Tyndall D A, Clifton T L, Webber R L, Ludlow J B, Horton R A
Department of Diagnostic Sciences, University of North Carolina, School of Dentistry, Chapel Hill, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997 Aug;84(2):214-25. doi: 10.1016/s1079-2104(97)90072-x.
Tuned-aperture computed tomography, a new method for creating 3-D radiographic information based on optical aperture theory, was evaluated for diagnostic efficacy in primary caries detection.
Sixty-four extracted teeth with 89 carious lesions were imaged with D-speed film, direct digital, and TACT modalities. A commercially available, 8-bit, charge-coupled device was used in the later two modalities. Six trained observers were asked to identify the presence or absence and depth of interproximal and occlusal lesions for all three modalities. The teeth were sectioned and examined microscopically to determine ground truth. Logistic regression analysis was performed for all three imaging systems for the detection task. Analysis of variance was used for depth determination. Detection of lesion, depth of lesion accuracy, and time for diagnosis were also examined.
For caries detection TACT and film were not different (p = 0.2216) with the Wald statistic. Film and TACT were significantly more accurate than the digital system (p = 0.0001). Scheffe's post hoc test revealed that TACT and film were more accurate than the direct digital system for determining lesion depth (p = 0.05) but not statistically different when compared with each other. The detection data were substantiated further by receiver operating characteristic analysis that demonstrated similar statistical relationships. Time required per diagnosis was not shown to be statistically different among the three imaging modalities.
We conclude for caries detection and depth determination that TACT could not be distinguished from film despite the significant relative loss of information capacity in the charge-coupled device receptor. The relatively poorer performance yielded by the digital control images suggests that increased information capacity associated with more modern charge-coupled device detectors may improve diagnostic performance for both direct digital and TACT displays over that demonstrated in this investigation.
调孔计算机断层扫描是一种基于光学孔径理论创建三维放射影像信息的新方法，本研究对其在原发性龋齿检测中的诊断效能进行评估。
用D速胶片、直接数字化成像和调孔计算机断层扫描（TACT）模式对64颗拔除的牙齿（共89处龋损）进行成像。后两种模式使用市售的8位电荷耦合器件。6名经过培训的观察者被要求识别所有三种模式下邻面和咬合面龋损的有无及深度。将牙齿切片并进行显微镜检查以确定实际情况。对所有三种成像系统的检测任务进行逻辑回归分析。采用方差分析确定龋损深度。还检查了龋损的检测、龋损深度准确性和诊断时间。
在龋齿检测方面，TACT和胶片成像无差异（p = 0.2216，Wald统计量）。胶片成像和TACT成像比数字系统显著更准确（p = 0.0001）。谢费尔事后检验显示，在确定龋损深度方面，TACT和胶片成像比直接数字系统更准确（p = 0.05），但两者之间无统计学差异。接受者操作特征分析进一步证实了检测数据，显示出相似的统计关系。三种成像模式下每次诊断所需时间无统计学差异。
我们得出结论，在龋齿检测和深度确定方面，尽管电荷耦合器件接收器的信息容量有显著相对损失，但TACT成像与胶片成像无法区分。数字控制图像相对较差的性能表明，与更现代的电荷耦合器件探测器相关的信息容量增加可能会提高直接数字成像和TACT成像的诊断性能，超过本研究中的表现。
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