Detection accuracy of maxillary sinus floor septa in panoramic radiographs using CBCT as gold standard: a multi-observer receiver operating characteristic (ROC) study

2018 ◽  
Vol 23 (1) ◽  
pp. 99-105 ◽  
Author(s):  
AC Lang ◽  
RK Schulze
2012 ◽  
Vol 38 (4) ◽  
pp. 337-344 ◽  
Author(s):  
Cem Üngör

The aim of this study was to evaluate differences in ossification of the 2 forms of demineralized bone matrix (DBM)—putty and powder—radiographically, using digital densitometry on panoramic radiographs in maxillary sinus floor augmentation procedures. Twelve subjects needing bilateral maxillary sinus floor augmentation for the placement of osseointegrated implants were included in this study. The left and right maxillary sinuses were augmented in the same session in each patient using the 2 preferred forms of DBM—putty and powder—during the same session. One sinus was augmented with DBM putty form and the other sinus was augmented with DBM powder form randomly. Every patient had a total of 4 panoramic radiographs taken, preoperatively and in the first, third, and sixth month postoperatively. The densitometry measurements were taken from each step of the aluminium step-wedge, from both sinuses from different points a total of 3 times, and the average of these measurements was calculated. The amount of mineralization in each graft material in every radiograph was clarified by the appearance of a difference in the equivalent aluminium thickness, and the obtained results were statistically evaluated. The results showed that there were no significant differences between two graft materials statistically. These two graft materials could be good alternatives in sinus lifting procedures because of less morbidity, lower price, and good ossification. The results indicate that 2 different types of DBM achieved good ossification in the sinus lifting procedure, and there is not a considerable distinction in these 2 forms.


2018 ◽  
Vol 9 (1-2) ◽  
pp. 38-44
Author(s):  
Onur S¸ahin ◽  
Kemal Özgür Demiralp

Background: Having knowledge about the anatomical and pathological relationship between the maxillary posterior root tip and the maxillary sinus floor is very significant for preoperative treatment planning. Aims and Objectives: The purpose of the present study was to compare the accuracy of original panoramic radiographs and digital panoramic images over cone beam computed tomography (CBCT) images in evaluating the relationship between the maxillary posterior teeth and the maxillary sinus floor, and to verify the accuracy of the signs of the relationship between the roots of the maxillary posterior teeth and maxillary sinus on the panoramic radiographs over CBCT images. Materials and Methods: From 106 subjects (47 males and 59 females; mean age = 39 years; range = 18-67 years) referred to our university, a pair of panoramic and CBCT images was selected for further analysis. The relationship between the maxillary posterior teeth, the maxillary sinus, and panoramic radiography signs (root projection into the sinus, interruption of the maxillary sinus floor cortex, absence of lamina dura, darkening of the root apex, and curvature of the sinus floor on the root apex) associated with the protrusion of root apexes into the sinus was evaluated. Results: The P values of the data obtained from the original and invert enhanced panoramic images were .53 and .52, respectively, and there was no statistically significant difference in the accuracy of the 2 methods ( P > .05). Conclusion: The root projection into the sinus is an indicative sign of root protrusion into the sinus on CBCT.


2018 ◽  
Vol 6 (1) ◽  
pp. 440-447
Author(s):  
Kathare Alfred ◽  
Otieno Argwings ◽  
Kimeli Victor

The use of gold standard procedures in screening may be costly, risky or even unethical. It is, therefore, not admissible for large scale application. In this case, a more acceptable diagnostic predictor is applied to a sample of subjects alongside a gold standard procedure. The performance of the predictor is then evaluated using Receiver Operating Characteristic curve. The area under the curve, then, provides a summative measure of the performance of the predictor. The Receiver Operating Characteristic curve is a trade-off between sensitivity and specificity which in most cases are of different clinical significance. Also, the area under the curve is criticized for lack of coherent interpretation. In this study, we proposed the use of entropy as a summary index measure of uncertainty to compare diagnostic predictors. Noting that a diseased subject who is truly identified with the disease at a lower cut-off will also be identified at a higher cut-off, we substituted time variable in survival analysis for cut-offs in a binary predictor. We then derived the entropy of the functions of diagnostic predictors. Application of the procedure to real data showed that entropy was a strong measure for quantifying the amount of uncertainty engulfed in a set of cut-offs of binary diagnostic predictor.


