AMERICAN JOURNAL OF ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS, vol.161, no.2, pp.228-269, 2022 (SCI-Expanded)
Introduction: Several imaging software packages report the ability to measure the oropharynx and minimum cross-sectional area (MCA). This study aimed to compare 4 imaging software packages for measuring the oropharynx volume and MCA. Methods: Twenty-eight randomly selected cone-beam computed tomography scans had oropharynx volume and MCA calculated by 2 experienced operators using 4 different programs: Dolphin 3D (version 11.95.8.64; Dolphin Imaging & Management Solutions and Management Solutions, Chatsworth, Calif), InVivo Dental (version 6; Anatomage Inc, San Jose, Calif), OnDemand3D (version 1.0.10.7510; CyberMed, Seoul, South Korea), and ITK-SNAP (version 3.8.0; www.itksnap.org). The measurements were repeated after 2 weeks, and intraclass correlation coefficients were used for the reliability tests. Analysis of variance with the Tukey post-hoc test was used to compare the measurements of oropharynx and MCA with different software programs. Paired t tests were used to compare measurements of both investigators and software programs. Bland-Altman analysis was used to assess interexaminer reliability and agreement between the software programs. Results: The intraclass correlation coefficients revealed excellent repeatability for the 4 programs for both investigators. Analysis of variance showed no statistically significant difference between programs when comparing the oropharynx and MCA. There were no significant differences in software programs when measuring the airway. Bland-Altman showed the maximum difference as 4.1 cm 3 for volume and 35 mm(2) for MCA. Those differences were below the standard deviations of 5.33 cm(3) for volume and 73.75 mm(2) for MCA. Conclusions: The use of 4 different software packages to measure the airway for oropharynx volume and MCA showed high intraoperator and interoperator reliability, no statistically significant difference when using analysis of variance, Tukey post-hoc, paired t tests, and variations within one standard deviation when using Bland-Altman.