Abstract

Sophisticated segmentation of the craniomaxillofacial bones (the mandible and maxilla) in computed tomography (CT) is essential for diagnosis and treatment planning for craniomaxillofacial surgeries. Conventional manual segmentation is time-consuming and challenging due to intrinsic properties of craniomaxillofacial bones and head CT such as the variance in the anatomical structures, low contrast of soft tissue, and artifacts caused by metal implants. However, data-driven segmentation methods, including deep learning, require a large consistent dataset, which creates a bottleneck in their clinical applications due to limited datasets. In this study, we propose a deep learning approach for the automatic segmentation of the mandible and maxilla in CT images and enhanced the compatibility for multi-center datasets. Four multi-center datasets acquired by various conditions were applied to create a scenario where the model was trained with one dataset and evaluated with the other datasets. For the neural network, we designed a hierarchical, parallel and multi-scale residual block to the U-Net (HPMR-U-Net). To evaluate the performance, segmentation with in-house dataset and with external datasets from multi-center were conducted in comparison to three other neural networks: U-Net, Res-U-Net and mU-Net. The results suggest that the segmentation performance of HPMR-U-Net is comparable to that of other models, with superior data compatibility.

Highlights

  • Segmentation of the craniomaxillofacial bones, such as the mandible and maxilla, in computed topography (CT) images is one of the crucial steps for generating threedimensional (3D) models that are required for the diagnosis and treatment planning of craniomaxillofacial deformities, craniofacial tumor resection, or free flap reconstruction of the mandible [1,2]

  • Dataset may have the largest characteristic difference in the image obtained by cone beam CT (CBCT) as compared to CenterA dataset acquired by multidetector CT (MDCT)

  • The four neural networks compared in this research exhibited similar performance in the CenterA dataset, which was the domain used for training

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Summary

Introduction

Segmentation of the craniomaxillofacial bones, such as the mandible and maxilla, in computed topography (CT) images is one of the crucial steps for generating threedimensional (3D) models that are required for the diagnosis and treatment planning of craniomaxillofacial deformities, craniofacial tumor resection, or free flap reconstruction of the mandible [1,2]. 3D segmentation of organs at risk (OARs) in head and neck (H&N) CT including the mandible is a critical step in radiotherapy planning for H&N cancer treatment [3]. Manual segmentation has limitations such as low reproducibility and operator variability. Accurate segmentation of head CT is challenging owing to the complexity of the anatomical structures, the low contrast of soft tissue, artifacts caused by mental implants, and variations between individual patients [6]. Weak and false edges of condyles appearing in CT images adversely affect the accurate segmentation of the mandible [7]

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