151
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Zhang Y, Ding SG, Gong XC, Yuan XX, Lin JF, Chen Q, Li JG. Generating synthesized computed tomography from CBCT using a conditional generative adversarial network for head and neck cancer patients. Technol Cancer Res Treat 2022; 21:15330338221085358. [PMID: 35262422 PMCID: PMC8918752 DOI: 10.1177/15330338221085358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose: To overcome the imaging artifacts and Hounsfield unit inaccuracy limitations of cone-beam computed tomography, a conditional generative adversarial network is proposed to synthesize high-quality computed tomography-like images from cone-beam computed tomography images. Methods: A total of 120 paired cone-beam computed tomography and computed tomography scans of patients with head and neck cancer who were treated during January 2019 and December 2020 retrospectively collected; the scans of 90 patients were assembled into training and validation datasets, and the scans of 30 patients were used in testing datasets. The proposed method integrates a U-Net backbone architecture with residual blocks into a conditional generative adversarial network framework to learn a mapping from cone-beam computed tomography images to pair planning computed tomography images. The mean absolute error, root-mean-square error, structural similarity index, and peak signal-to-noise ratio were used to assess the performance of this method compared with U-Net and CycleGAN. Results: The synthesized computed tomography images produced by the conditional generative adversarial network were visually similar to planning computed tomography images. The mean absolute error, root-mean-square error, structural similarity index, and peak signal-to-noise ratio calculated from test images generated by conditional generative adversarial network were all significantly different than CycleGAN and U-Net. The mean absolute error, root-mean-square error, structural similarity index, and peak signal-to-noise ratio values between the synthesized computed tomography and the reference computed tomography were 16.75 ± 11.07 Hounsfield unit, 58.15 ± 28.64 Hounsfield unit, 0.92 ± 0.04, and 30.58 ± 3.86 dB in conditional generative adversarial network, 20.66 ± 12.15 Hounsfield unit, 66.53 ± 29.73 Hounsfield unit, 0.90 ± 0.05, and 29.29 ± 3.49 dB in CycleGAN, and 16.82 ± 10.99 Hounsfield unit, 58.68 ± 28.34 Hounsfield unit, 0.92 ± 0.04, and 30.48 ± 3.83 dB in U-Net, respectively. Conclusions: The synthesized computed tomography generated from the cone-beam computed tomography-based conditional generative adversarial network method has accurate computed tomography numbers while keeping the same anatomical structure as cone-beam computed tomography. It can be used effectively for quantitative applications in radiotherapy.
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Affiliation(s)
- Yun Zhang
- Department of Radiation Oncology, Jiangxi Cancer Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China
| | - Sheng-gou Ding
- Department of Radiation Oncology, Jiangxi Cancer Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China
| | - Xiao-chang Gong
- Department of Radiation Oncology, Jiangxi Cancer Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China
| | - Xing-xing Yuan
- Department of Radiation Oncology, Jiangxi Cancer Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China
| | - Jia-fan Lin
- Department of Radiation Oncology, Jiangxi Cancer Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China
| | - Qi Chen
- MedMind Technology Co. Ltd, Beijing, People’s Republic of China
| | - Jin-gao Li
- Department of Radiation Oncology, Jiangxi Cancer Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China
- Key Laboratory of Personalized Diagnosis and Treatment of Nasopharyngeal Carcinoma Nanchang, Jiangxi, People’s Republic of China
- Medical College of Nanchang University, Nanchang, Jiangxi, People’s Republic of China
- Jin-gao Li, Department of Radiation Oncology, Jiangxi Cancer Hospital of Nanchang University Nanchang, Jiangxi 330029, People’s Republic of China.
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152
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Coutsiers Morell GF, Berlin-Broner Y, Flores-Mir C, Heo G. Tooth and root size as determined from 0.25- and 0.30-mm voxel size cone-beam CT imaging when contrasted to micro-CT scans (0.06 mm): An ex vivo study. J Orthod 2021; 49:174-178. [PMID: 34903069 PMCID: PMC9160778 DOI: 10.1177/14653125211066106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To quantify tooth volume differences from extracted teeth when using three different three-dimensional (3D) computed tomography (CT)-based imaging modalities. DESIGN Ex vivo study. SETTING Laboratory and clinics of the University of Alberta. METHODS Cone-beam CT (CBCT) of 12 extracted teeth were scanned using 0.25- and 0.30-mm voxel size from CBCT and a 0.06-mm voxel size from micro-CT (reference standard). 3D reconstructions for each tooth from each imaging modality were made through the software ITK-SNAP®. The mean volume differences between each pair of scanning modalities were calculated and then compared and analysed through a repeated measures ANOVA. RESULTS The average overestimations of the teeth volume were 15.2% for the high-resolution CBCT and 28.1% for the low-resolution CBCT compared to micro-CT measurements. The differences in absolute volume were 81.6 mm3 and 152.8 mm3, respectively. All differences were statistically significant (P < 0.05). CONCLUSIONS Orthodontists and researchers who assess root resorption through CBCT imaging should be aware that the depicted volumes may likely be overestimating tooth volume and camouflaging real root volumetric treatment changes.
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Affiliation(s)
| | | | | | - Giseon Heo
- School of Dentistry, University of Alberta, Edmonton, AB, Canada
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153
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Detection of Collaterals from Cone-Beam CT Images in Stroke. SENSORS 2021; 21:s21238099. [PMID: 34884102 PMCID: PMC8662458 DOI: 10.3390/s21238099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/09/2021] [Accepted: 11/18/2021] [Indexed: 11/17/2022]
Abstract
Collateral vessels play an important role in the restoration of blood flow to the ischemic tissues of stroke patients, and the quality of collateral flow has major impact on reducing treatment delay and increasing the success rate of reperfusion. Due to high spatial resolution and rapid scan time, advance imaging using the cone-beam computed tomography (CBCT) is gaining more attention over the conventional angiography in acute stroke diagnosis. Detecting collateral vessels from CBCT images is a challenging task due to the presence of noises and artifacts, small-size and non-uniform structure of vessels. This paper presents a technique to objectively identify collateral vessels from non-collateral vessels. In our technique, several filters are used on the CBCT images of stroke patients to remove noises and artifacts, then multiscale top-hat transformation method is implemented on the pre-processed images to further enhance the vessels. Next, we applied three types of feature extraction methods which are gray level co-occurrence matrix (GLCM), moment invariant, and shape to explore which feature is best to classify the collateral vessels. These features are then used by the support vector machine (SVM), random forest, decision tree, and K-nearest neighbors (KNN) classifiers to classify vessels. Finally, the performance of these classifiers is evaluated in terms of accuracy, sensitivity, precision, recall, F-Measure, and area under the receiver operating characteristics curve. Our results show that all classifiers achieve promising classification accuracy above 90% and able to detect the collateral and non-collateral vessels from images.
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154
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Pauwels R, Pittayapat P, Sinpitaksakul P, Panmekiate S. Scatter-to-primary ratio in dentomaxillofacial cone-beam CT: effect of field of view and beam energy. Dentomaxillofac Radiol 2021; 50:20200597. [PMID: 33882256 DOI: 10.1259/dmfr.20200597] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of field of view (FOV) and beam energy on the scatter-to-primary ratio (SPR) in dental cone-beam CT (CBCT). METHODS An anthropomorphic phantom representing an adult male (ATOM Max 711-HN, Norfolk, VA, USA) was scanned using the 3D Accuitomo 170 CBCT (J. Morita, Kyoto, Japan) using 11 FOVs. During each scan, half of the X-ray beam was blocked. Each scan was performed at three exposure settings with varying beam energy and equal radiation dose: 90 kV 5 mA, 77 kV 7.5 mA and 69 kV 10 mA. The SPR was estimated by measuring the grey values in the blocked and non-blocked regions of the RAW data. The effect of FOV on SPR was evaluated using Dunn's multiple comparison test, and the effect of the exposure settings was compared using a Wilcoxon signed rank test. RESULTS Larger FOVs showed increased scatter. FOVs with a shorter isocenter-detector distance showed a particularly high SPR. Most intercomparisons between FOVs were statistically significant. The largest difference was found between 17 × 12 cm and 6 × 6 cm (lower jaw), with the former showing a 4.9-fold higher SPR. The effect of beam energy was relatively small and varied between FOV sizes and positions. CONCLUSION While the choice of FOV size and position is determined by the diagnostic region of interest, the image quality deterioration for large FOVs due to scatter provides another incentive to limit the FOV size as much as possible.
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Affiliation(s)
- Ruben Pauwels
- Aarhus Institute of Advanced Studies, Aarhus University, Aarhus, Denmark.,Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Pisha Pittayapat
- Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Phonkit Sinpitaksakul
- Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Soontra Panmekiate
- Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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155
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Ren J, You M, Wang H, Tang B, Liu Y. A comparative evaluation of cone beam computed tomography and multi-slice computed tomography on the volume of tooth in-vitro. 2021 IEEE INTERNATIONAL CONFERENCE ON MEDICAL IMAGING PHYSICS AND ENGINEERING (ICMIPE) 2021. [DOI: 10.1109/icmipe53131.2021.9698963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Jiayin Ren
- National Clinical Research Center for Oral Diseases, Sichuan University,State Key Laboratory of Oral Diseases, West China Hospital of Stomatology,Department of Oral Radiology,Chengdu,China
| | - Meng You
- National Clinical Research Center for Oral Diseases, Sichuan University,State Key Laboratory of Oral Diseases, West China Hospital of Stomatology,Department of Oral Radiology,Chengdu,China
| | - Hu Wang
- National Clinical Research Center for Oral Diseases, Sichuan University,State Key Laboratory of Oral Diseases, West China Hospital of Stomatology,Department of Oral Radiology,Chengdu,China
| | - Bei Tang
- National Clinical Research Center for Oral Diseases, Sichuan University,State Key Laboratory of Oral Diseases, West China Hospital of Stomatology,Department of Oral Radiology,Chengdu,China
| | - Yuanyuan Liu
- National Clinical Research Center for Oral Diseases, Sichuan University,State Key Laboratory of Oral Diseases, West China Hospital of Stomatology,Department of Oral Radiology,Chengdu,China
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156
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Tan VL, Hardiman R, Pilbrow V, Parashos P. Dentinal microcracks and cemental tears related to chemo-mechanical root canal instrumentation: a micro-CT Cadaver Study. Aust Dent J 2021; 67:76-82. [PMID: 34762293 DOI: 10.1111/adj.12887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/03/2021] [Accepted: 11/07/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND The prevalence of radicular defects after root canal instrumentation is unresolved. This study used micro-CT to assess the relationship between the formation of radicular defects and chemo-mechanical instrumentation in a cadaver model. METHODS Maxillary and mandibular molars (n = 24) were sectioned from cadaver specimens as a tissue block containing the teeth, alveolar bone and attached mucogingival tissues. After a baseline micro-CT scan (13.45 μm), the specimens were distributed into 3 groups (n = 8 molars): Reciproc® , ProTaper Next™ and Mtwo® . Micro-CT scans of each specimen were obtained after access, glide path and preparation with each instrument. The pre-operative and final post-operative micro-CT cross-sectional images of the roots were screened by two blinded examiners to identify any pre-existing and new radicular defects. Pre-existing and new radicular defects were examined histologically. RESULTS Overall, 16 pre-existing radicular defects were identified in 12 of the 24 molars (50%). Most of these were cemental tears (87.5%), and not true dentinal microcracks. New dentinal microcracks were observed in the post-operative micro-CT scans of only 3 canals (3.9%; 3/77). However, only one of these defects was found to be present histologically. CONCLUSIONS Within the limitations of the study, chemo-mechanical instrumentation did not routinely promote the formation of radicular defects.
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Affiliation(s)
- V L Tan
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - R Hardiman
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - V Pilbrow
- The Australian Institute of Archaeology, Department of Archaeology and History, La Trobe University, Bundoora, Victoria, Australia
| | - P Parashos
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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157
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Ballikaya E, Koc N, Avcu N, Cehreli ZC. The quality of root canal treatment and periapical status of permanent teeth in Turkish children and teens: a retrospective CBCT study. Oral Radiol 2021; 38:405-415. [PMID: 34714509 DOI: 10.1007/s11282-021-00570-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 09/16/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE This study aimed to assess the quality of root canal fillings and the prevalence of periapical radiolucencies in the permanent teeth of 6-18 year-old Turkish children. METHODS CBCT images of 150 patients' 235 teeth with a mean age of 16.0 ± 2.06 years were included. Root development stage, quality of root canal filling, the presence and severity of periapical radiolucencies, and their relationship with anatomical structures were recorded. Correlations between the quality of root canal filling, periapical lesion, and lesion size were assessed using regression analyses. RESULTS A total of 235 teeth (528 root canals) were evaluated. 65.5% of root canals had periapical lesions. Immature roots and mandibular teeth had the highest prevalence and the largest size of periapical radiolucencies (p < 0.05). Overfilling (n = 52), underfilling (n = 93), unfilled (n = 46), inhomogeneously filled (n = 113) root canals and poor coronal restoration (n = 85 teeth) were observed in terms of technical failures of endodontic treatment. The quality of endodontic treatment was associated with the presence of periapical lesion and lesion size (p < 0.05). Teeth with under-filled, overfilled or inhomogeneously filled root canals and poor coronal restoration had a periapical lesion larger than 5 mm (p < 0.05). Immature teeth were most associated with the presence of lesion (OR = 4.07) and the lesion size > 5 mm (OR = 3.71). CONCLUSION The prevalence of periapical radiolucencies in young permanent teeth showed an increase when the tooth was an incisor, had incomplete root development, or the root filling had technical errors.
