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Erschienen in: Oral Radiology 2/2019

25.04.2018 | Original Article

Improvement of region of interest extraction and scanning method of computer-aided diagnosis system for osteoporosis using panoramic radiographs

verfasst von: Takashi Nakamoto, Akira Taguchi, Rinus Gerardus Verdonschot, Naoya Kakimoto

Erschienen in: Oral Radiology | Ausgabe 2/2019

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Abstract

Objectives

Patients undergoing osteoporosis treatment benefit greatly from early detection. We previously developed a computer-aided diagnosis (CAD) system to identify osteoporosis using panoramic radiographs. However, the region of interest (ROI) was relatively small, and the method to select suitable ROIs was labor-intensive. This study aimed to expand the ROI and perform semi-automatized extraction of ROIs. The diagnostic performance and operating time were also assessed.

Methods

We used panoramic radiographs and skeletal bone mineral density data of 200 postmenopausal women. Using the reference point that we defined by averaging 100 panoramic images as the lower mandibular border under the mental foramen, a 400 × 100-pixel ROI was automatically extracted and divided into four 100 × 100-pixel blocks. Valid blocks were analyzed using program 1, which examined each block separately, and program 2, which divided the blocks into smaller segments and performed scans/analyses across blocks. Diagnostic performance was evaluated using another set of 100 panoramic images.

Results

Most ROIs (97.0%) were correctly extracted. The operation time decreased to 51.4% for program 1 and to 69.3% for program 2. The sensitivity, specificity, and accuracy for identifying osteoporosis were 84.0, 68.0, and 72.0% for program 1 and 92.0, 62.7, and 70.0% for program 2, respectively. Compared with the previous conventional system, program 2 recorded a slightly higher sensitivity, although it occasionally also elicited false positives.

