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Doctoral Thesis
DOI
10.11606/T.23.2008.tde-13042009-103702
Document
Author
Full name
Valeria Campassi Reis Gambier
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2008
Supervisor
Committee
Pereira, Marlene Fenyo Soeiro de Matos (President)
Domingos, Vanda Beatriz Teixeira Coelho
Fernandes, Kristianne Porta Santos
Freitas, Claudio Froes de
Raitz, Ricardo
Title in Portuguese
Estudo comparativo entre imagens convencional e digital indireta na interpretação de lesões radiolúcidas multiloculares
Keywords in Portuguese
Ameloblastoma
Granuloma Central de Células Gigantes
Radiografia Dentária Digital
Radiografia Panorâmica
Tumores Odontogênicos
Abstract in Portuguese
A realização de um diagnóstico envolve várias etapas, dentre elas o exame radiográfico. Embora a experiência do profissional seja fundamental, é necessário que o mesmo se atualize constantemente, conhecendo as novas tecnologias e de que forma a era digital vem se incorporando nas mais diferentes áreas. Neste trabalho buscou-se avaliar se a tecnologia digital pode colaborar na elaboração de hipóteses diagnósticas de lesões ósseas. Para isso, foram selecionadas 24 radiografias panorâmicas nas quais existiam imagens de lesões do tipo ameloblastoma, tumor odontogênico queratocístico, mixoma e lesão central de células gigantes, atestadas por laudos anátomo-patológicos. As radiografias foram digitalizadas e entregues a 12 examinadores, sendo 3 profissionais para cada uma de 4 diferentes especialidades (radiologia, estomatologia, patologia e cirurgia buco-maxilo-facial). Os examinadores observaram as imagens em dois momentos diferentes. Primeiramente analisaram a radiografia convencional e depois a imagem digitalizada correspondente com intervalo mínimo de 30 dias. Quando do exame das imagens digitais, foi oferecida aos examinadores a opção de uso de ferramentas disponíveis no software, que pudessem auxiliá-lo no procedimento. As suas opiniões eram anotadas em formulários, cujos dados foram posteriormente tabulados e submetidos à análise estatística, por meio de equações de estimação generalizadas (EEG) e índice kappa. Os resultados possibilitaram concluir que houve equivalência na eficácia dos dois métodos avaliados, com boa concordância entre os diagnósticos dos especialistas, e que a probabilidade de acerto não depende da especialidade do observador e nem do tipo de lesão. O método digital foi o preferido para observação entre os avaliadores, sendo que a ferramenta brilho e contraste foi considerada como a melhor auxiliar na elaboração das hipóteses diagnósticas, não havendo uma padronização de valores para tal. Os resultados sugerem ainda que as ferramentas da análise digital favoreceram mais o diagnóstico de um determinado tipo de lesão em comparação aos outros.
Title in English
Comparative study between conventional and indirect digital images in the interpretation of multilocular radiolucent lesions
Keywords in English
Ameloblastoma
Dental
Digital
Giant Cell
Granuloma
Odontogenic Tumors
Panoramic
Radiography
Abstract in English
The achievement of a diagnosis includes several steps, among them, the radiographic exam. Although the professional experience is fundamental, it is necessary that the professional has been updated constantly, learning new technologies and how the digital era has been incorporated to different areas of knowledge. This work aimed to assess if the digital technology might play a role in the elaboration of diagnostic hypothesis of bone lesions. For that, it was selected 24 panoramic radiographs in which it was possible to observe lesion images of ameloblastoma, keratinizing cystic odontogenic tumor, odontogenic myxoma and central giant cell lesion, with histophatological diagnosis. The radiographs were digitalized and delivered to 12 examiners, being 3 professionals for each one of the 4 specialties (radiology, stomatology, pathology and oral surgery). The examiners have observed the images in two different situations. First they analyzed the conventional radiography and then the corresponding digitalized images, after at least 30 days long. Joined to the digitalized images, it was provided to the examiners software facilities in order to support them in the procedures. Their opinions were filled in booking forms, whose information were tabulated and submitted to statistical analysis through generalized estimation equations (EEG) and kappa index. The outcome has indicated that there was an equivalent fficiency between the two selected methods of assessment. There was a good match of the diagnosis made by the examiners from each speciality, and the probability of a right judgment did not rely on the observer specialty nor on the type of lesion. The examiners have preferred the digital method, and the digital tools bright and contrast were considered the best support for the elaboration of diagnostic hypothesis. Moreover, it was not obtained standard values for bright or contrast. The outcome of this work also suggests that the use of digital analysis tools tends to be more effective for a specific type of lesion than others.
 
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Publishing Date
2009-06-08
 
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