arXiv:2502.10277cs.CV2025-02被引 13

AI可精准识别全景牙片中的8类病变,诊断速度比医生快79倍。

Artificial Intelligence to Assess Dental Findings from Panoramic Radiographs -- A Multinational Study

  • 融合目标检测与语义分割技术,逐牙识别病变
  • 对根尖低密度影敏感度高出医生67.9%,总体AUC达96.2%
  • 跨国家数据集表现稳定,适合临床快速筛查场景

牙科全景片(DPRs)广泛用于口腔评估,但因结构重叠和时间限制带来解读挑战。本研究通过构建并评估AI系统,在荷兰、巴西、台湾三个跨国数据集共6,669张全景片上分析8类牙科异常。AI结合目标检测与语义分割实现逐牙定位。性能以敏感性、特异性及受试者工作特征曲线下面积(AUC-ROC)衡量。结果显示,AI对根尖低密度影的敏感度较人类专家高出67.9%(95% CI: 54.0%-81.9%; p < .001),对缺牙敏感度高出4.7%(95% CI: 1.4%-8.0%; p = .008)。AI在8类发现上的宏平均AUC-ROC为96.2%(95% CI: 94.6%-97.8%)。除龋齿外,7类发现的AI一致性接近人与人之间的一致性(龋齿:p = .024)。AI在不同成像和人群环境下具有强泛化能力,处理速度比人类快79倍(95% CI: 75-82)。AI在全景片分析中表现优于或媲美人类专家,显著提升诊断效率与准确性,具备临床整合潜力。

原文摘要 · Abstract (English)

Dental panoramic radiographs (DPRs) are widely used in clinical practice for comprehensive oral assessment but present challenges due to overlapping structures and time constraints in interpretation. This study aimed to establish a solid baseline for the AI-automated assessment of findings in DPRs by developing, evaluating an AI system, and comparing its performance with that of human readers across multinational data sets. We analyzed 6,669 DPRs from three data sets (the Netherlands, Brazil, and Taiwan), focusing on 8 types of dental findings. The AI system combined object detection and semantic segmentation techniques for per-tooth finding identification. Performance metrics included sensitivity, specificity, and area under the receiver operating characteristic curve (AUC-ROC). AI generalizability was tested across data sets, and performance was compared with human dental practitioners. The AI system demonstrated comparable or superior performance to human readers, particularly +67.9% (95% CI: 54.0%-81.9%; p < .001) sensitivity for identifying periapical radiolucencies and +4.7% (95% CI: 1.4%-8.0%; p = .008) sensitivity for identifying missing teeth. The AI achieved a macro-averaged AUC-ROC of 96.2% (95% CI: 94.6%-97.8%) across 8 findings. AI agreements with the reference were comparable to inter-human agreements in 7 of 8 findings except for caries (p = .024). The AI system demonstrated robust generalization across diverse imaging and demographic settings and processed images 79 times faster (95% CI: 75-82) than human readers. The AI system effectively assessed findings in DPRs, achieving performance on par with or better than human experts while significantly reducing interpretation time. These results highlight the potential for integrating AI into clinical workflows to improve diagnostic efficiency and accuracy, and patient management.

AI诊断全景牙片医疗影像多国验证

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