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Affiliation(s)
- Elif Ballikaya
- Faculty of Dentistry, Department of Pediatric Dentistry, Hacettepe University, Sıhhıye, 06100, Ankara, Turkey.
| | - Nagihan Koc
- Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Hacettepe University, Sıhhıye, 06100, Ankara, Turkey
| | - Nihal Avcu
- Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Hacettepe University, Sıhhıye, 06100, Ankara, Turkey
| | - Zafer Cavit Cehreli
- Faculty of Dentistry, Department of Pediatric Dentistry, Hacettepe University, Sıhhıye, 06100, Ankara, Turkey
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158
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Tamihardja J, Cirsi S, Kessler P, Razinskas G, Exner F, Richter A, Polat B, Flentje M. Cone beam CT-based dose accumulation and analysis of delivered dose to the dominant intraprostatic lesion in primary radiotherapy of prostate cancer. Radiat Oncol 2021; 16:205. [PMID: 34702305 PMCID: PMC8549146 DOI: 10.1186/s13014-021-01933-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/19/2021] [Indexed: 12/02/2022] Open
Abstract
Background Evaluation of delivered dose to the dominant intraprostatic lesion (DIL) for moderately hypofractionated radiotherapy of prostate cancer by cone beam computed tomography (CBCT)-based dose accumulation and target coverage analysis. Methods Twenty-three patients with localized prostate cancer treated with moderately hypofractionated prostate radiotherapy with simultaneous integrated boost (SIB) between December 2016 and February 2020 were retrospectively analyzed. Included patients were required to have an identifiable DIL on bi-parametric planning magnetic resonance imaging (MRI). After import into the RayStation treatment planning system and application of a step-wise density override, the fractional doses were computed on each CBCT and were consecutively mapped onto the planning CT via a deformation vector field derived from deformable image registration. Fractional doses were accumulated for all CBCTs and interpolated for missing CBCTs, resulting in the delivered dose for PTVDIL, PTVBoost, PTV, and the organs at risk. The location of the index lesions was recorded according to the sector map of the Prostate Imaging Reporting and Data System (PIRADS) Version 2.1. Target coverage of the index lesions was evaluated and stratified for location. Results In total, 338 CBCTs were available for analysis. Dose accumulation target coverage of PTVDIL, PTVBoost, and PTV was excellent and no cases of underdosage in DMean, D95%, D02%, and D98% could be detected. Delivered rectum DMean did not significantly differ from the planned dose. Bladder mean DMean was higher than planned with 19.4 ± 7.4 Gy versus 18.8 ± 7.5 Gy, p < 0.001. The penile bulb showed a decreased delivered mean DMean with 29.1 ± 14.0 Gy versus 29.8 ± 14.4 Gy, p < 0.001. Dorsal DILs, defined as DILs in the posterior medial peripheral zone of the prostate, showed a significantly lower delivered dose with a mean DMean difference of 2.2 Gy (95% CI 1.3–3.1 Gy, p < 0.001) compared to ventral lesions. Conclusions CBCT-based dose accumulation showed an adequate delivered dose to the dominant intraprostatic lesion and organs at risk within planning limits. Cautious evaluation of the target coverage for index lesions adjacent to the rectum is warranted to avoid underdosage.
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Affiliation(s)
- Jörg Tamihardja
- Department of Radiation Oncology, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany.
| | - Sinan Cirsi
- Department of Radiation Oncology, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Patrick Kessler
- Department of Radiation Oncology, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Gary Razinskas
- Department of Radiation Oncology, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Florian Exner
- Department of Radiation Oncology, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Anne Richter
- Department of Radiation Oncology, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Bülent Polat
- Department of Radiation Oncology, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Michael Flentje
- Department of Radiation Oncology, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
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159
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Köse TE, Günaçar DN, Ateş SM, Çağlar İ. Artifact expression of polyetheretherketone in cone beam computed tomography: An in vitro study. J Prosthet Dent 2021; 126:793.e1-793.e5. [PMID: 34674841 DOI: 10.1016/j.prosdent.2021.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/27/2021] [Accepted: 09/27/2021] [Indexed: 10/20/2022]
Abstract
STATEMENT OF PROBLEM Dental prosthetic materials can cause artifacts in cone beam computed tomography (CBCT) images, adversely affecting diagnostic quality, although the problem may be less with polyetheretherketone (PEEK). Studies evaluating the artifacts caused by frequently used prosthetic materials are lacking. PURPOSE The purpose of this in vitro study was to compare the artifacts in CBCT images caused by PEEK, zirconia, cobalt-chromium (Co-Cr) alloy, and titanium (Ti). MATERIAL AND METHODS A polymethylmethacrylate phantom (Ø4.0×4.0 cm) with a central cylindrical aperture (Ø0.5×0.5 cm) was produced. Co-Cr, Ti, zirconia, and PEEK cylinders (0.5×0.5 cm) were manufactured, and CBCT images of the empty phantom (control group) with the test cylinders inside were made 3 times. In all images, the axial sections passing through the middle of the materials were evaluated. Eight regions of interest (ROI) area were determined around the materials (0.5×0.5 cm). The presence of artifacts was evaluated by making gray value standard deviation (SD) calculations in these ROI areas. The average SD values of 8 ROI fields from the 3 CBCT scans were made, and the materials were compared with each other in terms of the presence of artifacts by using 1-way analysis of variance (α=.05). RESULTS The difference between the SD values of the control and the PEEK cylinder was not statistically significant (P>.05). The SD values of both the control and PEEK groups were significantly lower than those of the zirconia, Co-Cr, and Ti groups (P<.05). CONCLUSIONS Zirconia, Ti, and Co-Cr caused artifacts in CBCT images, but the artifacts with PEEK were similar to those in the control group, suggesting it was the optimal choice in terms of achieving diagnostic quality.
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Affiliation(s)
- Taha Emre Köse
- Assistant Professor, Oral and Maxillofacial Radiology Department, Faculty of Dentistry, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Dilara Nil Günaçar
- Assistant Professor, Oral and Maxillofacial Radiology Department, Faculty of Dentistry, Recep Tayyip Erdoğan University, Rize, Turkey.
| | - Sabit Melih Ateş
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Recep Tayyip Erdogan University, Rize, Turkey
| | - İpek Çağlar
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Recep Tayyip Erdogan University, Rize, Turkey
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160
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Oh SH, Lee SR, Choi JY, Ahn HW, Kim SH, Nelson G. Geometry of anchoring miniscrew in the lateral palate that support a tissue bone borne maxillary expander affects neighboring root damage. Sci Rep 2021; 11:19880. [PMID: 34615963 PMCID: PMC8494793 DOI: 10.1038/s41598-021-99442-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/27/2021] [Indexed: 11/12/2022] Open
Abstract
Anchoring miniscrews used for a tissue bone borne maxillary expander (C-expander) can fail if they contact tooth roots or perforate the maxillary sinus. Cone beam computed tomography images were reviewed retrospectively to evaluate the geometric factors of miniscrew placement in the palate that contribute to root proximity (RP) and sinus perforation (SP), and to investigate the differences of miniscrew placement depth (PD) and placement angle (PA) among the groups in each variable from 340 anchoring miniscrews on 70 patients whose C-expanders showed sufficient stability after palatal expansion for orthodontic treatment. Two types of miniscrews were used: a self-tapping miniscrew with 1.8 mm-in-diameter, and a self-drilling miniscrew with 1.6 mm-in-diameter. While the self-tapping larger diameter miniscrew influenced root proximity significantly, the screw location and PD affected the rate of sinus perforation. PA was significantly different between the right and left sides of the palate. The results of this study confirmed that root proximity and sinus perforation of anchoring miniscrews in a tissue bone borne palatal expander occurred due to certain risk factors, even when the palates were expanded successfully. Knowledge of these factors can help the clinician place miniscrews with less risk of root proximity or sinus perforation.
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Affiliation(s)
- Song Hee Oh
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Sae Rom Lee
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Jin-Young Choi
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| | - Hyo-Won Ahn
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| | - Seong-Hun Kim
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea.
| | - Gerald Nelson
- Division of Orthodontics, Department of Orofacial Science, University of California San Francisco, San Francisco, CA, USA
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161
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Abu El-Ela WH, Farid MM, Abou El-Fotouh M. The impact of different dental restorations on detection of proximal caries by cone beam computed tomography. Clin Oral Investig 2021; 26:2413-2420. [PMID: 34601634 DOI: 10.1007/s00784-021-04207-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 09/27/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To evaluate the effects of different types of restorations on observer ability to detect proximal caries in CBCT images. MATERIALS AND METHODS Forty human premolars and molars with artificial proximal caries were placed proximal and distal to 5 molars having different restorations (amalgam, composite, resin-modified glass ionomer cement (RMGIC) fillings, zirconia, and lithium disilicate crowns) and a non-restored molar. CBCT scans were obtained using i-CAT® Next Generation. Images were rated twice by 2 observers. The exact depth of artificial caries was histologically established. Sensitivity, specificity, and area under the receiver operating characteristic curve (Az) values were calculated. RESULTS Caries detection in teeth surfaces mesial and distal to amalgam showed compromised specificity and accuracy. Moreover, caries detection in teeth surfaces mesial to zirconia crown showed low sensitivity, specificity, and accuracy. Capability of CBCT in detection of proximal caries in teeth adjacent to composite, RMGIC, and lithium disilicate was comparable to those adjacent to non-restored molar. CONCLUSIONS CBCT scans performed for tasks other than caries detection should be assessed for proximal caries in absence of any restorations as well as in presence of composite, RMGIC fillings, and lithium disilicate crowns. However, CBCT should not be used for proximal caries detection in teeth adjacent to amalgam and teeth surfaces mesial to zirconia crowns. CLINICAL SIGNIFICANCE It is important to investigate the influence of artifacts produced by various restorations on CBCT-based caries detection to optimize CBCT benefits, caries diagnosis and avoid unnecessary treatment of sound surfaces.
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Affiliation(s)
- Walaa Hussein Abu El-Ela
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ain Shams University, Monazamet El Wehda El Afriqeya St, Cairo, Egypt.
| | - Mary Medhat Farid
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ain Shams University, Monazamet El Wehda El Afriqeya St, Cairo, Egypt
| | - Mona Abou El-Fotouh
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ain Shams University, Monazamet El Wehda El Afriqeya St, Cairo, Egypt
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162
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Evaluation of Ultra-High-Resolution Cone-Beam CT Prototype of Twin Robotic Radiography System for Cadaveric Wrist Imaging. Acad Radiol 2021; 28:e314-e322. [PMID: 32654956 DOI: 10.1016/j.acra.2020.06.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/12/2020] [Accepted: 06/13/2020] [Indexed: 01/14/2023]
Abstract
RATIONALE AND OBJECTIVES Cone-beam CT (CBCT) applications possess potential for dose reduction in musculoskeletal imaging. This study evaluates the ultra-high-resolution CBCT prototype of a twin robotic X-ray system in wrist examinations compared to high-resolution multidetector CT (MDCT). MATERIALS AND METHODS Sixteen wrists of body donors were examined with the CBCT scan mode and a 384 slice MDCT system. Radiation-equivalent low-dose (CTDIvol(16cm) = 3.3 mGy) and full-dose protocols (CTDIvol(16cm) = 13.8 mGy) were used for both systems. Two observers assessed image quality on a seven-point Likert scale. In addition, software-assisted quantification of signal intensity fractions in cancellous bone was performed. Fewer pixels with intermediate signal intensity were considered to indicate superior depiction of bone microarchitecture. RESULTS Subjective image quality in CBCT was superior to dose equivalent MDCT with p ≤ 0.03 for full-dose and p < 0.001 for low-dose scans, respectively. Median Likert values were 7/7 (reader 1 / reader 2) in full-dose CBCT, 6/6 in full-dose MDCT, 5/6 in low-dose CBCT and 3/3 in low-dose MDCT. Intraclass correlation coefficient was 0.936 (95% confidence interval, 0.897-0.961; p < 0.001), indicating excellent reliability. Objective analysis displayed smaller fractions of "indecisive" pixels with intermediate signal intensity for full-dose CBCT (0.57 [interquartile range 0.13]) compared to full-dose MDCT (0.68 [0.21]), low-dose CBCT (0.72 [0.19]), and low-dose MDCT (0.80 [0.15]) studies. No significant difference was observed between low-dose CBCT and full-dose MDCT. CONCLUSION The new CBCT prototype provides superior image quality for trabecula and bone marrow in cadaveric wrist studies and enables dose reduction up to 75% compared to high-resolution MDCT.
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Canal Transportation and Volumetric Dentin Removal Abilities of Ni-Ti Rotary File Systems in Curved Primary Root Canals: CBCT Study. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11199053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Current improvements in nickel-titanium (Ni-Ti) rotary file systems have created a paradigm shift in the root canal therapy of primary teeth. Therefore, it is necessary to perform a comprehensive evaluation regarding the efficiencies of newly manufactured instruments for different parameters. The current study was conducted to evaluate the abilities of RaceEvo, R-Motion, ProTaper Gold (PTG) systems in curved primary root canals with regard to the patterns of canal transportation and volumetric dentin removal by using cone-beam computed tomography (CBCT). Two experimental sets were designed following the determination of experimental groups by using pre- and post-operative CBCT data: canal transportation and volumetric dentin removal. The highest amount of canal transportation was significantly detected in the PTG group in comparison to RaceEvo and R-Motion groups. When the mean values of volumetric dentin removal data were analyzed across all groups, the PTG group again exhibited the significantly highest value of dentin removal volumetrically, compared to RaceEvo, R-Motion and manual instrumentation groups. It is possible to state that R-Motion and RaceEvo rotary systems could be used as reliable alternatives without causing adverse mechanical effects and maintaining the original root canal anatomy of curved primary root canal systems compared with PTG rotary systems and manual instrumentation, with a high diagnostic sensitivity of CBCT in pediatric endodontics when the alternative methods are not adequate.
