<p>Karcinom dojke predstavlja najče&scaron;ću malignu neoplazmu među ženskom populacijom, a po&scaron;tedna terapija dojke, preferirani je model lečenja bolesnica u ranom stadijumu bolesti. Smatra se da je optimalna hirur&scaron;ka resekciona margina 2 mm. Opisano je mnogo metoda koje služe za intraoperativnu proveru suficijentnosti resekcione hirur&scaron;ke margine i sve one imaju svoje prednosti i mane. Ciljevi ove studije bili su da se utvrdi, da li postoji statistički značajna razlika u određivanju &scaron;irine negativne resekcione hirur&scaron;ke margine izražene u milimetrima pri operacijama karcinoma dojke upotrebom palpatorne metode i intraoperativne mobilne radiografije, poređenjem nalaza merenja hiruga sa većim i manjim iskustvom u hirurgiji karcinoma dojke kao i nalaza radiologa u odnosu na patohistolo&scaron;ku ex tempore analizu. Istraživanje je sprovedeno kao retrospektivno&ndash;prospektivna studija na Klinici za operativnu onkologiju, Instituta za onkologiju Vojvodine i obuhvatilo je 150 bolesnica kod kojih je preoperativno dijagnostikovan karcinom dojke. Kriterijum za uključenje u studiju bilo je izvođenje po&scaron;tedne operacije dojke sa ili bez disekcije ipsilaterale aksile, dok su iz studije isključene bolesnice kod kojih nije bilo moguće izvesti po&scaron;tednu operaciju dojke, one sa radiolo&scaron;ki potvrđenom diseminovanom bole&scaron;ću, kao i bolesnice koje su ranije operisane zbog karcinoma iste dojke. Kod svih 150 ekstirpiranih karcinoma dojke urađena je procena &scaron;irine resekcione hirur&scaron;ke margine intraoperativno palpatornom metodom, zatim na aparatu za mobilnu digitalnu radiografiju, te radiogram analiziran od strane iskusnog i manje iskusnog hiruga u hirurgiji karcinoma dojke, kao i radiologa te upoređen sa nalazom ex tempore patohistolo&scaron;ke analize. Definitivna &scaron;irina resekcione hirur&scaron;ke margine potvrđena je na parafinskim patohistolo&scaron;kim preparatima. Srednja vrednost praćenja bolesnica, postoperativno, iznosila je 100,97 nedelja. Najveći broj bolesnica pripadao je starijoj životnoj dobi (56,67%). Preoperativna lokalizacija klinički nepalpabilnih tumora u dojci urađena je kod 52 (34,67%) bolesnice. Najče&scaron;će se tumor prezentovao kao solitarni fokus sa okolnim ognji&scaron;tima in situ karcinoma (72, 48%), dok je najče&scaron;ći histolo&scaron;ki subtip bio duktalni invazivni karcinom dojke (112 (74,67%)). Najveći broj operacija dojke okarakterisan je kao kvadrantektomija (85 (56,67)), dok je najučestalija operacija aksile bilo određivanje limfnog čvora stražara (119 (79,33%). Analizom rada aparata za mobilnu digitalnu radiografiju do&scaron;li smo do saznanja da nema statistički značajne razlike u oceni kvaliteta radiograma i &scaron;irine resekcione hirur&scaron;ke margine merene na aparatu za mobilnu digitalnu radiografiju između iskusnog hirurga i radiologa. Statistički značajna razlika nije uočena ni pri merenju &scaron;irine resekcione hirur&scaron;ke margine izražene u milimetrima na aparatu za mobilnu digitalnu radiografiju od strane iskusnog hirurga i radiologa u odnosu na ex tempore patohistolo&scaron;ku analizu, dok je ista uočena nakon definitivne patohistolo&scaron;ke analize. &Scaron;ansa doresekcije tkiva dojke nakon merenja na aparatu za mobilnu digitalnu radiografiju je 1,4 puta veća nego nakon patohistolo&scaron;ke ex tempore analize. Lokalni recidiv javio se kod jedne pacijentkinje tokom perioda praćenja. Ne postoji statistički značajna razlika u određivanju &scaron;irine resekcione hirur&scaron;ke margine izražene u milimetrima upotrebom aparata za mobilnu digitalnu radiografiju od strane iskusnog hirurga i radiologa u odnosu na patohistolo&scaron;ku ex tempore analizu, dok ista postoji nakon analize radiograma od strane manje iskusnog hirurga. Palpatorna metoda se ne može smatrati sigurnom metodom u određivanju &scaron;irine hirur&scaron;ke resekcione margine. Ne postoji statistički značajna razlika u broju doresekcije tkiva dojke između hirurga sa različitim hirur&scaron;kim iskustvom.