2018 ◽  
Vol 11 (1) ◽  
pp. 18
Author(s):  
Aditiyono Aditiyono Aditiyono ◽  
Ali Budi Harsono ◽  
Herman Susanto

Keganasan ovarium memiliki angka morbiditas dan mortalitas yang tinggi karena umumnya ditemukan pada stadium lanjut. Penelitian ini bertujuan untuk mengetahui spesifitas dan sensitivitas CA 125 dan RMI2 dalam menentukan keganasan kista ovarium jenis epitel. Kadar CA 125 dan RM12 kemudian dilihat histopatologinya sebagai gold standard. Penelitian ini merupakan uji diagnostik, dilakukan di RSUP dr. Hasan Sadikin Bandung periode April s.d. September 2017. Sampel berjumlah 90 dengan 47 berkategori jinak dan 43 berkategori ganas berdasarkan hasil histopatologinya. Analisis data dilakukan secara univariat dan bivariat. Data kategorik diuji dengan uji chi-square atau uji Exact Fisher. Data numerik digunakan uji-t tidak berpasangan atau uji Mann Whitney. Sensitivitas dan spesifisitas data numerik disajikan dalam kurva Receiver Operating Characteristic (ROC). Berdasarkan kurva ROC maka diperoleh nilai area under curve (AUC). Hasil penelitian menunjukkan nilai median CA 125 kelompok ganas dibanding kelompok jinak (142,2 vs 61,030) bermakna secara statistik p = 0,000 (nilai p < 0,05), cut off point CA 125 adalah 99,9 U/mL dengan nilai sensitivitas 76,7% dan nilai spesifisitas 61,7%. Nilai median RMI2 kelompok ganas lebih besar dibandingkan dengan kelompok jinak (1676,8 vs 125) bermakna secara statistik p = 0,000 (nilai p < 0,05), cut off point RMI2 pada penelitian ini adalah 212,7 dengan sensitivitas 86% dan spesifisitas 70,2%. Nilai sensitivitas RMI2 dengan cut off point 200 adalah 88% dan spesifisitas 63,87%. Kesimpulan penelitian ini adalah CA125 adalah biomarker yang berguna untuk memprediksi keganasan ovarium, dengan nilai cut off point 99,9 ng/mL. Hal ini sangat berguna bila digunakan kombinasi CA 125 dengan hasil pemeriksaan Ultrasonografi (USG) dan status menopause atau dikenal dengan Risk Malignancy Index (RMI2 cut off point > 200 ) dengan sensitivitas 86%, spesifisitas 63,87% dan akurasi 74,4%.   The malignancy of ovarian cancer has high level of morbidity and mortality due to the fact that it is commonly found in advanced stage. This research is aimed to find out the specificity and sensitivity of C125 and RMI2 in determining the malignancy of epithelial ovarian cysts. The level of CA 125 and RM12 is then histopathology-measured as a gold standard. This research is a diagnostic study conducted in Hasan Sadikin Hospital Bandung during April until September 2017. Sample consists of 90 patients with 47 patients belong to low-malignancy group and 43 patients belong to high-malignancy group based on its histopathology. Data analysis is conducted by using univariate and bivariate. Categorical data is tested by using chi-square or Exact Fisher. Numeric data is tested by using unpaired t test or Mann Whitney. Sensitivity and specificity of numeric data is displayed in Receiver Operating Characteristic (ROC) curve. The ROC curve shows the value of area under curve (AUC). The result shows that the median of CA125 of the high-malignancy group compared to the low-malignancy group is (142,2 vs 61,030) which statistically means p = 0,000 (value p < 0,05), cut off point CA125 is 99,9 U/mL with sensitivity value 76,7% and specificity value 61,7%. The median of RMI2 of high-malignancy group is bigger compare to the low-malignancy group (1676,8 vs 125) which statistically means p = 0,000 (value p < 0,05), cut off point RMI2 of this research is 212,7 with sensitivity value 86% and specificity value 70,2%. The sensitivity value of RMI2 with cut off points 200 is 88% and the specificity value is 63,87%. This research concludes that CA125 is a useful biomarker to predict the malignancy of ovarian cancer with cut off point 99,9ng/mL. It will be very useful if it is combined with CA125 with Ultrasonography (USG) examination and menopause status or known as Risk Malignancy Index (RMI cut off point > 200) with sensitivity 86%, specificity 63,87% and accuracy 74,4%.


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