DENTOMAXILLOFACIAL RADIOLOGY, 2025 (SCI-Expanded, Scopus)
Objectives Precise 3D segmentation of paranasal sinuses is essential for accurate diagnosis and treatment. This study aimed to develop a fully automated segmentation algorithm for the paranasal sinuses using the nnU-Net v2 architecture.Methods The nnU-Net v2-based segmentation algorithm was developed using Python 3.6.1 and the PyTorch library, and its performance was evaluated on a dataset of 97 cone beam CT (CBCT) scans. Ground truth annotations were manually generated by expert radiologists using the 3D Slicer software, employing a polygonal labelling technique across sagittal, coronal, and axial planes. Model performance was assessed using several quantitative metrics, including accuracy, Dice coefficient (DC), sensitivity, precision, Jaccard index, area under the curve (AUC), and 95% Hausdorff distance (95% HD).Results The nnU-Net v2-based algorithm demonstrated high segmentation performance across all paranasal sinuses. DC values were 0.94 for the frontal, 0.95 for the sphenoid, 0.97 for the maxillary, and 0.88 for the ethmoid sinuses. Accuracy scores exceeded 99% for all sinuses. The 95% HD values were 0.51 mm for both the frontal and maxillary sinuses, 0.85 mm for the sphenoid sinus, and 1.17 mm for the ethmoid sinus. Jaccard indices were 0.90, 0.91, 0.94, and 0.80, respectively.Conclusions This study highlights the high accuracy and precision of the nnU-Net v2-based CNN model in the fully automated segmentation of paranasal sinuses from CBCT images. The results suggest that the proposed model can significantly contribute to clinical decision-making processes, facilitating diagnostic and therapeutic procedures.