Cross-domain generalization of deep learning architectures for cephalometric landmark detection: A dual-dataset and multi-device benchmark

dc.authorid0009-0005-3767-7415
dc.authorid0009-0008-8331-9493
dc.contributor.authorAllaf, Ferdi
dc.contributor.authorÖzcan, Mustafa
dc.date.accessioned2026-10-22T16:55:48Z
dc.date.available2026-10-22T16:55:48Z
dc.date.issued2026
dc.departmentFakülteler, Diş Hekimliği Fakültesi, Klinik Bilimler Bölümü, Ortodonti Ana Bilim Dalı
dc.description.abstractBackground/Objectives: Deep learning models for cephalometric landmark detection report near-ceiling accuracy on single benchmarks, yet most are trained and tested on the same dataset. Whether the best in-domain architecture remains best out-of-domain has not been systematically quantified. Methods: Four architecture families (heatmap CNN, two-stage cascade, coordinate-regression Vision Transformer, pretrained ResNet-50) were each trained on two independently sourced datasets—ISBI 2015 (400 images, one device) and Aariz (1000 images, seven devices)—and evaluated on both, over their 19 shared landmarks in millimeters. All axes used three seeds (mean ± SD): the cross-dataset matrix, leave-one-device-out shift, balanced joint training, a pretrained-versus-scratch ablation, and a landmark-level breakdown. Results: In-domain mean radial error (MRE) was 2.47–3.04 mm (Aariz) and 4.12–5.55 mm (ISBI); cross-dataset error rose steeply (Generalization Drop—the relative increase in error out-of-domain—155–426%). The most accurate model in-domain (a from-scratch heatmap CNN, 2.47 mm) showed the largest drop, and every pretrained estimate fell below every from-scratch estimate (family means 248% vs. 380%): in-domain ranking did not predict cross-domain ranking. Leave-one-device-out revealed reproducible device-specific shift (held-out MRE 1.89–7.94 mm). Inter-observer variability was 0.53 mm, so cross-domain errors were 15–44× the human band. Balanced joint training reduced the cross-domain gap for all four architectures (both domains ≈ 2.1–3.5 mm) without harming in-domain accuracy. Pretraining more than halved cross-domain error from Aariz to ISBI (7.73 vs. 16.36 mm) but not in reverse, supporting the mechanism in one direction rather than uniformly. A-point, B-point, Nasion, and Menton all exceeded the 2 mm clinical threshold out-of-domain, including points localized to sub-millimeter accuracy in-domain. Conclusions: Single-dataset accuracy substantially overstates clinical generalizability, and the best in-domain architecture is not the most transferable, so in-domain leaderboards are an unreliable basis for selecting a model for clinical deployment; balanced multi-source training recovers most of the loss across the architectures tested.
dc.identifier.citationAllaf, F., & Özcan, M. (2026). Cross-domain generalization of deep learning architectures for cephalometric landmark detection: A dual-dataset and multi-device benchmark. Diagnostics, 16(17), pp. 1-18. https://doi.org/10.3390/diagnostics16172726
dc.identifier.doi10.3390/diagnostics16172726
dc.identifier.endpage18
dc.identifier.issn2075-4418
dc.identifier.issue17
dc.identifier.pmidPMID: 42739157
dc.identifier.scopus2-s2.0-105050356358
dc.identifier.scopusqualityQ1
dc.identifier.startpage1
dc.identifier.urihttps://doi.org/10.3390/diagnostics16172726
dc.identifier.urihttps://hdl.handle.net/20.500.13055/1678
dc.identifier.volume16
dc.identifier.wosWOS:001873259000001
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.indekslendigikaynak.otherSCI-E - Science Citation Index Expanded
dc.institutionauthorAllaf, Ferdi
dc.institutionauthorÖzcan, Mustafa
dc.institutionauthorid0009-0005-3767-7415
dc.institutionauthorid0009-0008-8331-9493
dc.language.isoen
dc.publisherMDPI Publishing
dc.relation.ispartofDiagnostics
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectCephalometry
dc.subjectAnatomic Landmarks
dc.subjectOrthodontics
dc.subjectDomain Shift
dc.subjectCross-Device Generalization
dc.subjectExternal Validation
dc.subjectBenchmarking
dc.titleCross-domain generalization of deep learning architectures for cephalometric landmark detection: A dual-dataset and multi-device benchmark
dc.typeArticle
dspace.entity.typePublication

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