# 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.

## Key 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.