Comparative evaluation of Tuned Aperture Computed Tomography for the detection of mandibular fractures.
OBJECTIVE
To compare the diagnostic efficacy of Tuned Aperture Computed Tomography (TACT) with conventional imaging modalities for detection of fractures of the mandible.


METHODS
Fractures were induced using blunt trauma in human defleshed mandibles. Conventional extra-oral and indirect digital images, unprocessed TACT images reconstructed from eight and 16 basis images (BI) and iteratively restored TACT images from eight and 16 BI were used for fracture evaluation. Twelve observers recorded their diagnoses using a five-point confidence rating scale. The data were analysed using ROC curve analysis.


RESULTS
Significant differences were found (P < 0.0001) in the areas under the curve (Az): film, 0.6954; digital images 0.6169; TACT unprocessed images using 8 BI, 0.7420; TACT unprocessed images using 8 BI, 0.7667; TACT unprocessed images using 16 BI, 0.7730; TACT iteratively restored images using 16 BI, 0.8143. No observer-based differences were found. Fractures in the condylar and coronoid regions were more difficult to detect than those in the ramus and body of the mandible.


CONCLUSIONS
Iteratively restored TACT images generated using 16 BI had a superior diagnostic performance to all the other imaging modalities. Studies are in order to evaluate its in vivo potential.
Nair
M K
MK
Department of Oral and Maxillofacial Radiology, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA.
Webber
R L
RL
Johnson
M P
MP
D000704:Analysis of Variance; D019540:Area Under Curve; D002102:Cadaver; D016001:Confidence Intervals; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008335:Mandibular Condyle / Q000293:injuries; D008337:Mandibular Fractures / Q000145:classification / Q000000981:diagnostic imaging*; D015588:Observer Variation; D012372:ROC Curve; D011856:Radiographic Image Enhancement; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging; D014962:X-Ray Film