The Effect of Panoramic Radiography Quality on the Agreement of Diagnosis of Apical Radiolucent Lesions in Maxillary Premolars

INTRODUCTION:The aim was to evaluate the diagnostic agreement of apical radiolucent lesions in the maxillary premolars between panoramic radiography (PAN) and periapical radiography (PAR) and to examine the effect of PAN image quality on diagnostic agreement.METHODS: Ninety patients who had PAN and PAR (XMind DC, Satelec Acteon, France; 70kVp, 8mA, 0.32 s) including all or part of the maxillary premolar teeth were included.The maxillary posterior crown region was masked on the panoramic radiography to avoid bias. 2 observers were asked to score the maxillary premolar teeth on radiographs as no lesion (0), lesion present (1), and no tooth (2).Observers were asked to evaluate PANs and classify them according to the diagnostic quality.Intra-observer and interobserver agreement were statistically evaluated using Cohen's kappa test. RESULTS:The sensitivity, precision, and F1 score for interobserver agreement regarding the presence of a lesion (score 1) in the first premolar were lower in PAN compared to PAR.Additionally, the sensitivity, precision, and F1 score for lesions in all premolars were lower in the low PAN quality group compared to the high PAN quality group.CONCLUSION: PAN quality can have an impact on the diagnostic accuracy of apical radiolucent lesions in the maxillary premolars.