Low-dose cone-beam computed tomography in simulated condylar erosion detection: a diagnostic accuracy study

Area of Science:

• Dentistry
• Radiology
• Medical Imaging

Background:

• Mandibular condyle erosions can indicate temporomandibular joint disorders.
• Accurate detection is crucial for timely diagnosis and treatment.
• Cone-beam computed tomography (CBCT) is a valuable imaging tool in dentistry.

Purpose of the Study:

• To evaluate the diagnostic accuracy of various low-dose CBCT protocols for detecting simulated mandibular condyle erosions.
• To compare the performance of high-definition (HD) and normal definition (NORM) CBCT with and without ultra-low-dose settings.

Main Methods:

• 102 simulated erosions were created on human mandible condyles.
• Four CBCT protocols were used: HD, NORM, ultra-low-dose HD (ULD-HD), and ultra-low-dose NORM (ULD-NORM).
• Two observers analyzed scans, assessing agreement with a gold standard and calculating diagnostic accuracy metrics.

Main Results:

• High agreement with the gold standard was observed for HD, NORM, and ULD-HD protocols.
• The ULD-NORM protocol showed only moderate agreement.
• Diagnostic accuracy (sensitivity, specificity, accuracy) was highest for HD, followed by NORM and ULD-HD, with ULD-NORM performing the poorest.

Conclusions:

• The ULD-HD CBCT protocol is recommended for detecting mandibular condyle erosions due to its reduced radiation dose and acceptable accuracy.
• The ULD-NORM CBCT protocol is not suitable for detecting condyle erosions.
• Optimizing CBCT protocols can balance diagnostic efficacy with radiation safety.