Comparative accuracy of artificial intelligence-based AudaxCeph software, Dolphin software, and the manual technique for orthodontic landmark identification and tracing of lateral cephalograms
	    		
		   		
		   			
		   		
	    	
    	- Author:
	        		
		        		
		        		
			        		Maryam FOROOZANDEH
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Fatemeh SALEMI
			        		
			        		;
		        		
		        		
		        		
			        		Abbas SHOKRI
			        		
			        		;
		        		
		        		
		        		
			        		Nasrin FARHADIAN
			        		
			        		;
		        		
		        		
		        		
			        		Nesa AEINI
			        		
			        		;
		        		
		        		
		        		
			        		Roghayyeh HASSANZADEH
			        		
			        		
		        		
		        		
		        		
			        		
			        		Author Information
			        		
 - Publication Type:Original Article
 - From:Imaging Science in Dentistry 2025;55(1):11-21
 - CountryRepublic of Korea
 - Language:English
 - 
		        	Abstract:
			       	
			       		
				        
				        	 Purpose:The aim of this study was to compare the accuracy of AI-based AudaxCeph software, Dolphin software, and the manual technique for identifying orthodontic landmarks and tracing lateral cephalograms. 
				        	
Materials and Methods:In this cross-sectional study, 23 anatomical landmarks were identified on 60 randomlyselected lateral cephalograms, and 5 dental indices, 4 skeletal indices, and 1 soft tissue index were measured. Each cephalogram was traced using 4 different methods: manually, with the Dolphin software, with the AudaxCeph software automatically, and with the AudaxCeph software in semi-automatic mode. The intra-class correlation coefficient (ICC) and Bland-Altman plots were used to evaluate the agreement between methods. Inter-observer and intra-observer agreements, calculated using the ICC, confirmed the accuracy, reliability, and reproducibility of the
results:.
Results:There was strong agreement among the AudexCeph (semi-automated or automated) AudaxCeph, Dolphin, and manual methods in measuring orthodontic indices, with ICC values consistently above 0.90. Bland-Altman plots confirmed satisfactory agreement between both versions of AudaxCeph (semi-automated and automated) with the manual method, with mean differences close to 0 and about 95% of data points within the limits of agreement.However, the semi-automated AudaxCeph showed greater agreement and precision than the automated version, as indicated by narrower limits of agreement. The ICC values for inter-observer and intra-observer agreements exceeded 0.98 and 0.99, respectively.
Conclusion:The semi-automated AudaxCeph software offers a robust and cost-effective solution for cephalometric analysis. Its high accuracy and affordability make it a compelling alternative to Dolphin software and the manual method. 
            