Hélen Kaline Farias Bezerra, Paulo Victor Mendes Penafort, Fábio de Abreu Alves, José Divaldo Prado, Pablo Agustin Vargas
{"title":"First case report of oral histoplasmosis in a patient receiving Secukinumab (Cosentyx): opportunistic infections as complication of emerging immunomodulatory therapies.","authors":"Hélen Kaline Farias Bezerra, Paulo Victor Mendes Penafort, Fábio de Abreu Alves, José Divaldo Prado, Pablo Agustin Vargas","doi":"10.1016/j.oooo.2025.04.096","DOIUrl":"https://doi.org/10.1016/j.oooo.2025.04.096","url":null,"abstract":"<p><strong>Introduction: </strong>Histoplasmosis is an opportunistic infection that can manifest in immunosuppressed patients, particularly those on biologic therapies.</p><p><strong>Case report: </strong>This report presents a rare case of localized oral histoplasmosis in a 42-year-old Brazilian female undergoing treatment for ankylosing spondylitis (AS) with Secukinumab (Cosentyx), an interleukin-17 (IL-17) inhibitor. The patient presented with a painful, irregular gingival ulcer persisting for 4 months. Clinical examination revealed a 3 cm granular lesion involving the upper left gingiva. Histopathological analysis showed histiocytes containing yeast-like structures surrounded by a refractile halo, consistent with Histoplasma capsulatum by Grocott-Gomori methenamine silver staining. Chest computed tomography demonstrated no pulmonary involvement. Treatment consisted of oral itraconazole and discontinuation of Secukinumab, resulting in complete resolution of the lesion.</p><p><strong>Conclusion: </strong>Oral histoplasmosis, despite being rare, should be considered in immunosuppressed patients with persistent oral ulcers. IL-17 inhibitors, while effective for AS, increase the risk of fungal infections due to impaired mucocutaneous immune responses. This case highlights the importance of vigilance, early diagnosis, and appropriate management in patients on immunomodulators. It also underscores the need for clinical awareness and further research into the long-term risks of immunomodulatory agents. This report contributes to the growing evidence on opportunistic infections associated with immunomodulatory therapies.</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Qiyue Zhang, Lin Ye, Ying Wang, Tiantian Xu, Shiyu Zhang, Zhiyong Wang, Qianming Chen, Jiang Liu, Xin Zeng, Jing Li
{"title":"Associations between MTA1 and the outcome of oral leukoplakia: evidence from cohort studies and functional analyses.","authors":"Qiyue Zhang, Lin Ye, Ying Wang, Tiantian Xu, Shiyu Zhang, Zhiyong Wang, Qianming Chen, Jiang Liu, Xin Zeng, Jing Li","doi":"10.1016/j.oooo.2025.04.005","DOIUrl":"https://doi.org/10.1016/j.oooo.2025.04.005","url":null,"abstract":"<p><strong>Objective: </strong>To describe the relationship between MTA1 expression and Oral leukoplakia (OLK) prognosis in cohort studies and its possible mechanism.</p><p><strong>Materials and methods: </strong>We assessed MTA1 expression levels in OLK and OSCC tissues and cell lines using immunohistochemistry and Western blot. Functional analyses were performed in vitro by CCK-8 and Western blot assays. We analyzed overall survival in our OSCC cohort and TCGA dataset and analyzed the microenvironmental landscape of different MTA1 expression patterns in OLK and OSCC by multiplex immunohistochemistry. The Cox proportional hazards regression model was used to determine multivariate hazard ratios for overall survival.</p><p><strong>Results: </strong>MTA1 is abnormally highly expressed in OLK and OSCC both in cells and tissue, promoting DOK cell proliferation and altering EMT through E-cadherin, Wnt3a, and β-catenin. Moreover, MTA1 gradually increased with increasing abnormal OLK proliferation and negatively correlated with OSCC prognosis. Notably, MTA1 shows a positive correlation with M2 macrophage infiltration levels. Additionally, we found that low expression of MTA1 and a low M2/M1 ratio panel predict good patient prognosis in OSCC.</p><p><strong>Conclusion: </strong>We suggest that the aberrant expression of MTA1 may contribute to the malignant transformation of OLK and that MTA1 may represent a new prognostic marker for OLK and OSCC.</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jarod Ruffing, Oscar Jaimes, David Paquette, Heather Khosa, Eric Holmes, Andres Flores-Hidalgo
