{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T00:36:43Z","timestamp":1793752603563,"version":"4.6.1"},"reference-count":24,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T00:00:00Z","timestamp":1700006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Wuhan Special Project on Knowledge Innovation","award":["2022020801010498"],"award-info":[{"award-number":["2022020801010498"]}]},{"name":"General Program of the National Natural Scientific Foundation of China","award":["81870761"],"award-info":[{"award-number":["81870761"]}]},{"name":"General Program of the National Natural Scientific Foundation of China","award":["81970923"],"award-info":[{"award-number":["81970923"]}]},{"name":"General Program of the National Natural Scientific Foundation of China","award":["82071107"],"award-info":[{"award-number":["82071107"]}]},{"name":"General Program of the National Natural Scientific Foundation of China","award":["82170944"],"award-info":[{"award-number":["82170944"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Dent Res"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p>Apical periodontitis (AP) is one of the most prevalent disorders in dentistry. However, it can be underdiagnosed in asymptomatic patients. In addition, the perioperative evaluation of 3-dimensional (3D) lesion volume is of great clinical relevance, but the required slice-by-slice manual delineation method is time- and labor-intensive. Here, for quickly and accurately detecting and segmenting periapical lesions (PALs) associated with AP on cone beam computed tomography (CBCT) images, we proposed and geographically validated a novel 3D deep convolutional neural network algorithm, named PAL-Net. On the internal 5-fold cross-validation set, our PAL-Net achieved an area under the receiver operating characteristic curve (AUC) of 0.98. The algorithm also improved the diagnostic performance of dentists with varying levels of experience, as evidenced by their enhanced average AUC values (junior dentists: 0.89\u20130.94; senior dentists: 0.91\u20130.93), and significantly reduced the diagnostic time (junior dentists: 69.3\u2009min faster; senior dentists: 32.4\u2009min faster). Moreover, our PAL-Net achieved an average Dice similarity coefficient over 0.87 (0.85\u20130.88), which is superior or comparable to that of other existing state-of-the-art PAL segmentation algorithms. Furthermore, we validated the generalizability of the PAL-Net system using multiple external data sets from Central, East, and North China, showing that our PAL-Net has strong robustness. Our PAL-Net can help improve the diagnostic performance and speed of dentists working from CBCT images, provide clinically relevant volume information to dentists, and can potentially be applied in dental clinics, especially without expert-level dentists or radiologists.<\/jats:p>","DOI":"10.1177\/00220345231201793","type":"journal-article","created":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T00:01:01Z","timestamp":1700092861000},"page":"5-12","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":46,"title":["Clinically Oriented CBCT Periapical Lesion Evaluation via 3D CNN Algorithm"],"prefix":"10.1177","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1830-3347","authenticated-orcid":false,"given":"W.T.","family":"Fu","sequence":"first","affiliation":[{"name":"State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China"},{"name":"Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Q.K.","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Li","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China"},{"name":"Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.Q.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.L.","family":"Deng","sequence":"additional","affiliation":[{"name":"Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.P.","family":"Chen","sequence":"additional","affiliation":[{"name":"Xiangyang Stomatological Hospital; Affiliated Stomatological Hospital of Hubei University of Arts and Science, Xiangyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of International VIP Dental Clinic, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7161-6492","authenticated-orcid":false,"given":"L.Y.","family":"Meng","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China"},{"name":"Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8035-4276","authenticated-orcid":false,"given":"Z.","family":"Bian","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China"},{"name":"Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, 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