Abstract
Objective: The aim of the present study was to predict osteoporosis on panoramic radiographs of women over 50 years of age through deep learning algorithms.Method: Panoramic radiographs of 744 female patients over 50 years of age were labeled as C1, C2, and C3 depending on mandibular cortical index (MCI). According to this index; C1: presence of a smooth and sharp mandibular cortex (normal); C2: resorption cavities at endosteal margin and 1 to 3-layer stratification (osteopenia); C3: completely porotic cortex (osteoporosis). The data of the present study were reviewed in different categories including C1-C2-C3, C1-C2, C1-C3 and C1-(C2+C3) as two-class and three-class prediction. The data were separated as 20% random test data; and the remaining data were used for training and validation with 5-fold cross-validation. AlexNET, GoogleNET, ResNET-50, SqueezeNET, and ShuffleNET deep learning models are trained through the transfer learning method. The results were evaluated by performance criteria including accuracy, sensitivity, specificity, F1-score, AUC and training duration. Findings: The dataset C1-C2-C3 has an accuracy rate of 81.14% with AlexNET; the dataset C1-C2 has an accuracy rate of 88.94% with GoogleNET; the dataset C1-C3 has an accuracy rate of 98.56% with AlexNET; and the dataset C1-(C2+C3) has an accuracy rate of 92.79% with GoogleNET. Conclusion: The highest accuracy was obtained in differentiation of C3 and C1 where osseous structure characteristics change significantly. Since the C2 score represent the intermediate stage (osteopenia), structural characteristics of the bone present behaviors closer to C1 and C3 scores. Therefore, the data set including the C2 score provided relatively lower accuracy results.