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Multi-stage deep learning segmentation of teeth
Key Investigators
  - Daniel Palkovics (Semmelweis Medical University)
 
  - Csaba Pinter (Ebatinca)
 
  - David Garcia Mato (Ebatinca)
 
  - Andres Diaz-Pinto (NVidia)
 
Project Description
Segmenting and identifying the teeth in a mandible or maxilla is a difficult task, especially due to the high number of structures and their similarity. Recent results suggest that multi-stage segmentation may yield more accurate segmentation in these scenarios.
Objective
The idea is to create a simple two-stage approach in MONAILabel where the first stage detects the teeth centre and the second stage accurately segments the teeth themselves.
Approach and Plan
  - Discuss with Andrés the details about multi-stage segmentation in MONAILabel
 
  - Design the changes to be made
 
Progress and Next Steps
  - Discussion with Andrés about multi-stage deep learning approach
    
      - Multistage approach is more robust because the complexity is separated (robustness is the main advantage)
        
          - Paper (see below) has several models: ROI, Centroid/Skeleton (numbers OR images), Multi-task tooth segmentation, Tooth ID classification, Cascaded bone segmentation
 
          - Baseline data for centroid model are just the centroids, that can be calculated from the baseline segmentation. Same with the centerline one
 
          - Implementing generic multi-stage approach in MONAILabel is a bit of a work
            
              - In MONAI core this is easier to set up
 
            
           
        
       
      - Why one model? Having one upper and one lower is OK for us
        
          - Even lower + upper + bone + implant/tooth separation is a possibility
 
          - Advantage of one multi-stage model is that we have only one system
 
          - If we have both upper and lower then we need more data
 
          - Clinically we’ll only have either upper or lower
 
        
       
      - How do we connect the stages?
        
          - Centroid/skeleton using numbers (not images) is regression (not segmentation)
 
          - Concatenate input numbers on the “bottom of the UNet” where we have a huge array of numbers after downsampling
 
        
       
      - MONAI files
        
          - .pt: model (need to define network first etc.)
 
          - .ts: torch script that contains preprocessing and the inference too
 
        
       
    
   
  - Proposal
    
      - Simple multi-stage model implementation using MONAI
 
      - Initial: ROI definition -> Centroids -> Tooth segmentation
 
      - Later still possible to add for example tooth identification, centerline, implant segmentation, etc.
 
    
   
Illustrations
There are some promising preliminary results

but there is room for improvement!

Background and References