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Souleyman S, Maria KD, Cheikh T, Karima KK. Impact of Acquisition Protocols on Accuracy of Dose Calculation Based on XVI Cone Beam Computed Tomography. J Med Phys 2021; 46:94-104. [PMID: 34566289 PMCID: PMC8415252 DOI: 10.4103/jmp.jmp_128_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 04/19/2021] [Accepted: 04/23/2021] [Indexed: 11/26/2022] Open
Abstract
Purpose: The objective of this work is to study the impact of acquisition protocols on the accuracy of cone beam computed tomography (CBCT)-based dose calculation and to determinate its limits from image characteristics such as image quality, Hounsfield numbers consistency, and restrictive sizes of volume acquisition, compared to the CT imaging for the different anatomy localizations: head and neck (H&N), thorax, and pelvis. Materials and Methods: In this work, we used a routine on-board imaging CBCT of the XVI system (Elekta, Stockholm, Sweden). Dosimetric calculations performed on CT images require the knowledge of the Hounsfield unit-relative electron density (HU-ReD) calibration curve, which is determined for each imaging technology and must be adapted to the imaging acquisition parameters (filter/field of view). The accuracy of the dose calculation from CBCT images strongly depends on the quality of these images and also on the appropriate correspondence to the electronic densities, which will be used by the treatment planning system to simulate the dose distribution. In this study, we evaluated the accuracy of the dose calculation for each protocol, as already pointed in many studies. Results: As a result, the protocols that give better results in terms of dose calculation are F0S20 for the H&N region and F1M20 for the thoracic and pelvic regions, with an error <2% compared to results obtained with CT images. In addition, the dose distributions obtained with CT and CBCT imaging modalities were compared by two different methods. The first comparison was done by gamma index in three planes (sagittal, coronal, and transverse) with 2%; 2 mm criteria. The results showed good correspondence, with more than 95% of points passed the criteria. We also compared the target volume, the organs at risk (OARs), and the maximum and minimum doses for the three localizations (H&N, thorax, and pelvis) in CT and CBCT imaging modalities using a Rando phantom. Conclusions: The choice of the adequate CBCT acquisition protocol and the appropriate phantom to determine the HU-ReD calibration curve provides a better precision in the calculation of dose on CBCT images. This allows improving the results obtained when using the HU-ReD calibration method for dose calculation in adaptive radiotherapy.
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Affiliation(s)
- Slimani Souleyman
- Department of Radiotherapy, HCA Hospital, Kouba, Algeria.,SNIRM Laboratory, Faculty of Physics, University of Sciences and Technology Houari Boumediene, Algiers, ALGERIA
| | - Khalal Dorea Maria
- Dosage, Analyse and Characterisation in High Resolution Laboratory, Department of Physics, Ferhat Abbas Setif 1 University, Setif, Algeria
| | - Tyeb Cheikh
- Department of Radiotherapy, HCA Hospital, Kouba, Algeria
| | - Khalal-Kouache Karima
- SNIRM Laboratory, Faculty of Physics, University of Sciences and Technology Houari Boumediene, Algiers, ALGERIA
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Slaidina A, Nikitina E, Abeltins A, Soboleva U, Lejnieks A. Gray values of the cervical vertebrae detected by cone beam computed tomography for the identification of osteoporosis and osteopenia in postmenopausal women. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:100-109. [PMID: 34535433 DOI: 10.1016/j.oooo.2021.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 05/18/2021] [Accepted: 06/15/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES This study aimed to determine whether the gray values (GVs) of the second and third cervical vertebrae in cone beam computed tomography (CBCT) are affected by general bone mineral density (BMD) in postmenopausal women and to evaluate whether CBCT can be used for predicting the risk of osteoporosis. STUDY DESIGN The present cross-sectional study included 127 edentulous postmenopausal women (average age, 70.4 ± 8.9 years) who underwent CBCT examinations. BMD measurements of the lumbar spine and both femoral necks were performed by dual-energy x-ray absorptiometry. The CBCT images were analyzed with OnDemand3D Dental software. GVs of the axial and sagittal sections of the cervical second and third vertebral bodies were obtained. RESULTS The GVs of the second and third cervical vertebrae decreased significantly with decreasing BMD. The axial GV of the second cervical vertebra showed the highest sensitivity (80.6%), highest negative predictive value (89.0%), lowest negative likelihood ratio (0.39), and highest area under the curve value (0.68) to predict osteoporosis. CONCLUSIONS Women with reduced BMD have lower GVs for the second and third cervical vertebrae. Changes in the GV of the second vertebra can potentially be used to determine the risk of osteoporosis in postmenopausal women.
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Affiliation(s)
- Anda Slaidina
- Leading Researcher, Department of Prosthodontics, Riga Stradins University, Riga Stradins University Institute of Stomatology, Riga, Latvia.
| | - Evija Nikitina
- Assistant, Department of Prosthodontics, Riga Stradins University, Riga Stradins University Institute of Stomatology, Riga, Latvia
| | - Andris Abeltins
- Associate Professor, Department of Orthodontics, Riga Stradins University, Riga Stradins University Institute of Stomatology, Riga, Latvia
| | - Una Soboleva
- Professor, Department of Prosthodontics, Riga Stradins University, Riga Stradins University Institute of Stomatology, Riga, Latvia
| | - Aivars Lejnieks
- Professor, Department of Internal Diseases, Riga Stradins University, Riga East Clinical University Hospital, Riga, Latvia
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de Oliveira Pinto MG, Melo SLS, Suassuna FCM, Marinho LE, Leite JBDS, Batista AUD, Bento PM, Melo DP. Influence of size of field of view (FOV), position within the FOV, and scanning mode on the detection of root fracture and observer's perception of artifacts in CBCT images. Dentomaxillofac Radiol 2021; 50:20200563. [PMID: 33565884 DOI: 10.1259/dmfr.20200563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To assess the influence of field of view (FOV) size, scanning position within the FOV and scanning mode on the detection of root fracture and artifact perception. METHODS Forty single-rooted premolars restored with NiCr and AgPd posts were divided into two groups: fractured and sound. All teeth were scanned using four CBCT scanning protocols varying FOV sizes (80 × 80 mm and 50 × 55 mm) and scanning modes (Standard and High Definition). The sample was positioned within the FOV in two pre-set positions (central and lateral) and in four positions established by the operator (quadrants). Detection of root fracture and artifact perception were assessed by two observers using 5-point and 4-point scales. Sensitivity, specificity, accuracy, and AUC values were calculated and compared by ANOVA two-way and Tukey's test. Chi-square and Fisher's exact test were used to assess artifact perception. The level of significance was set at p < 0.05. RESULTS The central position within the FOV presented higher sensitivity, specificity, accuracy, and AUC values and differed from the lateral position within the FOV for the studied metal posts (p<0.05). Quadrant 2 presented the best sensitivity, accuracy, and AUC values (p<0.05). The lateral position within the FOV, AgPd posts, quadrants 1 and 3 and protocols 1 (SM, 80 × 80) and 2 (HD, 80× 80) presented higher frequency of artifacts classified as "severe". CONCLUSION Positioning the object in the center or closer to the anterior periphery of the FOV while using a small FOV improved the detection of root fracture and decreased artifact perception.
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Affiliation(s)
| | - Saulo L Sousa Melo
- Department of Integrative Biomedical & Diagnostic Sciences, School of Dentistry, Oregon Health & Science University, Portland, USA
| | | | - Luiz Eduardo Marinho
- Department of Oral Diagnosis, Division of Oral Radiology, State University of Paraíba, Campina Grande, Brazil
| | | | | | - Patrícia Meira Bento
- Department of Oral Diagnosis, Division of Oral Radiology, State University of Paraíba, Campina Grande, Brazil
| | - Daniela Pita Melo
- Department of Oral Diagnosis, State University of Paraíba, Campina Grande, Brazil
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Gregoris Rabelo LE, Bueno MDR, Costa MVCD, de Musis CR, Estrela CRDA, Guedes OA, Gavini G, Estrela C. Blooming artifact reduction using different cone-beam computed tomography software to analyze endodontically treated teeth with intracanal posts. Comput Biol Med 2021; 136:104679. [DOI: 10.1016/j.compbiomed.2021.104679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 07/20/2021] [Indexed: 10/20/2022]
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168
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Domínguez-Delmás M, Bossema FG, Dorscheid J, Coban SB, Hall-Aquitania M, Batenburg KJ, Hermens E. X-ray computed tomography for non-invasive dendrochronology reveals a concealed double panelling on a painting from Rubens' studio. PLoS One 2021; 16:e0255792. [PMID: 34449802 PMCID: PMC8396786 DOI: 10.1371/journal.pone.0255792] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/26/2021] [Indexed: 11/18/2022] Open
Abstract
Dating the wood from historical art objects is a crucial step to ascertain their production time, and support or refute attribution to an artist or a workshop. Dendrochronology is commonly used for this purpose but requires access to the tree-ring pattern in the wood, which can be hindered by preparatory layers, polychromy, wax, or integrated frames. Here we implemented non-invasive dendrochronology based on X-ray computed tomography (CT) to examine a painting on panel attributed to Rubens' studio and its presumed dating around 1636 CE. The CT images achieved a resolution of 37.3 micron and revealed a double panelling, which was concealed by oak strips covering all four edges. The back (visible) board is made of deciduous oak (Quercus subg. Quercus), the most common type of wood used in 17th-century Netherlandish workshops, and was dated terminus post quem after 1557 CE. However, the front (original) board used for the painting has been identified through examination of the wood anatomy as a tropical wood, probably Swietenia sp., a species seldom used in Netherlandish paintings, and remains undated. Its very presence attests the global character of 17th-century trade, and demonstrates the use of exotic species in Flemish studios. The date of the oak board refutes previous results and suggests that this board was trimmed to meet the size of the tropical one, having been glued to it for conservation purposes or with deceiving intentions to pretend that the painting was made on an oak panel. These revelations have opened new lines of art historical inquiry and highlight the potential of X-ray CT as a powerful tool for non-invasive study of historical art objects to retrieve their full history.
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Affiliation(s)
- Marta Domínguez-Delmás
- Department of History of Art, University of Amsterdam, Amsterdam, Netherlands
- Department of Conservation and Science, Rijksmuseum, Amsterdam, Netherlands
- DendroResearch, Wageningen, Netherlands
| | - Francien G. Bossema
- Department of Conservation and Science, Rijksmuseum, Amsterdam, Netherlands
- Computational Imaging Group, Centrum Wiskunde & Informatica, Amsterdam, Netherlands
| | - Jan Dorscheid
- Department of Conservation and Science, Rijksmuseum, Amsterdam, Netherlands
| | - Sophia Bethany Coban
- Computational Imaging Group, Centrum Wiskunde & Informatica, Amsterdam, Netherlands
| | - Moorea Hall-Aquitania
- Department of History of Art, University of Amsterdam, Amsterdam, Netherlands
- Department of Conservation and Science, Rijksmuseum, Amsterdam, Netherlands
| | - K. Joost Batenburg
- Computational Imaging Group, Centrum Wiskunde & Informatica, Amsterdam, Netherlands
- Leiden Institute of Advanced Computer Science, Universiteit Leiden, Leiden, Netherlands
| | - Erma Hermens
- Department of History of Art, University of Amsterdam, Amsterdam, Netherlands
- Department of Conservation and Science, Rijksmuseum, Amsterdam, Netherlands
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169
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Bagis N, Kurt MH, Evli C, Camgoz M, Atakan C, Peker Ozturk H, Orhan K. Evaluation of a metal artifact reduction algorithm and an adaptive image noise optimization filter in the estimation of peri-implant fenestration defects using cone beam computed tomography: an in-vitro study. Oral Radiol 2021; 38:325-335. [PMID: 34387842 DOI: 10.1007/s11282-021-00561-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 08/03/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study is to assess the effects of metal artifact reduction (MAR) and adaptive image noise enhancer (AINO) in CBCT imaging on the detection accuracy of artificially created fenestration defects in proximity to titanium and zirconium implants in sheep jaw. METHODS Six zirconium and 10 titanium implants were planted on mandibular jaws of three sheep, and artificial defects were created. All images were obtained with a standard voxel size (0.150 mm3) and with 4 scan modes: (1) without MAR/without AINO; (2) with MAR/without AINO; (3) without MAR/with AINO; and (4) with MAR/with AINO during CBCT scanning. A total of 60 CBCT scans were produced. RESULTS For all types of implants, intra- and inter-observer kappa values were the highest for MAR filter. The scan mode of with MAR filter was found to have the highest area under the curve (AUC), whereas the scan mode of without both MAR and AINO filters was found to have the lowest AUC values with statistical significance (p ≤ 0.05). Titanium implants were found to have higher AUC values than zirconium (p ≤ 0.05). CONCLUSION Both MAR module and AINO filters enhance the accuracy of the detection of peri-implant fenestrations; however, the use of MAR filter solely can be recommended for detection of peri-implant fenestrations.
