Fractal Dimension on CBCT Images and Modular Neural Networks to Identify Reduced Bone Mineral Density in Women
Authors:   Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt, El-Sayed El ,   Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt; Dentistry Program, Clinical Dental Science Department, Division of Oral and Maxillofacial Surgery, Batterjee Medical College, Jeddah, 21442, Saudi Arabia,   Dentistry Program, Oral Medicine and Radiology Department, Batterjee Medical College, Jeddah, 21442, Saudi Arabia; PhD Candidate, Teerthankar Mahaveer Dental College, Moradabad, India,   Radiologic Science Program, Batterjee Medical College, Makkah Region, Jeddah, 21442, Saudi Arabia,   Intership Dentist, Dental Clinics of Batterjee Medical College, Jeddah, Makka Region, 21442, Saudi Arabia,   Intership Dentist, Dental Clinics of Batterjee Medical College, Jeddah, Makka Region, 21442, Saudi Arabia,   Intership Dentist, Dental Clinics of Batterjee Medical College, Jeddah, Makka Region, 21442, Saudi Arabia,   Intership Dentist, Dental Clinics of Batterjee Medical College, Jeddah, Makka Region, 21442, Saudi Arabia,   Department of Communications and Electronics, Delta Higher Institute of Engineering and Technology, Mansoura, 3511, Egypt,   Electronics and Communications Engineering Department, Faculty of Engineering, Delta University for Science and Technology, Gamasa City, 11152, Egypt, Sapri Ahmed Mohamed Saaduddin , Bashir Taseer , Hassan Khalid , Alghamdi Abdulhameed Saeed , Almasaabi Yousef , Maddah Nagham Talal , Kayal Hind F. , El-kenawy El-Sayed M. El , Saber Mohamed 
Published: June 2024

This paper provides two different methods to diagnose osteoporosis in women; the first method is the fractal analysis evaluated by CBCT at two bone locations (the mandible and the second cervical vertebrae) to see if there is any correlation between the two. At the same time, the second method is deep convolutional neural networks (DCNNs). One hundred eighty-eight patients' mandibular CBCT images were used, and DCNN models based on the ResNet-101 framework were employed. Dual X-ray absorptiometry of the hip and lumbar spine revealed that 139 of the 188 postmenopausal women tested had osteoporosis, whereas 49 had average bone mineral density. The second cervical vertebra and the mandible were selected as locations of interest for FD analysis on the CBCT images. Measurement accuracy, both within and between observers' agreements, and correlations between two data sets were all calculated. To evaluate osteoporosis, we used a segmented, three-phase approach. Stage 1 was devoted to the identification of mandibular bone slices. In Stage 2, the coordinates for the mandible's cross-sectional views were established, and Stage 3 calculated the thickness of the mandible bone, emphasizing osteoporotic variations. The average FD values within the interest area of the mandible were significantly lower in people with osteoporosis than in those with average bone mineral density. At the same time, the two groups had no significant difference in FD values at the second cervical vertebra. For the mandibular site, areas beneath the curve were 0.644 (P = 0.008), while the area under the curve for the vertebral site was 0.531 (P = 0.720). DCNN training in the first stage yielded an astounding 98.85% training accuracy, the second stage decreased L1 loss to a meager 1.02 pixels, and the bone thickness computation method used in the last stage had a mean squared error of 0. 8377. We concluded that FD was underutilized even though it distinguished between women with normal BMD and those with osteoporosis in the mandibular area. Additionally, even with small mandibular CBCT datasets, the results show the value of a modular transfer learning approach for osteoporosis detection.