# Deep Learning Techniques for Automatic Lateral X-ray Cephalometric Landmark Detection: Is the Problem Solved?

arXiv: https://arxiv.org/abs/2409.15834 · HTML: https://mlsanity.com/paper/2409.15834/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 26 of its 70 references that are in the map.
- First posted on arXiv 24 Sep 2024.

## Builds on (most cited first, 26 of 26)

- [PyTorch: An Imperative Style, High-Performance Deep Learning Library](https://mlsanity.com/paper/1912.01703/) (2019)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Very Deep Convolutional Networks for Large-Scale Image Recognition](https://mlsanity.com/paper/1409.1556/) (2014)
- [EfficientNet: Rethinking Model Scaling for Convolutional Neural Networks](https://mlsanity.com/paper/1905.11946/) (2019)
- [MobileNets: Efficient Convolutional Neural Networks for Mobile Vision Applications](https://mlsanity.com/paper/1704.04861/) (2017)
- [Xception: Deep Learning with Depthwise Separable Convolutions](https://mlsanity.com/paper/1610.02357/) (2016)
- [V-Net: Fully Convolutional Neural Networks for Volumetric Medical Image Segmentation](https://mlsanity.com/paper/1606.04797/) (2016)
- [Deep High-Resolution Representation Learning for Visual Recognition](https://mlsanity.com/paper/1908.07919/) (2019)
- [MMDetection: Open MMLab Detection Toolbox and Benchmark](https://mlsanity.com/paper/1906.07155/) (2019)
- [Instance Normalization: The Missing Ingredient for Fast Stylization](https://mlsanity.com/paper/1607.08022/) (2016)
- [Multi-Scale Context Aggregation by Dilated Convolutions](https://mlsanity.com/paper/1511.07122/) (2015)
- [PVT v2: Improved Baselines with Pyramid Vision Transformer](https://mlsanity.com/paper/2106.13797/) (2021)
- [An Introduction to Convolutional Neural Networks](https://mlsanity.com/paper/1511.08458/) (2015)
- [Distribution-Aware Coordinate Representation for Human Pose Estimation](https://mlsanity.com/paper/1910.06278/) (2019)
- [Adaptive Wing Loss for Robust Face Alignment via Heatmap Regression](https://mlsanity.com/paper/1904.07399/) (2019)
- [Methods and open-source toolkit for analyzing and visualizing challenge results](https://mlsanity.com/paper/1910.05121/) (2019)
- [BIAS: Transparent reporting of biomedical image analysis challenges](https://mlsanity.com/paper/1910.04071/) (2019)
- [Human Pose Regression by Combining Indirect Part Detection and Contextual Information](https://mlsanity.com/paper/1710.02322/) (2017)
- [Structured Landmark Detection via Topology-Adapting Deep Graph Learning](https://mlsanity.com/paper/2004.08190/) (2020)
- [Cephalometric Landmark Detection by AttentiveFeature Pyramid Fusion and Regression-Voting](https://mlsanity.com/paper/1908.08841/) (2019)
- [You Only Learn Once: Universal Anatomical Landmark Detection](https://mlsanity.com/paper/2103.04657/) (2021)
- [Efficient automatic segmentation for multi-level pulmonary arteries: The PARSE challenge](https://mlsanity.com/paper/2304.03708/) (2023)
- [An Attention-Guided Deep Regression Model for Landmark Detection in Cephalograms](https://mlsanity.com/paper/1906.07549/) (2019)
- [Learn Fine-grained Adaptive Loss for Multiple Anatomical Landmark Detection in Medical Images](https://mlsanity.com/paper/2105.09124/) (2021)
- [Revisiting Cephalometric Landmark Detection from the view of Human Pose Estimation with Lightweight Super-Resolution Head](https://mlsanity.com/paper/2309.17143/) (2023)
- [Locating Cephalometric X-Ray Landmarks with Foveated Pyramid Attention](https://mlsanity.com/paper/2008.04428/) (2020)

## Built on by (most cited first, 1 of 1)

- [Towards Generalist Intelligence in Dentistry: Vision Foundation Models for Oral and Maxillofacial Radiology](https://mlsanity.com/paper/2510.14532/) (2025)

## Abstract (arXiv)

Localization of the craniofacial landmarks from lateral cephalograms is a fundamental task in cephalometric analysis. The automation of the corresponding tasks has thus been the subject of intense research over the past decades. In this paper, we introduce the "Cephalometric Landmark Detection (CL-Detection)" dataset, which is the largest publicly available and comprehensive dataset for cephalometric landmark detection. This multi-center and multi-vendor dataset includes 600 lateral X-ray images with 38 landmarks acquired with different equipment from three medical centers. The overarching objective of this paper is to measure how far state-of-the-art deep learning methods can go for cephalometric landmark detection. Following the 2023 MICCAI CL-Detection Challenge, we report the results of the top ten research groups using deep learning methods. Results show that the best methods closely approximate the expert analysis, achieving a mean detection rate of 75.719% and a mean radial error of 1.518 mm. While there is room for improvement, these findings undeniably open the door to highly accurate and fully automatic location of craniofacial landmarks. We also identify scenarios for which deep learning methods are still failing. Both the dataset and detailed results are publicly available online, while the platform will remain open for the community to benchmark future algorithm developments at https://cl-detection2023.grand-challenge.org/.