Reproducibility of 3 mm-Slice-Thick Reconstruction of Paranasal Sinus Computed Tomography Scans  

作　　者：Matti Karjalainen Anna Julkunen Antti Markkola Prasun Dastidar Heini Huhtala Mikko Suvinen Anna-Maija Kuukka Markus Rautiainen Jura Numminen Sanna Toppila-Salmi Matti Karjalainen;Anna Julkunen;Antti Markkola;Prasun Dastidar;Heini Huhtala;Mikko Suvinen;Anna-Maija Kuukka;Markus Rautiainen;Jura Numminen;Sanna Toppila-Salmi(Department of Otorhinolaryngology, University of Tampere, Tampere, Finland;Transplantation Laboratory, Haartman Institute, University of Helsinki, Helsinki, Finland;Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;University of Helsinki and HUS Imaging, Helsinki, Finland;Medical Imaging Centre, Department of Radiology, Tampere University Hospital, Finland;School of Public Health, University of Tampere, Tampere, Finland;Department of Otorhinolaryngology, Tampere City Hospital, Tampere, Finland;Department of Ear and Oral diseases, Tampere University Hospital, Tampere, Finland;Department of Allergy, University of Helsinki and Helsinki University Hospital, Helsinki, Finland)

机构地区：[1]Department of Otorhinolaryngology, University of Tampere, Tampere, Finland [2]Transplantation Laboratory, Haartman Institute, University of Helsinki, Helsinki, Finland [3]Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland [4]University of Helsinki and HUS Imaging, Helsinki, Finland [5]Medical Imaging Centre, Department of Radiology, Tampere University Hospital, Finland [6]School of Public Health, University of Tampere, Tampere, Finland [7]Department of Otorhinolaryngology, Tampere City Hospital, Tampere, Finland [8]Department of Ear and Oral diseases, Tampere University Hospital, Tampere, Finland [9]Department of Allergy, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

出　　处：《Open Journal of Radiology》2016年第1期39-48,共10页放射学期刊（英文）

摘　　要：Background: After the failure of medical treatment, the surgery of chronic rhinosinusitis (CRS) is planned according to endoscopic and paranasal sinus computed tomography (CT) findings. Objective: The aim of this prospective study was to evaluate whether this study method might be eligible in studies aiming at radiation dose reduction. Sinus CT scans were chosen as a model because of the high variation of the radiological anatomy of surgically important sinonasal structures. We hypothesized that 3 mm-slice-thick reconstruction CT had poor reproducibility. Methods: 59 CRS patients underwent routine multi-detector sinus CT (CT_MD). CT_3mm was reconstructed from CT_MD data-sets. Lund-Mackay (LM) scores and 43 other structural parameters were analyzed blinded. Agreement was studied between CT_MD and CT_3mm (intra-observer reproducibility), and between three observers (inter-observer reproducibility) by using Cohen’s kappa. Results: The inter-observer agreement was moderate (kappa 0.4 - 0.6, p < 0.01) in the majority of structures of CT_3mm scans. The intra-observer reproducibility of CT_3mm scans was very good in most structures, however, it was poor in important structures such as frontal and spheno-ethmoid recess, lamina papyracae, and location of optic nerve or anterior ethmoidal artery. The grade of surgeon’s confidence of CT_3mm in comparison to CT_MD was lower (kappa 0.2 - 0.4, P < 0.05). Conclusion: This methodology might have some use in studies aiming at radiation dose reduction. As was expected, 3 mm-slice-thick reconstruction CT had poor reproducibility and surgeon’s confidence. More recent methods such as cone beam computed tomography scans have nowadays more relevant dose reduction potential.Background: After the failure of medical treatment, the surgery of chronic rhinosinusitis (CRS) is planned according to endoscopic and paranasal sinus computed tomography (CT) findings. Objective: The aim of this prospective study was to evaluate whether this study method might be eligible in studies aiming at radiation dose reduction. Sinus CT scans were chosen as a model because of the high variation of the radiological anatomy of surgically important sinonasal structures. We hypothesized that 3 mm-slice-thick reconstruction CT had poor reproducibility. Methods: 59 CRS patients underwent routine multi-detector sinus CT (CT_MD). CT_3mm was reconstructed from CT_MD data-sets. Lund-Mackay (LM) scores and 43 other structural parameters were analyzed blinded. Agreement was studied between CT_MD and CT_3mm (intra-observer reproducibility), and between three observers (inter-observer reproducibility) by using Cohen’s kappa. Results: The inter-observer agreement was moderate (kappa 0.4 - 0.6, p < 0.01) in the majority of structures of CT_3mm scans. The intra-observer reproducibility of CT_3mm scans was very good in most structures, however, it was poor in important structures such as frontal and spheno-ethmoid recess, lamina papyracae, and location of optic nerve or anterior ethmoidal artery. The grade of surgeon’s confidence of CT_3mm in comparison to CT_MD was lower (kappa 0.2 - 0.4, P < 0.05). Conclusion: This methodology might have some use in studies aiming at radiation dose reduction. As was expected, 3 mm-slice-thick reconstruction CT had poor reproducibility and surgeon’s confidence. More recent methods such as cone beam computed tomography scans have nowadays more relevant dose reduction potential.

关 键 词：Chronic Rhinosinusitis Computed Tomography Image Reconstruction Inter-Observer Agreement Intra-Observer Agreement KAPPA Radiation-Dose Reduction REPRODUCIBILITY Paranasal Sinus Sinus Imaging 

分 类 号：R76[医药卫生—耳鼻咽喉科]