Diagnostic Accuracy of Cone-Beam Computed Tomography in the Evaluation of Chronic Rhinosinusitis

Abstract

Introduction: This study assessed the agreement of cone-beam computed tomography (CBCT) scan and sinus endoscopy findings and attempted to find a diagnostic accuracy of CBCT in patients with chronic rhinosinusitis (CRS). Methods: Forty-two patients with CRS referred to the Aria and 22 Bahman Hospitals in Mashhad, Iran, during the year 2011 were included in this cross-sectional study. Paranasal sinus CBCT scanning and endoscopy were performed in all patients. The sensitivity, specificity, positive and negative predictive values (PPV and NPV), and accuracy of CBCT were determined, and the agreement between CBCT and endoscopy findings was evaluated. Results: In most of our findings, except for infundibulum thickening, there was a strong agreement between CBCT and paranasal sinus endoscopy, with a kappa coefficient >0.80 (p < 0.05). The sensitivity, specificity, PPV, NPV, and accuracy of CBCT were >80% for most of the findings, except for infundibulum thickening and septal deviation. Conclusion: CBCT has nearly the same diagnostic accuracy as sinus endoscopy. The accuracy of CBCT scanning is high, and CBCT findings are well correlated with sinus endoscopy findings. Considering its high accuracy and lower costs and radiation doses, CBCT may be a proper alternative method for diagnostic sinus endoscopy in the assessment of CRS in patients with a contraindication for sinus endoscopy.

Evaluation of factors affecting the association between thickening of sinus mucosa and the presence of periapical lesions using cone beam CT

“…Three-dimensional images derived from computed tomography (CT) or cone beam computed tomography (CBCT) have been shown to significantly contribute to the high detection rate of OMS as they provide multiplanar images of the maxillofacial region. CBCT is particularly recommended for identification of variations in the maxillary sinus and potential cause(s) of sinusitis due to its high-resolution and isotropic volume data at lower dose and cost (Maillet et al 2011, Shahbazian et al 2014, Simuntis et al 2014, Nagar & Gautam 2015, Zojaji et al 2015, Vidal et al 2017.…”

Evaluation of symptomatic maxillary sinus pathologies using panoramic radiography and cone beam computed tomography—influence of professional training

“…Sharma et al recommended CT scans prior sinus surgery in order to guide the surgeon [36]. Other researcher found the same diagnostic accuracy of CBCT scans of maxillary sinus pathologies when compared to sinus endoscopy [37] which underlines the importance of CBCT within this field. As shown by others as well [2, 38–43], a better evaluation of anatomical structures was found when using CBCT.…”

The fundaments of cbct and its use for evaluation of paranasal sinuses: review of literature

“…Despite the fact that MDCT scan of the paranasal sinuses can be recommended in case of normality and abnormality of the paranasal sinuses or in patients with chronic sinusitis, the high radiation dose and costs do not allow its usage routinely 8,12,14 . After all, the MDCT cannot stand alone as a gold standard for the diagnosis of rhinosinusitis because it may be positive in the absence of clinical disease.…”

“…CBCT is a 3-dimensional (3D) X-ray-based volume acquisition imaging modality, first introduced in 1998 14 . Offering the advantage of lower radiation dose 4,10,[14][15][16] , CBCT…”

“…has been widely used in dental practice for various purposes such as maxillary sinus evaluation, oral surgery, evaluation of temporomandibular joint, orthodontic evaluation, implant planning, and craniofacial trauma evaluation and treatment 2,8,14 . After these primary applications, CBCT has gained popularity and is now increasingly being used for the diagnostic imaging of the head and neck region and the ear, nose, and throat area, mucosal thickness, nasal septum deviation, conchal hypertrophy, bullous concha, and retention cysts in these areas 2,14,16 . In CBCT systems, the X-ray beam forms a conical geometry between the source and the detectors; in addition, digital flat-panel detectors replace the row(s) of detectors in MDCT.…”