Diagnostic accuracy of limited-volume cone-beam computed tomography in the detection of periapical bone loss: 360° scans versus 180° scans

Int Endod J. 2011 Dec;44(12):1118-27. doi: 10.1111/j.1365-2591.2011.01930.x. Epub 2011 Sep 5.

Abstract

Aim: To investigate the effect of reducing limited-volume cone-beam computed tomographs arc of rotation from 360° to 180° on the ability to diagnose small, artificially created apical lesions.

Methodology: Small, artificial apical bone lesions were prepared with a bur in the apical region of the distal root of ten mandibular first molars, in human dry mandibles. The jaws were scanned in a fixed position with limited-volume CBCT making a 360° and 180° arc of rotation, before and after each periapical lesion had been created. A 4 × 4 cm field of view was used at 90 kV, with a current of 4 mA. Ten examiners blinded to the scan parameters and controls scored the presence/absence of bone lesions. Intra-examiner reliability was determined after 2 weeks, reviewing half the data set. Statistical analyses with paired t-tests determined the diagnostic accuracy of the two modalities (360° vs. 180°) in terms of sensitivity, specificity, receiver operating characteristic area under the curve, positive predictive values and negative predictive values.

Results: The mean values for sensitivity of the 360° and 180° scans were 0.91 and 0.89, respectively; their mean specificities were 0.73. No significant differences were reflected in the statistical analyses.

Conclusions: Both 360° and 180° cone-beam computed tomography scans yielded similar accuracy in the detection of artificial bone lesions. The use of 180° scans might be advisable to reduce the radiation dose to the patient in line with the ICRP guidance to use as low a dosage as reasonably achievable.

Publication types

  • Comparative Study

MeSH terms

  • Alveolar Bone Loss / diagnostic imaging*
  • Area Under Curve
  • Cone-Beam Computed Tomography / methods*
  • Diagnosis, Differential
  • Humans
  • Mandible / diagnostic imaging
  • Molar / diagnostic imaging
  • Periapical Diseases / diagnostic imaging*
  • Predictive Value of Tests
  • ROC Curve
  • Radiation Dosage
  • Radiographic Image Enhancement / methods*
  • Rotation
  • Sensitivity and Specificity
  • Tooth Root / diagnostic imaging
  • Tooth Socket / diagnostic imaging