{"title":"Oral potentially malignant disorders: clinical-pathological correlations in a dental institution in North Carolina.","authors":"Jarod Ruffing, Oscar Jaimes, David Paquette, Heather Khosa, Eric Holmes, Andres Flores-Hidalgo","doi":"10.1016/j.oooo.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.oooo.2025.04.003","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the prevalence and diagnostic accuracy of oral potentially malignant disorders (OPMDs) in North Carolina, focusing on the agreement between clinical impressions and microscopic diagnoses.</p><p><strong>Study design: </strong>This retrospective study analyzed 76 patient records from the East Carolina University Oral Pathology Biopsy Service. Clinical impressions of OPMDs, including leukoplakia, erythroplakia, and chronic ulcers, were compared with histopathological diagnoses. Data were collected using HIPAA-compliant software, and Cohen's Kappa was used to evaluate diagnostic agreement.</p><p><strong>Results: </strong>The patient cohort had a mean age of 62.2 years, with 65.7% male and 60.5% identifying as Caucasian. The most common lesion locations were the lateral tongue (32.8%) and alveolar ridge mucosa (27.6%). Minimal agreement was observed between clinical impressions and microscopic diagnoses (Kappa: 0.0266 ± 0.0682, P = .6965). Smoking and alcohol use were significantly associated with higher grades of oral epithelial dysplasia.</p><p><strong>Conclusion(s): </strong>The study highlights significant diagnostic challenges in identifying OPMDs based on clinical impressions alone, emphasizing the need for histopathological evaluation. Improved diagnostic training and public health interventions are essential to enhance early detection and reduce the burden of oral cancer in North Carolina.</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Juan Pablo Castañeda-González, Juan José Capasso, Andrea Viviana Gualteros Bustos, Alejandro Escobar, Ana María Arredondo, Jairo Cajamarca-Barón, Héctor Cubides, José Fernando Polo, Claudia Ibáñez-Antequera, Gabriel-Santiago Rodríguez-Vargas, Andrés Felipe Lamos-Duarte, Carlos Santiago Rivadeneira-Chamorro, Adriana Rojas-Villarraga, Rafael Parra-Medina
{"title":"Clonal rearrangements of B and T lymphocytes in minor salivary gland biopsies of Sjögren's disease patients with a focus score of ≥1.","authors":"Juan Pablo Castañeda-González, Juan José Capasso, Andrea Viviana Gualteros Bustos, Alejandro Escobar, Ana María Arredondo, Jairo Cajamarca-Barón, Héctor Cubides, José Fernando Polo, Claudia Ibáñez-Antequera, Gabriel-Santiago Rodríguez-Vargas, Andrés Felipe Lamos-Duarte, Carlos Santiago Rivadeneira-Chamorro, Adriana Rojas-Villarraga, Rafael Parra-Medina","doi":"10.1016/j.oooo.2025.04.004","DOIUrl":"https://doi.org/10.1016/j.oooo.2025.04.004","url":null,"abstract":"<p><strong>Introduction: </strong>Sjögren's Disease (SjD) is a systemic autoimmune disease with an increased risk of developing hematolymphoid neoplasms, with mucosa-associated marginal zone lymphoma being the most common. This could be related to the lack of a diagnostic test to achieve early diagnosis. Clonal rearrangements are molecular tests used in the diagnosis of lymphoid neoplasms that have proven to be supportive in the diagnosis and may be useful in the early diagnosis process when applied to minor salivary gland biopsies (MSGB).</p><p><strong>Methods: </strong>Cross-sectional study including MSGB with a diagnosis of SjD between 2019 and 2022 at a university hospital in Bogota, Colombia. Sociodemographic data and histopathological characteristics were collected. Immunohistochemical studies and rearrangement tests were then performed according to the BIOMED-2 protocol.</p><p><strong>Results: </strong>Rearrangements were performed for T cell receptors and B cell immunoglobulins. A polyclonal result was found in most cases. Four cases were oligoclonal in IgH and two isolated clonal results: one in the TCR β segment and the other in the kappa light chain segment of immunoglobulin.</p><p><strong>Conclusion: </strong>Clonal rearrangements may be a useful tool for the early diagnosis of hematolymphoid neoplasms. Further studies with longer follow-up and application to MSGB are needed to better define a clonal pattern.</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marcos Paulo Maia-Lima, Livian Isabel de Medeiros Carvalho, Eduarda Gomes Onofre de Araújo, Hélder Domiciano Dantas Martins, Renato Assis Machado, Livia Maria Ferreira Sobrinho, Hercílio Martelli-Júnior, Paulo Rogério Ferreti Bonan
