Diagnostic usefulness of cone‐beam computed tomography versus multi‐detector computed tomography for sinonasal structure evaluation

Abstract

Objective: Cone-beam computed tomography (CBCT) is a promising imaging modality for sinonasal evaluation, with advantages of relatively low radiation dose, low cost, and quick outpatient imaging. Our study aimed to compare the diagnostic performance and image quality of CBCT with those of multi-detector computed tomography (MDCT) with different slice thickness. Methods:We retrospectively reviewed 60 consecutive patients who had undergone both CBCT and MDCT. MDCT images was reconstructed with 1 and 3 mm slice thickness. The quantitative image quality parameters (image noise, signal-to-noise ratio [SNR], and contrast-to noise ratio [CNR] were calculated and compared between the two imaging modalities. Two observers (ENT surgeon and neuroradiologist) evaluated the presence of seven sinonasal anatomic variations in each patient and interobserver agreements were analyzed. The diagnostic performance of CBCT (0.3 mm) and MDCT (3 mm) was assessed and compared with that of high resolution MDCT (1 mm), which is considered as the gold standard.Results: The image noise was significantly higher and SNR and CNR values were lower in the CBCT (0.3 mm) group than in the MDCT groups (1 and 3 mm). The diagnostic performance of CBCT (0.3 mm) was similar to that of MDCT (1 mm) and superior to that of MDCT (3 mm). The highest interobserver agreement was for high resolution MDCT (1 mm), followed by CBCT (0.3 mm), and MDCT (3 mm). Conclusion:Considering its low radiation dose, low cost, and ease of clinical access, CBCT may be a useful imaging modality for as first line sinonasal evaluation and repeated follow up.Study design: Retrospective study in a tertiary referral university center.Level of evidence: NA.

Evaluation of diagnostic accuracy of cone beam computed tomography and multi-detector computed tomography for detection of anatomical variations in rhinoplasty

“…In line with the results of our study, M Han et al [ 22 ] in 2022, by examining CBCT findings on 60 patients, showed that, due to high accuracy, low radiation dose, and low cost, CBCT can be a useful method for initial evaluation and follow-up of patients who are candidates for cosmetic surgery. In their study, they also evaluated radiation dose and cost, while in our study, due to the study’s purpose, we could not estimate radiation dose and cost.…”

“…Recent studies have shown that the use of cone beam computed tomography) CBCT (as one of the new methods has been of high accuracy in evaluating the structure of the nasal cavity, which can provide accurate and useful information about the bony structure of the nasal cavity and paranasal sinuses to the surgeon before rhinoplasty [ 17 , 21 ]. Many studies have shown that CBTC has a higher accuracy, lower radiation dose, and lower cost in diagnosing nasal abnormalities before rhinoplasty than other radiographic methods [ 19 , 20 , 22 ].…”

Tin filter compared to low kV protocols - optimizing sinonasal imaging in computed tomography

“…With excellent detail of bony anatomy, cone beam CT (CBCT) additionally plays an important role in imaging of the paranasal sinuses for out clinic patients but is of very limited soft-tissue information. In CBCT, dose exposure is considered low [34][35][36][37]. However, this is only true when compared to CT examinations with dose exposures as low as 0.27 mSv [35]/ 0.6 mSv [34] and 4 mGy [37] and not when compared to sophisticated ultra-low-dose CT protocols [6].…”

“…In CBCT, dose exposure is considered low [34][35][36][37]. However, this is only true when compared to CT examinations with dose exposures as low as 0.27 mSv [35]/ 0.6 mSv [34] and 4 mGy [37] and not when compared to sophisticated ultra-low-dose CT protocols [6]. Conventional radiography no longer plays any real role in diagnosing the paranasal sinuses as the resulting images lack the detail and image quality required to visualize the relevant complex anatomy.…”

Dose development in sinonasal imaging over the last decade – a retrospective patient study

“…Cone beam CT (CBCT) is considered an alternative, especially for out-clinic patients, for assessing the paranasal sinuses for diagnosing chronic sinusitis and preoperative assessment [ 21 – 24 ]. Radiography has disadvantages because of the difficulty of delineating anatomy due to superimposition, and magnetic resonance imaging is not broadly available in the numbers needed, but is also an alternative, especially for soft tissue imaging.…”