Reliability of three-dimensional measurements of the upper airway on cone beam computed tomography images.
OBJECTIVE
The aim of this study was (1) to assess intra- and interobserver reliability of the localization of anatomic landmarks of the upper airway on cone beam computed tomography (CBCT) images; and (2) to assess intra- and interobserver reliability of the three-dimensional measurements of the upper airway based on these landmarks.


METHODS
Fifteen NewTom 5G (QR systems, Verona, Italy) CBCT data sets were randomly selected from the archives of the Department of Oral Radiology, Academic Centre for Dentistry (ACTA) at University of Amsterdam and VU University, Amsterdam, The Netherlands. Three observers localized six anatomic landmarks that are relevant for upper airway analysis twice, with a 10-day interval, using 3Diagnosys software (v5.3.1, 3diemme, Cantu, Italy). Subsequently, the observers performed upper airway volume measurement based on those landmarks twice as well, again with a 10-day interval, using Amira software (v4.1, Visage Imaging Inc., Carlsbad, CA). The upper airway measurements also included the minimum cross-sectional area (CSAmin), location of the CSAmin, and anteroposterior and lateral dimensions of the CSAmin.


RESULTS
Both intraobserver reliability and interobserver reliability were excellent for the localization of the anatomic landmarks of the upper airway (intraclass correlation coefficients = 0.97-1.00) as well as for the three-dimensional upper airway measurements (intraclass correlation coefficients = 0.78-1.00).


CONCLUSIONS
The methodology of landmark localization and upper airway measurements, as used in this study, showed an excellent reliability and can thus be recommended for upper airway analysis on CBCT images.
Department of Oral and Maxillofacial Radiology and Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, The Netherlands. Electronic address: H2.chen@acta.nl.
Hui
H
Chen
Assistant Professor, Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands.
Ghizlane
G
Aarab
Assistant Professor, Department of Oral and Maxillofacial Radiology and Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, The Netherlands.
Azin
A
Parsa
Professor and Chair, Department of Oral and Maxillofacial Surgery, Academic Medical Centre (AMC), University of Amsterdam, Amsterdam, The Netherlands.
Jan
J
de Lange
Professor, Department of Oral and Maxillofacial Radiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, The Netherlands.
Paul F
PF
van der Stelt
Professor and Chair, Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands.
Frank
F
Lobbezoo
D059925:Anatomic Landmarks; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D010614:Pharynx / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results