{"title":"Performance of a virtual assistant based on ChatGPT-4 in the diagnosis of syndromes with orofacial manifestations.","authors":"Marcos Paulo Maia-Lima, Livian Isabel de Medeiros Carvalho, Eduarda Gomes Onofre de Araújo, Hélder Domiciano Dantas Martins, Renato Assis Machado, Livia Maria Ferreira Sobrinho, Hercílio Martelli-Júnior, Paulo Rogério Ferreti Bonan","doi":"10.1016/j.oooo.2025.04.002","DOIUrl":"https://doi.org/10.1016/j.oooo.2025.04.002","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the performance of the virtual assistant \"Syndromic Diseases and Orofacial Features\" (SDOF), developed based on the Generative Pre-trained Transformer 4 model, in formulating diagnostic hypotheses and recommendations for syndromes with orofacial manifestations.</p><p><strong>Study design: </strong>Twenty-six anonymized, previously diagnosed clinical cases, including clinical features and images, were selected. The assistant was trained using scientific references and configured to generate diagnostic hypotheses and suggest complementary exams. The responses were evaluated by two oral diagnosis specialists based on criteria such as accuracy, completeness, relevance, and comprehensibility. Statistical analysis was performed using RStudio software to calculate means and standard deviations.</p><p><strong>Results: </strong>The SDOF correctly identified 96.2% of the cases, with 80.8% being the first diagnostic hypothesis and 15.4% being the second. In only one case (3.8%), the correct diagnosis was presented as the third hypothesis. The assistant performed best in the criteria \"Relevance,\" \"Practicality,\" and \"Readability,\" while \"Completeness\" and \"Up-to-dateness\" scored the lowest. Despite the high accuracy rate, the assistant failed to mention all diagnostic steps in 7.69% of the cases.</p><p><strong>Conclusions: </strong>The SDOF demonstrated significant potential to assist in the diagnosis of orofacial syndromes, with promising accuracy rates. However, the tool still requires professional supervision and improvements in completeness and up-to-dateness.</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ola Mohsen Al-Akwa'a, Manal Mohammed Al-Hajri, Asma'a Mansour ALHowshabi, Sadeq Ali Al-Maweri, Esam Halboub
{"title":"Effects of khat (Catha edulis) chewing on dry mouth and taste function: a comparative cross-sectional study.","authors":"Ola Mohsen Al-Akwa'a, Manal Mohammed Al-Hajri, Asma'a Mansour ALHowshabi, Sadeq Ali Al-Maweri, Esam Halboub","doi":"10.1016/j.oooo.2025.03.016","DOIUrl":"https://doi.org/10.1016/j.oooo.2025.03.016","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study was to evaluate oral dryness and the taste sensation threshold (sweet, salt, sour, and bitter) among khat chewers.</p><p><strong>Methods: </strong>This cross-sectional comparative study enrolled 140 healthy individuals divided into 2 groups: khat chewers (KCs; n = 73), and non-chewers (NCs; n = 67). Oral dryness was assessed using the Clinical Oral Dryness Score (CODS), whereas taste perception was assessed using the 4 primary tastes: sweet, salty, sour, and bitter, along with the Total Taste Score (TTS), each prepared as 7 chemical solutions representing 7 concentrations. SPSS version 26 was used for data analysis.