Diagnostic Accuracy of Cystic Lesions Using a Pre-Programmed Low-Dose and Standard-Dose Dental Cone-Beam Computed Tomography Protocol: An Ex Vivo Comparison Study.

Adib Al-Haj Husain,Quirin Döbelin,Bernd Stadlinger,Barbara Giacomelli-Hiestand,Silvio Valdec,Daniel B Wiedemeier

doi:10.3390/s21217402

Abstract

Background: This study aimed to analyze the diagnostic reliability of radiographic assessment of cystic lesions using a pre-set, manufacturer-specific, low-dose mode compared to a standard-dose dental cone-beam computed tomography (CBCT) imaging protocol. Methods: Forty pig mandible models were prepared with cystic lesions and underwent both CBCT protocols on an Orthophos SL Unit (Dentsply-Sirona, Bensheim, Germany). Qualitative and quantitative analysis of CBCT data was performed by twelve investigators independently in SIDEXIS 4 (Dentsply-Sirona) using a trial-specific digital examination software tool. Thereby, the effect of the two dose types on overall detectability rate, the visibility on a scale of 1 (very low) to 10 (very high) and the difference between measured radiographic and actual lesion size was assessed. Results: Low-dose CBCT imaging showed no significant differences considering detectability (78.8% vs. 81.6%) and visibility (9.16 vs. 9.19) of cystic lesions compared to the standard protocol. Both imaging protocols performed very similarly in lesion size assessment, with an apparent underestimation of the actual size. Conclusion: Low-dose protocols providing confidential diagnostic evaluation with an improved benefit–risk ratio according to the ALADA principle could become a promising alternative as a primary diagnostic tool as well as for radiological follow-up in the treatment of cystic lesions.

Highlights

Clinical and radiological diagnosis of a cystic mass in the jaw is a daily challenge in dental surgery, especially when various differential diagnoses are suspected
As pre-set, manufacturer-specific low-dose imaging protocols provide a user-friendly option for predictable image quality, this study aimed to investigate the diagnostic accuracy in the radiographic assessment of mandibular cystic lesions compared to a standard-dose dental cone-beam computed tomography (CBCT) imaging protocol and to identify potential discrepancies in detection rates between low-dose and standard-dose protocols
Detection of cystic lesions was successful in 78.8% of cases with the low-dose protocol and in 81.6% with the standard protocol (Figure 2)

Summary

Introduction

Clinical and radiological diagnosis of a cystic mass in the jaw is a daily challenge in dental surgery, especially when various differential diagnoses are suspected. Recently, published reports highlight the enormous potential for development, there are still some significant limitations, so MRI is not yet the most commonly used and indicated imaging modality in clinical practice [13,14] Another interesting non-invasive imaging modality for detecting bony lesions in the jaws is ultrasound, as it offers better detectability of lesions than conventional radiation-based imaging. This study aimed to analyze the diagnostic reliability of radiographic assessment of cystic lesions using a pre-set, manufacturer-specific, low-dose mode compared to a standard-dose dental cone-beam computed tomography (CBCT) imaging protocol. CBCT imaging showed no significant differences considering detectability (78.8% vs 81.6%) and visibility (9.16 vs 9.19) of cystic lesions compared to the standard protocol Both imaging protocols performed very in lesion size assessment, with an apparent underestimation of the actual size. Conclusion: Low-dose protocols providing confidential diagnostic evaluation with an improved benefit–risk ratio according to the ALADA principle could become a promising alternative as a primary diagnostic tool as well as for radiological follow-up in the treatment of cystic lesions

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