Abstract
Aim
To assess and compare reader performance in interpreting digital periapical (PA) radiography
and cone beam computed tomography (CBCT) in endodontic disease detection, using a
free-response, factorial model.
Materials and Methods
A reader performance study of 2 image test sets was undertaken using a factorial,
free-response design, accounting for the independent variables: case type, case severity,
reader type, and imaging modality. Twenty-two readers interpreted 60 PA and 60 CBCT
images divided into 5 categories: diseased–subtle, diseased–moderate, diseased–obvious,
nondiseased–subtle, and nondiseased–obvious. Lesion localization fraction, specificity,
false positive (FP) marks, and the weighted alternative free-response receiver operating
characteristic figure of merit were calculated.
Results
CBCT had greater specificity than PA in the obvious nondiseased cases (P = .01) and no significant difference in the subtle nondiseased category. Weighted
alternative free-response receiver operating characteristic values were higher for
PA than CBCT in the subtle diseased (P = .02) and moderate diseased (P = .01) groups with no significant difference between in the obvious diseased groups.
CBCT had higher mean FPs than PA (P < .05) in subtle diseased cases. Mean lesion localization fraction in the moderate
diseased group was higher in PA than CBCT (P = .003). No relationships were found between clinical experience and all diagnostic
performance measures, except for in the obvious diseased CBCT group, where increasing
experience was associated mean FP marks (P = .04).
Conclusions
Reader performance in the detection of endodontic disease is better with PA radiography
than CBCT. Clinical experience does not impact upon the accuracy of interpretation
of both PA radiography and CBCT.
Key Words
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Article info
Publication history
Published online: February 09, 2023
Footnotes
The study was approved by the institutional review board of the University of Sydney (Approval number: 2020/477).
Identification
Copyright
© 2023 American Association of Endodontists.
