Evaluation of the influence of patient positioning on the reliability of lateral cephalometry
| Autor: | Irinel Panainte, Robert-Angelo Tuce, Oana Munteanu, Ovidiu-Tiberiu David, Adrian Neagu |
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| Rok vydání: | 2016 |
| Předmět: |
Cephalometric analysis
medicine.medical_specialty Intraclass correlation Cephalometry Radiography Patient positioning Patient Positioning 03 medical and health sciences 0302 clinical medicine Medicine Humans Radiology Nuclear Medicine and imaging Reliability (statistics) Orthodontics business.industry Reproducibility of Results 030206 dentistry General Medicine Craniometry Quality Improvement Surgery Standard error Anatomic Landmarks business Cephalogram 030217 neurology & neurosurgery |
| Zdroj: | La Radiologia medica. 122(7) |
| ISSN: | 1826-6983 |
| Popis: | Two-dimensional cephalometry is widely used for monitoring orthodontic treatments and for quantifying the outcome of maxillofacial surgery. Despite careful use of a cephalostat, successive radiographs might differ due to slight differences in patient posture. This study evaluates the reliability of lateral cephalometric measurements and estimates the impact of patient positioning on this reliability. We studied cephalograms of 104 patients; 31 of them had two radiographs because the first was deemed unsuitable for cephalometric analysis. Using AudaxCeph 3.0 (Audax, Ljubljana, Slovenia), two observers traced each cephalogram twice, one month apart. We evaluated intra- and interobserver agreement via Bland–Altman analysis, intraclass correlation coefficient (ICC), standard error of measurement, and smallest detectable difference (SDD). First, we studied the reliability of the hard tissue part of the Tweed-Merrifield analysis for 73 single cephalograms and for the better ones of patients with two exposures. Then, we studied 31 unsatisfactory cephalograms, and the ones recorded at improved patient posture. Although intraobserver bias was less than 0.5° or 0.3 mm, interobserver bias was significant for most measurements. Intraobserver reliability was high (ICC > 0.9), whereas interobserver reliability was good (ICC > 0.83) except for FMPA, FMIA and OP. Head rotations and inclinations had little impact on reliability (e.g., interobserver SDD decreased for 3 of 11 measurements). We conclude that averaging the positions of bilateral structures enables a reliable cephalometric analysis in spite of imprecise patient posture. Retaking cephalograms is ethically questionable in such cases. |
| Databáze: | OpenAIRE |
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