TITLE:
Poor Reproducibility in the Evaluation of Paranasal Sinus X-Rays in Chronic Rhinosinusitis
AUTHORS:
A. Luukkainen, E. Terna, J. Numminen, A. Markkola, P. Dastidar, J. Jarnstedt, H. Huhtala, M. Karjalainen, K. Blomgren, P. Kauppi, M. Rautiainen, S. Toppila-Salmi
KEYWORDS:
Sinusitis, Paranasal Sinus, Computed Tomography, Magnetic Resonance Imaging, X-Ray
JOURNAL NAME:
Open Journal of Radiology,
Vol.7 No.1,
March
7,
2017
ABSTRACT: Objective: The aim of this study was to evaluate intra- and inter-observer reproducibility of sinus x-rays in comparison to sinus computed tomography (CT) in chronic rhinosinusitis (CRS) patients. Methods: This was a prospective controlled study for which 14 adult CRS patients were recruited. Patients underwent a sinus multi-detector CT scan as well as additional sinus x-rays at the same time. Symptom interview and skin prick tests were performed. Lund-Mackay (LM) scores and 43 other findings in paranasal sinuses were analyzed by three blinded observers from CT-scans and x-rays. We compared agreement between sinus CT and x-rays (intra-observer reproducibility) and between three observers (inter-observer reproducibility) by Cohen’s kappa. Results: In at least 90% of the cases, the status of 47/49 structures was detectable in CT scans, whereas the status of only 8/49 structures was detectable in x-rays. The majority of the 25 visualized structures had poor intra-observer and inter-observer reproducibility. Conclusion: Only a few structures can be visualized in paranasal sinus x-rays and compared to paranasal sinus CT-scans, their reproducibility is poor. Our results strongly support the current consensus of radiation dose reduction by limiting the number of x-rays.