Influence of Examiner Experience on the Measurement of Bone-Loss by Low-Dose Cone-Beam Computed Tomography: An Ex Vivo Study

TL;DR

This study shows that training improves the accuracy and confidence of bone-loss measurements using low-dose CT scans among less experienced examiners.

Contribution

The study demonstrates that training can enhance diagnostic accuracy and confidence in low-dose CBCT bone-loss measurements.

Findings

Examiner experience significantly affects the accuracy of bone-loss measurements in HD and LD CBCT.

Training improved measurement accuracy and certainty for less experienced diagnosticians.

Diagnostic certainty increased notably after training, especially for diagnostician 3.

Abstract

The aim of this study was to investigate the influence of examiner experience on measurements of bone-loss using high-dose (HD) and low-dose (LD) CBCT. Three diagnosticians with varying levels of CBCT interpretation experience measured bone-loss from CBCT scans of three cadaveric heads at 30 sites, conducting measurements twice. Between the first and second measurements, diagnostician 2 and diagnostician 3 received training in LD-CBCT diagnostics. The diagnosticians also classified the certainty of their measurements using a three-grade scale. The accuracy of bone-loss measurements was assessed using the absolute difference between observed and clinical measurements and compared among diagnosticians with different experience levels for both HD and LD-CBCT. At baseline, there was a significant difference in measurement accuracy between diagnostician 1 and diagnostician 2, and between diagnostician 1 and diagnostician 3, but not between diagnostician 2 and diagnostician 3. Training improved the accuracy of both HD-CBCT and LD-CBCT measurements in diagnostician 2, and of LD-CBCT measurements in diagnostician 3. Regarding measurement certainty, there was a significant difference among diagnosticians before training. Training enhanced the certainty for diagnosticians 2 and 3, with a significant improvement noted only for diagnostician 3. Examiner experience level significantly impacts the accuracy and certainty of bone-loss measurements using HD- and LD-CBCT.

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