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. 2019 Jan;23(1):99-105.
doi: 10.1007/s00784-018-2414-1. Epub 2018 Mar 10.

Detection accuracy of maxillary sinus floor septa in panoramic radiographs using CBCT as gold standard: a multi-observer receiver operating characteristic (ROC) study

A C Lang  1 , R K Schulze  2
Affiliations

Detection accuracy of maxillary sinus floor septa in panoramic radiographs using CBCT as gold standard: a multi-observer receiver operating characteristic (ROC) study

A C Lang et al. Clin Oral Investig. 2019 Jan.

Abstract

Objectives: To investigate diagnostic accuracy of panoramic radiography in detecting maxillary sinus floor septa by means of a multi-observer receiver operating characteristic (ROC) analysis and a standardized protocol for reporting (STARD protocol; Clin Chem 49(1):1-6, 2003).

Material and methods: From our database, 25 cone beam computed tomographies (CBCTs) were selected with one maxillary sinus floor septum (height ≥ 2.5 mm). For the same patient, a recent panoramic radiograph (PAN) had to be available in the database. As controls, 28 CBCTs plus corresponding PANs without evidence of a sinus septum were selected. Using the CBCTs as ground truth, 17 observers from our dental school on a five-point confidence scale rated both sinuses in all 53 PANs with respect to presence/absence of a sinus septum. Areas beneath ROC curves (Az-values), sensitivity/specificity (SNT/SPF), positive/negative predictive values (PPV, NPV), and positive/negative likelihood ratios (LR+, LR-) were computed for each observer and pooled over all observers. Inter-rater reproducibility was assessed by means of the intraclass coefficient (ICC) using a two-way random effects model.

Results: A pooled Az-value of 0.839 was observed (SNT 84.6%, SPF 73.5%). PPV ranged between 0.492 and 0.824 (median 0.627) and NPV between 0.838 and 0.976 (median 0.917). A median LR+ of 3.567 was computed (LR- median 0.193). Inter-rater reliability revealed an ICC of 0.55 (95% confidence interval 0.48 to 0.62).

Conclusions: Our results indicate that PAN is a moderately accurate method for sinus elevation planning for the purpose of septum detection. Ruling out a septum by PAN seems to work more accurately than ruling in.

Clinical relevance: For the purpose of maxillary sinus floor septa detection, panoramic radiography can be relatively safely advocated, particularly for judgment of a septum-free sinus.

Keywords: CBCT; Diagnostic accuracy; Maxillary sinus septa; Panoramic radiography; ROC analysis.

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References

    1. J Oral Maxillofac Surg. 1999 Jun;57(6):667-71; discussion 671-2 - PubMed
    1. Clin Chem. 2003 Jan;49(1):1-6 - PubMed
    1. J Clin Epidemiol. 2005 Aug;58(8):859-62 - PubMed
    1. J Periodontol. 2006 May;77(5):903-8 - PubMed
    1. J Am Coll Radiol. 2004 Feb;1(2):127-32 - PubMed

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