Conclusions

Patients at risk for osteoporosis can be identified more rapidly using this new CAD system, which may contribute to earlier detection and intervention and improved medical care.
Literatur
1.
Zurück zum Zitat Dervis E. Oral implications of osteoporosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100:349–56.CrossRefPubMed Dervis E. Oral implications of osteoporosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100:349–56.CrossRefPubMed
3.
Zurück zum Zitat World Health Organization. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser. 1994;843:94–101. World Health Organization. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser. 1994;843:94–101.
4.
Zurück zum Zitat Lydick E, Cook K, Turpin J, Melton M, Stine R, Byrnes C. Development and validation of a simple questionnaire to facilitate identification of women likely to have low bone density. Am J Manag Care. 1998;4:37–48.PubMed Lydick E, Cook K, Turpin J, Melton M, Stine R, Byrnes C. Development and validation of a simple questionnaire to facilitate identification of women likely to have low bone density. Am J Manag Care. 1998;4:37–48.PubMed
5.
Zurück zum Zitat Weinstein L, Ullery B. Identification of at-risk women for osteoporosis screening. Am J Obstet Gynecol. 2000;183:547–9.CrossRefPubMed Weinstein L, Ullery B. Identification of at-risk women for osteoporosis screening. Am J Obstet Gynecol. 2000;183:547–9.CrossRefPubMed
6.
Zurück zum Zitat Cadarette SM, Jaglal SB, Kreiger N, Mclsaac WJ, Darlington GA, Tu JV. Development and validation of the osteoporosis risk assessment instrument to facilitate selection of women for bone densitometry. CMAJ. 2000;162:1289–94.PubMedPubMedCentral Cadarette SM, Jaglal SB, Kreiger N, Mclsaac WJ, Darlington GA, Tu JV. Development and validation of the osteoporosis risk assessment instrument to facilitate selection of women for bone densitometry. CMAJ. 2000;162:1289–94.PubMedPubMedCentral
7.
Zurück zum Zitat Koh LKH, Sedrine WB, Torralba TP, Kung A, Fujiwara S, Chan SP, Huang QR, Rajatanavin R, Tsai KS, Park HM, Reginster JY. Osteoporosis self-assessment tool for Asians (OSTA) Research Group. A simple tool to identify Asian women at increased risk of osteoporosis. Osteoporos Int. 2001;12:699–705.CrossRefPubMed Koh LKH, Sedrine WB, Torralba TP, Kung A, Fujiwara S, Chan SP, Huang QR, Rajatanavin R, Tsai KS, Park HM, Reginster JY. Osteoporosis self-assessment tool for Asians (OSTA) Research Group. A simple tool to identify Asian women at increased risk of osteoporosis. Osteoporos Int. 2001;12:699–705.CrossRefPubMed
8.
Zurück zum Zitat Fujiwara S, Masunari N, Suzuki G, Philip DR. Performance of osteoporosis risk indices in a Japanese population. Curr Ther Res. 2001;62:586–94.CrossRef Fujiwara S, Masunari N, Suzuki G, Philip DR. Performance of osteoporosis risk indices in a Japanese population. Curr Ther Res. 2001;62:586–94.CrossRef
9.
Zurück zum Zitat Miller PD, Siris ES, Barrett-Connor E, Faulkner KG, Wehren LE, Abbott TA, et al. Prediction of fracture risk in postmenopausal white women with peripheral bone densitometry: evidence from the National Osteoporosis Risk Assessment. J Bone Miner Res. 2002;17:2222–30.CrossRefPubMed Miller PD, Siris ES, Barrett-Connor E, Faulkner KG, Wehren LE, Abbott TA, et al. Prediction of fracture risk in postmenopausal white women with peripheral bone densitometry: evidence from the National Osteoporosis Risk Assessment. J Bone Miner Res. 2002;17:2222–30.CrossRefPubMed
10.
Zurück zum Zitat Kanis JA, Johnell O. Requirements for DXA for the management of osteoporosis in Europe. Osteoporos Int. 2005;16:229–38.CrossRefPubMed Kanis JA, Johnell O. Requirements for DXA for the management of osteoporosis in Europe. Osteoporos Int. 2005;16:229–38.CrossRefPubMed
11.
Zurück zum Zitat Taguchi A, Suei Y, Ohtsuka M, Otani K, Tanimoto K, Ohtaki M. Usefulness of panoramic radiography in the diagnosis of postmenopausal osteoporosis in women. Width and morphology of inferior cortex of the mandible. Dentomaxillofac Radiol. 1996;25:263–7.CrossRefPubMed Taguchi A, Suei Y, Ohtsuka M, Otani K, Tanimoto K, Ohtaki M. Usefulness of panoramic radiography in the diagnosis of postmenopausal osteoporosis in women. Width and morphology of inferior cortex of the mandible. Dentomaxillofac Radiol. 1996;25:263–7.CrossRefPubMed
12.
Zurück zum Zitat Devlin H, Horner K. Mandibular radiomorphometric indices in the diagnosis of reduced skeletal bone mineral density. Osteoporos Int. 2002;13:373–8.CrossRefPubMed Devlin H, Horner K. Mandibular radiomorphometric indices in the diagnosis of reduced skeletal bone mineral density. Osteoporos Int. 2002;13:373–8.CrossRefPubMed
13.
Zurück zum Zitat Nakamoto T, Taguchi A, Ohtsuka M, Suei Y, Fujita M, Tanimoto K, et al. Dental panoramic radiograph as a tool to detect postmenopausal women with low bone mineral density: untrained general dental practitioners’ diagnostic performance. Osteoporos Int. 2003;14:659–64.CrossRefPubMed Nakamoto T, Taguchi A, Ohtsuka M, Suei Y, Fujita M, Tanimoto K, et al. Dental panoramic radiograph as a tool to detect postmenopausal women with low bone mineral density: untrained general dental practitioners’ diagnostic performance. Osteoporos Int. 2003;14:659–64.CrossRefPubMed
14.
