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      Craniomaxillofacial landmarks detection in CT scans with limited labeled data via semi-supervised learning

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          Abstract

          Background

          Three-dimensional cephalometric analysis is crucial in craniomaxillofacial assessment, with landmarks detection in craniomaxillofacial (CMF) CT scans being a key component. However, creating robust deep learning models for this task typically requires extensive CMF CT datasets annotated by experienced medical professionals, a process that is time-consuming and labor-intensive. Conversely, acquiring large volume of unlabeled CMF CT data is relatively straightforward. Thus, semi-supervised learning (SSL), leveraging limited labeled data supplemented by sufficient unlabeled dataset, could be a viable solution to this challenge.

          Method

          We developed an SSL model, named CephaloMatch, based on a strong-weak perturbation consistency framework. The proposed SSL model incorporates a head position rectification technique through coarse detection to enhance consistency between labeled and unlabeled datasets and a multilayers perturbation method which is employed to expand the perturbation space. The proposed SSL model was assessed using 362 CMF CT scans, divided into a training set (60 scans), a validation set (14 scans), and an unlabeled set (288 scans).

          Result

          The proposed SSL model attained a detection error of 1.60 ± 0.87 mm, significantly surpassing the performance of conventional fully supervised learning model (1.94 ± 1.12 mm). Notably, the proposed SSL model achieved equivalent detection accuracy (1.91 ± 1.00 mm) with only half the labeled dataset, compared to the fully supervised learning model.

          Conclusions

          The proposed SSL model demonstrated exceptional performance in landmarks detection using a limited labeled CMF CT dataset, significantly reducing the workload of medical professionals and enhances the accuracy of 3D cephalometric analysis.

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          Most cited references25

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          FixMatch: Simplifying Semi-Supervised Learning with Consistency and Confidence

          Semi-supervised learning (SSL) provides an effective means of leveraging unlabeled data to improve a model's performance. In this paper, we demonstrate the power of a simple combination of two common SSL methods: consistency regularization and pseudo-labeling. Our algorithm, FixMatch, first generates pseudo-labels using the model's predictions on weakly-augmented unlabeled images. For a given image, the pseudo-label is only retained if the model produces a high-confidence prediction. The model is then trained to predict the pseudo-label when fed a strongly-augmented version of the same image. Despite its simplicity, we show that FixMatch achieves state-of-the-art performance across a variety of standard semi-supervised learning benchmarks, including 94.93% accuracy on CIFAR-10 with 250 labels and 88.61% accuracy with 40 -- just 4 labels per class. Since FixMatch bears many similarities to existing SSL methods that achieve worse performance, we carry out an extensive ablation study to tease apart the experimental factors that are most important to FixMatch's success. We make our code available at https://github.com/google-research/fixmatch. Published at NeurIPS 2020 as a conference paper
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            Accuracy of three-dimensional measurements using cone-beam CT.

            Lesions causing intraosseous defects in the head and neck region are difficult to diagnose using two-dimensional radiography, and three-dimensional (3D) data provided by CT is useful but often difficult to obtain. Recently, cone-beam CT (CBCT) was made available, with the potential to become a practical tool in dentistry. However, there is limited evidence to prove that defect volume can be determined accurately. Therefore, this in vitro validation study aimed at establishing whether linear and 3D CBCT, using volumetric measurements, is accurate for determining osseous defect sizes. Depth and diameter of simulated bone defects in (i) an acrylic block and (ii) a human mandible were blindly measured electronically by five examiners using CBCT. Linear measurements were compared with predetermined machined dimensions. Using software, volume extraction was performed by another examiner on the acrylic phantom and compared with known dimensions. Data were analysed using paired t-tests. Using the acrylic block, mean width accuracy was -0.01 mm (+/- 0.02 SE) and mean height difference was -0.03 mm (+/- 0.01 SE; P > 0.05). For the human mandible, mean width accuracy was -0.07 mm (+/- 0.02 SE) and mean height accuracy was -0.27 mm (+/- 0.02 SE; P < 0.01). Volume accuracy was -6.9 mm3 (+/- 4 SE) for automated calculations and -2.3 mm3 (+/- 2.6 SE) for the manual measurements (P < 0.001). CBCT has the potential to be an accurate, non-invasive, practical method to reliably determine osseous lesion size and volume. Further clinical validation will lead to a vast array of applications in oral and maxillofacial diagnosis.
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              Integrating spatial configuration into heatmap regression based CNNs for landmark localization

              In many medical image analysis applications, only a limited amount of training data is available due to the costs of image acquisition and the large manual annotation effort required from experts. Training recent state-of-the-art machine learning methods like convolutional neural networks (CNNs) from small datasets is a challenging task. In this work on anatomical landmark localization, we propose a CNN architecture that learns to split the localization task into two simpler sub-problems, reducing the overall need for large training datasets. Our fully convolutional SpatialConfiguration-Net (SCN) learns this simplification due to multiplying the heatmap predictions of its two components and by training the network in an end-to-end manner. Thus, the SCN dedicates one component to locally accurate but ambiguous candidate predictions, while the other component improves robustness to ambiguities by incorporating the spatial configuration of landmarks. In our extensive experimental evaluation, we show that the proposed SCN outperforms related methods in terms of landmark localization error on a variety of size-limited 2D and 3D landmark localization datasets, i.e., hand radiographs, lateral cephalograms, hand MRIs, and spine CTs.
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                Author and article information

                Contributors
                Journal
                Heliyon
                Heliyon
                Heliyon
                Elsevier
                2405-8440
                16 July 2024
                30 July 2024
                16 July 2024
                : 10
                : 14
                : e34583
                Affiliations
                [a ]Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
                [b ]National Center for Stomatology & National Clinical Research Center for Oral Diseases, Shanghai, 200011, China
                [c ]Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, 200011, China
                [d ]Mechanical College, Shanghai Dianji University, Shanghai, 201306, China
                [e ]Shanghai Lanhui Medical Technology Co., Ltd, Shanghai, 200333, China
                [f ]School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, 200030, China
                [g ]College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200125, China
                [h ]Appleby College, ON, L6K 3P1, Canada
                Author notes
                [* ]Corresponding author. Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China. yhb3508@ 123456163.com
                [** ]Corresponding author. ericwene@ 123456sjtu.edu.cn
                [1]

                Leran Tao and Xu Zhang have contributed equally to this work.

                Article
                S2405-8440(24)10614-7 e34583
                10.1016/j.heliyon.2024.e34583
                11315087
                39130473
                35ae6866-4926-47e2-b24b-df4488ea325b
                © 2024 The Authors. Published by Elsevier Ltd.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 16 February 2024
                : 21 May 2024
                : 11 July 2024
                Categories
                Research Article

                semi-supervised learning,landmarks detection,3d cephalometric analysis,computer-assisted surgery design,dentomaxillofacial deformities

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