Automatic detection of temporomandibular joint osteoarthritis radiographic features using deep learning artificial intelligence. A Diagnostic accuracy study.

Objective: The purpose of this study was to investigate the diagnostic performance of a neural network Artificial Intelligence model for the radiographic confirmation of Temporomandibular Joint Osteoarthritis in reference to an experienced radiologist.

Materials and methods: The diagnostic performance of an AI model in identifying radiographic features in patients with TMJ-OA was evaluated in a diagnostic accuracy cohort study. Adult patients elected for radiographic examination by the Diagnostic Criteria for Temporomandibular Disorders decision tree were included. Cone-beam computed Tomography images were evaluated by object detection YOLO deep learning model. The diagnostic performance was verified against examiner radiographic evaluation.

Results: The differences between the AI model and examiner were non-significant statistically, except in the subcortical cyst (P=0.049*). AI model showed substantial to near-perfect levels of agreement when compared to those of the examiner data. Regarding each radiographic phenotype, the AI model reported favorable sensitivity, specificity, accuracy, and highly statistically significant Receiver Operating Characteristic (ROC) analysis (p<0.001). Area Under Curve ranged from 0.872, for surface erosion, to 0.911 for subcortical cyst.

Conclusion: AI object detection model could open the horizon for a valid, automated, and convenient modality for TMJ-OA radiographic confirmation and radiomic features identification with a significant diagnostic power.