</p><p><strong>Results: </strong>Overall, KC revealed significantly higher overall CODS scores compared to NCs (4.26 ± 1.39 vs 2.10 ± 1.15, P < .001). The TTS was significantly lower in KCs (16.52 ± 3.367) compared to NCs (18.87 ± 3.592, P < .001), owing to revealing significantly lower mean taste sensation scores for sweet, salty, and bitter tastes but not for sour taste. Up to 20.5% of KCs had hypogeusia compared with only 4.5% of NCs (P = .005). Multivariate analyses also revealed khat chewing as an independent determinant factor for oral dryness and hypogeusia.</p><p><strong>Conclusions: </strong>Chronic khat chewing is associated with mouth dryness and taste impairment, gravely impacting on the patients' quality of life. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range).</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Annu Singh, Kevin Chung, Joseph M Huryn, Cherry L Estilo, Azeez Farooki, SaeHee K Yom
{"title":"Teriparatide as an adjuvant therapy in the management of advanced-stage medication-related osteonecrosis of the jaw.","authors":"Annu Singh, Kevin Chung, Joseph M Huryn, Cherry L Estilo, Azeez Farooki, SaeHee K Yom","doi":"10.1016/j.oooo.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.oooo.2025.04.001","url":null,"abstract":"<p><p>Teriparatide, recombinant human parathyroid hormone, is a US Food and Drug Administration (FDA)-approved drug used for the treatment of osteoporosis in men and postmenopausal women. Recent studies have shown that it may promote bone healing in medication-related osteonecrosis of the jaw (MRONJ). We describe a case of successful management of advanced-stage MRONJ with teriparatide therapy that was initially prescribed for osteoporosis. This case demonstrates that in patients with progressive MRONJ with significant pain and frequent flares of acute infection, teriparatide may be a viable adjunct in treating MRONJ, as well as helping alleviate symptoms and improve quality of life. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range).</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Impact of antibiotic stewardship on infection rates in oral surgery procedures: a descriptive study","authors":"Gaurav Patri MDS , Chintan Manjibhai Savani MDS , Lisamarie S.L. Colaco MDS , Supriya Sourabh MDS , Lakshmi Priya MDS , Paluck Meston","doi":"10.1016/j.oooo.2025.02.020","DOIUrl":"10.1016/j.oooo.2025.02.020","url":null,"abstract":"<div><h3>Background</h3><div>Antibiotic use in oral surgery procedures is common; and inappropriate prescribing may contribute to antibiotic resistance. However, the impact of antibiotic stewardship programs (ASPs) on infection rates in oral surgery settings is not well established. This study explores the effect of implementing an ASP in an oral surgery clinic to reduce infection rates.</div></div><div><h3>Methods</h3><div>A team comprising oral surgeons, pharmacists, and infection control specialists developed and implemented a targeted ASP focusing on patient education, prescribed guidelines, and infection prevention strategies. A retrospective review of patient records was conducted to evaluate infection rates in oral surgery procedures before and after the program’s implementation.</div></div><div><h3>Results</h3><div>Preintervention infection rates for oral surgery procedures were 8.3% (45/540). After the implementation of the ASP, infection rates decreased to 3.7% (15/400), representing a significant reduction (<strong><em>P</em> < .001)</strong>. Compliance with the revised prescribing guidelines increased, and feedback from oral surgeons and patients was positive.</div></div><div><h3>Conclusions</h3><div>The implementation of an ASP in an oral surgery setting significantly reduced infection rates. This model, based on evidence-based practices and tailored interventions, can be adapted to other oral surgery practices to enhance patient outcomes and reduce antibiotic overuse.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"140 2","pages":"Pages e29-e34"},"PeriodicalIF":2.