RT Journal Article T1 Multiclass classification of oral mucosal lesions by deep learning from clinical images without performing any restrictions A1 Redondo, Alejandro A1 Ivaylova, Katerina A1 Bachiller, Margarita A1 Rincón, Mariano A1 Cuadra, Jose Manuel A1 Tamimi, Faleh A1 López-Cedrún, Jose Luis A1 Diniz-Freitas, Márcio A1 Lago-Méndez, Lucía A1 Rubín-Roger, Guillermo A1 Torres García Denche, Jesús A1 Bagan, Leticia A1 Hernández Vallejo, Gonzalo A1 López-Pintor Muñoz, Rosa María AB Oral cancer is a frequently malignant tumor that can be detected during an oral examination. Unfortunately, it is often diagnosed in advanced stages, which leads to low survival rates of about 50% at five years. Due to the low survival rate, it is crucial to develop automated systems that allow the classification of oral lesions according to their severity, aiding in the early diagnosis of oral cancer.This study aims to investigate the effectiveness of using clinical images and deep learning based models to perform a multiclass classification of oral mucosal lesions in color photographs taken without following any acquisition protocol. The classification differentiated four classes: malignant, potentially malignant, benign and healthy. The dataset included a total of 3246 images from 1013 patients, with 40 different categories of oral lesions, including healthy oral mucosa. The images showed different areas of the oral cavity and were captured from different perspectives by diverse dentists and maxillofacial surgeons in the practice.For the classification, different deep learning architectures were applied and compared, from the best known convolutional neural networks (CNN) and skip connection networks (SCN), to more innovative architectures such as visual transformers and a recent hybrid architecture, ConvNeXt v2. The ConvNeXt v2 Tiny architecture, with 85.53% accuracy, 85.02% precision, 85.50% recall, 84.92% F1-score, and 97.40% ROC AUC for an input image size of 354 × 354 pixels, outperformed the other architectures on the same database. The present model improved on previous proposals by considering a greater number of oral lesions and output classes. PB Elsevier SN 1746-8094 YR 2025 FD 2025-07-18 LK https://hdl.handle.net/20.500.14352/123750 UL https://hdl.handle.net/20.500.14352/123750 LA eng NO Redondo A, Ivaylova K, Bachiller M, Rincón M, Cuadra JM, Tamimi F, López-Cedrún JL, Diniz-Freitas M, Lago-Méndez L, Rubín-Roger G, Torres J, Bagán L, Hernández G, López-Pintor RM. Multiclass classification of oral mucosal lesions by deep learning from clinical images without performing any restrictions. Biomedical Signal Processing and Control. 2026 En;111(108337) NO Instituto de Salud Carlos III co-funded by the European Union (PI22/00905) and Spanish Ministry of Science and Innovation (PID2019-110686RB-100) DS Docta Complutense RD 21 mar 2026