CORRELATION AND RELIABILITY OF CBCT-DERIVED AUTO-SEGMENTATION ASSESSMENTS OF ADENOID HYPERTROPHY

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Background

CBCT imaging has expanded the dental professional’s ability to assess the upper airway area with cross-sectional areas and volumetric portrayals.1,2

Objective

To evaluate the diagnostic correlation and reliability Dolphin Imaging® fully automated segmentation for assessing adenoid hypertrophy. This was investigated through three modes: 1) intra-observer and interobserver agreement of repeated airway auto-segmentation procedures, 2) correlation between auto-segmentation measures of Volume and MCA against nasopharyngoscopy and 3) optimum diagnostic cut-off thresholds for Volume and MCA identified and tested with sensitivity / specificity analysis.

Material and Methods

Ethical approval was obtained. CBCT scans of 38 patients with suspected upper airway obstruction were analyzed. Two calibrated evaluators applied a previously validated method to quantify nasopharyngeal MCA and volume using Dolphin Imaging®. Assessments were compared against the grades of obstruction provided by Otolaryngologists’ diagnosis.3

Results

The intra-and inter-reliability between evaluators on Dolphin automatic segmentation function for volume (ICC=0.97 CI 0.95, 0.98) and MCA (ICC= 0.84 CI 0.69, 0.91) was excellent. The inter-operator reliability for volume was also excellent (ICC=0.97 CI 0.95, 0.98), but only good (ICC=0.701 CI 0.44, 0.85) for MCA. In contrast, Spearman’s Rank Correlation (ρ) demonstrated weak association between the values presented by the automatic measurement for both, volume (4.9%; ρ = -0.22) and MCA (3.7%; ρ

Conclusions

The evaluators were reliable at manipulating the selected software, achieving consistent volume and MCA measurements. However, Dolphin® Imaging volumetric and MCA measurements did not correlate well with the nasopharyngoscopy-supported reference standard adenoid hypertrophy assessment. Under these study conditions, volume and MCA to assess localized adenoid hypertrophy using CBCT imaging based on Dolphin® Imaging automatic measurements was not accurate enough for clinical purposes.

References

1. Hatcher DC. Cone beam computed tomography: craniofacial and airway analysis. Dental Clin North Am. 2012;56:343-357.

2. Mattos CT, Cruz CV, da Matta TC, et al. Reliability of upper airway linear, area, and volumetric measurements in cone-beam computed tomography. Am J Orthod Dentofacial Orthop. 2014;145:188-197.

3. Ysunza A, Pamplona MC, Ortega JM, Prado H. Video fluoroscopy for evaluating adenoid hypertrophy in children. Int J Pediatr Otorhinolaryngol. 2008;72:1159-1165.

Acknowledgments

We thank Heather Howland and Carla Clarke for their help on data gathering.

Conflict of Interest

None.

This abstract is part of an original article accepted by AJODO on Nov 8, 2016.

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