</p> / <p>Breast cancer is the most common malignant neoplasm in the female population, and conservative breast therapy is the preferred treatment model for patients in early stages of the disease. The optimal surgical resection margin, from healthy breast tissue around the primary tumor is 2 mm. Many methods have been described that serve to check the resection margin during breast conservative surgery and all of them have their advantages and disadvantages. The aim of this study was to determine whether there was a statistically significant difference in the determination of the width of the negative resection margin expressed in millimeters in breast cancer surgery using palpatory method and intraoperative mobile specimen radiography, comparing the findings of measuring of surgeons with greater and lesser experience in breast cancer surgery as well as the findings of the radiologist in relation to histopathological ex tempore and definitive histopathological analysis. The study was conducted as a retrospective - prospective study at the Clinic for Operative Oncology, Oncology Institute of Vojvodina and included 150 patients who were preoperatively diagnosed with breast cancer. The criterion for inclusion in the study was the opportunity to perform breast conservative surgery with or without complete axillary lymph node dissection. Patients that were treated with breast amputation, those with radiological confirmed disseminated disease, as well as patients previously operated from cancer were excluded from the study. For all 150 extirpated breast cancers, an estimate of the width of the resection surgical margin was performed intraoperatively with a palpatory method, followed by measuring on device for mobile specimen digital radiography, and a radiogram was analyzed by an experienced and less experienced surgeon in breast cancer surgery, as well as by a radiologist and compared with an ex tempore histopathological analysis. The definitive width of the resection surgical margin was confirmed on histopathological preparations. The mean follow-up, postoperatively, was 100.97 weeks. The majority of patients belonged to the elderly age (56.67%). Preoperative localization of clinically impalpable breast tumors was performed in 52 (34.67%) patients. Most often the tumor was presented as a solitary focus with surrounding foci of in situ cancer (72, 48%), while the most common histological subtype was invasive ductal breast cancer (112 (74.67%)). The majority of breast operations were characterized like quadrantectomy (85 (56.67)), while the most frequent axillary surgery was the determination of the sentinel lymph node (119 (79.33%). No significant difference was observed in the evaluation of radiography quality and the width of the resection surgical margin measured on the mobile digital radiography device between the experienced surgeon and the radiologist. No statistically significant difference was observed in the measurement of the width of the resection surgical margin expressed in millimeters on the mobile digital radiography device by the experienced surgeon and radiologist versus ex tempore histopathological analysis, while the statistical difference was observed after definite histopathological analysis. The chance of breast tissue reexcision after measurement on a mobile digital radiography device is 1.4 times higher than after histopathological ex tempore analysis. Local relapse occurred in one patient during the follow-up period. There is no statistically significant difference in the determination of the width of the resection surgical margin expressed in millimeters using a mobile digital radiography device by an experienced surgeon in breast cancer surgery and radiologist with respect to histopathological ex tempore analysis. However, the statistical difference exists after radiogram analysis by a less experienced surgeon. The palpatory method cannot be considered as a safe method in determining the width of a surgical resection margin. There is no statistically significant difference in the number of breast tissue additional resections between surgeons with different surgical experience.</p>

<p>Циљ ове студије је да се упореди дијагностичкa значајност 2Д и 2Д+3Д мамографије у детектовању тумора дојке. Испитивали смо 864 дојки у 740 пацијенткиња. Студија је спроведена у току рутинског рада у Центру за имиџинг дијагностику Институту за онкологију Војводине. 