Deep learning for detection and 3D segmentation of maxillofacial bone lesions in cone beam CT

Talia Yeshua, Shmuel Ladyzhensky, Amal Abu-Nasser, Ragda Abdalla-Aslan, Tami Boharon, Avital Itzhak-Pur, Asher Alexander, Akhilanand Chaurasia, Adir Cohen, Jacob Sosna, Isaac Leichter, Chen Nadler*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Objectives: To develop an automated deep-learning algorithm for detection and 3D segmentation of incidental bone lesions in maxillofacial CBCT scans. Methods: The dataset included 82 cone beam CT (CBCT) scans, 41 with histologically confirmed benign bone lesions (BL) and 41 control scans (without lesions), obtained using three CBCT devices with diverse imaging protocols. Lesions were marked in all axial slices by experienced maxillofacial radiologists. All cases were divided into sub-datasets: training (20,214 axial images), validation (4530 axial images), and testing (6795 axial images). A Mask-RCNN algorithm segmented the bone lesions in each axial slice. Analysis of sequential slices was used for improving the Mask-RCNN performance and classifying each CBCT scan as containing bone lesions or not. Finally, the algorithm generated 3D segmentations of the lesions and calculated their volumes. Results: The algorithm correctly classified all CBCT cases as containing bone lesions or not, with an accuracy of 100%. The algorithm detected the bone lesion in axial images with high sensitivity (95.9%) and high precision (98.9%) with an average dice coefficient of 83.5%. Conclusions: The developed algorithm detected and segmented bone lesions in CBCT scans with high accuracy and may serve as a computerized tool for detecting incidental bone lesions in CBCT imaging. Clinical relevance: Our novel deep-learning algorithm detects incidental hypodense bone lesions in cone beam CT scans, using various imaging devices and protocols. This algorithm may reduce patients’ morbidity and mortality, particularly since currently, cone beam CT interpretation is not always preformed. Key Points: • A deep learning algorithm was developed for automatic detection and 3D segmentation of various maxillofacial bone lesions in CBCT scans, irrespective of the CBCT device or the scanning protocol. • The developed algorithm can detect incidental jaw lesions with high accuracy, generates a 3D segmentation of the lesion, and calculates the lesion volume.

Original languageAmerican English
Pages (from-to)7507-7518
Number of pages12
JournalEuropean Radiology
Issue number11
StatePublished - Nov 2023

Bibliographical note

Publisher Copyright:
© 2023, The Author(s), under exclusive licence to European Society of Radiology.


  • Cone beam computed tomography
  • Deep learning
  • Incidental findings
  • Oral
  • Pathology


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