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Augmented intelligence in oral and maxillofacial radiology: a systematic review","authors":"Swarna Yerebairapura Math BDS, MDS, MFDS RCPS, PhD student , Nazila Ameli DDS, MSc, PhD , Cristine Miron Stefani DDS, MScs, PhD , Janice Y. Kung MLIS , Kumaradevan Punithakumar MASc, PhD , Maryam Amin DMD, MSc, PhD , Camila Pacheco-Pereira DDS, MBA, MScs, PhD, MS/Dip OMR, FRCDC","doi":"10.1016/j.oooo.2025.03.015","DOIUrl":"10.1016/j.oooo.2025.03.015","url":null,"abstract":"<div><h3>Background</h3><div>Artificial intelligence (AI) is transforming diagnostic imaging in dentistry. This systematic review evaluates existing literature on augmented intelligence in dentomaxillofacial radiology, focusing on its influence on human collaboration in interpreting dental imaging.</div></div><div><h3>Study Design</h3><div>A literature search across seven databases and gray literature was conducted. Studies evaluating clinician performance with AI-assistance were included, while reviews, surveys, and case reports were excluded. The QUADAS-2 tool assessed the risk of bias.</div></div><div><h3>Results</h3><div>Sixteen studies assessed the influence of AI on radiographic interpretation. AI-assisted caries detection consistently improved accuracy, sensitivity, and specificity. Detection of apical pathoses and jaw lesion segmentation improved accuracy, reducing diagnostic time. Cephalometric landmark identification showed increased accuracy, particularly for students. Soft tissue calcification detection improved accuracy, but sensitivity decreased. Overall, augmented intelligence enhanced interobserver agreement and reduced diagnostic variability, with general dentists and students showing the greatest gains.</div></div><div><h3>Conclusions</h3><div>Augmented intelligence enhances dental radiographic interpretation by improving tasks, particularly for less experienced clinicians, and positively influences clinical decision-making. However, AI performance remains inconsistent in challenging cases involving complex pathoses or varied imaging conditions. While it complements rather than replaces clinicians, further validation of AI's generalizability and reliability using larger, diverse datasets is necessary.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"140 2","pages":"Pages 237-250"},"PeriodicalIF":2.0,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jialu He MM , Xueer Zhou MM , Yilin Hu MM , Jinbo Zhou BS , Guiquan Zhu MD , Jian Pan MD
{"title":"Ultrasound-based deep learning to differentiate salivary gland tumors","authors":"Jialu He MM , Xueer Zhou MM , Yilin Hu MM , Jinbo Zhou BS , Guiquan Zhu MD , Jian Pan MD","doi":"10.1016/j.oooo.2025.03.014","DOIUrl":"10.1016/j.oooo.2025.03.014","url":null,"abstract":"<div><h3>Objective</h3><div>Accurate preoperative diagnosis is essential for selecting appropriate surgical interventions. This study aims to develop a deep learning model based on ultrasound (US) imaging to accurately differentiate between benign and malignant salivary gland tumors (SGTs).</div></div><div><h3>Study design</h3><div>A retrospective study was conducted on 315 patients who had preoperative US examinations and pathologically confirmed SGTs following surgical resection at our department (2020-2024). We included all three major salivary glands in our analysis, addressing class imbalance issues and expanding the scope of our study. US images were processed using several convolutional neural networks, including Inception v3, ResNet101d, EfficientNet, DenseNet, Vision Transformer, and ResNet50d. The ResNet50d model was fine-tuned using Focal Loss to further address class imbalance. The model's performance was compared with sonographers' diagnoses.</div></div><div><h3>Results</h3><div>DeepSGT effectively identified critical regions within US images, achieving great diagnostic performance with an accuracy of 91.1%, sensitivity of 92.9%, specificity of 89.2%, and an area under the curve (AUC) of 0.94. This performance significantly exceeded that of sonographers, who had an accuracy of 80% and an AUC of 0.73.</div></div><div><h3>Conclusions</h3><div>The DeepSGT model demonstrates superior diagnostic capabilities over traditional methods in distinguishing benign from malignant SGTs, offering a valuable tool for clinical decision-making.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"140 2","pages":"Pages 227-236"},"PeriodicalIF":2.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}