Oral and Maxillofacial Radiology Department, Faculty of Oral and Dental Medicine, Cairo University, 11, El Saraya St., Almanyal, Cairo, 11553, Egypt.
Oral Radiol. 2021 Jul;37(3):427-435. doi: 10.1007/s11282-020-00474-7. Epub 2020 Aug 16.
The purpose of the present study was to assess the diagnostic accuracy of low-dose cone-beam computed tomography (CBCT) in the detection of simulated mandibular condyle erosions.
102 simulated erosions were performed on the condyles of eight dry human mandibles. Each mandible was subjected to four CBCT scan protocols: high-definition (HD), normal definition (NORM), ultra-low-dose high-definition (ULD-HD), and ultra-low-dose normal definition (ULD-NORM). All scans were analyzed by two observers. The inter-observer and intra-observer agreement as well as the agreement with the gold standard were assessed. The sensitivity, specificity, positive-predictive value, negative-predictive value and accuracy of erosion detection were calculated.
A substantial to almost perfect agreement with the gold standard was found regarding the HD protocol and substantial agreement in NORM and ULD-HD protocols; however, moderate agreement was found regarding the ULD-NORM protocol. The sensitivity, specificity and accuracy values were highest for the HD protocol followed by the NORM and ULD-HD which showed comparable results; while, the ULD-NORM protocol showed the least values.
The studied ULD-HD CBCT protocol can be recommended for the detection of mandibular condylar erosions due to the reduced radiation dose; however, ULD-NORM is not advocated for similar clinical use.
本研究旨在评估低剂量锥形束 CT（CBCT）在检测模拟下颌髁突侵蚀中的诊断准确性。
在 8 个干燥的人下颌骨的髁突上进行了 102 个模拟侵蚀。每个下颌骨接受四种 CBCT 扫描方案：高清（HD）、标准定义（NORM）、超低剂量高清（ULD-HD）和超低剂量标准定义（ULD-NORM）。所有扫描均由两位观察者进行分析。评估了观察者间和观察者内的一致性以及与金标准的一致性。计算了侵蚀检测的敏感性、特异性、阳性预测值、阴性预测值和准确性。
HD 方案与金标准具有实质性到几乎完美的一致性，NORM 和 ULD-HD 方案具有实质性一致性；然而，ULD-NORM 方案则显示出中度一致性。HD 方案的敏感性、特异性和准确性最高，其次是 NORM 和 ULD-HD，结果相当；而 ULD-NORM 方案则显示出最低的值。
由于辐射剂量降低，研究中的 ULD-HD CBCT 方案可推荐用于检测下颌髁突侵蚀；然而，不建议将 ULD-NORM 用于类似的临床用途。
