Performance of a Convolutional Neural Network-Based Artificial Intelligence Algorithm for Automatic Cephalometric Landmark Detection

Objective: The aim of this study is to develop an artificial intelligence model to detect cephalometric landmark automatically enabling the automatic analysis of cephalometric radiographs which have a very important place in dental practice and is used routinely in the diagnosis and treatment of dental and skeletal disorders. Methods: In this study, 1620 lateral cephalograms were obtained and 21 landmarks were included. The coordinates of all landmarks in the 1620 films were obtained to establish a labeled data set: 1360 were used as a training set, 140 as a validation set, and 180 as a testing set. A convolutional neural network-based artificial intelligence algorithm for automatic cephalometric landmark detection was developed. Mean radial error and success detection rate within the range of 2 mm, 2.5 mm, 3 mm, and 4 mm were used to evaluate the performance of the model. Results: Presented artificial intelligence system (CranioCatch, Eskisehir, Turkey) could detect 21 anatomic landmarks in a lateral cephalometric radiograph. The highest success detection rate scores of 2 mm, 2.5 mm, 3 mm, and 4 mm were obtained from the sella point as 98.3, 99.4, 99.4, and 99.4, respectively. The mean radial error +/- standard deviation value of the sella point was found as 0.616 +/- 0.43. The lowest success detection rate scores of 2 mm, 2.5 mm, 3 mm, and 4 mm were obtained from the Gonion point as 48.3, 62.8, 73.9, and 87.2, respectively. The mean radial error +/- standard deviation value of Gonion point was found as 8.304 +/- 2.98. Conclusion: Although the success of the automatic landmark detection using the developed artificial intelligence model was not insufficient for clinical use, artificial intelligence-based cephalometric analysis systems seem promising to cephalometric analysis which provides a basis for diagnosis, treatment planning, and following-up in clinical orthodontics practice.