2Д + 3Д мамографија су начињене појединачно или у истом акту снимања као комбо опција на Selenia Dimensions апарату произвођача фирме Холоџик. Радиолошки извешатаји су класификовани у категорије 1-5 према АЦР БИ РAДС-у. Патохистолошка верификација је вршена у свих суспектних промена или у току њиховог праћења . Све пацијенткиње са уредним налазом или мамографски уочених бенигних промена су радиолошки праћене најкраће током 2 године. Уочено је 103 малигне лезије у дојкама класификованих као БИ РАДС 4, 5 на дигиталној мамографији и у 22 дојке чије су промене класификоване као БИ РАДС 1-3, током праћења или прегледа дојки помоћу других модалитета. На 2Д + 3Д мамографији малигните је потврђен у 125 дојке од којих је 118 класификовано као БИ РАДС 4,5 и у 7 дојки чује су промене категорисане у БИРАДС 1-3. Постоји статистички значајна разлика у дистрибуцији малигних налаза у односу на подгрупе Студија је показала 20% лажно негативних налаза на 2Д, а 5,6% на 2Д + 3Д модалитету прегледа дојки. Осетљивост у откривању рака у овој студији износи 82,4% на 2Д и 94,4% на 2Д+3Д методи прегледа, док је специфичност 90,5% и 92,0%, респективно. ППВ је већа за 2Д + 3Д технику прегледа , износи 66,7%, као и негативна предиктивна вредност која износи 99,0%. У 172 случаја (19, 9%) налази 2Д мамографије се не уочавају на 3Д техници прегледа и сматрају се последицом структурне или анатомске &bdquo;буке&ldquo;. Већина не -сталних налаза (85%) је класификовано као фокална асиметрија. У овој студији 500 дојки је класификовано према АЦР структури у масне (АЦР 1) или дифузне фибро-гландуларне (АЦР 2), а преосталих 264 је било хетеродензно (АЦР 3) и значајно дензно (АЦР 4). Статистички значајна разлика није показана приликом дистрибуције малигних налаза у поређењу са подгрупама дојки начињеним према њиховој густини - складу са правилима АЦР-а. Укупна тачност теста износи 89,4% за 2Д и 92,4% за 2Д + 3Д мамографију. Предиктивне вредности добијене за 2Д + 3Д мамографију су боље од оних које се односе само на 2Д мамографију, што је резултат њене веће осетљивости и шире могућности карактеризације промена. Варијабилност у интерпретацији налаза међу два радиолога је је ниска, показано је слагање у интершпретавцији евалуираних мамограма у 94.1% случајева.</p> / <p>Cilj ove studije je da se uporedi dijagnostička značajnost 2D i 2D+3D mamografije u detektovanju tumora dojke. Ispitivali smo 864 dojki u 740 pacijentkinja. Studija je sprovedena u toku rutinskog rada u Centru za imidžing dijagnostiku Institutu za onkologiju Vojvodine. 2D + 3D mamografija su načinjene pojedinačno ili u istom aktu snimanja kao kombo opcija na Selenia Dimensions aparatu proizvođača firme Holodžik. Radiološki izvešataji su klasifikovani u kategorije 1-5 prema ACR BI RADS-u. Patohistološka verifikacija je vršena u svih suspektnih promena ili u toku njihovog praćenja . Sve pacijentkinje sa urednim nalazom ili mamografski uočenih benignih promena su radiološki praćene najkraće tokom 2 godine. Uočeno je 103 maligne lezije u dojkama klasifikovanih kao BI RADS 4, 5 na digitalnoj mamografiji i u 22 dojke čije su promene klasifikovane kao BI RADS 1-3, tokom praćenja ili pregleda dojki pomoću drugih modaliteta. Na 2D + 3D mamografiji malignite je potvrđen u 125 dojke od kojih je 118 klasifikovano kao BI RADS 4,5 i u 7 dojki čuje su promene kategorisane u BIRADS 1-3. Postoji statistički značajna razlika u distribuciji malignih nalaza u odnosu na podgrupe Studija je pokazala 20% lažno negativnih nalaza na 2D, a 5,6% na 2D + 3D modalitetu pregleda dojki. Osetljivost u otkrivanju raka u ovoj studiji iznosi 82,4% na 2D i 94,4% na 2D+3D metodi pregleda, dok je specifičnost 90,5% i 92,0%, respektivno. PPV je veća za 2D + 3D tehniku pregleda , iznosi 66,7%, kao i negativna prediktivna vrednost koja iznosi 99,0%. U 172 slučaja (19, 9%) nalazi 2D mamografije se ne uočavaju na 3D tehnici pregleda i smatraju se posledicom strukturne ili anatomske &bdquo;buke&ldquo;. Većina ne -stalnih nalaza (85%) je klasifikovano kao fokalna asimetrija. U ovoj studiji 500 dojki je klasifikovano prema ACR strukturi u masne (ACR 1) ili difuzne fibro-glandularne (ACR 2), a preostalih 264 je bilo heterodenzno (ACR 3) i značajno denzno (ACR 4). Statistički značajna razlika nije pokazana prilikom distribucije malignih nalaza u poređenju sa podgrupama dojki načinjenim prema njihovoj gustini - skladu sa pravilima ACR-a. Ukupna tačnost testa iznosi 89,4% za 2D i 92,4% za 2D + 3D mamografiju. Prediktivne vrednosti dobijene za 2D + 3D mamografiju su bolje od onih koje se odnose samo na 2D mamografiju, što je rezultat njene veće osetljivosti i šire mogućnosti karakterizacije promena. Varijabilnost u interpretaciji nalaza među dva radiologa je je niska, pokazano je slaganje u interšpretavciji evaluiranih mamograma u 94.1% slučajeva.</p> / <p>The aim of this study was to compare diagnostic importance of 2D and 2D+3D diagnostic mammography in breast tumor detection. We evaluated 864 breasts in 740 patients. Study was performed in Diagnostic Imaging Center at Oncology Institute of Vojvodina. 