Advertisement

Oral Radiology

, Volume 35, Issue 2, pp 143–151 | Cite as

Improvement of region of interest extraction and scanning method of computer-aided diagnosis system for osteoporosis using panoramic radiographs

  • Takashi NakamotoEmail author
  • Akira Taguchi
  • Rinus Gerardus Verdonschot
  • Naoya Kakimoto
Original Article

Abstract

Objectives

Patients undergoing osteoporosis treatment benefit greatly from early detection. We previously developed a computer-aided diagnosis (CAD) system to identify osteoporosis using panoramic radiographs. However, the region of interest (ROI) was relatively small, and the method to select suitable ROIs was labor-intensive. This study aimed to expand the ROI and perform semi-automatized extraction of ROIs. The diagnostic performance and operating time were also assessed.

Methods

We used panoramic radiographs and skeletal bone mineral density data of 200 postmenopausal women. Using the reference point that we defined by averaging 100 panoramic images as the lower mandibular border under the mental foramen, a 400 × 100-pixel ROI was automatically extracted and divided into four 100 × 100-pixel blocks. Valid blocks were analyzed using program 1, which examined each block separately, and program 2, which divided the blocks into smaller segments and performed scans/analyses across blocks. Diagnostic performance was evaluated using another set of 100 panoramic images.

Results

Most ROIs (97.0%) were correctly extracted. The operation time decreased to 51.4% for program 1 and to 69.3% for program 2. The sensitivity, specificity, and accuracy for identifying osteoporosis were 84.0, 68.0, and 72.0% for program 1 and 92.0, 62.7, and 70.0% for program 2, respectively. Compared with the previous conventional system, program 2 recorded a slightly higher sensitivity, although it occasionally also elicited false positives.

Conclusions

Patients at risk for osteoporosis can be identified more rapidly using this new CAD system, which may contribute to earlier detection and intervention and improved medical care.

Keywords

Diagnostic imaging Osteoporosis Radiography Mandible 

Notes

Compliance with ethical standards

Conflict of interest

Nakamoto T, Taguchi A, Verdonschot RG, and Kakimoto N declare that they have no conflict of interest.

Human rights statement and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from all patients for being included in the study.

Animal rights statement

This article does not contain any studies with animal subjects performed by the author.

