A Comparative Study of Diagnostic Accuracy in Soft- and Hard-Tissue Lesions: Integration of Ultrasound and Conventional Radiography in Oral Radiology

Abstract

Objective: To ascertain whether the integration of ultrasound imaging with conventional radiography enhances the detection and characterisation of oral and maxillofacial lesions in comparison to each modality utilised independently.

Study Design: Prospective cohort study
Place and Duration of Study: This study was conducted at the Oral & Maxillofacial Radiology Clinic at Central Hospital, Iraq from 1st May 2025 31st October 2025.

Methods: 80 patients with diverse oral lesions received standard intraoral and/or panoramic radiographs, succeeded by intraoral or extraoral ultrasound examinations utilising a high-frequency (≥10 MHz) linear probe.
Histopathology, surgical results, or clinical follow-up constituted the reference standard. We calculated diagnostic metrics like sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for radiography alone, ultrasound alone, and the combination of the two.

Results: Ultrasound was better at diagnosing soft-tissue lesions than radiography (sensitivity 92%, specificity 85% vs. 68% and 78% for radiography). The combined method increased the overall accuracy for hard-tissue lesions from 78% (radiography alone) to 85%.

Conclusion: Ultrasound is a useful addition to standard radiography in oral radiology. Combining both methods increases diagnostic confidence, especially for soft tissue lesions, and decreases the need for ionising radiation.