Comparative evaluation of Tuned Aperture Computed Tomography (R) for the detection of mandibular fractures

Objectives: To compare the diagnostic efficacy of Tuned Aperture Computed T omography (TACT(R)) with conventional imaging modalities for detection of f ractures of the mandible. Methods: Fractures were induced using blunt trauma in human defleshed mandi bles. Conventional extra-oral and indirect digital images, unprocessed TACT images reconstructed from eight and 16 basis images (BI) and iteratively r estored TACT images from eight and 16 BI were used for fracture evaluation. Twelve observers recorded their diagnoses using a five-point confidence ra ting scale. The data were analysed using ROC curve analysis. Results: Significant differences were found (P <0.0001) in the areas under the curve (Az): film, 0.6954; digital images 0.6169; TACT unprocessed image s using 8 BI, 0.7420; TACT unprocessed images using 8 BI, 0.7667; TACT unpr ocessed images using 16 BI, 0.7730; TACT iteratively restored images using 16 BI, 0.8143. No observer-based differences were found. Fractures in the c ondylar and coronoid regions were more difficult to detect than those in th e ramus and body of the mandible. Conclusions: Iteratively restored TACT images generated using 16 BI had a s uperior diagnostic performance to all the other imaging modalities. Studies are in order to evaluate its in vivo potential.