References

  1. 1.
    Dervis E. Oral implications of osteoporosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100:349–56.CrossRefGoogle Scholar
  2. 2.
    International Osteoporosis Foundation. Report on Japan, Asia-Pacific regional audit. 2013. http://www.iofbonehealth.org/sites/default/files/media/PDFs/Regional%20Audits/2013-Asia_Pacific_Audit-Japan_0_0.pdf. Cited 28 Nov 2017.
  3. 3.
    World Health Organization. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser. 1994;843:94–101.Google Scholar
  4. 4.
    Lydick E, Cook K, Turpin J, Melton M, Stine R, Byrnes C. Development and validation of a simple questionnaire to facilitate identification of women likely to have low bone density. Am J Manag Care. 1998;4:37–48.Google Scholar
  5. 5.
    Weinstein L, Ullery B. Identification of at-risk women for osteoporosis screening. Am J Obstet Gynecol. 2000;183:547–9.CrossRefGoogle Scholar
  6. 6.
    Cadarette SM, Jaglal SB, Kreiger N, Mclsaac WJ, Darlington GA, Tu JV. Development and validation of the osteoporosis risk assessment instrument to facilitate selection of women for bone densitometry. CMAJ. 2000;162:1289–94.Google Scholar
  7. 7.
    Koh LKH, Sedrine WB, Torralba TP, Kung A, Fujiwara S, Chan SP, Huang QR, Rajatanavin R, Tsai KS, Park HM, Reginster JY. Osteoporosis self-assessment tool for Asians (OSTA) Research Group. A simple tool to identify Asian women at increased risk of osteoporosis. Osteoporos Int. 2001;12:699–705.CrossRefGoogle Scholar
  8. 8.
    Fujiwara S, Masunari N, Suzuki G, Philip DR. Performance of osteoporosis risk indices in a Japanese population. Curr Ther Res. 2001;62:586–94.CrossRefGoogle Scholar
  9. 9.
    Miller PD, Siris ES, Barrett-Connor E, Faulkner KG, Wehren LE, Abbott TA, et al. Prediction of fracture risk in postmenopausal white women with peripheral bone densitometry: evidence from the National Osteoporosis Risk Assessment. J Bone Miner Res. 2002;17:2222–30.CrossRefGoogle Scholar
  10. 10.
    Kanis JA, Johnell O. Requirements for DXA for the management of osteoporosis in Europe. Osteoporos Int. 2005;16:229–38.CrossRefGoogle Scholar
  11. 11.
    Taguchi A, Suei Y, Ohtsuka M, Otani K, Tanimoto K, Ohtaki M. Usefulness of panoramic radiography in the diagnosis of postmenopausal osteoporosis in women. Width and morphology of inferior cortex of the mandible. Dentomaxillofac Radiol. 1996;25:263–7.CrossRefGoogle Scholar
  12. 12.
    Devlin H, Horner K. Mandibular radiomorphometric indices in the diagnosis of reduced skeletal bone mineral density. Osteoporos Int. 2002;13:373–8.CrossRefGoogle Scholar
  13. 13.
    Nakamoto T, Taguchi A, Ohtsuka M, Suei Y, Fujita M, Tanimoto K, et al. Dental panoramic radiograph as a tool to detect postmenopausal women with low bone mineral density: untrained general dental practitioners’ diagnostic performance. Osteoporos Int. 2003;14:659–64.CrossRefGoogle Scholar
  14. 14.
    Lee K, Taguchi A, Ishii K, Suei Y, Fujita M, Nakamoto T, et al. Visual assessment of the mandibular cortex on panoramic radiographs to identify postmenopausal women with low bone mineral densities. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100:226–31.CrossRefGoogle Scholar
  15. 15.
    Devlin H, Karayianni K, Mitsea A, Jacobs R, Lindh C, van der Stelt P, et al. Diagnosing osteoporosis by using dental panoramic radiographs: the OSTEODENT project. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104:821–8.CrossRefGoogle Scholar
  16. 16.
    Passos JS, Gomes Filho IS, Sarmento VA, Sampaio DS, Gonçalves FP, Coelho JM, et al. Women with low bone mineral density and dental panoramic radiography. Menopause. 2012;19:704–9.CrossRefGoogle Scholar
  17. 17.
    Nakamoto T, Taguchi A, Ohtsuka M, Suei Y, Fujita M, Tsuda M, et al. A computer-aided diagnosis system to screen for osteoporosis using dental panoramic radiographs. Dentomaxillofac Radiol. 2008;37:274–81.CrossRefGoogle Scholar
  18. 18.
    Kanis JA, WHO Study Group. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. Osteoporos Int. 1994;4:368–81.CrossRefGoogle Scholar
  19. 19.
    Orimo H, Nakamura T, Hosoi T, Iki M, Uenishi K, Endo N, et al. Japanese 2011 guidelines for prevention and treatment of osteoporosis—executive summary. Arch Osteoporos. 2012;7:3–20.CrossRefGoogle Scholar
  20. 20.
    Canny JF. A computational approach to edge detection. IEEE Trans Pattern Anal Mach Intell. 1986;8:679–98.CrossRefGoogle Scholar
  21. 21.
    Soille P. Morphological image analysis: principle and applications. 2nd ed. Berlin: Springer; 2003.Google Scholar
  22. 22.
    Arifin AZ, Asano A, Taguchi A, Nakamoto T, Ohtsuka M, Tsuda M, Kudo Y, Tanimoto K. Computer-aided system for measuring the mandibular cortical width on dental panoramic radiographs in identifying postmenopausal women with low bone mineral density. Osteoporos Int. 2006;17:753–9.CrossRefGoogle Scholar
  23. 23.
    Kavitha MS, Asano A, Taguchi A, Kurita T, Sanada M. Diagnosis of osteoporosis from dental panoramic radiographs using the support vector machine method in a computer-aided system. BMC Med Imaging. 2012;12:1.  https://doi.org/10.1186/1471-2342-12-1.CrossRefGoogle Scholar
  24. 24.
    Kavitha MS, Samopa F, Asano A, Taguchi A, Sanada M. Computer-aided measurement of mandibular cortical width on dental panoramic radiographs for identifying osteoporosis. J Investig Clin Dent. 2012;3:36–44.CrossRefGoogle Scholar
  25. 25.
    López-López J, Alvarez-López JM, Jané-Salas E, Estrugo-Devesa A, Ayuso-Montero R, Velasco-Ortega E, et al. Computer-aided system for morphometric mandibular index computation (using dental panoramic radiographs). Med Oral Patol Oral Cir Bucal. 2012;17:624–32.CrossRefGoogle Scholar
  26. 26.
    Muramatsu C, Matsumoto T, Hayashi T, Hara T, Katsumata A, Zhou X, et al. Automated measurement of mandibular cortical width on dental panoramic radiographs. Int J Comput Assist Radiol Surg. 2013;8:877–85.CrossRefGoogle Scholar

Copyright information

© Japanese Society for Oral and Maxillofacial Radiology and Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.Department of Oral and Maxillofacial RadiologyHiroshima University HospitalMinami-kuJapan
  2. 2.Department of Oral and Maxillofacial RadiologyMatsumoto Dental UniversityNaganoJapan
  3. 3.Department of Oral and Maxillofacial Radiology, Institute of Biomedical and Health ScienceHiroshima UniversityHiroshimaJapan

Personalised recommendations