Clinical history and incidental abnormality detection in endodontic cone beam computed tomography

Kehn E. Yapp; Ernest Ekpo

doi:10.1117/1.JMI.10.4.045502

31 July 2023 Clinical history and incidental abnormality detection in endodontic cone beam computed tomography

Kehn E. Yapp, Ernest Ekpo

Author Affiliations +

Journal of Medical Imaging, Vol. 10, Issue 4, 045502 (July 2023). https://doi.org/10.1117/1.JMI.10.4.045502

Abstract

Purpose

To assess the effect of clinical history on incidental abnormality detection, false positive (FP) marks, and diagnostic confidence in endodontic cone beam computed tomography (CBCT) imaging.

Approach

A reader performance study using a free-response, factorial study design was undertaken, which accounted for changes in the independent variables: native case type, native case severity, reader type, and reading modality. Twenty-three readers interpreted 26 cases (18 diseased and 8 non-diseased) twice, once with and once without access to clinical history. Each case had at least one incidental abnormality that was not a native endodontic finding. Lesion localization (LL), non-localizations (FPs), and diagnostic confidence (rating 2, 3, or 4: lowest, middle, and highest, respectively) of incidental abnormalities were analyzed.

Results

Clinical history increased the detection of incidental abnormalities in non-diseased subtle cases (76 versus 59, p = 0.04). Reader experience and monthly CBCT reading volume did not affect incidental abnormality detection. FPs were neither affected by clinical history nor reader characteristics. The highest confidence rating was most often used in each case type when clinical history was available. For this rating, history had significantly greater LLs in subtle diseased (53 versus 41, p = 0.03) and non-diseased images (53 versus 33, p = 0.02).

Conclusions

Clinical history improved the detection of incidental endodontic abnormalities in non-diseased subtle CBCT images and did not affect the number of FP marks. Reader confidence in correctly identified abnormalities was higher with clinical history when disease and non-disease were subtle but was not associated with an improvement in diagnostic performance.

Citation Download Citation

Kehn E. Yapp and Ernest Ekpo "Clinical history and incidental abnormality detection in endodontic cone beam computed tomography," Journal of Medical Imaging 10(4), 045502 (31 July 2023). https://doi.org/10.1117/1.JMI.10.4.045502

Received: 30 April 2023; Accepted: 21 July 2023; Published: 31 July 2023

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KEYWORDS

Cone beam computed tomography

Diagnostics

Diseases and disorders

Target detection

Design and modelling

Teeth

Dental caries

Purpose

Approach

Results

Conclusions

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