Inter-observer agreement and inter-imaging accuracy in sinus computed tomography scans and panoramic radiography on signs of local dentoalveolar bone loss and periapical radiolucency

Background: There can be variability between observer's opinions when reading radiographic images. Aims: The aim of this prospective study was to evaluate inter-observer agreement and inter-imaging accuracy regarding radiological signs of local dentoalveolar bone loss and apical radiolucency on sinonasal computed tomography (CT) images and Panoramic tomography (PTG) images. Materials and Methods: Imaging data of 59 patients with oral maxillofacial or sinonasal diseases were used. Radiological signs of local dentoalveolar bone loss and apical radiolucency were analyzed blinded. Using Cohen's kappa statistic the reproducibility of the findings between the oral radiologist and three other observers were compared. Inter-imaging accuracy was calculated, based on the records by the oral radiologist. Results: Inter-observer agreement between the oral radiologist and the three different professionals was from poor (kappa - 0.054) to moderate (kappa 0.455) with PTG and CT scans. Inter-imaging accuracy was moderate (0.565) to very good (0.908). Conclusions: This study showed a large diagnostic variation between the oral radiologist and the three professional observers in recording signs of local dentoalveolar bone loss and periapical radiolucency. This finding indicates that before final treatment plan of the patient, multi-professional consultation is recommended. PTG may not be as reliable imaging method as CT.