Zitat Yasaka K, Akai H, Kunimatsu A, Kiryu S, Abe O (2018) Deep learning with convolutional neural network in radiology. Jpn J Radiol 36:257–272CrossRef Yasaka K, Akai H, Kunimatsu A, Kiryu S, Abe O (2018) Deep learning with convolutional neural network in radiology. Jpn J Radiol 36:257–272CrossRef
Metadaten
Titel
Artificial intelligence in orthodontics
Evaluation of a fully automated cephalometric analysis using a customized convolutional neural network
verfasst von
Dr. med. dent. Felix Kunz
Prof. Dr. med. dent. Angelika Stellzig-Eisenhauer
Florian Zeman, M.Sc.
Dr. med. dent. Julian Boldt
Publikationsdatum
18.12.2019
Verlag
Springer Medizin
Erschienen in
Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie / Ausgabe 1/2020
Print ISSN: 1434-5293
Elektronische ISSN: 1615-6714
DOI
https://doi.org/10.1007/s00056-019-00203-8

Weitere Artikel der Ausgabe 1/2020

Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie 1/2020 Zur Ausgabe

Mitteilungen der DGKFO

Mitteilungen der DGKFO

Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Zahnmedizin und bleiben Sie gut informiert – ganz bequem per eMail.