{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T12:31:59Z","timestamp":1781526719972,"version":"3.54.1"},"reference-count":39,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: The objective of our study was to compare the diagnostic performance of a popular, commercial dental artificial intelligence (AI) platform (Diagnocat, DGNCT LLC, Miami, FL, USA) for detecting maxillary sinus abnormalities on paired panoramic radiographs (OPG) and cone-beam computed tomography (CBCT) acquired in the same patients, and to examine whether lesion conspicuity predicts correct AI decisions. Methods: In this retrospective paired study, 166 patients contributed 332 maxillary sinuses with OPG and CBCT performed \u226430 days apart. The reference standard was consensus CBCT reading by two observers with third-reader arbitration. The index test was the AI\u2019s sinus-level binary output (any abnormality). Accuracy, precision, recall, and F1 score were estimated with patient-clustered 95% bootstrap CIs; secondary analyses assessed category-specific performance and the effect of mucosal thickness and polyp\/cyst volume. Results: Our evaluation showed that the platform\u2019s performance depended on modality. On CBCT, the accuracy was 69.88% (64.76\u201374.70%), precision was 87.83% (81.58\u201393.33%), recall was 54.01% (46.74\u201361.17%), and F1 score was 66.89% (60.34\u201372.84%). On OPG, the accuracy was 50.6% (44.58\u201355.41%), precision was 67.80% (55.38\u201379.66%), recall was 21.39% (15.62\u201327.32%), and F1 score 32.52% (24.79\u201339.69%). On CBCT, higher mucosal thickness and larger polyp\/cyst volume strongly predicted correct AI calls; no such effect was seen with OPG. Conclusions: In conclusion, the evaluated AI showed high precision but only moderate recall on CBCT and unreliable performance on OPG. Outputs must be interpreted by a professional; AI alerts on OPG should not guide management without CBCT confirmation.<\/jats:p>","DOI":"10.3390\/diagnostics16111667","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T10:06:56Z","timestamp":1780049216000},"page":"1667","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Imaging Modality on AI-Based Detection of Incidental Maxillary Sinus Pathology: Comparison of Panoramic Radiography and CBCT"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0506-2851","authenticated-orcid":false,"given":"Anna","family":"Lackowska","sequence":"first","affiliation":[{"name":"Department of Radiology and Diagnostic Imaging, Collegium Medicum, Nicolaus Copernicus University in Torun, Jagiello\u0144ska 13-15, 85-067 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1850-3525","authenticated-orcid":false,"given":"Natalia","family":"Kazimierczak","sequence":"additional","affiliation":[{"name":"Kazimierczak Clinic, Dworcowa 13\/u6a, 85-009 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0342-3809","authenticated-orcid":false,"given":"Natalia","family":"Chwar\u015bcianek","sequence":"additional","affiliation":[{"name":"Independent Researcher, 87-100 Torun, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1877-6833","authenticated-orcid":false,"given":"Nora","family":"Sultani","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University in Torun, Jagiello\u0144ska 13-15, 85-067 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4307-6852","authenticated-orcid":false,"given":"Zbigniew","family":"Serafin","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Bydgoszcz University of Science and Technology, Kaliskiego 7, 85-796 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8372-0550","authenticated-orcid":false,"given":"Wojciech","family":"Kazimierczak","sequence":"additional","affiliation":[{"name":"Department of Radiology and Diagnostic Imaging, Collegium Medicum, Nicolaus Copernicus University in Torun, Jagiello\u0144ska 13-15, 85-067 Bydgoszcz, Poland"},{"name":"Kazimierczak Clinic, Dworcowa 13\/u6a, 85-009 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1097\/ID.0000000000000902","article-title":"Prevalence of Maxillary Sinus Pathology Based on Cone-Beam Computed Tomography Evaluation of Multiethnicity Dental School Population","volume":"28","author":"Hsiao","year":"2019","journal-title":"Implant. 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