Automated Cephalometric Landmark Localization using a Coupled Shape Model

Cephalometric analysis is an important method in orthodontics for the diagnosis and treatment of patients. It is performed manually in clinical practice, therefore automation of this time consuming task would be of great assistance. In order to provide dentists with such tools, a robust and accurate identification of the necessary landmarks is required. However, poor image quality of lateral cephalograms like low contrast or noise make this task difficult. In this paper, an approach for automatic landmark localization is presented and used to find 19 landmarks in lateral cephalometric images. An initial predicting of the individual landmark locations is done by using a 2-D coupled shape model to utilize the spatial relation between landmarks and other anatomical structures. These predictions are refined with a Hough Forest to determine the final landmark location. The approach achieves competitive performance with a successful detection rate of 70.24% on 250 images for the clinically relevant 2mm accuracy range.