Accuracy and Reliability of Oral Maxillofacial Radiologists when evaluating Cone-Beam Computed Tomography imaging for Adenoid Hypertrophy screening: A comparison with Nasopharyngoscopy

• Published in: Oral surgery, oral medicine, oral pathology and oral radiology Vol. 121; no. 6; pp. e168 - e174
• Main Authors: Pachêco-Pereira, Camila, DDS, MBA, Alsufyani, Noura, B.D.S., M.Sc, FRCD(c), Diplm. ABOMR, Major, Michael P., DMD, MSc, FRCD(c), Flores-Mir, Carlos, DDS, PhD, FRCD(c)
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2016
• Subjects: Adenoids - diagnostic imaging; Adenoids - pathology; Adolescent; Child; Cone-Beam Computed Tomography - methods; Dentistry; Endoscopy - methods; Female; Humans; Hypertrophy; Male; Nasopharynx; Observer Variation; Radiologists; Reproducibility of Results; Sensitivity and Specificity; Surgery; Radiology; Diagnostic Imaging; Adenoids; Cone-Beam Computer Tomography; Hypertrophy
• ISSN: 2212-4403; 2212-4411
• DOI: 10.1016/j.oooo.2016.03.010

Abstract Objective To determine how accurate and reliable is a sample of Oral Maxillofacial Radiologists (OMFRs) in screening for adenoid hypertrophy using CBCT imaging as compared to Nasopharyngoscopy (NP). Study Design CBCT scans of 10 patients with distinct levels of adenoid hypertrophy were randomly selected. Fourteen board-certified OMFRs classified the levels of hypertrophy. The intraclass correlation coefficient (ICC) was used to assess accuracy by comparing their diagnosis against an NP diagnosis – the reference standard. OMFRs inter-reliability was assessed. Kappa assessed dichotomous data - healthy and unhealthy patients. Results Overall, the reliability between OMFRs was good (ICC=0.79 with CI 0.63,0.93). The “statistical mode” was very good, ICC=0.81(0.43-0.94). The accuracy of OMFRs against NP was good, ICCmean = 0.69(0.43-0.94). In average, the Kappa statistic, Kmean = 0.77(0.62-0.92) demonstrated a good agreement between the OMFRs and NP. The individualized results from each evaluator were presented and investigated according to their performance. Conclusion When compared to the reference standard, the accuracy of OMFRs to classify adenoid hypertrophy on 4-level scale was moderate to strong and improved when the adenoid hypertrophy was classified as healthy/unhealthy. The reliability of OMFR was greater than 80% assuring their consistency and reliability on screening adenoids hypertrophy via CBCT.