A deep learning-based automatic segmentation of zygomatic bones from cone-beam computed tomography images: A proof of concept

Objectives: To investigate the efficiency and accuracy of a deep learning-based automatic segmentation method for zygomatic bones from cone-beam computed tomography (CBCT) images. Methods: One hundred thirty CBCT scans were included and randomly divided into three subsets (training, validation, and test) in a 6:2:2 ratio. A deep learning-based model was developed, and it included a classification network and a segmentation network, where an edge supervision module was added to increase the attention of the edges of zygomatic bones. Attention maps were generated by the Grad-CAM and Guided Grad-CAM algorithms to improve the interpretability of the model. The performance of the model was then compared with that of four dentists on 10 CBCT scans from the test dataset. A p value <0.05 was considered statistically significant. Results: The accuracy of the classification network was 99.64%. The Dice coefficient (Dice) of the deep learningbased model for the test dataset was 92.34 & PLUSMN; 2.04%, the average surface distance (ASD) was 0.1 & PLUSMN; 0.15 mm, and the 95% Hausdorff distance (HD) was 0.98 & PLUSMN; 0.42 mm. The model required 17.03 s on average to segment zygomatic bones, whereas this task took 49.3 min for dentists to complete. The Dice score of the model for the 10 CBCT scans was 93.2 & PLUSMN; 1.3%, while that of the dentists was 90.37 & PLUSMN; 3.32%. Conclusions: The proposed deep learning-based model could segment zygomatic bones with high accuracy and efficiency compared with those of dentists. Clinical significance: The proposed automatic segmentation model for zygomatic bone could generate an accurate 3D model for the preoperative digital planning of zygoma reconstruction, orbital surgery, zygomatic implant surgery, and orthodontics.