AIM To determine if small and medium field of view (FOV) cone beam computed tomography (CBCT) adjusted grey density values can be used to distinguish between periapical cystic and solid lesions. METHODOLOGY Fifty-seven patients with periapical lesions having retrievable small or medium FOV CBCT images and biopsy samples were included. Two oral and maxillofacial pathologists examined the biopsy samples to provide the gold standard diagnosis of cystic or solid lesion. From the CBCT images, two independent examiners recorded the minimum adjusted grey density value of each lesion twice. Intra-examiner and inter-examiner reliability of the measurements were analysed, and sensitivity, specificity and accuracy of the minimum grey values in distinguishing a solid from cystic lesion were calculated. A receiver operating curve for diagnostic ability of adjusted grey density values to differentiate between periapical cystic and solid lesions was obtained, and the area under the curve (AUC) was calculated. RESULTS The intra- and inter-examiner reliability of the grey density values of the lesions and dentine were excellent. The AUC was 0.44 (P-value = 0.45). The adjusted grey density value with the greatest accuracy for differentiating between cystic and solid lesions had an accuracy, sensitivity and specificity of 0.54, 1.00 and 0.075, respectively. CONCLUSIONS Small FOV CBCT adjusted grey density values obtained by the device used in the study could not distinguish between periapical cystic and solid lesions. Further developments in CBCT devices are needed to improve the accuracy of grey density measurements.

中文翻译：

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用小视场锥束计算机断层摄影术获得的平均灰度密度值在根尖周囊性病变和实体性病变之间的区分的准确性。

目的确定中小视野（FOV）锥束计算机断层扫描（CBCT）调整的灰度密度值是否可用于区分根尖周囊性病变和实体病变。方法包括57例根尖周病变的患者，这些患者具有可检索的中小FOV CBCT图像和活检样本。两名口腔颌面病理学家检查了活检样本，以提供诊断囊性或实体性病变的金标准。从CBCT图像中，两名独立的检查者两次记录了每个病变的最小调整灰度密度值。分析了内部检查者和内部检查者的可靠性，并计算了区分灰质和囊性病变的最小灰度值的敏感性，特异性和准确性。获得用于调节灰密度值以区分根尖周囊性病变和实体病变的诊断能力的接收器工作曲线，并计算曲线下面积（AUC）。结果病变和牙本质的灰度密度值在检查者内和检查者间具有极好的可靠性。AUC为0.44（P值= 0.45）。调整后的灰度密度值（用于区分囊性病变和实体病变）的准确性最高，其准确性，敏感性和特异性分别为0.54、1.00和0.075。结论本研究中使用的设备通过小视场CBCT调整的灰度密度值无法区分根尖周围的囊性病变和实体病变。为了提高灰度密度测量的准确性，需要对CBCT设备进行进一步的开发。