A COMPARISON OF KODAK EKTASPEED PLUS FILM AND THE SIEMENS SIDEXIS DIGITAL IMAGING-SYSTEM FOR CARIES DETECTION USING RECEIVER OPERATING CHARACTERISTIC ANALYSIS

Objective, To evaluate the accuracy of proximal caries detection compa ring enhanced and unenhanced Siemens Sidexis CCD-based digital images with Ektaspeed Plus films utilizing receiver operating characteristic analysis. Study Design. Sixty extracted teeth (24 posterior and 36 ant erior) were imaged under identical standardized geometric and exposure conditions. Six observers, using a 5-point confidence scale, rated 12 0 proximal surfaces for the presence or absence of carious lesions by means of three image modalities: (1) observer enhanced and (2) unenhan ced Sidexis displays, and (3) Ektaspeed Plus films. The ground truth w as determined by microscopic analysis of ground sections. Receiver ope rating characteristic curves were generated with calculated areas (A(2 )) analyzed with analysis of variance for effect of reader, reading, a nd modality. Results. Analysis of variance demonstrated significant di fferences among readers, readings and modalities (mean square values o f 0.012, 0.005, 0.004, F ratios of 13.604, 5.329, 5.100; p = values of 0.001, 0.043, and 0.030, respectively). Post-hoc paired comparisons o f modalities using Tukey's statistic demonstrated that only film and e nhanced Sidexis images were different from each other (p = 0.024). A(z ) scores were 0.7650, 0.7499, and 0.8008 respectively, for unenhanced Sidexis, enhanced Sidexis, and Ektaspeed Plus film. Conclusion. Unenha nced digital Sidexis images were equivalent to film for the detection of proximal caries in this in vitro study. Observer enhanced Sidexis i mages exhibited a statistically significant lower diagnostic accuracy than the unenhanced digital and film images.