Patient-, software-, and observer-related factors associated with the time required for semi-automated measurements of the maxillary sinus volume using cone beam computed tomography (CBCT)

This study aimed to evaluate patient-, software-, and observer-related factors influencing the time required for volumetric measurements of maxillary sinuses using cone beam computed tomography (CBCT) and a commercially available software. The volumes of healthy bilateral maxillary sinuses of adult patients from CBCT images taken during a 15-month study period were measured using dedicated software by two observers. The time required for volumetric assessments was evaluated statistically with respect to the potential influence of gender, age, sinus side, sinus volume, sequence of measurement, and selection threshold of the software. The resulting average sinus volume of the 174 sinuses from 87 patients was 16.9 cm3. The average time required to measure one sinus volume was 91.8 s. Sinuses from male patients required a longer time (median of 95.5 s) for the measurements than their female counterparts (median of 87.5 s). Measurement time increased with increasing age, sinus volume and selection threshold based on calculated grey values provided by the software. The volumetric measurements and measurement times exhibited a high intra-observer agreement. The volumetric measurements were highly reproducible. Each measurement was completed within 4 minutes, though there was a marked difference in the mean measurement time between the two observers. Semi-automated volumetric measurement of the maxillary sinus with commercially available software is feasible, efficient, and reproducible. Based on these favorable findings, practitioners might consider using such volumetric instead of linear measurements to plan and analyse outcomes of sinus grafting procedures in daily clinical practice.