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Affiliation(s)
- Nilsun Bagis
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Mehmet Hakan Kurt
- Department of Dentoaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey.
| | - Cengiz Evli
- Department of Dentoaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Melike Camgoz
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Cemal Atakan
- Department of Statistics, Faculty of Science, Ankara University, Ankara, Turkey
| | - Hilal Peker Ozturk
- Department of Dentomaxillofacial Radiology, Gulhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey
| | - Kaan Orhan
- Department of Dentoaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey.,Ankara University Medical Design Application and Research Center (MEDITAM), Ankara, Turkey
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170
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Rossi M, Cerveri P. Comparison of Supervised and Unsupervised Approaches for the Generation of Synthetic CT from Cone-Beam CT. Diagnostics (Basel) 2021; 11:diagnostics11081435. [PMID: 34441369 PMCID: PMC8395013 DOI: 10.3390/diagnostics11081435] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/30/2021] [Accepted: 08/07/2021] [Indexed: 12/04/2022] Open
Abstract
Due to major artifacts and uncalibrated Hounsfield units (HU), cone-beam computed tomography (CBCT) cannot be used readily for diagnostics and therapy planning purposes. This study addresses image-to-image translation by convolutional neural networks (CNNs) to convert CBCT to CT-like scans, comparing supervised to unsupervised training techniques, exploiting a pelvic CT/CBCT publicly available dataset. Interestingly, quantitative results were in favor of supervised against unsupervised approach showing improvements in the HU accuracy (62% vs. 50%), structural similarity index (2.5% vs. 1.1%) and peak signal-to-noise ratio (15% vs. 8%). Qualitative results conversely showcased higher anatomical artifacts in the synthetic CBCT generated by the supervised techniques. This was motivated by the higher sensitivity of the supervised training technique to the pixel-wise correspondence contained in the loss function. The unsupervised technique does not require correspondence and mitigates this drawback as it combines adversarial, cycle consistency, and identity loss functions. Overall, two main impacts qualify the paper: (a) the feasibility of CNN to generate accurate synthetic CT from CBCT images, which is fast and easy to use compared to traditional techniques applied in clinics; (b) the proposal of guidelines to drive the selection of the better training technique, which can be shifted to more general image-to-image translation.
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171
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Eckl M, Sarria GR, Springer S, Willam M, Ruder AM, Steil V, Ehmann M, Wenz F, Fleckenstein J. Dosimetric benefits of daily treatment plan adaptation for prostate cancer stereotactic body radiotherapy. Radiat Oncol 2021; 16:145. [PMID: 34348765 PMCID: PMC8335467 DOI: 10.1186/s13014-021-01872-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/27/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Hypofractionation is increasingly being applied in radiotherapy for prostate cancer, requiring higher accuracy of daily treatment deliveries than in conventional image-guided radiotherapy (IGRT). Different adaptive radiotherapy (ART) strategies were evaluated with regard to dosimetric benefits. METHODS Treatments plans for 32 patients were retrospectively generated and analyzed according to the PACE-C trial treatment scheme (40 Gy in 5 fractions). Using a previously trained cycle-generative adversarial network algorithm, synthetic CT (sCT) were generated out of five daily cone-beam CT. Dose calculation on sCT was performed for four different adaptation approaches: IGRT without adaptation, adaptation via segment aperture morphing (SAM) and segment weight optimization (ART1) or additional shape optimization (ART2) as well as a full re-optimization (ART3). Dose distributions were evaluated regarding dose-volume parameters and a penalty score. RESULTS Compared to the IGRT approach, the ART1, ART2 and ART3 approaches substantially reduced the V37Gy(bladder) and V36Gy(rectum) from a mean of 7.4cm3 and 2.0cm3 to (5.9cm3, 6.1cm3, 5.2cm3) as well as to (1.4cm3, 1.4cm3, 1.0cm3), respectively. Plan adaptation required on average 2.6 min for the ART1 approach and yielded doses to the rectum being insignificantly different from the ART2 approach. Based on an accumulation over the total patient collective, a penalty score revealed dosimetric violations reduced by 79.2%, 75.7% and 93.2% through adaptation. CONCLUSION Treatment plan adaptation was demonstrated to adequately restore relevant dose criteria on a daily basis. While for SAM adaptation approaches dosimetric benefits were realized through ensuring sufficient target coverage, a full re-optimization mainly improved OAR sparing which helps to guide the decision of when to apply which adaptation strategy.
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Affiliation(s)
- Miriam Eckl
- Department of Radiation Oncology, University Medical Centre Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
| | - Gustavo R Sarria
- Department of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Sandra Springer
- Department of Radiation Oncology, University Medical Centre Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Marvin Willam
- Department of Radiation Oncology, University Medical Centre Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Arne M Ruder
- Department of Radiation Oncology, University Medical Centre Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Volker Steil
- Department of Radiation Oncology, University Medical Centre Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Michael Ehmann
- Department of Radiation Oncology, University Medical Centre Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Frederik Wenz
- University Medical Center Freiburg, University of Freiburg, Freiburg im Breisgau, Germany
| | - Jens Fleckenstein
- Department of Radiation Oncology, University Medical Centre Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
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Minnema J, Wolff J, Koivisto J, Lucka F, Batenburg KJ, Forouzanfar T, van Eijnatten M. Comparison of convolutional neural network training strategies for cone-beam CT image segmentation. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 207:106192. [PMID: 34062493 DOI: 10.1016/j.cmpb.2021.106192] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 05/11/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND OBJECTIVE Over the past decade, convolutional neural networks (CNNs) have revolutionized the field of medical image segmentation. Prompted by the developments in computational resources and the availability of large datasets, a wide variety of different two-dimensional (2D) and three-dimensional (3D) CNN training strategies have been proposed. However, a systematic comparison of the impact of these strategies on the image segmentation performance is still lacking. Therefore, this study aimed to compare eight different CNN training strategies, namely 2D (axial, sagittal and coronal slices), 2.5D (3 and 5 adjacent slices), majority voting, randomly oriented 2D cross-sections and 3D patches. METHODS These eight strategies were used to train a U-Net and an MS-D network for the segmentation of simulated cone-beam computed tomography (CBCT) images comprising randomly-placed non-overlapping cylinders and experimental CBCT images of anthropomorphic phantom heads. The resulting segmentation performances were quantitatively compared by calculating Dice similarity coefficients. In addition, all segmented and gold standard experimental CBCT images were converted into virtual 3D models and compared using orientation-based surface comparisons. RESULTS The CNN training strategy that generally resulted in the best performances on both simulated and experimental CBCT images was majority voting. When employing 2D training strategies, the segmentation performance can be optimized by training on image slices that are perpendicular to the predominant orientation of the anatomical structure of interest. Such spatial features should be taken into account when choosing or developing novel CNN training strategies for medical image segmentation. CONCLUSIONS The results of this study will help clinicians and engineers to choose the most-suited CNN training strategy for CBCT image segmentation.
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Affiliation(s)
- Jordi Minnema
- Department of Oral and Maxillofacial Surgery/Pathology, 3D Innovationlab, Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam 1081 HV, theNetherlands.
| | - Jan Wolff
- Fraunhofer Research Institution for Additive Manufacturing Technologies IAPT, Am Schleusengraben 13, Hamburg 21029, Germany; Department of Oral and Maxillofacial Surgery, Division for Regenerative Orofacial Medicine, University Hospital Hamburg-Eppendorf, Hamburg 20246, Germany; Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9, DK-8000 Aarhus C, Denmark
| | - Juha Koivisto
- Department of Physics, University of Helsinki, Helsinki 20560, Finland
| | - Felix Lucka
- Centrum Wiskunde & Informatica (CWI), Amsterdam 1090 GB, the Netherlands; University College London, London WC1E 6BT, United Kingdom
| | | | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery/Pathology, 3D Innovationlab, Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam 1081 HV, theNetherlands
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Cascante-Sequeira D, Coelho-Silva F, Rosado LPL, Freitas DQ, de-Azevedo-Vaz SL, Haiter-Neto F. Comparison of the expression of the volumetric alteration artifact in cylindrical and triangular fields of view in two cone-beam computed tomography devices. Clin Oral Investig 2021; 26:1025-1033. [PMID: 34324084 DOI: 10.1007/s00784-021-04086-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 07/17/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To compare the expression of the volumetric alteration (VA) artifact between cylindrical and convex triangular fields of view (FOVs) using high-density materials in different positions in two cone-beam computed tomography (CBCT) devices. MATERIALS AND METHODS Cylinders of five high-density materials (amalgam, chromium-cobalt, gutta-percha, titanium, and zirconium) with known physical volume were individually submitted to CBCT acquisition in four positions inside a polymethylmethacrylate phantom using two different FOV shapes (convex triangular and cylindrical) on the Veraviewepocs® R100 (R100) and Veraview® X800 (X800) devices. Two oral radiologists obtained the tomographic volumes by segmenting each cylinder. The difference between the tomographic and physical volumes corresponded to the VA. These values were analyzed by intraclass correlation coefficient and analysis of variance for repeated measures with Tukey post hoc test (α = 5%). RESULTS The FOV influenced the VA only in the X800 device (p = 0.014): the VA in the triangular FOV was greater than in the cylindrical FOV. The VA in the triangular FOV of the X800 device was greater than the R100 device (p < 0.0001). The material influenced the expression of the VA only in the R100 device (p < 0.0001); gutta-percha presented the highest VA, being underestimated, and differing from the other materials (p < 0.01). CONCLUSION The triangular FOV increased the VA of high-density materials in the X800 device. CLINICAL RELEVANCE It is important to know if there is an influence on the volumetric alteration artifact of dental materials due to the different image formation geometry in the convex triangular FOV.
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Affiliation(s)
- Deivi Cascante-Sequeira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, PO Box 52, Piracicaba, SP, 13414-903, Brazil.
| | - Fernanda Coelho-Silva
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, PO Box 52, Piracicaba, SP, 13414-903, Brazil
| | - Lucas P Lopes Rosado
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, PO Box 52, Piracicaba, SP, 13414-903, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, PO Box 52, Piracicaba, SP, 13414-903, Brazil
| | | | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, PO Box 52, Piracicaba, SP, 13414-903, Brazil
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174
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Yong TH, Yang S, Lee SJ, Park C, Kim JE, Huh KH, Lee SS, Heo MS, Yi WJ. QCBCT-NET for direct measurement of bone mineral density from quantitative cone-beam CT: a human skull phantom study. Sci Rep 2021; 11:15083. [PMID: 34301984 PMCID: PMC8302740 DOI: 10.1038/s41598-021-94359-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 07/12/2021] [Indexed: 02/07/2023] Open
Abstract
The purpose of this study was to directly and quantitatively measure BMD from Cone-beam CT (CBCT) images by enhancing the linearity and uniformity of the bone intensities based on a hybrid deep-learning model (QCBCT-NET) of combining the generative adversarial network (Cycle-GAN) and U-Net, and to compare the bone images enhanced by the QCBCT-NET with those by Cycle-GAN and U-Net. We used two phantoms of human skulls encased in acrylic, one for the training and validation datasets, and the other for the test dataset. We proposed the QCBCT-NET consisting of Cycle-GAN with residual blocks and a multi-channel U-Net using paired training data of quantitative CT (QCT) and CBCT images. The BMD images produced by QCBCT-NET significantly outperformed the images produced by the Cycle-GAN or the U-Net in mean absolute difference (MAD), peak signal to noise ratio (PSNR), normalized cross-correlation (NCC), structural similarity (SSIM), and linearity when compared to the original QCT image. The QCBCT-NET improved the contrast of the bone images by reflecting the original BMD distribution of the QCT image locally using the Cycle-GAN, and also spatial uniformity of the bone images by globally suppressing image artifacts and noise using the two-channel U-Net. The QCBCT-NET substantially enhanced the linearity, uniformity, and contrast as well as the anatomical and quantitative accuracy of the bone images, and demonstrated more accuracy than the Cycle-GAN and the U-Net for quantitatively measuring BMD in CBCT.
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Affiliation(s)
- Tae-Hoon Yong
- grid.31501.360000 0004 0470 5905Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
| | - Su Yang
- grid.31501.360000 0004 0470 5905Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
| | - Sang-Jeong Lee
- grid.31501.360000 0004 0470 5905Dental Research Institute, Seoul National University, Seoul, Korea
| | - Chansoo Park
- grid.31501.360000 0004 0470 5905Department of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National University, Seoul, Korea
| | - Jo-Eun Kim
- grid.459982.b0000 0004 0647 7483Department of Oral and Maxillofacial Radiology, Seoul National University Dental Hospital, Seoul, Korea
| | - Kyung-Hoe Huh
- grid.31501.360000 0004 0470 5905Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Sam-Sun Lee
- grid.31501.360000 0004 0470 5905Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Min-Suk Heo
- grid.31501.360000 0004 0470 5905Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Won-Jin Yi
- grid.31501.360000 0004 0470 5905Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea ,grid.31501.360000 0004 0470 5905Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
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175
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Kaasalainen T, Ekholm M, Siiskonen T, Kortesniemi M. Dental cone beam CT: An updated review. Phys Med 2021; 88:193-217. [PMID: 34284332 DOI: 10.1016/j.ejmp.2021.07.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/16/2021] [Accepted: 07/09/2021] [Indexed: 12/12/2022] Open
Abstract
Cone beam computed tomography (CBCT) is a diverse 3D x-ray imaging technique that has gained significant popularity in dental radiology in the last two decades. CBCT overcomes the limitations of traditional two-dimensional dental imaging and enables accurate depiction of multiplanar details of maxillofacial bony structures and surrounding soft tissues. In this review article, we provide an updated status on dental CBCT imaging and summarise the technical features of currently used CBCT scanner models, extending to recent developments in scanner technology, clinical aspects, and regulatory perspectives on dose optimisation, dosimetry, and diagnostic reference levels. We also consider the outlook of potential techniques along with issues that should be resolved in providing clinically more effective CBCT examinations that are optimised for the benefit of the patient.
