title: Comparison of panoramic radiography and panoramic digital subtraction radiography in the detection of simulated osteophytic lesions of the mandibular condyle.
abstract: OBJECTIVE
  The aim of this study was to compare panoramic temporomandibular joint radiography, unenhanced and color-enhanced digital-subtraction radiography with respect to detectability of simulated osteophytic lesions of the mandibular condyle.
  
  
  METHODS
  Three dry human skulls with no obvious temporomandibular joint pathology were selected. Four sizes of bone chips were placed on the anterior aspect of the condyle at medial, central, and lateral locations. Panoramic radiographs were made with and without the chips in place. These paired radiographs were digitized, and unenhanced and color-enhanced digital-subtraction images of the original panoramic images were obtained. Eight observers evaluated 72 randomized images of each modality for the presence or absence of simulated osteophytic lesions of the mandibular condyle, grading the images on a 100-point scale.
  
  
  RESULTS
  A(z) values for overall diagnostic accuracy of the three imaging modalities were 0.5376 for panoramic radiography, 0.7861 for unenhanced digital subtraction radiography, and 0.7923 for color-enhanced digital-subtraction radiography. Digital-subtraction radiography improved the detection accuracy of the original panoramic films.
  
  
  CONCLUSIONS
  Panoramic radiographs were significantly less accurate in the detection of simulated osteophytic lesions of the mandibular condyle than the two digital-subtraction techniques.
authors.affiliation: University of Oklahoma, Oklahoma City, Okla 73190, USA.
authors.forename: Farah
authors.initials: F
authors.lastname: Masood
authors.forename: Jerald O
authors.initials: JO
authors.lastname: Katz
authors.forename: Patrick K
authors.initials: PK
authors.lastname: Hardman
authors.forename: Alan G
authors.initials: AG
authors.lastname: Glaros
authors.forename: Paulette
authors.initials: P
authors.lastname: Spencer
mesh_terms: D000704:Analysis of Variance; D019540:Area Under Curve; D003116:Color; D005096:Exostoses / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D016013:Likelihood Functions; D008335:Mandibular Condyle / Q000000981:diagnostic imaging*; D008336:Mandibular Diseases / Q000000981:diagnostic imaging; D015588:Observer Variation; D012372:ROC Curve; D011856:Radiographic Image Enhancement; D011862:Radiography, Panoramic / Q000379:methods; D015203:Reproducibility of Results; D013223:Statistics as Topic; D013382:Subtraction Technique / Q000145:classification; D013705:Temporomandibular Joint Disorders / Q000000981:diagnostic imaging*; D014963:X-Ray Intensifying Screens