Zurück zum Zitat Lee K, Taguchi A, Ishii K, Suei Y, Fujita M, Nakamoto T, et al. Visual assessment of the mandibular cortex on panoramic radiographs to identify postmenopausal women with low bone mineral densities. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100:226–31.CrossRefPubMed Lee K, Taguchi A, Ishii K, Suei Y, Fujita M, Nakamoto T, et al. Visual assessment of the mandibular cortex on panoramic radiographs to identify postmenopausal women with low bone mineral densities. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100:226–31.CrossRefPubMed
15.
Zurück zum Zitat Devlin H, Karayianni K, Mitsea A, Jacobs R, Lindh C, van der Stelt P, et al. Diagnosing osteoporosis by using dental panoramic radiographs: the OSTEODENT project. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104:821–8.CrossRefPubMed Devlin H, Karayianni K, Mitsea A, Jacobs R, Lindh C, van der Stelt P, et al. Diagnosing osteoporosis by using dental panoramic radiographs: the OSTEODENT project. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104:821–8.CrossRefPubMed
16.
Zurück zum Zitat Passos JS, Gomes Filho IS, Sarmento VA, Sampaio DS, Gonçalves FP, Coelho JM, et al. Women with low bone mineral density and dental panoramic radiography. Menopause. 2012;19:704–9.CrossRefPubMed Passos JS, Gomes Filho IS, Sarmento VA, Sampaio DS, Gonçalves FP, Coelho JM, et al. Women with low bone mineral density and dental panoramic radiography. Menopause. 2012;19:704–9.CrossRefPubMed
17.
Zurück zum Zitat Nakamoto T, Taguchi A, Ohtsuka M, Suei Y, Fujita M, Tsuda M, et al. A computer-aided diagnosis system to screen for osteoporosis using dental panoramic radiographs. Dentomaxillofac Radiol. 2008;37:274–81.CrossRefPubMed Nakamoto T, Taguchi A, Ohtsuka M, Suei Y, Fujita M, Tsuda M, et al. A computer-aided diagnosis system to screen for osteoporosis using dental panoramic radiographs. Dentomaxillofac Radiol. 2008;37:274–81.CrossRefPubMed
18.
Zurück zum Zitat Kanis JA, WHO Study Group. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. Osteoporos Int. 1994;4:368–81.CrossRefPubMed Kanis JA, WHO Study Group. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. Osteoporos Int. 1994;4:368–81.CrossRefPubMed
19.
Zurück zum Zitat Orimo H, Nakamura T, Hosoi T, Iki M, Uenishi K, Endo N, et al. Japanese 2011 guidelines for prevention and treatment of osteoporosis—executive summary. Arch Osteoporos. 2012;7:3–20.CrossRefPubMedPubMedCentral Orimo H, Nakamura T, Hosoi T, Iki M, Uenishi K, Endo N, et al. Japanese 2011 guidelines for prevention and treatment of osteoporosis—executive summary. Arch Osteoporos. 2012;7:3–20.CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Canny JF. A computational approach to edge detection. IEEE Trans Pattern Anal Mach Intell. 1986;8:679–98.CrossRefPubMed Canny JF. A computational approach to edge detection. IEEE Trans Pattern Anal Mach Intell. 1986;8:679–98.CrossRefPubMed
21.
Zurück zum Zitat Soille P. Morphological image analysis: principle and applications. 2nd ed. Berlin: Springer; 2003. Soille P. Morphological image analysis: principle and applications. 2nd ed. Berlin: Springer; 2003.
22.
Zurück zum Zitat Arifin AZ, Asano A, Taguchi A, Nakamoto T, Ohtsuka M, Tsuda M, Kudo Y, Tanimoto K. Computer-aided system for measuring the mandibular cortical width on dental panoramic radiographs in identifying postmenopausal women with low bone mineral density. Osteoporos Int. 2006;17:753–9.CrossRefPubMed Arifin AZ, Asano A, Taguchi A, Nakamoto T, Ohtsuka M, Tsuda M, Kudo Y, Tanimoto K. Computer-aided system for measuring the mandibular cortical width on dental panoramic radiographs in identifying postmenopausal women with low bone mineral density. Osteoporos Int. 2006;17:753–9.CrossRefPubMed
24.
Zurück zum Zitat Kavitha MS, Samopa F, Asano A, Taguchi A, Sanada M. Computer-aided measurement of mandibular cortical width on dental panoramic radiographs for identifying osteoporosis. J Investig Clin Dent. 2012;3:36–44.CrossRefPubMed Kavitha MS, Samopa F, Asano A, Taguchi A, Sanada M. Computer-aided measurement of mandibular cortical width on dental panoramic radiographs for identifying osteoporosis. J Investig Clin Dent. 2012;3:36–44.CrossRefPubMed
25.
Zurück zum Zitat López-López J, Alvarez-López JM, Jané-Salas E, Estrugo-Devesa A, Ayuso-Montero R, Velasco-Ortega E, et al. Computer-aided system for morphometric mandibular index computation (using dental panoramic radiographs). Med Oral Patol Oral Cir Bucal. 2012;17:624–32.CrossRef López-López J, Alvarez-López JM, Jané-Salas E, Estrugo-Devesa A, Ayuso-Montero R, Velasco-Ortega E, et al. Computer-aided system for morphometric mandibular index computation (using dental panoramic radiographs). Med Oral Patol Oral Cir Bucal. 2012;17:624–32.CrossRef
26.
Zurück zum Zitat Muramatsu C, Matsumoto T, Hayashi T, Hara T, Katsumata A, Zhou X, et al. Automated measurement of mandibular cortical width on dental panoramic radiographs. Int J Comput Assist Radiol Surg. 2013;8:877–85.CrossRefPubMed Muramatsu C, Matsumoto T, Hayashi T, Hara T, Katsumata A, Zhou X, et al. Automated measurement of mandibular cortical width on dental panoramic radiographs. Int J Comput Assist Radiol Surg. 2013;8:877–85.CrossRefPubMed
Metadaten
Titel
Improvement of region of interest extraction and scanning method of computer-aided diagnosis system for osteoporosis using panoramic radiographs
verfasst von
Takashi Nakamoto
Akira Taguchi
Rinus Gerardus Verdonschot
Naoya Kakimoto
Publikationsdatum
25.04.2018
Verlag
Springer Singapore
Erschienen in
Oral Radiology / Ausgabe 2/2019
Print ISSN: 0911-6028
Elektronische ISSN: 1613-9674
DOI
https://doi.org/10.1007/s11282-018-0330-3

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