The Journal of International
Advanced Otology
Original Article

A Computer Vision Algorithm to Classify Pneumatization of the Mastoid Process on Temporal Bone Computed Tomography Scans


University of Sydney, Faculty of Medicine and Health, New South Wales, Australia


Department of Otolaryngology – Head and Neck Surgery, Westmead Hospital, New South Wales, Australia


Department of Otolaryngology Royal Children’s Hospital Melbourne, Victoria, Australia


Monash University, Faculty of Medicine, Nursing and Health Sciences, Victoria, Australia


University of Notre Dame, Faculty of Medicine, New South Wales, Australia


Department of Otolaryngology - Head and Neck Surgery, Concord Hospital, New South Wales, Australia

J Int Adv Otol 2023; 19: 217-222
DOI: 10.5152/iao.2023.22958
Read: 684 Downloads: 369 Published: 01 May 2023

BACKGROUND: Pneumatization of the mastoid process is variable and of significance to the operative surgeon. Surgical approaches to the temporal bone require an understanding of pneumatization and its implications for surgical access. This study aims to determine the feasibility of using deep learning convolutional neural network algorithms to classify pneumatization of the mastoid process.

METHODS: De-identified petrous temporal bone images were acquired from a tertiary hospital radiology picture archiving and communication system. A binary classification mode in the pretrained convolutional neural network was used to investigate the utility of convolutional neural networks in temporal bone imaging. False positive and negative images were reanalyzed by the investigators and qualitatively assessed to consider reasons for inaccuracy.

RESULTS: The overall accuracy of the model was 0.954. At a probability threshold of 65%, the sensitivity of the model was 0.860 (95% CI 0.783-0.934) and the specificity was 0.989 (95% CI 0.960-0.999). The positive predictive value was 0.973 (95% CI 0.904-0.993) and the negative predictive value was 0.935 (95% CI 0.901-0.965). The false positive rate was 0.006. The F1 number was 0.926 demonstrating a high accuracy for the model.

CONCLUSION: The temporal bone is a complex anatomical region of interest to otolaryngologists. Surgical planning requires high-resolution computed tomography scans, the interpretation of which can be augmented with machine learning. This initial study demonstrates the feasibility of utilizing machine learning algorithms to discriminate anatomical variation with a high degree of accuracy. It is hoped this will lead to further investigation regarding more complex anatomical structures in the temporal bone.

Cite this article as: Hasan Z, Lee M, Chen F, et al. A computer vision algorithm to classify pneumatization of the mastoid process on temporal bone computed tomography scans. J Int Adv Otol. 2023;19(3):217-222.

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