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Affiliation(s)
- Touko Kaasalainen
- HUS Diagnostic Center, Radiology, Helsinki University and Helsinki University Hospital, P.O. Box 340, Haartmaninkatu 4, 00290 Helsinki, Finland.
| | - Marja Ekholm
- Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, 20520 Turku, Finland; South West Finland Imaging Center, Turku University Hospital, Lemminkäisenkatu 2, 20520 Turku, Finland
| | - Teemu Siiskonen
- Radiation Practices Regulation, Radiation and Nuclear Safety Authority - STUK, P.O. Box 14, FI-00881 Helsinki, Finland
| | - Mika Kortesniemi
- HUS Diagnostic Center, Radiology, Helsinki University and Helsinki University Hospital, P.O. Box 340, Haartmaninkatu 4, 00290 Helsinki, Finland
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176
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Stewart HL, Siewerdsen JH, Nelson BB, Kawcak CE. Use of cone-beam computed tomography for advanced imaging of the equine patient. Equine Vet J 2021; 53:872-885. [PMID: 34053096 DOI: 10.1111/evj.13473] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 04/14/2021] [Accepted: 05/27/2021] [Indexed: 11/28/2022]
Abstract
Access to volumetric imaging modalities, such as magnetic resonance imaging (MRI) and computed tomography (CT), has increased over the past decade and has revolutionised the way clinicians evaluate equine anatomy. More recent advancements have resulted in the development of multiple commercially available cone-beam CT (CBCT) scanners for equine use. CBCT scanners modify the traditional fan-shaped beam of ionising radiation into a three-dimensional pyramidal- or cone-shaped beam of radiation. This modification enables the scanner to acquire sufficient data to create diagnostic images of a region of interest after a single rotation of the gantry. The rapid acquisition of data and divergent X-ray beam causes some artifacts to be more prominent on CBCT images-as well as the unique cone-beam artifact-resulting in decreased contrast resolution. While the use of CT for evaluation of the equine musculoskeletal anatomy is not new, there is a paucity of literature and scientific studies on the capabilities of CBCT for equine imaging. CBCT units do not require a specialised table for imaging and in some cases are portable for imaging in the standing or anaesthetised patient. This review article summarises the basic physics of CT technology, including how CBCT imaging differs, and provides objective information about the strengths and limitations of this modality. Finally, potential future applications and techniques for imaging with CT which will need to be explored in order to fully consider the capabilities of CT imaging in the horse are discussed.
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Affiliation(s)
- Holly L Stewart
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Jeffery H Siewerdsen
- The Russel H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Brad B Nelson
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Christopher E Kawcak
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
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177
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Wanderley VA, de Faria Vasconcelos K, Leite AF, Pauwels R, Shujaat S, Jacobs R, Oliveira ML. Impact of the blooming artefact on dental implant dimensions in 13 cone-beam computed tomography devices. Int J Implant Dent 2021; 7:67. [PMID: 34258634 PMCID: PMC8277908 DOI: 10.1186/s40729-021-00347-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 04/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to objectively assess dimensional alteration (blooming artefact) on dental implant using 13 cone-beam computed tomography (CBCT) devices adjusted to device-specific scanning protocols and to assess whether subjective adjustment of brightness and contrast (B&C) could alter its visualization. METHODS An anthropomorphic phantom containing a dental implant was scanned in 13 CBCT devices adjusted to three scanning protocols: medium-FOV standard resolution, small-FOV standard resolution, and small-FOV high resolution. The diameter of the implant was measured at five levels, averaged, and compared with those from a reference standard industrial CT image. B&C adjustments were performed and measurements were repeated. The intraclass correlation coefficient assessed the reliability of the measurements and general linear mixed models were applied for multiples comparisons at a 95% confidence interval. RESULTS Implant diameter obtained from small-FOV high-resolution protocols in most CBCT devices was not significantly different when compared to that from the reference (p > 0.05). For standard protocols, significant dimensional alteration of the implant ranging from 23 to 34% (0.67 to 1.02 mm) was observed in 9 CBCT devices for small-FOV scanning (p < 0.05), and in 8 CBCT devices for medium-FOV scanning, implant dimensional alteration ranged significantly from 21 to 35% (0.62 to 1.04 mm). After B&C adjustments, dimensional alteration was reduced for several of the CBCT devices tested (p < 0.05). CONCLUSIONS The visualization of the implant dimensional alteration differed between CBCT devices and scanning protocols with an increase in diameter ranging from 0.27 to 1.04 mm. For most CBCT devices, B&C adjustments allowed to reduce visualization of implant blooming.
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Affiliation(s)
- Victor Aquino Wanderley
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium. .,Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil.
| | - Karla de Faria Vasconcelos
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Andre Ferreira Leite
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dentistry, Faculty of Health Sciences University of Brasília, Brasília, Brazil
| | - Ruben Pauwels
- Aarhus Institute of Advanced Studies, Aarhus University, Aarhus, Denmark.,Department of Mechanical Engineering, Catholic University of Leuven, Leuven, Belgium
| | - Sohaib Shujaat
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Matheus L Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
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178
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Dahiya N, Alam SR, Zhang P, Zhang SY, Li T, Yezzi A, Nadeem S. Multitask 3D CBCT-to-CT translation and organs-at-risk segmentation using physics-based data augmentation. Med Phys 2021; 48:5130-5141. [PMID: 34245012 DOI: 10.1002/mp.15083] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/18/2021] [Accepted: 06/22/2021] [Indexed: 12/25/2022] Open
Abstract
PURPOSE In current clinical practice, noisy and artifact-ridden weekly cone beam computed tomography (CBCT) images are only used for patient setup during radiotherapy. Treatment planning is performed once at the beginning of the treatment using high-quality planning CT (pCT) images and manual contours for organs-at-risk (OARs) structures. If the quality of the weekly CBCT images can be improved while simultaneously segmenting OAR structures, this can provide critical information for adapting radiotherapy mid-treatment as well as for deriving biomarkers for treatment response. METHODS Using a novel physics-based data augmentation strategy, we synthesize a large dataset of perfectly/inherently registered pCT and synthetic-CBCT pairs for locally advanced lung cancer patient cohort, which are then used in a multitask three-dimensional (3D) deep learning framework to simultaneously segment and translate real weekly CBCT images to high-quality pCT-like images. RESULTS We compared the synthetic CT and OAR segmentations generated by the model to real pCT and manual OAR segmentations and showed promising results. The real week 1 (baseline) CBCT images which had an average mean absolute error (MAE) of 162.77 HU compared to pCT images are translated to synthetic CT images that exhibit a drastically improved average MAE of 29.31 HU and average structural similarity of 92% with the pCT images. The average DICE scores of the 3D OARs segmentations are: lungs 0.96, heart 0.88, spinal cord 0.83, and esophagus 0.66. CONCLUSIONS We demonstrate an approach to translate artifact-ridden CBCT images to high-quality synthetic CT images, while simultaneously generating good quality segmentation masks for different OARs. This approach could allow clinicians to adjust treatment plans using only the routine low-quality CBCT images, potentially improving patient outcomes. Our code, data, and pre-trained models will be made available via our physics-based data augmentation library, Physics-ArX, at https://github.com/nadeemlab/Physics-ArX.
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Affiliation(s)
- Navdeep Dahiya
- Department of Electrical & Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Sadegh R Alam
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Pengpeng Zhang
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Si-Yuan Zhang
- Department of Radiation Oncology, Peking University Cancer Hospital, Beijing, China
| | - Tianfang Li
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Anthony Yezzi
- Department of Electrical & Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Saad Nadeem
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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179
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G K, Singh N, Yadav R, Duhan J, Tewari S, Gupta A, Sangwan P, Mittal S. Comparative analysis of the accuracy of periapical radiography and cone-beam computed tomography for diagnosing complex endodontic pathoses using a gold standard reference - A prospective clinical study. Int Endod J 2021; 54:1448-1461. [PMID: 33904603 DOI: 10.1111/iej.13535] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 04/20/2021] [Indexed: 12/20/2022]
Abstract
AIM To compare the diagnostic accuracy of periapical radiography (PR) and cone-beam computed tomography (CBCT) for detecting pathoses of endodontic origin using the gold standard of direct surgical visualization. METHODOLOGY Seventy-four patients (112 teeth) underwent radiographic examination by periapical radiography and CBCT. The presence of periapical lesions, root perforations and their locations, root fractures, different types of external root resorptive defects, apicomarginal bone defects, through and through bone defects, buccal bone status and proximity of root apices and lesions to vital anatomical structures were assessed. These same parameters were assessed intraoperatively by direct surgical visualization which served as the gold standard reference for the radiographic assessments. Sensitivity, specificity, positive predictive values, negative predictive values were determined for comparison of diagnostic accuracy between two modalities. RESULTS There were no significant differences between the two imaging modalities for root resorptive defects and root fractures. However, CBCT accurately detected periapical lesions, root perforations, apicomarginal bone defects and through and through bone defects. The overall accuracy of CBCT varied from 91% to 96% in detecting dehiscence and fenestration of buccal cortical plates. CONCLUSION Overall, CBCT had a higher diagnostic accuracy in complex endodontic pathoses compared to PR. Nevertheless, CBCT failed to diagnose apicomarginal bone defects in 33% teeth. In evaluating the status of buccal cortical plate from CBCT images, observers could detect absence of bone better than its presence. Thus, limited FOV CBCT should be considered for selective cases where periapical radiography has diagnostic ambiguity.
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Affiliation(s)
- Keerthana G
- Department of Conservative Dentistry & Endodontics, Postgraduate Institute of Dental Sciences (PGIDS), Rohtak, India
| | - Natwar Singh
- Department of Conservative Dentistry & Endodontics, Postgraduate Institute of Dental Sciences (PGIDS), Rohtak, India
| | - Ritika Yadav
- Department of Conservative Dentistry & Endodontics, Postgraduate Institute of Dental Sciences (PGIDS), Rohtak, India
| | - Jigyasa Duhan
- Department of Conservative Dentistry & Endodontics, Postgraduate Institute of Dental Sciences (PGIDS), Rohtak, India
| | - Sanjay Tewari
- Department of Conservative Dentistry & Endodontics, Postgraduate Institute of Dental Sciences (PGIDS), Rohtak, India
| | - Ambika Gupta
- Department of Oral Medicine & Radiology, Postgraduate Institute of Dental Sciences (PGIDS), Rohtak, India
| | - Pankaj Sangwan
- Department of Conservative Dentistry & Endodontics, Postgraduate Institute of Dental Sciences (PGIDS), Rohtak, India
| | - Shweta Mittal
- Department of Conservative Dentistry & Endodontics, Postgraduate Institute of Dental Sciences (PGIDS), Rohtak, India
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180
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Wenzel A. Radiographic modalities for diagnosis of caries in a historical perspective: from film to machine-intelligence supported systems. Dentomaxillofac Radiol 2021; 50:20210010. [PMID: 33661697 PMCID: PMC8231685 DOI: 10.1259/dmfr.20210010] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/03/2021] [Accepted: 02/16/2021] [Indexed: 01/17/2023] Open
Abstract
Radiographic imaging for the diagnosis of caries lesions has been a supplement to clinical examination for approximately a century. Various methods, and particularly X-ray receptors, have been developed over the years, and computer systems have focused on aiding the dentist in the detection of lesions and in estimating lesion depth. The present historical review has sampled accuracy ex vivo studies and clinical studies on radiographic caries diagnosis that have compared two or more receptors for capturing the image. The epochs of film radiography, xeroradiography, digital intraoral radiography, panoramic radiography and other extraoral methods, TACT analysis, cone-beam CT and artificial intelligence systems aiding in decision-making are reviewed. The author of this review (43 years in academia) has been involved in caries research and contributed to the literature in all the mentioned epochs.
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Affiliation(s)
- Ann Wenzel
- Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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181
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Evaluation of the combined assessment of two digital enhancement filters in periapical radiographs obtained with different projection angles in the detection of simulated dental root fractures. Oral Radiol 2021; 38:234-239. [PMID: 34195932 DOI: 10.1007/s11282-021-00550-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 06/19/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To evaluate the diagnostic efficacy of the combined assessment of the original radiographic image with the Invert or Emboss digital enhancement filters in periapical radiographs obtained with different horizontal projection angles in the detection of simulated dental root fracture. MATERIALS AND METHODS Thirty-four single-rooted teeth were selected, out of which 17 teeth were subjected to root fracture. Each tooth was individually placed in an empty socket of a dry human maxilla or mandible and X-rayed following the paralleling technique at three horizontal projections: mesial, right angle, distal. Then, the Invert and Emboss enhancement filters were applied. Five examiners independently evaluated all the images and rated the fractures using a 5-point scale. Weighted kappa test assessed the intra- and interexaminer agreements. Diagnostic values were calculated and the areas under the receiver operating characteristic curve (AUC) were compared using two-way ANOVA with Tukey test as post hoc (α = 0.05). RESULTS The inter- and intraexaminer agreement ranged from moderate to almost perfect and from substantial to almost perfect, respectively. Diagnostic values were considerably high for all conditions with no significant difference between the AUC values (p > 0.05). CONCLUSIONS The combined use of the original radiographic image with the Invert or Emboss digital enhancement filters in periapical radiographs obtained with different projection angles did not influence the detection of simulated dental root fracture.
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182
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Komuro A, Yamada Y, Uesugi S, Terashima H, Kimura M, Kishimoto H, Iida T, Sakamoto K, Okuda K, Kusano K, Baba S, Sakamoto T. Accuracy and dimensional reproducibility by model scanning, intraoral scanning, and CBCT imaging for digital implant dentistry. Int J Implant Dent 2021; 7:63. [PMID: 34189641 PMCID: PMC8241962 DOI: 10.1186/s40729-021-00343-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/19/2021] [Indexed: 11/24/2022] Open
Abstract
Background Recently, it has become possible to analyze implant placement position using the digital matching data of optical impression data of the oral cavity or plaster models with cone beam computed tomography (CBCT) data, and create a highly accurate surgical guide. It has been reported that CBCT measurements were smaller than the actual values, termed shrinkage. Matching of digital data is reliable when the plaster model or intraoral impression values show shrinkage at the same rate as the CBCT data. However, if the shrinkage rate is significantly different, the obtained digital data become unreliable. To clarify digital matching reliability, we examined dimensional reproducibility and shrinkage in measurements obtained with a model scanner, intra-oral scanner (iOS), and CBCT. Materials and methods Three implants that were arranged in a triangle were fixed in an acrylic plate. The distance between each implants were measured using model scanner, iOS, and CBCT. The actual size measured by electronic caliper was regarded as control. Results All values measured with CBCT were significantly smaller than that of model scanner, iOS, and control (p<0.001). The model scanner shrinkage was 0.37-0.39%, iOS shrinkage was 0.9-1.4%, and CBCT shrinkage was 1.8-6.9%. There were statistically significant differences among the shrinkage with iOS, CBCT, and model scanner (p<0.001). Conclusion Our findings showed that all measurements obtained with those modalities showed shrinkage as compared to the actual values. In addition, CBCT shrinkage was largest among three different measuring methods. They indicated that data matching between CBCT and scanner measurements requires attention in regard to the reliability of values obtained with those devices.
