Machine Learning in the Detection of Oral Lesions With Clinical Intraoral Images

Introduction: Artificial intelligence in oncology has gained a lot of interest in recent years. Early detection of Oral squamous cell carcinoma (OSCC) is crucial for early management to attain a better prognosis and overall survival. Machine learning (ML) has also been used in oral cancer studies to explore the discrimination between clinically normal and oral cancer.

Materials And Methods: A dataset comprising 360 clinical intra-oral images of OSCC, Oral Potentially Malignant Disorders (OPMDs) and clinically healthy oral mucosa were used. Clinicians trained the machine learning model with the clinical images (n=300). Roboflow software (Roboflow Inc, USA) was used to classify and annotate images along with Multi-class annotation and object detection models trained by two expert oral pathologists. The test dataset (n=60) of new clinical images was again evaluated by two clinicians and Roboflow. The results were tabulated and Kappa statistics was performed using SPSS v23.0 (IBM Corp., Armonk, NY).  Results: Training dataset clinical images (n=300) were used to train the clinicians and Roboflow algorithm. The test dataset (n=60) of new clinical images was again evaluated by the clinicians and Roboflow. The observed outcomes revealed that the Mean Average Precision (mAP) was 25.4%, precision 29.8% and Recall 32.9%. Based on the kappa statistical analysis the 0.7 value shows a moderate agreement between the clinicians and the machine learning model. The test dataset showed the specificity and sensitivity of the Roboflow machine learning model to be 75% and 88.9% respectively.  Conclusion: In conclusion, machine learning showed promising results in the early detection of suspected lesions using clinical intraoral images and aids general dentists and patients in the detection of suspected lesions such as OPMDs and OSCC that require biopsy and immediate treatment.