# Structure-Aware Long Short-Term Memory Network for 3D Cephalometric Landmark Detection

arXiv: https://arxiv.org/abs/2107.09899 · HTML: https://mlsanity.com/paper/2107.09899/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Builds on 14 of its 45 references that are in the map.
- First posted on arXiv 21 Jul 2021.

## Builds on (most cited first, 14 of 14)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Adam: A Method for Stochastic Optimization](https://mlsanity.com/paper/1412.6980/) (2014)
- [Graph Attention Networks](https://mlsanity.com/paper/1710.10903/) (2017)
- [End-to-End Object Detection with Transformers](https://mlsanity.com/paper/2005.12872/) (2020)
- [3D U-Net: Learning Dense Volumetric Segmentation from Sparse Annotation](https://mlsanity.com/paper/1606.06650/) (2016)
- [A Survey on Deep Learning in Medical Image Analysis](https://mlsanity.com/paper/1702.05747/) (2017)
- [Transformers in Vision: A Survey](https://mlsanity.com/paper/2101.01169/) (2021)
- [Attention Gated Networks: Learning to Leverage Salient Regions in Medical Images](https://mlsanity.com/paper/1808.08114/) (2018)
- [Integrating Spatial Configuration into Heatmap Regression Based CNNs for Landmark Localization](https://mlsanity.com/paper/1908.00748/) (2019)
- [Medical Image Segmentation Using Squeeze-and-Expansion Transformers](https://mlsanity.com/paper/2105.09511/) (2021)
- [Cephalometric Landmark Detection by AttentiveFeature Pyramid Fusion and Regression-Voting](https://mlsanity.com/paper/1908.08841/) (2019)
- [An Attention-Guided Deep Regression Model for Landmark Detection in Cephalograms](https://mlsanity.com/paper/1906.07549/) (2019)
- [Semi-supervised Anatomical Landmark Detection via Shape-regulated Self-training](https://mlsanity.com/paper/2105.13593/) (2021)
- [Deep Geodesic Learning for Segmentation and Anatomical Landmarking](https://mlsanity.com/paper/1810.04021/) (2018)

## Built on by (most cited first, 2 of 2)

- [nnLandmark: A Self-Configuring Method for 3D Medical Landmark Detection](https://mlsanity.com/paper/2504.06742/) (2025)
- [Aortic root landmark localization with optimal transport loss for heatmap regression](https://mlsanity.com/paper/2407.04921/) (2024)

## Abstract (arXiv)

Detecting 3D landmarks on cone-beam computed tomography (CBCT) is crucial to assessing and quantifying the anatomical abnormalities in 3D cephalometric analysis. However, the current methods are time-consuming and suffer from large biases in landmark localization, leading to unreliable diagnosis results. In this work, we propose a novel Structure-Aware Long Short-Term Memory framework (SA-LSTM) for efficient and accurate 3D landmark detection. To reduce the computational burden, SA-LSTM is designed in two stages. It first locates the coarse landmarks via heatmap regression on a down-sampled CBCT volume and then progressively refines landmarks by attentive offset regression using multi-resolution cropped patches. To boost accuracy, SA-LSTM captures global-local dependence among the cropping patches via self-attention. Specifically, a novel graph attention module implicitly encodes the landmark's global structure to rationalize the predicted position. Moreover, a novel attention-gated module recursively filters irrelevant local features and maintains high-confident local predictions for aggregating the final result. Experiments conducted on an in-house dataset and a public dataset show that our method outperforms state-of-the-art methods, achieving 1.64 mm and 2.37 mm average errors, respectively. Furthermore, our method is very efficient, taking only 0.5 seconds for inferring the whole CBCT volume of resolution 768×768×576.