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Affiliation(s)
- Akira Komuro
- Osaka Academy of Oral Implantology, 1-1-43 Abenosuji, Abenoku, Osaka, 545-6008, Japan.
| | - Yoichi Yamada
- Department of Oral Implantology, Osaka Dental University, 1-5-17 Otemae Chuo-ku, Osaka, 540-0008, Japan
| | - Satoshi Uesugi
- Osaka Academy of Oral Implantology, 1-1-43 Abenosuji, Abenoku, Osaka, 545-6008, Japan
| | - Hiroaki Terashima
- Osaka Academy of Oral Implantology, 1-1-43 Abenosuji, Abenoku, Osaka, 545-6008, Japan
| | - Masashi Kimura
- Osaka Academy of Oral Implantology, 1-1-43 Abenosuji, Abenoku, Osaka, 545-6008, Japan
| | - Hiroto Kishimoto
- Osaka Academy of Oral Implantology, 1-1-43 Abenosuji, Abenoku, Osaka, 545-6008, Japan
| | - Tsutomu Iida
- Osaka Academy of Oral Implantology, 1-1-43 Abenosuji, Abenoku, Osaka, 545-6008, Japan
| | - Katsuya Sakamoto
- Osaka Academy of Oral Implantology, 1-1-43 Abenosuji, Abenoku, Osaka, 545-6008, Japan
| | - Kenichi Okuda
- Osaka Academy of Oral Implantology, 1-1-43 Abenosuji, Abenoku, Osaka, 545-6008, Japan
| | - Kaoru Kusano
- Department of Oral Implantology, Osaka Dental University, 1-5-17 Otemae Chuo-ku, Osaka, 540-0008, Japan
| | - Shunsuke Baba
- Department of Oral Implantology, Osaka Dental University, 1-5-17 Otemae Chuo-ku, Osaka, 540-0008, Japan
| | - Takashi Sakamoto
- Osaka Academy of Oral Implantology, 1-1-43 Abenosuji, Abenoku, Osaka, 545-6008, Japan
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Neppl S, Kurz C, Köpl D, Yohannes I, Schneider M, Bondesson D, Rabe M, Belka C, Dietrich O, Landry G, Parodi K, Kamp F. Measurement-based range evaluation for quality assurance of CBCT-based dose calculations in adaptive proton therapy. Med Phys 2021; 48:4148-4159. [PMID: 34032301 DOI: 10.1002/mp.14995] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 04/08/2021] [Accepted: 05/10/2021] [Indexed: 12/30/2022] Open
Abstract
PURPOSE The implementation of volumetric in-room imaging for online adaptive radiotherapy makes extensive testing of this image data for treatment planning necessary. Especially for proton beams the higher sensitivity to stopping power properties of the tissue results in more stringent requirements. Current approaches mainly focus on recalculation of the plans on the new image data, lacking experimental verification, and ignoring the impact on the plan re-optimization process. The aim of this study was to use gel and film dosimetry coupled with a three-dimensional (3D) printed head phantom (based on the planning CT of the patient) for 3D range verification of intensity-corrected cone beam computed tomography (CBCT) image data for adaptive proton therapy. METHODS Single field uniform dose pencil beam scanning proton plans were optimized for three different patients on the patients' planning CT (planCT) and the patients' intensity-corrected CBCT (scCBCT) for the same target volume using the same optimization constraints. The CBCTs were corrected on projection level using the planCT as a prior. The dose optimized on planCT and recalculated on scCBCT was compared in terms of proton range differences (80% distal fall-off, recalculation). Moreover, the dose distribution resulting from recalculation of the scCBCT-optimized plan on the planCT and the original planCT dose distribution were compared (simulation). Finally, the two plans of each patient were irradiated on the corresponding patient-specific 3D printed head phantom using gel dosimetry inserts for one patient and film dosimetry for all three patients. Range differences were extracted from the measured dose distributions. The measured and the simulated range differences were corrected for range differences originating from the initial plans and evaluated. RESULTS The simulation approach showed high agreement with the standard recalculation approach. The median values of the range differences of these two methods agreed within 0.1 mm and the interquartile ranges (IQRs) within 0.3 mm for all three patients. The range differences of the film measurement were accurately matching with the simulation approach in the film plane. The median values of these range differences deviated less than 0.1 mm and the IQRs less than 0.4 mm. For the full 3D evaluation of the gel range differences, the median value and IQR matched those of the simulation approach within 0.7 and 0.5 mm, respectively. scCBCT- and planCT-based dose distributions were found to have a range agreement better than 3 mm (median and IQR) for all considered scenarios (recalculation, simulation, and measurement). CONCLUSIONS The results of this initial study indicate that an online adaptive proton workflow based on scatter-corrected CBCT image data for head irradiations is feasible. The novel presented measurement- and simulation-based method was shown to be equivalent to the standard literature recalculation approach. Additionally, it has the capability to catch effects of image differences on the treatment plan optimization. This makes the measurement-based approach particularly interesting for quality assurance of CBCT-based online adaptive proton therapy. The observed uncertainties could be kept within those of the registration and positioning. The proposed validation could also be applied for other alternative in-room images, e.g. for MR-based pseudoCTs.
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Affiliation(s)
- Sebastian Neppl
- Department of Radiation Oncology, University Hospital, LMU Munich, 81377, Munich, Germany.,Department of Medical Physics, Faculty of Physics, Ludwig-Maximilians-Universität München (LMU Munich), 85748, Garching bei München, Germany
| | - Christopher Kurz
- Department of Radiation Oncology, University Hospital, LMU Munich, 81377, Munich, Germany.,Department of Medical Physics, Faculty of Physics, Ludwig-Maximilians-Universität München (LMU Munich), 85748, Garching bei München, Germany
| | - Daniel Köpl
- Rinecker Proton Therapy Center, 81371, Munich, Germany
| | | | - Moritz Schneider
- Department of Radiology, University Hospital, LMU Munich, 81377, Munich, Germany.,Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), 81377, Munich, Germany
| | - David Bondesson
- Department of Radiology, University Hospital, LMU Munich, 81377, Munich, Germany.,Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), 81377, Munich, Germany
| | - Moritz Rabe
- Department of Radiation Oncology, University Hospital, LMU Munich, 81377, Munich, Germany.,Department of Medical Physics, Faculty of Physics, Ludwig-Maximilians-Universität München (LMU Munich), 85748, Garching bei München, Germany
| | - Claus Belka
- Department of Radiation Oncology, University Hospital, LMU Munich, 81377, Munich, Germany.,German Cancer Consortium (DKTK), Partner site Munich, 81377, Munich, Germany
| | - Olaf Dietrich
- Department of Radiology, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Guillaume Landry
- Department of Radiation Oncology, University Hospital, LMU Munich, 81377, Munich, Germany.,Department of Medical Physics, Faculty of Physics, Ludwig-Maximilians-Universität München (LMU Munich), 85748, Garching bei München, Germany
| | - Katia Parodi
- Department of Medical Physics, Faculty of Physics, Ludwig-Maximilians-Universität München (LMU Munich), 85748, Garching bei München, Germany
| | - Florian Kamp
- Department of Radiation Oncology, University Hospital, LMU Munich, 81377, Munich, Germany
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Field M, Hardcastle N, Jameson M, Aherne N, Holloway L. Machine learning applications in radiation oncology. PHYSICS & IMAGING IN RADIATION ONCOLOGY 2021; 19:13-24. [PMID: 34307915 PMCID: PMC8295850 DOI: 10.1016/j.phro.2021.05.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 05/19/2021] [Accepted: 05/22/2021] [Indexed: 12/23/2022]
Abstract
Machine learning technology has a growing impact on radiation oncology with an increasing presence in research and industry. The prevalence of diverse data including 3D imaging and the 3D radiation dose delivery presents potential for future automation and scope for treatment improvements for cancer patients. Harnessing this potential requires standardization of tools and data, and focused collaboration between fields of expertise. The rapid advancement of radiation oncology treatment technologies presents opportunities for machine learning integration with investments targeted towards data quality, data extraction, software, and engagement with clinical expertise. In this review, we provide an overview of machine learning concepts before reviewing advances in applying machine learning to radiation oncology and integrating these techniques into the radiation oncology workflows. Several key areas are outlined in the radiation oncology workflow where machine learning has been applied and where it can have a significant impact in terms of efficiency, consistency in treatment and overall treatment outcomes. This review highlights that machine learning has key early applications in radiation oncology due to the repetitive nature of many tasks that also currently have human review. Standardized data management of routinely collected imaging and radiation dose data are also highlighted as enabling engagement in research utilizing machine learning and the ability integrate these technologies into clinical workflow to benefit patients. Physicists need to be part of the conversation to facilitate this technical integration.
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Affiliation(s)
- Matthew Field
- South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.,Ingham Institute for Applied Medical Research, Sydney, NSW, Australia
| | - Nicholas Hardcastle
- Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia
| | - Michael Jameson
- GenesisCare, Alexandria, NSW, Australia.,St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Australia
| | - Noel Aherne
- Mid North Coast Cancer Institute, NSW, Australia.,Rural Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Lois Holloway
- South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.,Ingham Institute for Applied Medical Research, Sydney, NSW, Australia.,Cancer Therapy Centre, Liverpool Hospital, Sydney, NSW, Australia.,Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia
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185
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Mouzinho-Machado S, Rosado LDPL, Coelho-Silva F, Neves FS, Haiter-Neto F, de-Azevedo-Vaz SL. Influence of Voxel Size and Filter Application in Detecting Second Mesiobuccal Canals in Cone-beam Computed Tomographic Images. J Endod 2021; 47:1391-1397. [PMID: 34166686 DOI: 10.1016/j.joen.2021.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/26/2021] [Accepted: 06/14/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION This study assessed the influence of voxel size and filter application in detecting second mesiobuccal (MB2) canals in cone-beam computed tomographic (CBCT) images. METHODS Using the OP300 CBCT system (Instrumentarium, Tuusula, Finland) and 3 voxel size protocols (80 μm, 125 μm, and 200 μm), we scanned 40 first molars: 20 with an MB2 canal and 20 without. All molars received silver palladium pins on the palatal root, whereas the non-MB2 molars were also filled with gutta-percha. Five oral radiologists assessed the presence of an MB2 canal under 3 filter application conditions: without filter, with sharpen 1 × filter, and with sharpen 2 × filter. Intra- and interobserver reproducibility was evaluated using the weighted kappa index. We compared the area under the receiver operating characteristic curves with SPSS Statistics v.20.0 (IBM Corp, Armonk, NY) using 2-way analysis of variance and the Tukey post hoc test with 5% significance level. RESULTS Our analysis found median intra- and interobserver agreement values of 0.70 and 0.56, respectively. The 80-μm voxel with sharpen 1 × filter image group had the highest sensitivity, accuracy, and negative predictive values. As for specificity and positive predictive, the 80-μm voxel group without filter application presented the highest values. The areas under the receiver operating characteristic curve were higher in the 80-μm groups than in the 125-μm and 200-μm voxel size groups (P < .05). We found no differences among the filters used (P = .22) or for the filter-voxel size interactions (P = .88). CONCLUSIONS A smaller voxel size increased the accuracy in detecting MB2 canals, whereas the enhancement filters did not.
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Affiliation(s)
- Sâmia Mouzinho-Machado
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Lucas de Paula Lopes Rosado
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Fernanda Coelho-Silva
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Frederico Sampaio Neves
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil; Division of Oral Radiology, Department of Propedeutics and Integrated Clinic, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Francisco Haiter-Neto
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Sergio Lins de-Azevedo-Vaz
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil; Department of Clinical Dentistry, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil.
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Maret D, Vergnes JN, Peters OA, Peters C, Nasr K, Monsarrat P. Recent Advances in Cone-beam CT in Oral Medicine. Curr Med Imaging 2021; 16:553-564. [PMID: 32484089 DOI: 10.2174/1573405615666190114152003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/09/2018] [Accepted: 12/19/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND The cone-beam computed tomography (CBCT) technology has continuously evolved since its appearance in oral medicine in the early 2000s. OBJECTIVES To present recent advances in CBCT in oral medicine: i) selection of recent and consensual evidence-based sources, ii) structured summary of the information based on an iterative framework and iii) compliance with ethical, public health and patient-centered concerns. MAIN FINDINGS We will focus on technological advances, such as sensors and reconstruction algorithms used to improve the constant quality of the image and dosimetry. CBCT examination is now performed in almost all disciplines of oral medicine: currently, the main clinical disciplines that use CBCT acquisitions are endodontics and oral surgery, with clearly defined indications. Periodontology and ear, nose and throat medicine are more recent fields of application. For a given application and indication, the smallest possible field of view must be used. One of the major challenges in contemporary healthcare is ensuring that technological developments do not take precedence over admitted standards of care. The entire volume should be reviewed in full, with a systematic approach. All findings are noted in the patient's record and explained to the patient, including incidental findings. This presupposes the person reviewing the images is sufficiently trained to interpret such images, inform the patient and organize the clinical pathway, with referrals to other medical or oral medicine specialties as needed. CONCLUSION A close collaboration between dentists, medical physicists, radiologists, radiographers and engineers is critical for all aspects of CBCT technology.
