Knowledge Distillation Approach for SOS Fusion Staging: Towards Fully Automated Skeletal Maturity Assessment

We introduce a novel deep learning framework for the automated staging of spheno-occipital synchondrosis (SOS) fusion, a critical diagnostic marker in both orthodontics and forensic anthropology. Our approach leverages a dual-model architecture wherein a teacher model, trained on manually cropped images, transfers its precise spatial understanding to a student model that operates on full, uncropped images. This knowledge distillation is facilitated by a newly formulated loss function that aligns spatial logits as well as incorporates gradient-based attention spatial mapping, ensuring that the student model internalizes the anatomically relevant features without relying on external cropping or YOLO-based segmentation. By leveraging expert-curated data and feedback at each step, our framework attains robust diagnostic accuracy, culminating in a clinically viable end-to-end pipeline. This streamlined approach obviates the need for additional pre-processing tools and accelerates deployment, thereby enhancing both the efficiency and consistency of skeletal maturation assessment in diverse clinical settings.

Gradient Attention Map Based Verification of Deep Convolutional Neural Networks with Application to X-ray Image Datasets

Deep learning models have great potential in medical imaging, including orthodontics and skeletal maturity assessment. However, applying a model to data different from its training set can lead to unreliable predictions that may impact patient care. To address this, we propose a comprehensive verification framework that evaluates model suitability through multiple complementary strategies. First, we introduce a Gradient Attention Map (GAM)-based approach that analyzes attention patterns using Grad-CAM and compares them via similarity metrics such as IoU, Dice Similarity, SSIM, Cosine Similarity, Pearson Correlation, KL Divergence, and Wasserstein Distance. Second, we extend verification to early convolutional feature maps, capturing structural mis-alignments missed by attention alone. Finally, we incorporate an additional garbage class into the classification model to explicitly reject out-of-distribution inputs. Experimental results demonstrate that these combined methods effectively identify unsuitable models and inputs, promoting safer and more reliable deployment of deep learning in medical imaging.