New perspectives in the differential diagnosis of jaw lesions: Machine learning and inflammatory biomarkers.

Journal: Journal of stomatology, oral and maxillofacial surgery
PMID:

Abstract

This study aimed to assess the diagnostic performance of a machine learning approach that utilized radiomic features extracted from Cone Beam Computer Tomography (CBCT) images and inflammatory biomarkers for distinguishing between Dentigerous Cysts (DCs), Odontogenic Keratocysts (OKCs), and Unicystic Ameloblastomas (UAs). This retrospective study involves 103 patients who underwent jaw lesion surgery in the Maxillofacial Surgery Unit of Federico II University Of Naples between January 2018 and January 2023. Nonparametric Wilcoxon-Mann-Whitney and Kruskal Wallis tests were used for continuous variables. Linear and non-logistic regression models (LRM and NLRM) were employed, along with machine learning techniques such as decision tree (DT), k-nearest neighbor (KNN), and support vector machine (SVM), to predict the outcomes. When individual inflammatory biomarkers were considered alone, their ability to differentiate between OKCs, UAs, and DCs was below 50 % accuracy. However, a linear regression model combining four inflammatory biomarkers achieved an accuracy of 95 % and an AUC of 0.96. The accuracy of single radiomics predictors was lower than that of inflammatory biomarkers, with an AUC of 0.83. The Fine Tree model, utilizing NLR, SII, and one radiomic feature, achieved an accuracy of 94.3 % (AUC = 0.95) on the training and testing sets, and a validation set accuracy of 100 %. The Fine Tree model demonstrated the capability to discriminate between OKCs, UAs, and DCs. However, the LRM utilizing four inflammatory biomarkers proved to be the most effective algorithm for distinguishing between OKCs, UAs, and DCs.

Authors

  • Umberto Committeri
    Head and Neck Section, Department of Neurosciences, Reproductive and Odontostomatological Science, Federico II University of Naples, Naples, Italy.
  • Simona Barone
    Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Sergio Pansini 5, Naples 80131, Italy.
  • Antonio Arena
    Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Sergio Pansini 5, Naples 80131, Italy.
  • Roberta Fusco
    Radiology Division, 'Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale', via Mariano Semmola 53, 80131 Naples, Italy. Electronic address: r.fusco@istitutotumori.na.it.
  • Stefania Troise
    Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Sergio Pansini 5, Naples 80131, Italy. Electronic address: stefy.troise@gmail.com.
  • Francesco Maffia
    Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Sergio Pansini 5, Naples 80131, Italy.
  • Sara Tramontano
    Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Sergio Pansini 5, Naples 80131, Italy.
  • Paola Bonavolontà
    Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Sergio Pansini 5, Naples 80131, Italy.
  • Vincenzo Abbate
    Department of Analytical, Environmental and Forensic Sciences, King's College London London UK giuseppe.floresta@kcl.ac.uk vincenzo.abbate@kcl.ac.uk.
  • Vincenza Granata
    Radiology Division, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Naples, Italy.
  • Andrea Elefante
    Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
  • Lorenzo Ugga
    Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy.
  • Francesco Giovacchini
  • Giovanni Salzano
    Head and Neck Section, Department of Neurosciences, Reproductive and Odontostomatological Science, Federico II University of Naples, Naples, Italy.
  • Luigi Califano
  • Giovanni Dell'Aversana Orabona