Journal Article

Enhancement of early proximal caries annotations in radiographs: introducing the Diagnostic Insights for Radiographic Early-caries with micro-CT (ACTA-DIRECT) dataset

Berkhout, Erwin, Valenzuela, Ricardo E. Gonzalez, Loos, Bruno G., Marquering, Henk, Mettes, Pascal

2024

Overview

Background Proximal caries datasets for training artificial intelligence (AI) algorithms commonly include clinician-annotated radiographs. These conventional annotations are susceptible to observer variability, and early caries may be missed. Micro-computed tomography (CT), while not feasible in clinical applications, offers a more accurate imaging modality to support the creation of a reference-standard dataset for caries annotations. Herein, we present the Academic Center for Dentistry Amsterdam—Diagnostic Insights for Radiographic Early-caries with micro-CT (ACTA-DIRECT) dataset, which is the first dataset pairing dental radiographs and micro-CT scans to enable higher-quality annotations. Methods The ACTA-DIRECT dataset encompasses 179 paired micro-CT scans and radiographs of early proximal carious teeth, along with three types of annotations: conventional annotations on radiographs, micro-CT-assisted annotations on radiographs, and micro-CT annotations (reference standard). Three dentists independently annotated proximal caries on radiographs, both with and without micro-CT assistance, enabling determinations of interobserver agreement and diagnostic accuracy. To establish a reference standard, one dental radiologist annotated all caries on the related micro-CT scans. Results Micro-CT support improved interobserver agreement (Cohen’s Kappa), averaging 0.64 (95% confidence interval [CI]: 0.59–0.68) versus 0.46 (95% CI: 0.44–0.48) in its absence. Likewise, average sensitivity and specificity increased from 42% (95% CI: 34–51%) to 63% (95% CI: 54–71%) and from 92% (95% CI: 88–95%) to 95% (95% CI: 92–97%), respectively. Conclusion The ACTA-DIRECT dataset offers high-quality images and annotations to support AI-based early caries diagnostics for training and validation. This study underscores the benefits of incorporating micro-CT scans in lesion assessments, providing enhanced precision and reliability. Graphical Abstract

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Accuracy / Algorithms / Annotations / Artificial Intelligence / Computed tomography / CT imaging / Data mining / Dataset / Datasets / Dental caries / Dental Caries - diagnostic imaging / Dental enamel / Dentistry / Dentists / Diagnosis / High-quality annotations / Humans / Image processing / Medical diagnosis / Medical imaging / Medicine / Methods / Observer Variation / Oral and Maxillofacial Surgery / Prevention and management of dental erosion and decay / Radiography / Radiography, Dental - methods / Sensors / Teeth / X-ray microtomography / X-Ray Microtomography - methods / X-Ray Microtomography - statistics & numerical data