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Affiliation(s)
- Delphine Maret
- Oral Rehabilitation Department, Dental Faculty, Paul Sabatier University, Toulouse University Hospital (CHU de Toulouse), Toulouse, France.,AMIS Laboratory - Laboratoire Anthropologie Moléculaire et Imagerie de Synthèse, Université de Toulouse, UMR 5288 CNRS, UPS, Toulouse, France
| | - Jean-Noel Vergnes
- Epidemiology and Public Health Department, Dental Faculty, Paul Sabatier University, Toulouse University Hospital (CHU de Toulouse), Toulouse, France.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Ove A Peters
- Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California, United States.,School of Dentistry, University of Queensland, Brisbane, Queensland, Australia
| | - Christine Peters
- Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California, United States
| | - Karim Nasr
- Oral Rehabilitation Department, Dental Faculty, Paul Sabatier University, Toulouse University Hospital (CHU de Toulouse), Toulouse, France
| | - Paul Monsarrat
- Oral Rehabilitation Department, Dental Faculty, Paul Sabatier University, Toulouse University Hospital (CHU de Toulouse), Toulouse, France.,STROMALab, Université de Toulouse, CNRS ERL 5311, EFS, ENVT, Inserm U1031, UPS, Toulouse, France
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187
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Enriquez JS, Chu Y, Pudakalakatti S, Hsieh KL, Salmon D, Dutta P, Millward NZ, Lurie E, Millward S, McAllister F, Maitra A, Sen S, Killary A, Zhang J, Jiang X, Bhattacharya PK, Shams S. Hyperpolarized Magnetic Resonance and Artificial Intelligence: Frontiers of Imaging in Pancreatic Cancer. JMIR Med Inform 2021; 9:e26601. [PMID: 34137725 PMCID: PMC8277399 DOI: 10.2196/26601] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/24/2021] [Accepted: 04/03/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND There is an unmet need for noninvasive imaging markers that can help identify the aggressive subtype(s) of pancreatic ductal adenocarcinoma (PDAC) at diagnosis and at an earlier time point, and evaluate the efficacy of therapy prior to tumor reduction. In the past few years, there have been two major developments with potential for a significant impact in establishing imaging biomarkers for PDAC and pancreatic cancer premalignancy: (1) hyperpolarized metabolic (HP)-magnetic resonance (MR), which increases the sensitivity of conventional MR by over 10,000-fold, enabling real-time metabolic measurements; and (2) applications of artificial intelligence (AI). OBJECTIVE Our objective of this review was to discuss these two exciting but independent developments (HP-MR and AI) in the realm of PDAC imaging and detection from the available literature to date. METHODS A systematic review following the PRISMA extension for Scoping Reviews (PRISMA-ScR) guidelines was performed. Studies addressing the utilization of HP-MR and/or AI for early detection, assessment of aggressiveness, and interrogating the early efficacy of therapy in patients with PDAC cited in recent clinical guidelines were extracted from the PubMed and Google Scholar databases. The studies were reviewed following predefined exclusion and inclusion criteria, and grouped based on the utilization of HP-MR and/or AI in PDAC diagnosis. RESULTS Part of the goal of this review was to highlight the knowledge gap of early detection in pancreatic cancer by any imaging modality, and to emphasize how AI and HP-MR can address this critical gap. We reviewed every paper published on HP-MR applications in PDAC, including six preclinical studies and one clinical trial. We also reviewed several HP-MR-related articles describing new probes with many functional applications in PDAC. On the AI side, we reviewed all existing papers that met our inclusion criteria on AI applications for evaluating computed tomography (CT) and MR images in PDAC. With the emergence of AI and its unique capability to learn across multimodal data, along with sensitive metabolic imaging using HP-MR, this knowledge gap in PDAC can be adequately addressed. CT is an accessible and widespread imaging modality worldwide as it is affordable; because of this reason alone, most of the data discussed are based on CT imaging datasets. Although there were relatively few MR-related papers included in this review, we believe that with rapid adoption of MR imaging and HP-MR, more clinical data on pancreatic cancer imaging will be available in the near future. CONCLUSIONS Integration of AI, HP-MR, and multimodal imaging information in pancreatic cancer may lead to the development of real-time biomarkers of early detection, assessing aggressiveness, and interrogating early efficacy of therapy in PDAC.
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Affiliation(s)
- José S Enriquez
- Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, United States.,Graduate School of Biomedical Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Yan Chu
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Shivanand Pudakalakatti
- Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Kang Lin Hsieh
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Duncan Salmon
- Department of Electrical and Computer Engineering, Rice University, Houston, TX, United States
| | - Prasanta Dutta
- Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Niki Zacharias Millward
- Graduate School of Biomedical Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, United States.,Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Eugene Lurie
- Department of Translational Molecular Pathology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Steven Millward
- Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, United States.,Graduate School of Biomedical Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Florencia McAllister
- Graduate School of Biomedical Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, United States.,Department of Clinical Cancer Prevention, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Anirban Maitra
- Graduate School of Biomedical Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, United States.,Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Subrata Sen
- Graduate School of Biomedical Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, United States.,Department of Translational Molecular Pathology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Ann Killary
- Graduate School of Biomedical Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, United States.,Department of Translational Molecular Pathology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jian Zhang
- Division of Computer Science and Engineering, Louisiana State University, Baton Rouge, LA, United States
| | - Xiaoqian Jiang
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Pratip K Bhattacharya
- Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, United States.,Graduate School of Biomedical Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Shayan Shams
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, United States
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188
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Coelho-Silva F, Gaêta-Araujo H, Rosado LPL, Freitas DQ, Haiter-Neto F, de-Azevedo-Vaz SL. Distortion or magnification? An in vitro cone-beam CT study of dimensional changes of objects with different compositions. Dentomaxillofac Radiol 2021; 50:20210063. [PMID: 34111368 DOI: 10.1259/dmfr.20210063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To assess whether dimensional changes occur as shape distortion (unevenly), contraction or magnification (evenly) in cone beam computed tomography (CBCT) considering materials, anatomical regions and metal artefact reduction algorithms. METHODS Four cylinders of amalgam (Am), cobalt-chromium (Co-Cr), gutta-percha (Gu), titanium (Ti) and zirconium (Zi) were inserted inside a polymethylmethacrylate phantom in anterior and posterior regions for acquisitions in Picasso Trio and OP300 with MAR enabled and disabled. Two observers measured the dimensions of each cylinder in three axes: Y (height), Z (antero posterior diameter) and X (latero-lateral diameter). Repeated measures ANOVA with Tukey post-hoc test compared the data (α = 5%). RESULTS Shape distortion occurred for all materials in anterior region of Picasso Trio without MAR (p < 0.05). With MAR enabled, Gu and Ti contracted (p ≥ 0.05), while the others showed distortion (p < 0.05). In posterior region, all materials distorted in both MAR conditions (p < 0.05), except Gu, which magnified without MAR (p ≥ 0.05) and contracted unevenly with MAR (p < 0.05). In anterior region of OP300, all materials magnified without MAR, (p ≥ 0.05) and had shape distortion with MAR (p < 0.05). In posterior region, only Am showed magnification without MAR (p ≥ 0.05), while all materials presented shape distortion with MAR (p < 0.05). CONCLUSION Dimensional changes of high-density materials in CBCT can be either a magnification, a contraction or a distortion; the last condition is the most prevalent. Furthermore, changes differ considering material, anatomical region and MAR condition.
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Affiliation(s)
- Fernanda Coelho-Silva
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Hugo Gaêta-Araujo
- Oral Radiology Section, School of Dentistry, Federal University of Alfenas, Minas Gerais, Brazil
| | - Lucas P Lopes Rosado
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Sergio Lins de-Azevedo-Vaz
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.,Department of Clinical Dentistry, Federal University of Espírito Santo, Espírito Santo, Brazil
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189
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Choi Y, Jeon WS, Cho JM, Jeong HG, Shin Y, Park W. Access opening guide produced using a 3D printer (AOG-3DP) as an effective tool in difficult cases for dental students. J Dent Educ 2021; 85:1640-1645. [PMID: 34131924 DOI: 10.1002/jdd.12705] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 04/19/2021] [Accepted: 05/23/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The aim of this study was to determine the effectiveness of using an access opening guide in teaching ideal access opening shape and preventing excessive tooth loss, with a focus on predoctoral dental students. METHODS Ninety teeth that were mounted in a box just below the level of the cementoenamel junction using tray resin were randomly divided into two study groups. An access opening guide produced using a 3D printer (AOG-3DP) was designed using cone-beam computed tomography (CBCT). The AOG-3DP was applied in the test groups, while no aid was used in the control group. Access preparations in both groups performed by predoctoral dental students were scanned using CBCT to detect overpreparation. The preparation time and access cavity volume were evaluated. RESULTS The mean times required for achieving access opening were 327.2 and 97.4 s in the control and AOG-3DP groups, respectively, for premolars, and 547.4 and 104.5 s for molars. The mean volumes for premolars and molars differed from the ideal cavities by 38.1 and 72.2 mm3 , respectively, in the control group, and by -2.0 and -8.7 mm3 the AOG-3DP group. CONCLUSIONS Using the AOG-3DP significantly reduced the access opening time for premolars and molars. However, there is a limitation in that CBCT DICOM images must be converted to stereolithographic .stl files in order to be printed via 3D technology. This requires additional preclinical treatment time for imaging and subsequent printing. It could be considered that this can be a useful method in difficult cases.
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Affiliation(s)
- Yiseul Choi
- Department of Advanced General Dentistry and Human Identification Research Institute, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Woo Seok Jeon
- Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Jung Min Cho
- Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Ho-Gul Jeong
- Imaging Dentistry Research Center, InVisionLab Inc., Seoul, Republic of Korea
| | - Yooseok Shin
- Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Wonse Park
- Department of Advanced General Dentistry, Yonsei University College of Dentistry, Seoul, Republic of Korea
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Salemi F, Jamalpour MR, Eskandarloo A, Tapak L, Rahimi N. Efficacy of Metal Artifact Reduction Algorithm of Cone-Beam Computed Tomography for Detection of Fenestration and Dehiscence around Dental Implants. J Biomed Phys Eng 2021; 11:305-314. [PMID: 34189119 PMCID: PMC8236107 DOI: 10.31661/jbpe.v0i0.2102-1284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/02/2021] [Indexed: 11/30/2022]
Abstract
Background: Beam hardening and scattering artifacts from high-density objects such as dental implants adversely affect the image quality and subsequently the detection of fenestration or dehiscence around dental implants. Objective: This study aimed to assess the efficacy of metal artifact reduction (MAR) algorithm of two cone-beam computed tomography (CBCT) systems for detection of peri-implant fenestration and dehiscence. Material and Methods: In this experimental study, thirty-six titanium implants were placed in bone blocks of bovine ribs. Fenestration and dehiscence were created in the buccal bone around implants.
CBCT images were obtained using Cranex 3D and ProMax 3D CBCT systems with and without MAR algorithm. Two experienced radiologists observed the images. Data were analyzed using SPSS software.
The Kappa coefficient of agreement, the area under the receiver operating characteristic (ROC) curve, sensitivity, specificity, and accuracy of different imaging modalities were calculated and analyzed. Results: In both CBCT systems, the use of MAR algorithm decreased the area under the ROC curve and subsequently the diagnostic accuracy for the detection of fenestration and dehiscence.
The sensitivity, specificity and accuracy of both CBCT systems were higher in absence of the MAR algorithm. The specificity of ProMax 3D for detection of fenestration was equal with/without the MAR algorithm. Conclusion: Although CBCT is suitable for detection of peri-implant defects, the application of the MAR algorithm does not enhance the detection of peri-implant fenestration and dehiscence.
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Affiliation(s)
- Fatemeh Salemi
- PhD, Department of Oral & Maxillofacial Radiology, School of Dentistry, Hamadan university of Medical Science, Hamadan, Iran
| | - Mohamad Reza Jamalpour
- MScD, Department of Oral and Maxillofacial Surgery, Dental Implants Research Center, School of Dentistry, Hamadan university of Medical Science. Hamadan, Iran
| | - Amir Eskandarloo
- PhD, Department of Oral & Maxillofacial Radiology, School of Dentistry, Hamadan university of Medical Science, Hamadan, Iran
| | - Leili Tapak
- PhD, Department of Biostatistics, School of Health Modeling of Noncommunicable Diseases Research Center, Health Sciences & Technology Research Institute, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Narges Rahimi
- DMD, General Dentist, Hamadan University of Medical Sciences, Hamadan, Iran
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191
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Isman O, Isman E. Identification of various orthodontic materials as foreign bodies via panoramic radiography, cone beam computed tomography, magnetic resonance imaging, and ultrasonography: an in vitro study. Oral Radiol 2021; 37:524-530. [PMID: 34037939 DOI: 10.1007/s11282-021-00537-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 05/08/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES We evaluated the in vitro detection sensitivity of orthodontic materials (serving as foreign bodies) using panoramic radiography, cone beam computed tomography (CBCT), magnetic resonance imaging (MRI), and ultrasonography. METHODS Five different orthodontic materials served as foreign bodies: titanium-molybdenum alloy wire (TMA; ORMCO, Orange, CA, USA; 0.017 × 0.025 in in cross-sectional dimensions and 1 cm long); stainless steel bracket tooth #34 (American Orthodontics, Sheboygan, WI, USA); a monocrystalline, sapphire ceramic bracket tooth #34 (Skyortho Dental Supplies Medical, China); a polycrystalline alumina clear bracket, Damon clear bracket tooth #34 (ORMCO); and a 1 × 1 × 0.1 cm polyurethane-based thermoplastic material, Invisalign clear aligner (Align Technology, San Jose, CA, USA). Panoramic radiography, CBCT, MRI, and ultrasonography were used, and four observers scored all findings independently. RESULTS The TMA and stainless steel bracket were visualised in all fields by panoramic radiography and CBCT. The sapphire and Damon brackets were very clear on CBCT. The Invisalign in air was evident only on CBCT. MRI was unable to identify any material in muscle. Ultrasonography detected the TMA, sapphire bracket, and the Invisalign in muscle but only the TMA on bone. CONCLUSIONS Panoramic radiography does not reveal nonmetallic orthodontic equipment in air and reveals them only poorly in muscle. CBCT was the optimal imaging modality for all materials in all fields except for the Invisalign in muscle and bone. CBCT was the only method that revealed the Invisalign in air. MRI and ultrasonography should be used to detect orthodontic materials in muscle.
