Highlights
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Goals
To evaluate and compare reader performance in the interpretation of digital periapical (PA) radiography and cone beam computed tomography (CBCT) in the detection of endodontic diseases, using a free-response factorial model.
Materials and methods
A reader performance study of two sets of imaging tests was conducted using a free-response factorial design, taking into account the independent variables: case type, case severity, reader type, and imaging modality.
Twenty-two readers interpreted 60 PA and 60 CBCT images divided into five categories: diseased – subtle, diseased – moderate, diseased – obvious, non-diseased – subtle, and non-diseased – obvious.
Lesion localization fraction, specificity, false positive flags, and weighted alternative free response receiver operating characteristic (wAFROC1) figure of merit were calculated.
Results
Cone beam CT (CBCT) had higher specificity than periapical (PA) radiography in obvious disease-free cases (p = 0.01) and no significant difference in the subtle disease-free category.
wAFROC1 values were higher for PA than for CBCT in the subtle disease (p = 0.02) and moderate disease (p = 0.01) groups with no significant differences between the overt disease group.
CBCT had a higher mean number of false positives than PA (p<0.05) in cases of subtle disease.
The mean lesion localization fraction in the moderate disease group was higher in PA than in CBCT (p = 0.003).
No relationships were found between clinical experience and all measures of diagnostic performance, except in the CBCT group with overt disease, where increasing experience was associated with average false-positive marks (p = 0.04).
Conclusions
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