Shika Hoshasen

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Objective: We have developed a computer-aided diagnosis system of osteoporosis that is used for detecting linearly eroded endosteal margin of the mandible lower border on panoramic radiographs. This newly developed system had sufficient reproducibility and diagnostic accuracy to screen for low bone mineral density (BMD) patients when it was used by two developers. However, the reproducibility and diagnostic accuracy were not evaluated when the system was used by dental practitioners, who would be considered the main users. The aim of this study was to evaluate the reproducibility and diagnostic accuracy when the system was used by dental practitioners.
Materials and methods: Fourteen dental practitioners evaluated panoramic radiographs of 100 postmenopausal women using the system. All of the women had completed BMD assessments of the lumbar spine. Intra- and inter-observer agreements were analyzed with kappa statistics. Based on the result of the system, the diagnostic efficacy (sensitivity, specificity, predictive values and accuracy) was analyzed by comparing the two groups classified by the system (women with normal and eroded lower border of the mandible) with those classified by BMD (women with normal and low BMD).
Results: Intra- and inter-observer agreements were almost perfect (κ > 0.81). The mean sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 80%, 65%, 43%, 90%, and 69%, respectively.
Conclusion: This system had good reproducibility and accuracy. We conclude that this system can be used in clinical dental practice to identify postmenopausal women who have undetected low BMD and should undergo further testing with bone densitometry.

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