SPIE Journal Paper | 31 July 2023
KEYWORDS: Cone beam computed tomography, Diagnostics, Diseases and disorders, Target detection, Design and modelling, Teeth, Dental caries, Eye tracking, Computed tomography, Target recognition
PurposeTo assess the effect of clinical history on incidental abnormality detection, false positive (FP) marks, and diagnostic confidence in endodontic cone beam computed tomography (CBCT) imaging.ApproachA reader performance study using a free-response, factorial study design was undertaken, which accounted for changes in the independent variables: native case type, native case severity, reader type, and reading modality. Twenty-three readers interpreted 26 cases (18 diseased and 8 non-diseased) twice, once with and once without access to clinical history. Each case had at least one incidental abnormality that was not a native endodontic finding. Lesion localization (LL), non-localizations (FPs), and diagnostic confidence (rating 2, 3, or 4: lowest, middle, and highest, respectively) of incidental abnormalities were analyzed.ResultsClinical history increased the detection of incidental abnormalities in non-diseased subtle cases (76 versus 59, p = 0.04). Reader experience and monthly CBCT reading volume did not affect incidental abnormality detection. FPs were neither affected by clinical history nor reader characteristics. The highest confidence rating was most often used in each case type when clinical history was available. For this rating, history had significantly greater LLs in subtle diseased (53 versus 41, p = 0.03) and non-diseased images (53 versus 33, p = 0.02).ConclusionsClinical history improved the detection of incidental endodontic abnormalities in non-diseased subtle CBCT images and did not affect the number of FP marks. Reader confidence in correctly identified abnormalities was higher with clinical history when disease and non-disease were subtle but was not associated with an improvement in diagnostic performance.
