Reproducibility of 3 mm-Slice-Thick Reconstruction of Paranasal Sinus Computed Tomography Scans

Matti Karjalainen,Markus Rautiainen,Anna-Maija Kuukka,Sanna Toppila-Salmi,Prasun Dastidar,Jura Numminen,Antti Markkola,Heini Huhtala,Mikko Suvinen,Anna Julkunen

doi:10.4236/ojrad.2016.61006

Matti Karjalainen, Markus Rautiainen + Show 8 more

Open Access

https://doi.org/10.4236/ojrad.2016.61006

Copy DOI

Abstract

Background: After the failure of medical treatment, the surgery of chronic rhinosinusitis (CRS) is planned according to endoscopic and paranasal sinus computed tomography (CT) findings. Objective: The aim of this prospective study was to evaluate whether this study method might be eligible in studies aiming at radiation dose reduction. Sinus CT scans were chosen as a model because of the high variation of the radiological anatomy of surgically important sinonasal structures. We hypothesized that 3 mm-slice-thick reconstruction CT had poor reproducibility. Methods: 59 CRS patients underwent routine multi-detector sinus CT (CTMD). CT3mm was reconstructed from CTMD data-sets. Lund-Mackay (LM) scores and 43 other structural parameters were analyzed blinded. Agreement was studied between CTMD and CT3mm (intra-observer reproducibility), and between three observers (inter-observer reproducibility) by using Cohen’s kappa. Results: The inter-observer agreement was moderate (kappa 0.4 - 0.6, p 3mm scans. The intra-observer reproducibility of CT3mm scans was very good in most structures, however, it was poor in important structures such as frontal and spheno-ethmoid recess, lamina papyracae, and location of optic nerve or anterior ethmoidal artery. The grade of surgeon’s confidence of CT3mm in comparison to CTMD was lower (kappa 0.2 - 0.4, P < 0.05). Conclusion: This methodology might have some use in studies aiming at radiation dose reduction. As was expected, 3 mm-slice-thick reconstruction CT had poor reproducibility and surgeon’s confidence. More recent methods such as cone beam computed tomography scans have nowadays more relevant dose reduction potential.

Highlights

Chronic rhinosinusitis (CRS) is a common, multifactorial and variable disease with a prevalence of around 10% - 16% [1]
The mean age was 43 (13 - 77) years by the time of taking the computed tomography (CT) scans. 54.2% of patients underwent sinonasal operation within a year after the CT scans were performed (Table 1). Of these patients that were operated at the time of CT scans, 7 (21.9%) underwent revision sinonasal surgery in average 3 years later. 47.5% of patients reported suffering from diseases with regular need of medications
This study was carried out to evaluate whether the used method would be eligible when studying radiation dose reduction potential

Summary

Introduction

Chronic rhinosinusitis (CRS) is a common, multifactorial and variable disease with a prevalence of around 10% - 16% [1]. The main findings in CRS are mucosal changes within the osteomeatal complex and/or sinuses. After the failure of medical treatment, the surgery of chronic rhinosinusitis (CRS) is planned according to endoscopic and paranasal sinus computed tomography (CT) findings. Sinus CT scans were chosen as a model because of the high variation of the radiological anatomy of surgically important sinonasal structures. Methods: 59 CRS patients underwent routine multi-detector sinus CT (CTMD). Agreement was studied between CTMD and CT3mm (intra-observer reproducibility), and between three observers (inter-observer reproducibility) by using Cohen’s kappa. Results: The inter-observer agreement was moderate (kappa 0.4 - 0.6, p < 0.01) in the majority of structures of CT3mm scans. The intra-observer reproducibility of CT3mm scans was very good in most structures, it was poor in important structures such as frontal and spheno-ethmoid recess, lamina pa-

Objectives

Methods

Results

Conclusion