Wei-Yu Mao1,2,3,4, Jie Lei1,2,3,4, Li Zhen Lim5,6, Yan Gao2,3,4,7, Donald A Tyndall6, Kaiyuan Fu1,2,3,4. 1. Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing, China. 2. National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China. 3. National Clinical Research Center for Oral Diseases, Beijing, China. 4. Beijing Key Laboratory of Digital Stomatology, Beijing, China. 5. Discipline of Oral & Maxillofacial Surgery, Faculty of Dentistry, National University of Singapore, Singapore, Singapore. 6. Department of Diagnostic Sciences, University of North Carolina at Chapel Hill Adams School of Dentistry, Chapel Hill, NC, USA. 7. Department of Oral Pathology, Peking University School & Hospital of Stomatology, Beijing, China.
Abstract
OBJECTIVE: To investigate the differences in imaging characteristics and the diagnostic accuracy of 225 intraosseous jaw lesions on panoramic radiographs (PAN) versus cone beam computed tomography (CBCT). METHODS: 225 sets of PAN and CBCT images with biopsy-proven histopathological diagnoses were retrospectively compared in terms of radiographic features and diagnostic accuracy. The imaging characteristics of PAN and CBCT were independently evaluated by two oral and maxillofacial radiologists who were required to answer 12 questions and provided up to three differential diagnoses with their confidence scores. RESULTS: Odds ratios (ORs) were statistically significant for border cortication (OR = 1.521; p = .003) and border continuity (OR = 0.421; p = .001), involvement on neurovascular canals (OR = 2.424; p < .001), expansion (OR = 7.948; p < .001), cortical thinning (OR = 20.480; p < .001) as well as its destruction (OR = 25.022; p < .001) and root resorption (OR = 2.477; p < .001). Furthermore, imaging features in the posterior and mandibular regions showed better agreement than those in the anterior and maxillary regions, respectively. The diagnostic accuracy of the first differential diagnosis was higher on CBCT than on PAN (Observer 1:78.7 vs 64.4%; Observer 2: 78.7 vs 70.2% (p < .001)). The observers' confidence scores were also higher at CBCT interpretation compared with PAN. CONCLUSIONS: CBCT demonstrated a greater number of imaging characteristics of intraosseous jaw lesions compared with PAN, especially in the anterior regions of both jaws and in the maxilla. Diagnostic accuracy is improved with CBCT compared to PAN, especially for lesions in the maxilla. Radiologists have greater confidence when using CBCT.
OBJECTIVE: To investigate the differences in imaging characteristics and the diagnostic accuracy of 225 intraosseous jaw lesions on panoramic radiographs (PAN) versus cone beam computed tomography (CBCT). METHODS: 225 sets of PAN and CBCT images with biopsy-proven histopathological diagnoses were retrospectively compared in terms of radiographic features and diagnostic accuracy. The imaging characteristics of PAN and CBCT were independently evaluated by two oral and maxillofacial radiologists who were required to answer 12 questions and provided up to three differential diagnoses with their confidence scores. RESULTS: Odds ratios (ORs) were statistically significant for border cortication (OR = 1.521; p = .003) and border continuity (OR = 0.421; p = .001), involvement on neurovascular canals (OR = 2.424; p < .001), expansion (OR = 7.948; p < .001), cortical thinning (OR = 20.480; p < .001) as well as its destruction (OR = 25.022; p < .001) and root resorption (OR = 2.477; p < .001). Furthermore, imaging features in the posterior and mandibular regions showed better agreement than those in the anterior and maxillary regions, respectively. The diagnostic accuracy of the first differential diagnosis was higher on CBCT than on PAN (Observer 1:78.7 vs 64.4%; Observer 2: 78.7 vs 70.2% (p < .001)). The observers' confidence scores were also higher at CBCT interpretation compared with PAN. CONCLUSIONS: CBCT demonstrated a greater number of imaging characteristics of intraosseous jaw lesions compared with PAN, especially in the anterior regions of both jaws and in the maxilla. Diagnostic accuracy is improved with CBCT compared to PAN, especially for lesions in the maxilla. Radiologists have greater confidence when using CBCT.
Authors: Andrea Borghesi; Cosimo Nardi; Caterina Giannitto; Andrea Tironi; Roberto Maroldi; Francesco Di Bartolomeo; Lorenzo Preda Journal: Insights Imaging Date: 2018-07-31