Detection and classification of mandibular fracture on CT scan using deep convolutional neural network

Objectives: This study aimed to evaluate the accuracy and reliability of convolutional neural networks (CNNs) for the detection and classification of mandibular fracture on spiral computed tomography (CT).

Materials and methods: Between January 2013 and July 2020, 686 patients with mandibular fractures who underwent CT scan were classified and annotated by three experienced maxillofacial surgeons serving as the ground truth. An algorithm including two convolutional neural networks (U-Net and ResNet) was trained, validated, and tested using 222, 56, and 408 CT scans, respectively. The diagnostic performance of the algorithm was compared with the ground truth and evaluated by DICE, accuracy, sensitivity, specificity, and area under the ROC curve (AUC).

Results: One thousand five hundred six mandibular fractures in nine subregions of 686 patients were diagnosed. The DICE of mandible segmentation using U-Net was 0.943. The accuracies of nine subregions were all above 90%, with a mean AUC of 0.956.

Conclusions: CNNs showed comparable reliability and accuracy in detecting and classifying mandibular fractures on CT.

Clinical relevance: The algorithm for automatic detection and classification of mandibular fractures will help improve diagnostic efficiency and provide expertise to areas with lower medical levels.