Continuous measurements of mandibular cortical width on dental panoramic radiographs for computer-aided diagnosis of osteoporosis

摘要

The aim of this study is to develop a computer-aided osteoporosis diagnosis system that automatically determines the inferior cortical width of the mandible continuously on dental panoramic radiographs to realize statistically more robust measurements than the conventional one-point measurements. The cortical width was continuously measured on dental panoramic radiographs by enhancing the original image, determining cortical boundaries, and finally evaluating the distance between boundaries continuously throughout the region of interest. The diagnostic performance using the average width calculated from the continuous measurement was compared with BMD at lumbar spine and femoral neck in 100 postmenopausal women of whom 50 to the development of the tool and 50 to its validation with no history of osteoporosis was evaluated. We experimentally showed the superiority of our method with improved sensitivity and specificity of identifying the development subjects were 90.0% and 75.0% in women with low spinal BMD and 81.8% and 69.2% in those with low femoral BMD, respectively. The corresponding values in the validation subjects were 93.3% and 82.9% at the lumbar spine and 92.3% and 75.7% at the femoral neck, respectively in terms of efficacy for diagnosing osteoporosis. We also assessed the diagnosis and classification of women with osteoporosis using support vector machine employing the average and variance of the continuous measurements gave excellent discrimination ability. It yields sensitivity and specificity of 90.9% and 83.8%, respectively with lumbar spine and 90.0% and 69.1%, respectively with femoral neck BMD. Performance comparison and simplicity of this method indicate that our computer-aided system is readily applicable to clinical practice.