title: Assessment of using digital manipulation tools for diagnosing mandibular radiolucent lesions.
abstract: OBJECTIVE
  The purpose of this study was to analyse the use of digital tools for image enhancement of mandibular radiolucent lesions and the effects of this manipulation on the percentage of correct radiographic diagnoses.
  
  
  METHODS
  24 panoramic radiographs exhibiting radiolucent lesions were selected, digitized and evaluated by non-experts (undergraduate and newly graduated practitioners) and by professional experts in oral diagnosis. The percentages of correct and incorrect diagnoses, according to the use of brightness/contrast, sharpness, inversion, highlight and zoom tools, were compared. All dental professionals made their evaluations without (T₁) and with (T₂) a list of radiographic diagnostic parameters.
  
  
  RESULTS
  Digital tools were used with low frequency mainly in T₂. The most preferred tool was sharpness (45.2%). In the expert group, the percentage of correct diagnoses did not change when any of the digital tools were used. For the non-expert group, there was an increase in the frequency of correct diagnoses when brightness/contrast was used in T₂ (p=0.008) and when brightness/contrast and sharpness were not used in T₁ (p=0.027). The use or non-use of brightness/contrast, zoom and sharpness showed moderate agreement in the group of experts [kappa agreement coefficient (κ) = 0.514, 0.425 and 0.335, respectively]. For the non-expert group there was slight agreement for all the tools used (κ ≤ 0.237).
  
  
  CONCLUSIONS
  Consulting the list of radiographic parameters before image manipulation reduced the frequency of tool use in both groups of examiners. Consulting the radiographic parameters with the use of some digital tools was important for improving correct diagnosis only in the group of non-expert examiners.
authors: São Leopoldo Mandic, Dental Research Institute, Campus,São Paulo, Brazil.
authors: R
authors: R
authors: Raitz
authors: J N R
authors: JN
authors: Assunção Junior
authors: M
authors: M
authors: Fenyo-Pereira
authors: L
authors: L
authors: Correa
authors: L P
authors: LP
authors: de Lima
mesh_terms: D000564:Ameloblastoma / Q000000981:diagnostic imaging; D003803:Dentigerous Cyst / Q000000981:diagnostic imaging; D003815:Dentists; D003945:Diagnosis, Oral; D006801:Humans; D007570:Jaw Cysts / Q000000981:diagnostic imaging; D008336:Mandibular Diseases / Q000000981:diagnostic imaging*; D008339:Mandibular Neoplasms / Q000000981:diagnostic imaging; D009808:Odontogenic Tumors / Q000000981:diagnostic imaging; D011856:Radiographic Image Enhancement / Q000379:methods*; D019252:Radiography, Dental, Digital / Q000379:methods; D011862:Radiography, Panoramic / Q000379:methods*; D011871:Radiology; D013335:Students, Dental