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. 2009 Feb;107(2):256-65.
doi: 10.1016/j.tripleo.2008.05.039. Epub 2008 Aug 20.

Observer reliability of three-dimensional cephalometric landmark identification on cone-beam computerized tomography

Ana Emilia F de Oliveira  1 , Lucia Helena S Cevidanes, Ceib Phillips, Alexandre Motta, Brandon Burke, Donald Tyndall
Affiliations

Observer reliability of three-dimensional cephalometric landmark identification on cone-beam computerized tomography

Ana Emilia F de Oliveira et al. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Feb.

Abstract

Objective: To evaluate reliability in 3-dimensional (3D) landmark identification using cone-beam computerized tomography (CBCT).

Study design: Twelve presurgery CBCTs were randomly selected from 159 orthognathic surgery patients. Three observers independently repeated 3 times the identification of 30 landmarks in the sagittal, coronal, and axial slices. A mixed-effects analysis of variance model estimated the intraclass correlations (ICC) and assessed systematic bias.

Results: The ICC was >0.9 for 86% of intraobserver assessments and 66% of interobserver assessments. Only 1% of intraobserver and 3% of interobserver coefficients were <0.45. The systematic difference among observers was greater in X and Z than in Y dimensions, but the maximum mean difference was quite small.

Conclusion: Overall, the intra- and interobserver reliability was excellent. Three-dimensional landmark identification using CBCT can offer consistent and reproducible data if a protocol for operator training and calibration is followed. This is particularly important for landmarks not easily specified in all 3 planes of space.

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Figures

Figure 1
Figure 1
Example of identification of A point landmark in the 3 planes of space. The software allows tracking of the cursor with display of all 3 planes of space, and 3D rendering in the same software window to verify landmark location.
Figure 2
Figure 2
Selection of one plane window display to improve visualization for careful landmark location at each plane at a time. This example displays selection of the axial view in zoom to aid identification of the lateral pole of the left condyle.
Figure 3
Figure 3
Landmarks displayed in the 3D rendering. Note that landmark locations appear distorted for landmarks located away from the center of the projected rendered view.
See this image and copyright information in PMC

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