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Automated osteoporosis risk assessment by dentists: a new pathway to diagnosis

Pavitt, S, Devlin, H, Allen, P, Graham, J, Jacobs, R, Karayianni, K, Lindh, C, van der Stelt, P, Harrison, E, Adams, J and Horner, K (2007) Automated osteoporosis risk assessment by dentists: a new pathway to diagnosis. Bone, 40 (4). 835 - 842 . ISSN 8756-3282


General dental practitioners use a vast amount of panoramic radiography in their routine clinical work, but valuable information about patients' osteoporotic status is not collected. There are many reasons for this, but one of the prime reasons must be the disruption involved in clinical routine with lengthy manual radiographic assessment. We have developed computer software, based on active shape modeling that will automatically detect the mandibular cortex on panoramic radiographs, and then measure its width. Automatic or semi-automatic measurement of the cortical width will indicate the osteoporotic risk of the patient. The aim of our work was to assess the computer search technique's ability to measure the mandibular cortical width and to assess its potential for detection of osteoporosis of the hip, spine and femoral neck. Mandibular cortical width was measured using the manually initialized (semi-automatic) method and, when assessed for diagnosing osteoporosis at one of the three measurement sites, gave an area under the ROC curve (Az) = 0.816 (95% CI = 0.784 to 0.845) and for the automatically initialized searches, Az = 0.759 (95% CI = 0.724 to 0.791). The difference between areas = 0.057 (95% Confidence interval = 0.025 to 0.089), p < 0.0001. For diagnosing osteoporosis at the femoral neck, mandibular cortical width derived from the manually initialized fit gave an area under the ROC curve (Az) = 0.835 (95% CI = 0.805 to 0.863) and for the automatically initialized searches Az = 0.805 (95% CI = 0.773 to 0.835). The difference in Az values between active shape modeling search methods = 0.030 (95% CI = − 0.010 to 0.070), and this was not significant, p = 0.138. We concluded that measurement of mandibular cortical width using active shape modeling is capable of diagnosing skeletal osteoporosis with good diagnostic ability and repeatability.

Item Type: Article
Institution: The University of Leeds
Academic Units: The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Psychiatry and Behavioural Sciences (Leeds)
Depositing User: Symplectic Publications
Date Deposited: 06 Jun 2011 11:12
Last Modified: 24 Jun 2014 09:34
Published Version: http://dx.doi.org/10.1016/j.bone.2006.10.024
Publisher: Elsevier Inc.
Identification Number: 10.1016/j.bone.2006.10.024
URI: http://eprints.whiterose.ac.uk/id/eprint/43037

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