Virtual dissection table in diagnosis and classification of Le Fort fractures: A retrospective study of feasibility

Abstract

Objectives: The usefulness of Virtual dissection tables (VDTs) as diagnostic tools is still poorly assessed.The purpose of this study was to evaluate their ability to improve the diagnostic accuracy of maxillofacial CT scans of patients presenting with Le Fort fractures. Methods: We retrospectively enrolled 10 trauma patients who had previously undergone maxillofacial CT scan. Five of these patients had been diagnosed with type I, II or III Le Fort fractures, while the other five had not revealed any evident maxillary bone fractures (control group). Four different reader groups were identified: staff radiologists, senior residents, junior residents, and students. Each group consisted of two readers who carried out a blinded double reading session. Readers evaluated CT scans on the radiological workstation first, and after they reviewed the VDT-generated 3D models (Anatomage Table, Anatomage Europe, Italy). We assessed: 1) Le Fort fracture grade, 2) confidence in diagnosis, 3) anatomic resolution, 4) 3D-model handling. Intra-reader agreement on Le Fort fracture grade was assessed using Cohen's. Qualitative parameters were determined using Likert scale. Results: Intra-reader agreement for Le Fort fracture grade according to Cohen's was above 90% in all readers. showed almost perfect agreement in 7 out of 8 readers and substantial agreement in 1 out of 8. Qualitative parameters indicated a substantial preference of the VDT over the radiological workstation in all readers. Conclusions: VDT represents a valuable tool for diagnosis and classification of complex maxillofacial injuries, regardless of whether the user is a student, a junior or senior resident, or a staff radiologist. Keywords: Imaging, Three-dimensional, Skull fractures, Facial injuries, Education, Medical, Tomography, X-ray computed, Virtual dissection table