2D+3D mammography were performed during single procedure or via combo option at Selenia Dimensions unit, Hologic, BE. Radiological findings were classified in categories 1-5 according to ACR BIRADS. Pathohistologic verification was obtained in all suspicious findings or after follow up studies. All other patients with mammographic normal findings or benign findings were fallowed up during 2 years period or longer. We detected malignant lesions in 103 breasts classified as BIRADS 4,5 at digital mammography, and in 22 breasts classified as BIRADS 1-3 after followed up or diagnosed by other imaging modalities. At 2D+3D mammography malignancy was confirmed in 125 breasts, 118 classified as BIRADS 4,5 and in 7 breasts classified as BIRADS 1-3. There is statistically significant difference (p&lt;0.001) in distribution of malignant findings compared to the subgroups classified according to 2D mammography. There was 20% false negative findings on 2D, and 5.6% on 2D+3D modality. Sensitivity in cancer detection in this study is 82.4% and 94.4% for 2D and 2D+3D mammography, while specificity is 90.5% and 92.0%, respectively. PPV is higher for 2D+3D technique (66.7%), as well as negative predictive value (99.0%). In 172 cases (19, 9%) 2D mammography findings did not persist on 3D mammography and were considered as structural or anatomical noise. The majority of the non-persistent findings (85%) were classified as asymmetric focal density. In this study 500 breast were classified according to ACR as fatty (ACR 1) or scattered fibroglandular densities (ACR 2), and the remaining 264 had heterogeneously (ACR 3) and extremely dense breasts (ACR 4). Statistically significant difference (p&lt;0.001) was not shown in distribution of malignant findings compared to the subgroups of density structure according to ACR. Overall accuracy of the test was 89.4% and 92.4% for 2D and 2D+3D mammography, respectively. Predictive values obtained in 2D+ 3D mammography are better than those for 2D mammography alone, as a result of its higher sensitivity and better possibility of lesion characterization. Interobserver variability is low, there is an agreement between two radiologist between two radiologic interpretations in 94.1% cases.</p>

Thesis--University of Oklahoma. / Bibliography: leaves 91-98.

Indiana University-Purdue University Indianapolis (IUPUI) / Accurate determination of working length during endodontic therapy is a crucial step in achieving a predictable outcome. This is determined by the use of electronic apex locators, tactile perception, and knowledge of average tooth lengths and/or dental radiography whether digital or conventional is utilized. It is the aim of this study to determine if there is a difference between Schick digital radiography and Kodak Insight conventional film in accurately determining working lengths when modifying exposure time and source-film/sensor distance. Twelve teeth with size 15 K-flex files at varying known lengths from the anatomical apex were mounted in a resin-plaster mix to simulate bone density. Each tooth was radiographed while varying the source-film/sensor distance and exposure 122 time. Four dental professionals examined the images and films independently. Ten images and 10 films were selected at random and re-examined to determine each examiner?s repeatability. The error in working length was calculated as the observed value minus the known working length for each tooth type. A mixed-effects, full-factorial analysis of variance (ANOVA) model was used to model the error in working length. Included in the ANOVA model were fixed effects for type of image, distance, exposure time, and all two-way and three-way interactions. The repeatability of each examiner for each film type was assessed by estimating the intra-class correlation coefficient (ICC). The repeatability of each examiner on digital film was good with ICCs ranging from 0.67 to 1.0. Repeatability on the conventional film was poor with ICCs varying from -0.29 to 0.55.We found there was an overall difference between the conventional and digital films (p < 0.001). After adjusting for the effects of distance and exposure time, the error in the working length from the digital image was 0.1 mm shorter (95% CI: 0.06, 0.14) than the error in the working length from the film image. There was no difference among distances (p = 0.999) nor exposure time (p = 0.158) for film or images. Based on the results of our study we conclude that although there is a statistically significant difference, there is no clinically significant difference between digital radiography and conventional film when exposure time and source-film/sensor distance are adjusted.

