DefinePK

Research Objective

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 aged 18-70 with suspected PNS pathologies were selected through purposive sampling. 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.

Methodology Flowchart

                        graph TD
    A["Patient Recruitment 100 patients, 18-70 years"] --> B["Informed Consent & Demographics Collection"];
    B --> C["X-ray PNS Procedure"];
    C --> D["CT PNS Procedure for all patients"];
    D --> E["Comparison of X-ray PNS and CT PNS findings"];
    E --> F["Data Analysis: Sensitivity, Specificity, PPV, NPV, Accuracy"];
    F --> G["Conclusion & Recommendations"];                    

Discussion

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. However, X-ray PNS showed limitations for smaller and more complex sinus structures, where CT PNS provided crucial additional information.

Key Findings

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. Maxillary sinuses were most commonly involved (67% of cases). Sinusitis was the most common pathology (33% of cases).

Conclusion

X-ray PNS has a diagnostic accuracy of 66% in diagnosing PNS pathologies. It shows potential as a valuable first-line screening tool, especially for larger sinus structures, which could help minimize unnecessary radiation exposure and reduce healthcare costs. However, CBCT remains crucial for evaluating complex cases and smaller sinus structures.

Fact Check

- The study included 100 patients.
- X-ray PNS showed 67% sensitivity and 60% specificity.
- The study was conducted from January 2021 to December 2022.

Mind Map