IADR Abstract Archives
Diagnostic Accuracy of Lateral Cephalograms and CBCT for the Assessment of Sella Turcica Bridging
Objectives: To assess the diagnostic accuracy of sella turcica bridging on synthetic lateral cephalograms when compared to true sella turcica bridging determined via CBCT.
Methods: A cross-sectional study was conducted using CBCT images from which lateral cephalograms were generated. The study included 185 subjects (118 females and 67 males, age range 10-30 years, mean age 16.63+4.2 years). Sella turcica landmarks and measurements were collected for both diagnostic methods and analyzed by one examiner. After application of the Sundareswaran formula, subjects were classified into one of three outcome groups: no bridging, partial bridging, and complete bridging. Diagnostic accuracy was evaluated using sensitivity, specificity, positive and negative predictive values (PPV; NPV), and receiver operator characteristic (ROC) curves.
Results: 10 cases were diagnosed as complete bridging on CBCT while 31 cases were diagnosed as complete bridging on lateral cephalogram. Although the lateral cephalogram detected all subjects with complete bridging, it incorrectly classified 12% of subjects. The percent agreement between both diagnostic methods was 55.68% with a kappa statistic of 0.218, indicating fair but statistically significant agreement. The overall accuracy of lateral cephalograms as a diagnostic modality in discriminating between no bridging and partial bridging was fair to good as determined with area under the curve values between 0.72 and 0.86.
Conclusions: Although lateral cephalograms overestimate cases of complete bridging when compared to CBCTs, they are a suitable diagnostic modality in accurately diagnosing complete sella turcica bridging and differentiating between cases of no bridging and partial bridging. Additional studies are necessary to establish a standardized method to quantify calcification present in the clinioid processes.
Methods: A cross-sectional study was conducted using CBCT images from which lateral cephalograms were generated. The study included 185 subjects (118 females and 67 males, age range 10-30 years, mean age 16.63+4.2 years). Sella turcica landmarks and measurements were collected for both diagnostic methods and analyzed by one examiner. After application of the Sundareswaran formula, subjects were classified into one of three outcome groups: no bridging, partial bridging, and complete bridging. Diagnostic accuracy was evaluated using sensitivity, specificity, positive and negative predictive values (PPV; NPV), and receiver operator characteristic (ROC) curves.
Results: 10 cases were diagnosed as complete bridging on CBCT while 31 cases were diagnosed as complete bridging on lateral cephalogram. Although the lateral cephalogram detected all subjects with complete bridging, it incorrectly classified 12% of subjects. The percent agreement between both diagnostic methods was 55.68% with a kappa statistic of 0.218, indicating fair but statistically significant agreement. The overall accuracy of lateral cephalograms as a diagnostic modality in discriminating between no bridging and partial bridging was fair to good as determined with area under the curve values between 0.72 and 0.86.
Conclusions: Although lateral cephalograms overestimate cases of complete bridging when compared to CBCTs, they are a suitable diagnostic modality in accurately diagnosing complete sella turcica bridging and differentiating between cases of no bridging and partial bridging. Additional studies are necessary to establish a standardized method to quantify calcification present in the clinioid processes.
