LM-PCVMNet: Pediatric Cervical Vertebral Maturation Analysis with Deep Fusion of Landmarks and Metadata

Cervical vertebral maturation (CVM) assessment plays a pivotal role in orthodontic diagnosis and determining the optimal timing of treatment, especially for pediatric patients. In this paper, we propose LM-PCVMNet, a novel deep learning framework for automatic pediatric CVM staging. Specifically, our method integrates vertebral anatomical landmark information, heatmap-guided feature modulation, and metadata-informed similarity modeling into a unified learning framework. We introduce a heatmap-guided feature modulation module that enhances feature extraction by leveraging landmark-centered heatmaps to highlight morphologically relevant vertebral regions. A vertebral landmark-prompting block is designed to incorporate anatomical geometry into the representation learning process. Furthermore, we develop a learnable metadata supervised contrastive loss that adaptively modulates positive-pair similarity based on metadata similarity, enabling the model to learn more biologically consistent and discriminative features. To facilitate further research in pediatric orthodontic treatment, we additionally release PCVM+. It contains 1800 lateral cephalometric radiographs from real-world patients aged 3-15 years, with expert-annotated CVM stages, 13 vertebral anatomical landmarks, and corresponding metadata. We perform comprehensive experiments on two datasets, and the results show that our method achieves state-of-the-art performance, effectively improving landmark localization and classification accuracy over existing models. Code and dataset will be available at github.com/ybupengwang/LM-PCVMNet.