DIAGNOSTIC ACCURACY OF COMPUTED TOMOGRAPHY SCAN IN THE DIAGNOSIS OF FUNGAL SINUSITIS TAKING HISTOPATHOLOGY AS GOLD STANDARD: A CROSS-SECTIONAL STUDY
DOI:
https://doi.org/10.71000/bav56d17Keywords:
Computed Tomography, Diagnostic Accuracy, Fungal Sinusitis, Histopathology, Imaging, Paranasal Sinuses, Sensitivity and SpecificAbstract
Background: Fungal sinusitis represents a significant diagnostic challenge due to its nonspecific symptoms and potential for severe complications, particularly in immunocompromised individuals. Computed tomography (CT) imaging plays an essential role in its early detection and differentiation from other sinus pathologies. Despite its frequent clinical use, limited regional data exist on the diagnostic accuracy of CT in comparison with histopathology, which remains the gold standard.
Objective: To determine the diagnostic accuracy of CT scan in the diagnosis of fungal sinusitis, using histopathological findings as the gold standard.
Methods: This cross-sectional validation study was conducted at the Department of Radiology, Khyber Teaching Hospital, Peshawar, over six months. A total of 177 patients aged 18–70 years presenting with symptoms suggestive of fungal sinusitis were enrolled through non-probability consecutive sampling. All patients underwent CT scanning followed by histopathological confirmation. Diagnostic accuracy parameters including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were calculated using a 2×2 contingency table. Data analysis was performed using SPSS v21, and a p-value <0.05 was considered statistically significant.
Results: Among 177 patients, the mean age was 42.8 ± 12.6 years, with 57.6% males. CT detected fungal sinusitis in 98 (55.4%) cases, while histopathology confirmed 94 (53.1%) cases. The CT findings demonstrated a sensitivity of 93.6%, specificity of 88.0%, PPV of 89.8%, NPV of 92.4%, and an overall diagnostic accuracy of 91.0%. Stratified analysis showed consistent diagnostic performance across age, gender, and residence groups, indicating strong reliability of CT imaging.
Conclusion: CT scan demonstrated excellent diagnostic accuracy for fungal sinusitis when compared with histopathology, supporting its role as a reliable, non-invasive, and rapid diagnostic tool. Its application in clinical practice may significantly improve early detection and management, particularly in settings with limited access to histopathological facilities.
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