Guido de Jong

Bo Berends, Freek Bielevelt, Ruud Schreurs et al.

Three-dimensional facial stereophotogrammetry provides a detailed representation of craniofacial soft tissue without the use of ionizing radiation. While manual annotation of landmarks serves as the current gold standard for cephalometric analysis, it is a time-consuming process and is prone to human error. The aim in this study was to develop and evaluate an automated cephalometric annotation method using a deep learning-based approach. Ten landmarks were manually annotated on 2897 3D facial photographs by a single observer. The automated landmarking workflow involved two successive DiffusionNet models and additional algorithms for facial segmentation. The dataset was randomly divided into a training and test dataset. The training dataset was used to train the deep learning networks, whereas the test dataset was used to evaluate the performance of the automated workflow. The precision of the workflow was evaluated by calculating the Euclidean distances between the automated and manual landmarks and compared to the intra-observer and inter-observer variability of manual annotation and the semi-automated landmarking method. The workflow was successful in 98.6% of all test cases. The deep learning-based landmarking method achieved precise and consistent landmark annotation. The mean precision of 1.69 (+/-1.15) mm was comparable to the inter-observer variability (1.31 +/-0.91 mm) of manual annotation. The Euclidean distance between the automated and manual landmarks was within 2 mm in 69%. Automated landmark annotation on 3D photographs was achieved with the DiffusionNet-based approach. The proposed method allows quantitative analysis of large datasets and may be used in diagnosis, follow-up, and virtual surgical planning.

C. H. E. Jordaan, M. van der Stelt, T. J. J. Maal et al.

The quality of a transtibial prosthetic socket depends on the prosthetist's skills and expertise, as the fitting is performed manually. This study investigates multiple artificial intelligence (AI) approaches to help standardize transtibial prosthetic socket design. Data from 118 patients were collected by prosthetists working in the Dutch healthcare system. This data consists of a three-dimensional (3D) scan of the residual limb and a corresponding 3D model of the prosthetist-designed socket. Multiple data pre-processing steps are performed for alignment, standardization and optionally compression using Morphable Models and Principal Component Analysis. Afterward, three different algorithms - a 3D neural network, Feedforward neural network, and random forest - are developed to either predict 1) the final socket shape or 2) the adaptations performed by a prosthetist to predict the socket shape based on the 3D scan of the residual limb. Each algorithm's performance was evaluated by comparing the prosthetist-designed socket with the AI-generated socket, using two metrics in combination with the error location. First, we measure the surface-to-surface distance to assess the overall surface error between the AI-generated socket and the prosthetist-designed socket. Second, distance maps between the AI-generated and prosthetist sockets are utilized to analyze the error's location. For all algorithms, estimating the required adaptations outperformed direct prediction of the final socket shape. The random forest model applied to adaptation prediction yields the lowest error with a median surface-to-surface distance of 1.24 millimeters, a first quartile of 1.03 millimeters, and a third quartile of 1.54 millimeters.