Sarah Constantine1, Bruce Clark2, Andreas Kiermeier3, Professor Peter Anderson4. 1. Clinical Senior Lecturer, University of Adelaide, Faculty of Health Sciences, Adelaide, SA, Australia; South Australian Dental Service, Adelaide Dental Hospital, University of Adelaide Health and Medical Sciences Building, Adelaide, SA, Australia; Queen Elizabeth Hospital, Department of Radiology, Woodville South, SA, Australia; Women's and Children's Hospital, Department of Medical Imaging, North Adelaide, SA, Australia. Electronic address: sconstantine@internode.on.net. 2. Retired Craniomaxillofacial Radiologist, Women's and Children's Hospital, Department of Medical Imaging, North Adelaide, SA, Australia. 3. Director, Statistical Process Improvement Consulting and Training Pty Ltd., Statistical Process Improvement Consulting and Training Pty Ltd, Gumeracha, SA, Australia. 4. Director of Research, Australian Craniofacial Unit, Women's and Children's Hospital, Australian Craniofacial Unit, Women's and Children's Hospital, North Adelaide, SA, Australia.
Abstract
OBJECTIVES: The aim of this study was to determine (1) the diagnostic efficacy of orthopantomography (OPG) in the diagnosis of sinus diseases by using cone beam computed tomography (CBCT) as the imaging gold standard, (2) which diseases can be diagnosed by using panoramic radiography or CBCT, and (3) the interobserver agreement of 2 experienced dental radiologists. STUDY DESIGN: The images of 714 individuals who underwent OPG and CBCT on the same day were assessed separately by 2 dental radiologists. The results were compared by using Gwet's AC1 statistical methods. RESULTS: In total, 1322 maxillary sinuses were imaged. The sensitivity of OPG for the detection of any maxillary sinus pathology was poor compared with CBCT, but the specificity was high. The sensitivity of OPG for detecting mucosal thickening was 36.7%. The positive predictive value of OPG for diagnosing mucosal thickening was 79.9 %, but the negative predictive value was 51.9%. Interobserver agreement was strong (≥0.912) for all lesions except mucosal thickening. CONCLUSIONS: Panoramic imaging has low efficacy in the diagnosis of sinus disease, even when examined by experienced dental radiologists. OPG can be useful in excluding disease, but 3-dimensional scanning is necessary for the definitive investigation of sinus lesions.
OBJECTIVES: The aim of this study was to determine (1) the diagnostic efficacy of orthopantomography (OPG) in the diagnosis of sinus diseases by using cone beam computed tomography (CBCT) as the imaging gold standard, (2) which diseases can be diagnosed by using panoramic radiography or CBCT, and (3) the interobserver agreement of 2 experienced dental radiologists. STUDY DESIGN: The images of 714 individuals who underwent OPG and CBCT on the same day were assessed separately by 2 dental radiologists. The results were compared by using Gwet's AC1 statistical methods. RESULTS: In total, 1322 maxillary sinuses were imaged. The sensitivity of OPG for the detection of any maxillary sinus pathology was poor compared with CBCT, but the specificity was high. The sensitivity of OPG for detecting mucosal thickening was 36.7%. The positive predictive value of OPG for diagnosing mucosal thickening was 79.9 %, but the negative predictive value was 51.9%. Interobserver agreement was strong (≥0.912) for all lesions except mucosal thickening. CONCLUSIONS: Panoramic imaging has low efficacy in the diagnosis of sinus disease, even when examined by experienced dental radiologists. OPG can be useful in excluding disease, but 3-dimensional scanning is necessary for the definitive investigation of sinus lesions.