Automated scheme for measuring mandibular cortical thickness on dental panoramic radiographs for osteoporosis screening

Findings of dental panoramic radiographs (DPRs) have shown that the mandibular cortical thickness (MCT) was significantly correlated with osteoporosis. Identifying asymptomatic patients with osteoporosis through dental examinations may bring a supplemental benefit for the patients. However, most of the DPRs are used for only diagnosing dental conditions by dentists in their routine clinical work. The aim of this study was to develop a computeraided diagnosis scheme that automatically measures MCT to assist dentists in screening osteoporosis. First, the inferior border of mandibular bone was detected by use of an active contour method. Second, the locations of mental foramina were estimated on the basis of the inferior border of mandibular bone. Finally, MCT was measured on the basis of the grayscale profile analysis. One hundred DPRs were used to evaluate our proposed scheme. Experimental results showed that the sensitivity and specificity for identifying osteoporotic patients were 92.6 % and 100 %, respectively. We conducted multiclinic trials, in which 223 cases have been obtained and processed in about a month. Our scheme succeeded in detecting all cases of suspected osteoporosis. Therefore, our scheme may have a potential to identify osteoporotic patients at an early stage.