The Detection of Simulated Periapical Lesions in Human Dry Mandibles with Cone Beam Computed Tomography - A Dose Reduction Study
International Endodontic Journal
Abstract
Aim
To assess in an ex vivo model the accuracy of detection of simulated periapical lesions using two CBCT dose modes and periapical radiography.
Methodology
Small
and large artificial periapical lesions were created with burs at the
base of the socket of eleven mandibular molars, in 7 human dry
mandibles. Digital periapical radiographs, 360° and 180° rotations CBCT
scans with standard dose and dose reduction (DR) modes were obtained
before and after periapical lesions were prepared. Six blinded examiners
scored the presence/absence of lesions. Inter- and intra-examiner
reliability were determined. Sensitivity, specificity, positive
predictive values and negative predictive values and receiver operating
characteristic (ROC) area under the curve (overall accuracy) were
determined for each modality.
Results
The
mean sensitivity and specificity of both CBCT rotations with dose
reduction mode were higher compared to that of standard dose CBCT scans.
The ROC Az mean values for periapical radiographs, 360° scan with
standard dose and dose reduction and 180° scans with standard dose and
dose reduction were 0.62, 0.94, 0.95, 0.95 and 0.97, respectively. No
significant difference in the diagnostic accuracy of CBCT scans taken
with standard and dose reduction modes, while their accuracy was
significantly higher than periapical radiographs.
Conclusions
Using
dose reduction with 360° and 180° CBCT scans demonstrated good
diagnostic accuracy in the detection of simulated periapical lesions
while reducing the radiation dose by 54%, and 51% respectively compared
to conventional settings. Clinical evaluation is now needed to determine
whether this is applicable to patients.
Comments