Accuracy of measurements and reliability of landmark identification with computed tomography (CT) techniques in the maxillofacial area: a systematic review

Objective. The objective of this study was to evaluate the available published information on the reliability and accuracy of skeletal CT landmark identification and associated measurement accuracy through CT in the maxillofacial region. Study design. Electronic databases were searched with the help of a senior health sciences librarian. Abstracts that appeared to fulfill the initial selection criteria were selected by consensus. The original articles were then retrieved and their references hand-searched for possible missing articles. Results. A total of 8 articles met the selection criteria. Differences between the magnitudes of errors of landmarks and their associated measurements were discussed. Conclusions. It was concluded that each landmark exhibited a characteristic pattern of error that contributed to measurement inaccuracy, and with repeated practice of landmark identifications, the error can be reduced to within 0.5 mm for 2-D CT. Considerations have to be given to some of the 3-D CT reliability values because they can have diagnosis implications.