Diagnostic Accuracy of X-Ray PNS for Paranasal Sinuses (X-Ray PNS) Sinus Pathologies with Computed Tomography Paranasal Sinuses (CT PNS) A The Gold Standard

Authors

  • Karishma Israr Rehman Medical Institute, Peshawar
  • Wasif Farman Rehman Medical Institute, Peshawar
  • Ummara Siddique Umer Rehman Medical Institute, Peshawar
  • Abdullah Rehman Medical Institute, Peshawar
  • Shahjehan Alam Rehman Medical Institute, Peshawar
  • Hadia Abid Rehman Medical Institute, Peshawar

Keywords:

X-Ray Image, Cone Beam Computed Tomography, Paranasal Sinuses, diagnostic accuracy, Radiation Exposure

Abstract

OBJECTIVES

To determine the diagnostic accuracy of X-ray PNS in different pathologies of paranasal sinuses, using CT PNS as the gold standard, and establishing X-ray PNS as a potential first-line screening tool.

METHODOLOGY

This cross-sectional study was conducted over two years in the Department of Radiology, Rehman Medical Institute Peshawar. 100 patients in the sample with suspected PNS pathologies were selected through the purposive sampling technique, aged 18-70. All patients underwent X-ray PNS initially, followed by CT scans. CT PNS was performed even in cases with normal X-ray findings to check for false negatives or positives.

RESULTS
Out of 100 patients, 56% were male. Most PNS pathologies (55%) were in the 15-35 age group (mean age 24 years, SD ±3.89). The most common symptoms were nasal obstruction (40%) and headache (39%). X-ray PNS showed 67% sensitivity, 60% specificity, 85% PPV, and 64% NPV. The overall diagnostic accuracy of X-ray PNS was 66% compared to CT PNS.

CONCLUSION

X-ray PNS demonstrates a diagnostic accuracy of 66% in diagnosing PNS pathologies. While not as comprehensive as CBCT, X-ray PNS shows potential as a first-line screening tool, particularly for larger sinuses, potentially reducing unnecessary radiation exposure from CT scans.

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Author Biographies

Karishma Israr, Rehman Medical Institute, Peshawar

Resident,
Department of Radiology,
Rehman Medical Institute, Peshawar

Wasif Farman, Rehman Medical Institute, Peshawar

Radiologist,
Department of Radiology,
Rehman Medical Institute, Peshawar

Ummara Siddique Umer, Rehman Medical Institute, Peshawar

Associate Professor,
Department of Radiology,
Rehman Medical Institute, Peshawar

Abdullah, Rehman Medical Institute, Peshawar

Consultant Radiologist,
Department of Radiology,
Rehman Medical Institute, Peshawar

Shahjehan Alam, Rehman Medical Institute, Peshawar

Professor,
Department of Radiology,
Rehman Medical Institute, Peshawar

Hadia Abid, Rehman Medical Institute, Peshawar

Consultant Radiologist,
Department of Radiology,
Rehman Medical Institute, Peshawar

References

Herring W. Learning radiology: recognizing the basics. Elsevier Health Sciences; 2019 Feb 2

Koparal M, Kurt E, Altuntas EE, Dogan F. Assessment of mucociliary clearance as an indicator of nasal function in patients with COVID-19: a cross-sectional study. European Archives of Oto-Rhino-Laryngology. 2021 Jun;278:1863-8

Waldmann M, Grosch A, Witzler C, Lehner M, Benda O, Koch W, Vogt K, Kohn C, Schröder W, Göbbert JH, Lintermann A. An effective simulation-and measurement-based workflow for enhanced diagnostics in rhinology. Medical & biological engineering & computing. 2022 Feb;60(2):365-91

Park DY, Choi JH, Kim DK, Jung YG, Mun SJ, Min HJ, Park SK, Shin JM, Yang HC, Hong SN, Mo JH. Clinical practice guideline: nasal irrigation for chronic rhinosinusitis in adults. Clinical and Experimental Otorhinolaryngology. 2022 Feb 15;15(1):5-23

Slavin RG, Spector SL, Bernstein IL, et al.: The diagnosis and management of sinusitis: a practice parameter update. J Allergy Clin Immunol. 2005, 116:13