Indiana University-Purdue University Indianapolis (IUPUI) / Accurate determination of working length during endodontic therapy is critical in achieving a predictable and successful outcome. Working length is determined by the use of electronic apex locators, tactile perception, knowledge of average tooth lengths and dental radiography. Due to the increasing use of digital radiography in clinical practice, a comparison with conventional film in working length determination is justified. The purpose of this study is to determine if there is a difference between Schick digital radiography and Kodak Ultra-speed film in the accurate determination of working lengths when vertical angulation of the object is variable. Twelve teeth with #15 K-flex files at varying known lengths from the anatomical apex were mounted in a resin-plaster mix to simulate bone density. A mounting jig for the standardization of projection geometries allowed for exact changes in vertical angulation as it related to the object (tooth) and the film/sensor. Each tooth was imaged using Schick CDR and Kodak Ultra-speed film at varying angles with a consistent source-film distance and exposure time. Four dental professionals examined the images and films independently and measured the distance from the tip of the file to radiographic apex and recorded their results. The error in working length was calculated as the observed value minus the known working length for each tooth type. A mixed-effects, full-factorial analysis of variance (ANOVA) model was used to model the error in working length. Included in the ANOVA model were fixed effects for type of image, vertical angulation, and the interaction of angle and film type. Tooth type and examiner were included in the model as random effects assuming a compound symmetry covariance structure. The repeatability of each examiner, for each film type, was assessed by estimating the intra-class correlation coefficient (ICC). The ICC was determined when 12 randomly selected images and radiographs were reevaluated 10 days after initial measurements. The repeatability of each examiner for Schick CDR was good with ICCs ranging from 0.67 to 1.0. Repeatability for the conventional film was poor with ICCs varying from -0.29 to 0.55. We found the error in the working length was not significantly different between film types (p = 0.402). After adjusting for angle, we found that error in the working length from the digital image was only 0.02 mm greater (95-percent CI: -0.03, 0.06) than the conventional film. Furthermore, there was not a significant difference among the angles (p = 0.246) nor in the interaction of image type with angle (p = 0.149). Based on the results of our study, we conclude that there is not a statistically significant difference in determining working length between Schick CDR and Kodak Ektaspeed film when vertical angulation is modified.

Made available in DSpace on 2014-07-29T15:22:00Z (GMT). No. of bitstreams: 1 Parte 1.pdf: 1874528 bytes, checksum: 7e46501ade5b782c1d4f3f9926c18a43 (MD5) Previous issue date: 2006-11-30 / Control of the process of repair or progression of periapical lesions after endodontic treatment is monitored by conventional or digital radiography. In this research digital subtraction radiography (DSR) was used that uses the subtraction of images longitudinally, in which the change in the alveolar bone is visualized against a uniform gray background. The objectives of this study were: (1) to evaluate the repair process of periapical lesions after endodontic treatment by using DSR; (2) to quantify by means of point/pixel (picture element), area (histogram) and linear measures (profile line), the gain or loss of mineral density in the area of the lesion, using the average of the pixel values; (3) to compare the diagnostic information, suggestive of the repair process, obtained through a subjective evaluation of DSR with a conventional radiographic evaluation and digitalized image and (4) to evaluate the contribution of DSR to an early identification of the repair of periapical lesions after endodontic treatment. The sample consisted of twelve patients with a total of seventeen periapical lesions. The x-rays were digitalized and submitted to DSR using DSR&#61650; software. The pixel values of the subtracted images were determined by using Image Tool&#61650; software. Both the conventional x-rays as well as the digitalized and subtracted images were qualitatively evaluated. The results showed a gain in mineral density with a mean&#61617;dp of 133.49&#61617;5.17, 130.27&#61617;5.77 and 129.41&#61617;4.46 for the points/pixel, histogram and profile line tools, respectively. In the evaluation of numerical gain Pearson s Coefficient of Correlation (r) presented these values: mean of points/histogram = 0.746; mean of points/profile line = 0.724 and histogram/profile line = 0.860. When the numerical