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Abstract
Purpose
This study was performed to compare paranasal sinus tomosynthesis with computed tomography (CT) imaging as a radiologic tool to evaluate the paranasal sinuses, using measurement of the soft tissue thickness of the maxillary sinus.
Materials and Methods
A total of 114 patients with sinusitis who underwent both paranasal sinus digital tomosynthesis (DT) and CT were enrolled in this retrospective study. Two observers independently assessed soft tissue thickness in both maxillary sinus chambers using both DT and CT images.
Results
The mean difference in soft tissue thickness measured by each observer was -0.31 mm on CT and 0.15 mm on DT. The mean differences in soft tissue thickness measured with DT and CT were -0.15 by observer 1 and -0.31 by observer 2. Evaluation of the agreement in measurement of soft tissue thickness in the maxillary sinus using DT and CT showed a high intraclass correlation, with the 95% limit of agreement ranging from -3.36 mm to 3.06 mm [intraclass correlation coefficient (ICC), 0.994: p < 0.01] for observer 1 and from -5.56 mm to 4.95 mm (ICC, 0.984: p < 0.01) for observer 2.
Index terms
Radiography, Maxillary Sinus, Sinusitis, Tomography, Radiation DosageREFERENCES
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Fig. 1.
DT (A) and MDCT (B) MPR coronal images of the paranasal sinuses acquired on the same day in a 52-year-old man with clinically suspected sinusitis. (A) DT shows abnormal mucosal thickening of both maxillary sinuses which is comparable to that shown by MDCT (B). DT = digital tomosynthesis, MDCT = multidetector computed tomography, MPR = multiplanar reconstruction
Fig. 2.
Bland-Altman plots showing the difference in mean soft tissue thickness measurements between the observers’ measurements as a function of the mean CT (A) and DT values (B). The dashed middle line represents the bias (mean difference between measurements). The dashed lower and upper lines represent the limits of agreement (mean ± 1.96 SD). CT = computed tomography, DT = digital tomosynthesis, SD = standard deviation
Fig. 3.
Bland-Altman plots showing the difference in measurements of soft tissue thickness between DT and CT as a function of the mean measurement according to the two modalities obtained by observer 1 (A) and observer 2 (B). The dashed middle line represents the bias (mean difference between measurements). The dashed lower and upper lines represent the limits of agreement (mean ± 1.96 SD). CT = computed tomography, DT = digital tomosynthesis, SD = standard deviation
Table 1.
Measurement of Maxillary Sinus Soft Tissue Thickness with Both DT and CT (mm)
| DT | CT | |||
|---|---|---|---|---|
| Observer 1 | Observer 2 | Observer 1 | Observer 2 | |
| Mean measurement | 12.67 | 12.82 | 12.82 | 13.13 |
| Standard deviation | 15.00 | 14.96 | 15.02 | 14.83 |
Table 2.
Mean Maxillary Sinus Soft Tissue Thickness Measurement Error between the Two Observers according to Modality and Interobserver Agreement (mm)
| Difference in Mean Measurement | Standard Deviation | Lower LOA | Upper LOA | ICC (95% CI) | |
|---|---|---|---|---|---|
| DT | −0.15 | 1.66 | −3.41 | 3.11 | 0.994 (0.992–0.995) |
| CT | −0.31 | 2.03 | −4.29 | 3.67 | 0.991 (0.988–0.993) |
Table 3.
Mean Error for Maxillary Sinus Soft Tissue Thickness Measurements Using DT Compared to CT for All Observers with Intraobserver Agreement (mm)
| Difference in Mean Measurement | Standard Deviation | Lower LOA | Upper LOA | ICC (95% CI) | |
|---|---|---|---|---|---|
| Observer 1 | −0.15 | 1.64 | −3.37 | 3.06 | 0.994 (0.992–0.995) |
| Observer 2 | −0.31 | 2.68 | −5.56 | 4.95 | 0.984 (0.979–0.987) |
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