{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T19:42:33Z","timestamp":1779219753580,"version":"3.51.4"},"reference-count":30,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,14]],"date-time":"2022-08-14T00:00:00Z","timestamp":1660435200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union\u2019s Horizon 2020 research and innovation programme","award":["857287"],"award-info":[{"award-number":["857287"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>The detection and classification of cystic lesions of the jaw is of high clinical relevance and represents a topic of interest in medical artificial intelligence research. The human clinical diagnostic reasoning process uses contextual information, including the spatial relation of the detected lesion to other anatomical structures, to establish a preliminary classification. Here, we aimed to emulate clinical diagnostic reasoning step by step by using a combined object detection and image segmentation approach on panoramic radiographs (OPGs). We used a multicenter training dataset of 855 OPGs (all positives) and an evaluation set of 384 OPGs (240 negatives). We further compared our models to an international human control group of ten dental professionals from seven countries. The object detection model achieved an average precision of 0.42 (intersection over union (IoU): 0.50, maximal detections: 100) and an average recall of 0.394 (IoU: 0.50\u20130.95, maximal detections: 100). The classification model achieved a sensitivity of 0.84 for odontogenic cysts and 0.56 for non-odontogenic cysts as well as a specificity of 0.59 for odontogenic cysts and 0.84 for non-odontogenic cysts (IoU: 0.30). The human control group achieved a sensitivity of 0.70 for odontogenic cysts, 0.44 for non-odontogenic cysts, and 0.56 for OPGs without cysts as well as a specificity of 0.62 for odontogenic cysts, 0.95 for non-odontogenic cysts, and 0.76 for OPGs without cysts. Taken together, our results show that a combined object detection and image segmentation approach is feasible in emulating the human clinical diagnostic reasoning process in classifying cystic lesions of the jaw.<\/jats:p>","DOI":"10.3390\/diagnostics12081968","type":"journal-article","created":{"date-parts":[[2022,8,14]],"date-time":"2022-08-14T21:09:06Z","timestamp":1660511346000},"page":"1968","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Emulating Clinical Diagnostic Reasoning for Jaw Cysts with Machine Learning"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4386-6237","authenticated-orcid":false,"given":"Balazs","family":"Feher","sequence":"first","affiliation":[{"name":"Department of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Competence Center Oral Biology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9744-9856","authenticated-orcid":false,"given":"Ulrike","family":"Kuchler","sequence":"additional","affiliation":[{"name":"Department of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1223-1669","authenticated-orcid":false,"given":"Falk","family":"Schwendicke","sequence":"additional","affiliation":[{"name":"Department of Oral Diagnostics, Digital Health, and Health Services Research, Charit\u00e9\u2014University Medicine Berlin, 14197 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Schneider","sequence":"additional","affiliation":[{"name":"Department of Oral Diagnostics, Digital Health, and Health Services Research, Charit\u00e9\u2014University Medicine Berlin, 14197 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose Eduardo","family":"Cejudo Grano de Oro","sequence":"additional","affiliation":[{"name":"Department of Oral Diagnostics, Digital Health, and Health Services Research, Charit\u00e9\u2014University Medicine Berlin, 14197 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9142-9253","authenticated-orcid":false,"given":"Tong","family":"Xi","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, 6525 GA Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2679-3841","authenticated-orcid":false,"given":"Shankeeth","family":"Vinayahalingam","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, 6525 GA Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7198-7832","authenticated-orcid":false,"given":"Tzu-Ming Harry","family":"Hsu","sequence":"additional","affiliation":[{"name":"Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA 02139, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janet","family":"Brinz","sequence":"additional","affiliation":[{"name":"Department of Restorative Dentistry, Ludwig-Maximilians-University of Munich, 80336 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8356-9512","authenticated-orcid":false,"given":"Akhilanand","family":"Chaurasia","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine and Radiology, Faculty of Dental Sciences, King George\u2019s Medical University, Lucknow 226003, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4318-480X","authenticated-orcid":false,"given":"Kunaal","family":"Dhingra","sequence":"additional","affiliation":[{"name":"Periodontics Division, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi 110029, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9061-7220","authenticated-orcid":false,"given":"Robert Andre","family":"Gaudin","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Charit\u00e9\u2014University Medicine Berlin, 14197 Berlin, Germany"},{"name":"Berlin Institute of Health, 10178 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4971-5926","authenticated-orcid":false,"given":"Hossein","family":"Mohammad-Rahimi","sequence":"additional","affiliation":[{"name":"Dentofacial Deformities Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran 1416634793, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9265-2724","authenticated-orcid":false,"given":"Nielsen","family":"Pereira","sequence":"additional","affiliation":[{"name":"Private Practice in Oral and Maxillofacial Radiology, Rio de Janeiro 22430-000, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3735-4465","authenticated-orcid":false,"given":"Francesc","family":"Perez-Pastor","sequence":"additional","affiliation":[{"name":"Servei Salut Dental, Gerencia Atencio Primaria, Institut Balear de la Salut, 07003 Palma, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5145-6812","authenticated-orcid":false,"given":"Olga","family":"Tryfonos","sequence":"additional","affiliation":[{"name":"Department of Periodontology and Oral Biochemistry, Academic Centre for Dentistry Amsterdam, 1081 LA Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0684-2025","authenticated-orcid":false,"given":"Sergio E.","family":"Uribe","sequence":"additional","affiliation":[{"name":"Department of Conservative Dentistry & Oral Health, Riga Stradins University, LV-1007 Riga, Latvia"},{"name":"School of Dentistry, Universidad Austral de Chile, Valdivia 5110566, Chile"},{"name":"Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, LV-1658 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcel","family":"Hanisch","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, University Clinic M\u00fcnster, 48143 M\u00fcnster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6010-8940","authenticated-orcid":false,"given":"Joachim","family":"Krois","sequence":"additional","affiliation":[{"name":"Department of Oral Diagnostics, Digital Health, and Health Services Research, Charit\u00e9\u2014University Medicine Berlin, 14197 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1855","DOI":"10.1038\/s41598-022-05913-5","article-title":"Deep learning based diagnosis for cysts and tumors of jaw with massive healthy samples","volume":"12","author":"Yu","year":"2022","journal-title":"Sci. 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