Will image quality influence diagnostic accuracy efficacy when diagnosing osteoporosis by intraoral radiography?

• Introduction In 2003-2005, the OSTEODENT study was performed with the aim of identifying the most valid and effective radiographic index for diagnosis of osteoporosis to be used in oral health care. One of the proposed indices was based on visual assessment of the trabecular pattern in intraoral periapical radiographs. Although strict quality criteria were used, the quality of the intraoral radiographs differed due to film placement and projection errors (Lindh et al 2008). Objectives To investigate if the diagnostic accuracy of visual assessment of the trabecular pattern to diagnose osteoporosis in intraoral radiography increased for images with optimal image quality. Material and methods One hundred intraoral radiographs of the upper and lower premolar regions with optimal image quality were chosen from the original sample of 600 images. The trabecular pattern was assessed by four observers and classified into one of three groups (i) dense homogenous trabecular patter, (ii) heterogeneous trabecular pattern, or (iii) sparse homogenous trabecular pattern. The criterion standard was comprised of osteoporosis as measured by DXA. Sensitivity, specificity, odds ratio, and inter- and intra-observer agreement for the assessment of the 100 images with optimal quality were compared to the values obtained from the assessment of the original sample. Results Sensitivity of images of optimal quality increased in the upper jaw as compared to that of the original sample. The odds ratios of images with optimal image quality were higher for both the upper and the lower jaw. The median intraobserver agreement (weighted Kappa) was also slightly higher for both jaws whilst the median interobserver agreement was comparable for the two samples. Conclusions and discussion Although image quality of intraoral radiography influenced the diagnostic accuracy efficacy in osteoporosis diagnosis to some extent, optimal image quality might not be necessary for the usability of the proposed classification in clinical practice. Reference: Lindh C, Horner K, Jonasson G, Olsson P, Rohlin M, Jacobs R , Karayianni K, van der Stelt P, Adams J, Marjanovic E, Pavitt S, Devlin H. The use of visual assessment of dental radiographs for identifying women at risk of having osteoporosis: the OSTEODENT project. Oral Surg, Oral Med, Oral Pathol, Oral Radiol Endod 2008;106:285- 93

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Odontologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Dentistry (hsv//eng)

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