Detecting Mandible Fractures in CBCT Scans Using a 3-Stage Neural Network.

Journal: Journal of dental research
PMID:

Abstract

After nasal bone fractures, fractures of the mandible are the most frequently encountered injuries of the facial skeleton. Accurate identification of fracture locations is critical for effectively managing these injuries. To address this need, JawFracNet, an innovative artificial intelligence method, has been developed to enable automated detection of mandibular fractures in cone-beam computed tomography (CBCT) scans. JawFracNet employs a 3-stage neural network model that processes 3-dimensional patches from a CBCT scan. Stage 1 predicts a segmentation mask of the mandible in a patch, which is subsequently used in stage 2 to predict a segmentation of the fractures and in stage 3 to classify whether the patch contains any fracture. The final output of JawFracNet is the fracture segmentation of the entire scan, obtained by aggregating and unifying voxel-level and patch-level predictions. A total of 164 CBCT scans without mandibular fractures and 171 CBCT scans with mandibular fractures were included in this study. Evaluation of JawFracNet demonstrated a precision of 0.978 and a sensitivity of 0.956 in detecting mandibular fractures. The current study proposes the first benchmark for mandibular fracture detection in CBCT scans. Straightforward replication is promoted by publicly sharing the code and providing access to JawFracNet on grand-challenge.org.

Authors

  • N van Nistelrooij
    Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
  • S Schitter
    Department of Oral and Maxillofacial Surgery, Division of Regenerative, Orofacial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • P van Lierop
    Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
  • K El Ghoul
    Department of Oral and Maxillofacial Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.
  • D König
    Department of Oral and Maxillofacial Surgery, Division of Regenerative, Orofacial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • M Hanisch
    Department of Oral and Maxillofacial Surgery, Universitätsklinikum, Münster, Münster, Germany.
  • A Tel
    Clinic of Maxillofacial Surgery, Head-Neck and NeuroScience Department University Hospital of Udine, Udine, Italy.
  • T Xi
    Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
  • D G E Thiem
    Klinik und Poliklinik für Mund‑, Kiefer- und Gesichtschirurgie - Plastische Operationen, Universitätsmedizin Mainz, Augustusplatz 2, 55131, Mainz, Deutschland.
  • R Smeets
    Department of Oral and Maxillofacial Surgery, Division of Regenerative, Orofacial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • L Dubois
    Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • T Flügge
    Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Oral and Maxillofacial Surgery, Berlin, Germany.
  • B van Ginneken
  • S Bergé
    Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
  • S Vinayahalingam
    Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.