Osteoporosis detection in panoramic radiographs using a deep convolutional neural network-based computer-assisted diagnosis system: a preliminary study

Objectives To evaluate the diagnostic performance of a deep convolutional neural network (DCNN)-based computer-assisted diagnosis (CAD) system in the detection of osteoporosis on panoramic radiographs, through a comparison with diagnoses made by oral and maxillofacial radiologists. Methods: Oral and maxillofacial radiologists with >10 years of experience reviewed the panoramic radiographs of 1268 females {mean [+/- standard deviation (SD)] age: 52.5 +/- 22.3 years) and made a diagnosis of osteoporosis when cortical erosion of the mandibular inferior cortex was observed. Among the females, 635 had no osteoporosis [mean (+/- SD) age: 32.8 +/- SD 12.1 years] and 633 had osteoporosis (72.2 +/- 8.5 years). All panoramic radiographs were analysed using three CAD systems, single-column DCNN (SC-DCNN), single-column with data augmentation DCNN (SC-DCNN Augment) and multicolumn DCNN (MC-DCNN). Among the radiographs, 200 panoramic radiographs [mean (+/- SD) patient age: 63.9 +/- 10.7 years] were used for testing the performance of the DCNN in detecting osteoporosis in this study. The diagnostic performance of the DCNN-based CAD system was assessed by receiver operating characteristic (ROC) analysis. Results: The area under the curve (AUC) values obtained using SC-DCNN, SC-DCNN (Augment) and MC-DCNN were 0.9763, 0.9991 and 0.9987, respectively. Conclusions: The DCNN-based CAD system showed high agreement with experienced oral and maxillofacial radiologists in detecting osteoporosis. A DCNN-based CAD system could provide information to dentists for the early detection of osteoporosis, and asymptomatic patients with osteoporosis can then be referred to the appropriate medical professionals.