values were transformed into percentile gain mean&#61617;dp of 0.67&#61617;4.01, 1.21&#61617;4.33 and 1.16&#61617;3.36 were obtained for the points/pixels, histogram and profile line tools, respectively. In the evaluation of the percentile gain Spearman s Coefficient of Correlation (rs) showed the following values: mean of points/histogram = 0.697; mean of the points/profile line = 0.646 and histogram/profile line = 0.844. In the qualitative analysis, the frequency of success in the ordering of the correct sequence of the repair process using conventional radiography, digitalized image and DSR was 37.3%, 31.4% and 31.4%, respectively. One concluded, therefore, that: (1) the process of repair of periapical lesions after endodontic treatment can be evaluated quantitatively by means of longitudinal analysis using DSR; (2) any one of the three tools can be used to quantify the repair, considering that correlation exists between the time of repair and the increase of the value of pixel; (3) the comparative evaluation between the subjective methods using conventional radiography, digitalized image and SDR, it showed that all had been capable to evidence the process of repair of periapical lesions from the first radiography (15 days), not having difference between them and (4) the quantitative evaluation by SDR obtained to after evidence the beginning of the repair with 15 days the beginning of the endodontic treatment, even so this repair was really effective from 105 days after the beginning of the endodontic treatment. / O controle do processo de reparo ou progressão de lesões periapicais pós-tratamento endodôntico é monitorado pelo exame radiográfico convencional ou digital. Nesta pesquisa foi utilizada a subtração digital radiográfica (SDR), que utiliza a subtração de imagens longitudinalmente, na qual a mudança no osso alveolar é visualizada contra um plano de fundo (background) cinza homogêneo. Os objetivos desse estudo foram: (1) avaliar o processo de reparo de lesões periapicais pós-tratamento endodôntico por meio de SDR; (2) quantificar por meio de ponto/pixel (picture element), área (histograma) e medida linear (perfil linha) na área da lesão, o ganho ou perda de densidade mineral por meio da média dos valores dos pixels; (3) comparar as informações diagnósticas, sugestivas do processo de reparo, obtidas por meio da avaliação subjetiva da SDR com a avaliação radiográfica convencional e imagem digitalizada; e (4) avaliar a contribuição da SDR na identificação precoce do reparo de lesões periapicais pós-tratamento endodôntico. A amostra constituiu-se de doze indivíduos totalizando dezessete lesões periapicais. As radiografias foram digitalizadas e submetidas à SDR utilizando o programa DSR&#61650;. As imagens subtraídas tiveram os valores de pixel determinados utilizando o programa Image Tool&#61650;. Tanto as radiografias convencionais quanto as imagens digitalizadas e subtraídas foram avaliadas qualitativamente. Os resultados evidenciaram ganho de densidade mineral com média&#61617;dp de 133,49&#61617;5,17; 130,27&#61617;5,77; 129,41&#61617;4,46 para as ferramentas ponto/pixel; histograma e perfil linha respectivamente. Na avaliação do ganho numérico o Coeficiente de Correlação de Pearson (r) mostrou valores de: média dos pontos/ histograma = 0,746; média dos pontos/ perfil linha = 0,724 e histograma/ perfil linha = 0,860. Quando os valores numéricos foram transformados em ganho percentual foram obtidas média&#61617;dp de 0,67&#61617;4,01; 1,21&#61617;4,33; 1,16&#61617;3,36 para as ferramentas ponto/pixel; histograma e perfil linha respectivamente. Na avaliação do ganho percentual o Coeficiente de Correlação de Spearman (rs) mostrou valores de: média dos pontos/ histograma = 0,697; média dos pontos/ perfil linha = 0,646 e histograma/ perfil linha = 0,844. Na análise qualitativa, a freqüência de acertos na ordenação da seqüência correta do processo de reparo usando radiografia convencional, imagem digitalizada e SDR foi de 37,3%; 31,4% e 31,4% respectivamente. Concluiu-se, portanto, que: (1) o processo de reparo de lesões periapicais pós-tratamento endodôntico pode ser avaliado quantitativamente por meio de análise longitudinal com SDR (2) qualquer uma das três ferramentas pode ser utilizada para quantificar o reparo, considerando que existe correlação entre o tempo de reparo e o aumento do valor de pixel; (3) a avaliação comparativa entre os métodos subjetivos, usando radiografia convencional, imagem digitalizada e a SDR, mostrou que todos foram capazes de evidenciar o processo de reparo de lesões periapicais desde a primeira radiografia (15 dias), não havendo diferença entre eles e (4) a avaliação quantitativa por meio de SDR conseguiu evidenciar o início do reparo com 15 dias após o início do tratamento endodôntico, embora esse reparo fosse realmente efetivo a partir de 105 dias após o início do tratamento endodôntico.