A reject analysis of cone-beam CTs in under-aged patients

Abstract

Objectives: The main objective of this study was to perform a retrospective reject analysis (or audit) of 79 cone-beam CTs (CBCTs) taken in under-aged patients at the Ghent University hospital over a 2-year timespan. Methods: Observer agreement between two oral radiologists and two senior year Master students in Paediatric Dentistry was performed for quality, diagnostic and therapeutic value. The senior year Master Students followed appropriate modules of an online course. Descriptive and comparative statistics were performed. Results: For the oral radiologists, all intra rater reliabilities were moderate to good (Gwet's AC1 = 0.41-0.75). For the senior students in Paediatric dentistry, these varied highly from fair to very good (Gwet's AC1 = 0.28-0.95). There was a high level of disagreement between oral radiologists and students (Gwet's AC1 = 0.16-0.45) and in-between students concerning observed quality (Gwet's AC1 = 0.29). A total of 16 CBCTs (20%) was rejected, 24 images (30%) were acceptable and 39 images (50%) had an excellent quality. 50 CBCTs were perceived to have a diagnostic advantage. 13 of the images would have no influence on the therapy, according to the oral radiologists. A significant correlation was found between unacceptable quality, absence of perceived diagnostic advantage (p = 0.004, RR = 2.4) and influence on therapy (p < 0.0005, RR = 1.8). A small field of view (FOV) was positively correlated to an excellent quality of the image (p = 0.011, RR = 2.8). conclusions: Image quality did not reach the proposed boundary of 10% according to the European Guidelines on Radiation Protection in Dental Radiology. This is the first published audit on an overall database of under-age children for CBCT.

Validation of a tool for determining the clinical utility of stillbirth investigations

“…The inter‐rater agreement, measured by Gwet AC1 on cause of death assigned after all investigation results were reviewed was 0.93 (95% CI 0.87–1.0) (Table 3 ). 21 …”

“…The Gwet AC1 statistics were calculated for assigning cause of death 20 . The GwetAC1 was rated as poor (<0.20), fair (0.21–0.40), moderate (0.41–0.60), good (0.61–0.80) and very good (0.81–1.00) 21 . Descriptive statistics of the clinical utility of the investigation were performed.…”

Reject Rates of Radiographic Images in Dentomaxillofacial Radiology: A Literature Review

“…In contrast to intra-oral radiography, extra-oral and CBCT imaging often take approximately 10 s up to nearly a minute, and therefore patient movement can only be reduced but not totally eliminated. In patients under 18 years of age, reject rates were highest for scans of dento-alveolar trauma (50%), surgical application (36%), and generalized evaluation of developing dentition (33%) [36]. Meanwhile, for CBCT rejects due to incomplete FOV coverage, the most frequently involved reasons were incomplete coverage of the apex of impacted lower third molars and/or pericoronal pathology (22.4%), and incomplete coverage of the opposite teeth of implant planning sites, associated maxillary sinus floor, and/or sleeves of radiographic stent (20.4%) [23].…”