title: A comparative evaluation of the diagnostic efficacy of film and digital sensors for detection of simulated periapical lesions.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the diagnostic efficacy of Ektaspeed Plus film (EPF), a charge-coupled device (CCD), and photostimulable phosphor (PSP)-based digital images for detection of simulated periapical lesions.
  
  
  METHODS
  Lesions were simulated in the periapical areas of 24 human mandibular sections invested in acrylic using burs of sizes #1, 2, 4, and 6 and imaged using EPF, CCD, and PSP sensors. Percent correct response scores, sensitivity, and specificity values were computed for all variables. Repeated-measures analysis of variance and post hoc testing were performed to determine the effects of imaging modality, observer, and lesion sizes with respect to lesion detection.
  
  
  RESULTS
  EPF displayed the highest sensitivity and specificity, followed by PSP and CCD images (P <.001). Percent correct score was the highest for 3 of 4 observers when EPF was used. Analysis of variance revealed significance (P <.001) with respect to all variables. Observers with experience in digital image-viewing performed better than those without such experience (P <.001). Intraobserver agreement was fair (kappa = 0.5).
  
  
  CONCLUSIONS
  EPF outperformed CCD and PSP images when observers could manipulate image characteristics.
authors.affiliation: School of Dental Medicine, University of Pittsburgh, PA, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Wallace
authors.forename: M K
authors.initials: MK
authors.lastname: Nair
authors.forename: M F
authors.initials: MF
authors.lastname: Colaco
authors.forename: S F
authors.initials: SF
authors.lastname: Kapa
mesh_terms: D000704:Analysis of Variance; D006801:Humans; D008334:Mandible; D015588:Observer Variation; D010483:Periapical Diseases / Q000000981:diagnostic imaging*; D011856:Radiographic Image Enhancement / Q000295:instrumentation / Q000379:methods; D019252:Radiography, Dental, Digital / Q000295:instrumentation* / Q000379:methods; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D014962:X-Ray Film