Is peripheral cortication of intraosseous lesions accurately displayed on panoramic radiography?

Hugo Gaêta-Araujo; Larissa Moreira-Souza; Luciana Asprino; Christiano Oliveira-Santos

doi:10.1016/j.oooo.2020.06.008

Is peripheral cortication of intraosseous lesions accurately displayed on panoramic radiography?

Oral Surg Oral Med Oral Pathol Oral Radiol. 2020 Dec;130(6):725-730. doi: 10.1016/j.oooo.2020.06.008. Epub 2020 Jun 17.

Authors

Hugo Gaêta-Araujo¹, Larissa Moreira-Souza², Luciana Asprino³, Christiano Oliveira-Santos⁴

Affiliations

¹ Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil. Electronic address: hugogaeta@hotmail.com.
² Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil.
³ Department of Oral Diagnosis, Division of Oral Surgery, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil.
⁴ Department of Stomatology, Public Oral Health, Forensic Dentistry, Division of Oral Radiology, School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Sao Paulo, Brazil.

PMID: 32636166
DOI: 10.1016/j.oooo.2020.06.008

Abstract

Objective: The aim of this study was to calculate the sensitivity, specificity, and positive and negative predictive values (PPV and NPV) for the detection of the presence and continuity of peripheral cortication (PC) around benign intraosseous lesions on panoramic radiography (PR), with cone beam computed tomography (CBCT) as the reference standard.

Study design: The sample consisted of the mesial, distal, superior, and inferior borders of 40 bony lesions (n = 160) depicted on both PR and CBCT. Ten observers assessed the PRs. CBCT images were assessed by 2 radiologists. For each lesion, observers classified the 4 borders with regard to the presence of PC, and if present, its continuity. Sensitivity, specificity, PPV, and NPV were calculated for the presence and continuity of PC. Intra- and interobserver agreements were calculated.

Results: PR had sensitivity, specificity, PPV, and NPV for PC detection of 0.844, 0.435, 0.435, and 0.844, respectively. With regard to PC continuity, those values were 0.750, 0.810, 0.577, and 0.904. Observer agreement was slight to fair.

Conclusions: The high sensitivity and low specificity for the presence of PC indicate a large false-positive rate. The high NPVs suggest greater validity for negative decisions. The findings corroborate the influence of the eggshell effect. Observer agreement rates indicate that interpretation of PC is substantially subjective.

MeSH terms

Cone-Beam Computed Tomography*
Radiography, Panoramic
Sensitivity and Specificity