Godley FA, Casiano RR, Mehle M, McGeeney B, Gottschalk C. Update on the diagnostic considerations for neurogenic nasal and sinus symptoms: a current review suggests adding a possible diagnosis of migraine. American journal of otolaryngology. 2019 Mar 1;40(2):306-11

Ehigiamusoe FO, Obi-Egbedi-Ejakpovi EE. Computed tomographic scan utilization in the diagnosis of otorhinolaryngological diseases. Sahel Medical Journal. 2020 Jul 1;23(3):164-9

Hamdi AA. Role of Computed Tomography in Determining the Spectrum of Paranasal Sinuses Pathologies in Saudi patients (Master's thesis, Alfaisal University (Saudi Arabia))

Ahmed A, Malik G, Rauf M: Comparison between imaging technologies (x-ray with computed tomography scan) of paranasal sinuses (PNS) in sinusitis patients. PPMJ. 2016, 27:68-71

Ebell MH, McKay B, Dale A, Guilbault R, Ermias Y: Accuracy of signs and symptoms for the diagnosis of acute rhinosinusitis and acute bacterial rhinosinusitis. Ann Fam Med. 2019, 17:164-72

Kanwar SS, Mital M, Gupta PK, Saran S, Parashar N, Singh A: Evaluation of paranasal sinus diseases by computed tomography and its histopathological correlation. J Oral Maxillofac Radiol. 2017, 5:46-52

Zarei E, Bagheri SM, Tadayon A: Evaluation of ultrasound efficiency in the diagnosis of acute maxillary sinusitis in comparison with. CT scan findings in children aged 5 to 15 years, J Res Med Dent Sci. 2018, 6:363-7

Al Qahtani F. Diagnostic accuracy of digital paranasal sinus view and computed tomography in the evaluation of maxillary sinusitis–A comparative study. IP International Journal of Maxillofacial Imaging. 2019;5(1):3-9

Dong D, Wang Y, Li C, Zhang H, Zhao Y, Lai J. Fibro‐osseous Lesions of Paranasal Sinus and Craniofacial Region: A Retrospective Study of 282 Cases. The Laryngoscope. 2021 Jan;131(1):E1-7

Gendeh HS, Gendeh BS. Paranasal sinuses anatomy and anatomical variations. Paranasal Sinuses Anatomy and Conditions. 2022 Mar 30;49

Yoon JH, Na DG, Byun HS, Koh YH, Chung SK, Dong HJ. Calcification in chronic maxillary sinusitis: comparison of CT findings with histopathologic results. American journal of neuroradiology. 1999 Apr 1;20(4):571-4

Gupta SC, Singh M, Jain A, Walia DK. A comparative study of radiological and antroscopic findings in the lesions of maxillary sinus. Indian Journal of Otolaryngology and Head and Neck Surgery. 2004 Jan;56:9-13

Verma J, Tyagi S, Srivastava M, Agarwal A. Computed tomography of paranasal sinuses for early and proper diagnosis of nasal and sinus pathology. Int J Otorhinolaryngol Head Neck Surg. 2016 Apr;2(2):70

Pak F, Hosseini Pooya SM, Shabani H, Baradaran S, Salim Sadeq U. Comparison of CBCT and ct in terms of dose value of organs at risk in paranasal sinus imaging. Radiation Protection Dosimetry. 2022 Mar;198(4):208-13

Mishra S, Thakur V, Kapila S, Moudgil S, Mishra S. Comparison of Low-Dose Non-contrast CT in Detecting Anatomical and Surgically Important Variants of Paranasal Sinuses to Standard Dose Non-contrast CT: Experience from a Tertiary Care Hospital in Sub-Himalayan Region of Northern India. Indian Journal of Otolaryngology and Head & Neck Surgery. 2024 Feb;76(1):64-72

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Published

2024-09-30

How to Cite

Israr, K., Wasif Farman, Siddique Umer, U., Abdullah Safi, Shahjehan Alam, & Hadia Abid. (2024). Diagnostic Accuracy of X-Ray PNS for Paranasal Sinuses (X-Ray PNS) Sinus Pathologies with Computed Tomography Paranasal Sinuses (CT PNS) A The Gold Standard. Journal of Gandhara Medical and Dental Science, 11(4), 28–32. Retrieved from http://jgmds.org.pk/index.php/JGMDS/article/view/570