Abstract

ObjectivesTo investigate the efficiency and accuracy of a deep learning-based automatic segmentation method for zygomatic bones from cone-beam computed tomography (CBCT) images. MethodsOne hundred thirty CBCT scans were included and randomly divided into three subsets (training, validation, and test) in a 6:2:2 ratio. A deep learning-based model was developed, and it included a classification network and a segmentation network, where an edge supervision module was added to increase the attention of the edges of zygomatic bones. Attention maps were generated by the Grad-CAM and Guided Grad-CAM algorithms to improve the interpretability of the model. The performance of the model was then compared with that of four dentists on 10 CBCT scans from the test dataset. A p value <0.05 was considered statistically significant. ResultsThe accuracy of the classification network was 99.64%. The Dice coefficient (Dice) of the deep learning-based model for the test dataset was 92.34 ± 2.04%, the average surface distance (ASD) was 0.1 ± 0.15 mm, and the 95% Hausdorff distance (HD) was 0.98 ± 0.42 mm. The model required 17.03 s on average to segment zygomatic bones, whereas this task took 49.3 min for dentists to complete. The Dice score of the model for the 10 CBCT scans was 93.2 ± 1.3%, while that of the dentists was 90.37 ± 3.32%. ConclusionsThe proposed deep learning-based model could segment zygomatic bones with high accuracy and efficiency compared with those of dentists. Clinical significanceThe proposed automatic segmentation model for zygomatic bone could generate an accurate 3D model for the preoperative digital planning of zygoma reconstruction, orbital surgery, zygomatic implant surgery, and orthodontics.

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