Comparison of Reliability and Validity of Posteroanterior Cephalometric Measurements Obtained from AutoCEPH© and Dolphin® Cephalometric Software Programs with Manual Tracing

Objectives: The objective of this study is to evaluate the reliability and accuracy of linear and angular cephalometric measurements obtained from two computerized cephalometric analysis software programs, namely AutoCEPH© (version 2.1.1) and Dolphin® (version 11.9) as compared to manual tracings in posteroanterior (PA) cephalometry. Materials and Methods: Sixty pretreatment (PA) cephalograms were selected from the database of a postgraduate orthodontic clinic. The digital images of each cephalogram were imported directly into two softwares Dolphin® and AutoCEPH© for digitization. For manual tracings, digital images were printed using an X-ray printer (Drystar 5302, Agfa HealthCare NV, Mortsel, Belgium). After images were standardized and calibrated, 19 anatomical landmarks were plotted on each cephalogram. These landmarks were then utilized to evaluate 17 cephalometric parameters. Intraclass correlation coefficient (ICC) was used to determine both intrarater reliability for repeated measurements and agreement between linear and angular measurements obtained from the three methods. Results: High ICC values in the range of 0.813–0.998 were obtained for all parameters while comparing three methods, i.e., manual tracings versus AutoCEPH©; manual tracings versus Dolphin®; and AutoCEPH© versus Dolphin®. Conclusion: A high level of agreement (ICC >0.8) for cephalometric measurements was obtained from both the computerized softwares Dolphin® and AutoCEPH© in comparison with manual tracings.