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基于全景X线片的深度学习在成釉细胞瘤与牙源性角化囊肿鉴别诊断中的应用

[Application of Deep Learning in Differential Diagnosis of Ameloblastoma and Odontogenic Keratocyst Based on Panoramic Radiographs].

作者信息

Li Min, Mu Chuang-Chuang, Zhang Jian-Yun, Li Gang

机构信息

Department of Oral and Maxillofacial Radiology,Peking University Hospital of Stomatology,Peking University School of Stomatology,Beijing 100081,China.

Beijing Key Laboratory of Digital Stomatology,National Engineering Research Center of Oral Biomaterials and Digital Medical Devices,National Clinical Research Center for Oral Diseases,Beijing 100081,China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2023 Apr;45(2):273-279. doi: 10.3881/j.issn.1000-503X.15139.

Abstract

Objective To evaluate the accuracy of different convolutional neural networks (CNN),representative deep learning models,in the differential diagnosis of ameloblastoma and odontogenic keratocyst,and subsequently compare the diagnosis results between models and oral radiologists. Methods A total of 1000 digital panoramic radiographs were retrospectively collected from the patients with ameloblastoma (500 radiographs) or odontogenic keratocyst (500 radiographs) in the Department of Oral and Maxillofacial Radiology,Peking University School of Stomatology.Eight CNN including ResNet (18,50,101),VGG (16,19),and EfficientNet (b1,b3,b5) were selected to distinguish ameloblastoma from odontogenic keratocyst.Transfer learning was employed to train 800 panoramic radiographs in the training set through 5-fold cross validation,and 200 panoramic radiographs in the test set were used for differential diagnosis.Chi square test was performed for comparing the performance among different CNN.Furthermore,7 oral radiologists (including 2 seniors and 5 juniors) made a diagnosis on the 200 panoramic radiographs in the test set,and the diagnosis results were compared between CNN and oral radiologists. Results The eight neural network models showed the diagnostic accuracy ranging from 82.50% to 87.50%,of which EfficientNet b1 had the highest accuracy of 87.50%.There was no significant difference in the diagnostic accuracy among the CNN models (=0.998,=0.905).The average diagnostic accuracy of oral radiologists was (70.30±5.48)%,and there was no statistical difference in the accuracy between senior and junior oral radiologists (=0.883).The diagnostic accuracy of CNN models was higher than that of oral radiologists (<0.001). Conclusion Deep learning CNN can realize accurate differential diagnosis between ameloblastoma and odontogenic keratocyst with panoramic radiographs,with higher diagnostic accuracy than oral radiologists.

摘要

目的 评估不同的卷积神经网络(CNN)这一代表性深度学习模型在成釉细胞瘤与牙源性角化囊肿鉴别诊断中的准确性,并随后比较模型与口腔放射科医生的诊断结果。方法 回顾性收集北京大学口腔医学院口腔颌面放射科成釉细胞瘤患者(500张X线片)或牙源性角化囊肿患者(500张X线片)的1000张数字化全景X线片。选择8种CNN,包括ResNet(18、50、101)、VGG(16、19)和EfficientNet(b1、b3、b5),以区分成釉细胞瘤与牙源性角化囊肿。采用迁移学习通过5折交叉验证对训练集中的800张全景X线片进行训练,测试集中的200张全景X线片用于鉴别诊断。采用卡方检验比较不同CNN的性能。此外,7名口腔放射科医生(包括2名资深医生和5名初级医生)对测试集中的200张全景X线片进行诊断,并比较CNN与口腔放射科医生的诊断结果。结果 8种神经网络模型的诊断准确率在82.50%至87.50%之间,其中EfficientNet b1的准确率最高,为87.50%。CNN模型之间的诊断准确率无显著差异(=0.998,=0.905)。口腔放射科医生的平均诊断准确率为(70.30±5.48)%,资深和初级口腔放射科医生之间的准确率无统计学差异(=0.883)。CNN模型的诊断准确率高于口腔放射科医生(<0.001)。结论 深度学习CNN能够利用全景X线片实现成釉细胞瘤与牙源性角化囊肿之间的准确鉴别诊断,诊断准确率高于口腔放射科医生。

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