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Affiliation(s)
- Ozlem Isman
- Vocational High School of Health Service, Gaziantep University, Gaziantep, 27310, Şehitkamil/Gaziantep, Turkey.
| | - Eren Isman
- Private Practice, Gaziantep, 27310, Turkey
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192
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Fontenele RC, Machado AH, de Oliveira Reis L, Freitas DQ. Influence of metal artefact reduction tool on the detection of vertical root fractures involving teeth with intracanal materials in cone beam computed tomography images: A systematic review and meta-analysis. Int Endod J 2021; 54:1769-1781. [PMID: 34003491 DOI: 10.1111/iej.13569] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND The effectiveness of the metal artefact reduction (MAR) tool for the detection of vertical root fracture (VRF) by cone beam computed tomography (CBCT) images is controversial. OBJECTIVE To evaluate the effectiveness of the MAR tool on VRF detection involving teeth with intracanal materials in CBCT images. METHODOLOGY In September 2019, an electronic search was performed in six databases (PubMed, Scopus, Web of Science, Cochrane, Lilacs and Embase). The electronic search was updated in May 2020 through searches in Google Scholar and references of included studies (embracing the electronic and gray literature searches). No language or year restrictions were applied. Independently, two reviewers examined titles, abstracts and full texts according to the eligibility criteria that were as follows: diagnostic studies that evaluated the effectiveness of the MAR tool on the diagnosis of VRF in human teeth (laboratory or in vivo studies) on CBCT images. The risk of bias was evaluated using the Quality Assessment Tool for Diagnostic of Accuracy Studies-2 (QUADAS-2). For conducting the meta-analysis, the values of sensitivity, specificity, diagnostic odds ratio (DOR) and area under the ROC curve (AUC) were obtained, considering the subgroups with and without MAR active. The Grading of Recommendation, Assessment, Development and Evaluation instrument was applied to assess the level of evidence across the studies using GRADEpro software. RESULTS A total of 8 laboratory studies were included in both systematic review and meta-analysis. The values of sensitivity, specificity, DOR and AUC to VRF diagnosis with and without MAR active were, respectively, 0.586 and 0.603; 0.699 and 0.713, 3.037 and 3.767; 0.67 and 0.71. The quality of the evidence suggested low confidence in estimating the outcomes. DISCUSSION The MAR tool decreased slightly the diagnostic values of VRF involving teeth with intracanal materials in laboratory studies. However, it is important to highlight that most studies had an uncertain risk of bias. CONCLUSIONS Although a low level of evidence and high heterogeneity were observed in the included studies, the meta-analysis revealed better diagnosis values for VRF detection when the MAR was deactivated when analysing extracted teeth in a laboratory setting. REGISTRATION PROSPERO-CRD42020145222. FUNDING This study was financed in party by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brasil (CAPES).
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Affiliation(s)
- Rocharles C Fontenele
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Alessiana H Machado
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Larissa de Oliveira Reis
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Deborah Q Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
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193
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Ibrahim N, Parsa A, Hassan B, van der Stelt P, Rahmat RA, Ismail SM, Aartman IHA. Comparison of anterior and posterior trabecular bone microstructure of human mandible using cone-beam CT and micro CT. BMC Oral Health 2021; 21:249. [PMID: 33964918 PMCID: PMC8106860 DOI: 10.1186/s12903-021-01595-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 04/12/2021] [Indexed: 11/30/2022] Open
Abstract
Background The aim of this study was to compare the trabecular bone microstructures of anterior and posterior edentulous regions of human mandible using cone-beam computed tomography (CBCT) and micro computed tomography (µCT). Methods Twenty volumes of interests consisting of six anterior and fourteen posterior edentulous regions were obtained from human mandibular cadavers. A CBCT system with a resolution of 80 µm (3D Accuitomo 170, J. Morita, Kyoto, Japan) and a µCT system with a resolution of 35 µm (SkyScan 1173, Kontich, Belgium) were used to scan the mandibles. Three structural parameters namely, trabecular number (Tb.N), trabecular thickness (Tb.Th), and trabecular separation (Tb.Sp) were analysed using CTAn software (v 1.11, SkyScan, Kontich, Belgium). For each system, the measurements obtained from anterior and posterior regions were tested using independent sample t-test. Subsequently, all measurements between systems were tested using paired t-test. Results In CBCT, all parameters of the anterior and posterior mandible showed no significant differences (p > 0.05). However, µCT showed a significant different of Tb.Th (p = 0.023) between anterior and posterior region. Regardless of regions, the measurements obtained using both imaging systems were significantly different (p ≤ 0.021) for Tb.Th and Tb.N. Conclusions The current study demonstrated that only the variation of Tb.Th between anterior and posterior edentulous region of mandible can be detected using µCT. In addition, CBCT is less feasible than µCT in assessing trabecular bone microstructures at both regions.
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Affiliation(s)
- Norliza Ibrahim
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Azin Parsa
- Department of Diagnostic Sciences, School of Dentistry, The University of North Carolina, Chapel Hill, USA
| | - Bassam Hassan
- Department of Oral and Maxillofacial Radiology, Academic Center for Dentistry Amsterdam (ACTA), Louwesweg 1, 1066 EA, Amsterdam, The Netherlands
| | - Paul van der Stelt
- Department of Oral and Maxillofacial Radiology, Academic Center for Dentistry Amsterdam (ACTA), Louwesweg 1, 1066 EA, Amsterdam, The Netherlands
| | - Rabiah A Rahmat
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Siti M Ismail
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Irene H A Aartman
- Department of Oral and Maxillofacial Radiology, Academic Center for Dentistry Amsterdam (ACTA), Louwesweg 1, 1066 EA, Amsterdam, The Netherlands
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194
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Siqueira R, Sinjab K, Pan YC, Soki F, Chan HL, Kripfgans O. Comprehensive peri-implant tissue evaluation with ultrasonography and cone-beam computed tomography: A pilot study. Clin Oral Implants Res 2021; 32:777-785. [PMID: 33866602 DOI: 10.1111/clr.13758] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 03/27/2021] [Accepted: 03/31/2021] [Indexed: 01/13/2023]
Abstract
OBJECTIVES The aim of the present study was to explore the feasibility of ultrasonography (US) for clinical imaging of peri-implant tissues. MATERIAL AND METHODS Patients with ≥1 implant, a cone-beam computed tomography (CBCT) scan, an US scan, and clinical photographs taken during the surgery were included. The crestal bone thickness (CBT) and facial bone level (FBL) were measured on both US and CBCT modalities, and direct FBL measurements were also made on clinical images. US measurements were compared with CBCT and direct readings. RESULTS A total of eight implants from four patients were included. For FBL measurements, US and direct (r2 = 0.95) as well as US and CBCT (r2 = 0.85) were highly correlated, whereas CBCT correlated satisfactorily with the direct reading (r2 = 0.75). In one implant without facial bone, CBCT was not able to measure CBT and FBL accurately. The estimated bias for CBT readings was 0.17 ± 0.23 mm (p = .10) between US and CBCT. US blood flow imaging was successfully recorded and showed a wide dynamic range among patients with different degrees of clinical inflammation. CONCLUSION US is a feasible method to evaluate peri-implant facial crestal bone dimensions. Additional US features, for example, functional blood flow imaging, may be useful to estimate the extent and severity of inflammation.
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Affiliation(s)
- Rafael Siqueira
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Khaled Sinjab
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Ying-Chun Pan
- Department of Biomedical Engineering, College of Engineering, Ann Arbor, MI, USA
| | - Fabiana Soki
- Department of Periodontics and Oral Medicine and Division of Oral Pathology/Medicine/Radiology, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Oliver Kripfgans
- Department of Biomedical Engineering, College of Engineering, Ann Arbor, MI, USA.,Department of Radiology, University of Michigan Medical School, Ann Arbor, MI, USA
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195
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Gao A, Cao D, Lin Z. Diagnosis of cracked teeth using cone-beam computed tomography: literature review and clinical experience. Dentomaxillofac Radiol 2021; 50:20200407. [PMID: 33237813 DOI: 10.1259/dmfr.20200407] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Cone-beam computed tomography (CBCT) has been widely used in diagnosis of vertical root fractures (VRFs) in recent years. According to the American Association of Endodontists (AAE) classification, there are five types of cracked teeth and VRF is one of them. Due to the variability and overlapping of the cracks and fractures, some narrow fractures on the roots of VRFs could not be detected by CBCT, and some wide cracks on the crown of cracked teeth could be detected by CBCT. In this review, we firstly discussed the value of CBCT in the diagnosis of the AAE five types of cracked teeth and presented CBCT manifestations of some typical cases. Secondly, we summarized the factors influencing the diagnosis of cracks/fractures using CBCT, namely, CBCT device-related factors, patient-related factors, and evaluator-related factors. The possible strategies to improve the diagnostic accuracy in the clinic practice are also discussed in this part. Finally, we compared the differences of root fractures with lateral canals and external root resorption on CBCT images.
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Affiliation(s)
- Antian Gao
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Dantong Cao
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Zitong Lin
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
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196
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Bahmani A, Karkehabadi H, Shokri A, Farhadian M. Performance of Bioceramic-based Root Filling Material with Artifact Reduction Properties in the Detection of Vertical Root Fractures Using Cone-beam Computed Tomography. Open Dent J 2021. [DOI: 10.2174/1874210602115010170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Introduction:
In Cone-beam Computed Tomography (CBCT) images, metallic artifacts by root filling materials reduce the quality of images. It seems that bioceramic sealers produce fewer artifacts than gutta-percha. In this situation, the possibility of VRF detection could increase, and therefore, flap and exploratory surgery would not be needed. The purpose of this study was to evaluate the performance of a bioceramic-based root filling material in the detection of Vertical Root Fractures (VRF) in CBCT imaging.
Materials and Methods:
This study was conducted at the dental school from March to August 2019, and 100 healthy human mandibular premolar teeth were obtained and randomly divided into two equal groups. The teeth were filled with either AH26 and gutta-percha or bioceramic root filling materials. VRF was induced on half of the decoronated teeth in each group using a Global Testing Machine, and the others were considered control. CBCT imaging was performed by the Cranex 3D machine. Comparisons of the 2 groups were made using the Mann-Whitney test.
Results:
There was a significant difference between the two groups of bioceramic and gutta-percha in the measured indices, including sensitivity (P=0.017), specificity (P=0.018), positive predictive value (P=0.018), negative predictive value (P=0.018), and accuracy (P=0.011). The Area Under Curve (AUC) also showed a significant difference between the two groups (P=0.011). According to Kappa test results, no significant difference was obtained between the findings of the two observers.
Conclusion:
Different root filling materials showed a different extent of artifact in CBCT images. Bioceramic root filling material induces fewer artifacts in CBCT images, and the diagnostic value of VRF in CBCT images in the root canals filled with it is greater than those filled with AH26 and gutta-percha.
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197
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Oliveira MR, Sousa TO, Caetano AF, de Paiva RR, Valladares-Neto J, Yamamoto-Silva FP, Silva MAG. Influence of CBCT metal artifact reduction on vertical radicular fracture detection. Imaging Sci Dent 2021; 51:55-62. [PMID: 33828962 PMCID: PMC8007395 DOI: 10.5624/isd.20200191] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/17/2020] [Accepted: 11/24/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose This study evaluated the influence of a metal artifact reduction (MAR) tool in a cone-beam computed tomography (CBCT) device on the diagnosis of vertical root fractures (VRFs) in teeth with different root filling materials. Materials and Methods Forty-five extracted human premolars were classified into three subgroups; 1) no filling; 2) gutta-percha; and 3) metallic post. CBCT images were acquired using an Orthopantomograph 300 unit with and without a MAR tool. Subsequently, the same teeth were fractured, and new CBCT scans were obtained with and without MAR. Two oral radiologists evaluated the images regarding the presence or absence of VRF. Receiver operating characteristic (ROC) curves and diagnostic tests were performed. Results The overall area under the curve values were 0.695 for CBCT with MAR and 0.789 for CBCT without MAR. The MAR tool negatively influenced the overall diagnosis of VRFs in all tested subgroups, with lower accuracy (0.45–0.72), sensitivity (0.6–0.67), and specificity (0.23–0.8) than were found for the images without MAR. In the latter group, the accuracy, sensitivity, and specificity values were 0.68–0.77, 0.67–083, and 0.53–087, respectively. However, no significant difference was found between images with and without MAR for the no filling and gutta-percha subgroups (P>0.05). In the metallic post subgroup, CBCT showed a significant difference according to MAR use (P<0.05). Conclusion The OP 300 MAR tool negatively influenced the detection of VRFs in teeth with no root canal filling, gutta-percha, or metallic posts. Teeth with metallic posts suffered the most from the negative impact of MAR.
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Affiliation(s)
- Mariana Rodrigues Oliveira
- Department of Stomatological Sciences, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | - Aline Ferreira Caetano
- Department of Stomatological Sciences, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Rogério Ribeiro de Paiva
- Department of Oral Radiology, School of Dentistry, Anápolis University Centre, Anápolis, Goiás, Brazil
| | - José Valladares-Neto
- Department of Oral Rehabilitation, Division of Orthodontics, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | - Maria Alves Garcia Silva
- Department of Stomatological Sciences, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
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198
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Wang H, Minnema J, Batenburg KJ, Forouzanfar T, Hu FJ, Wu G. Multiclass CBCT Image Segmentation for Orthodontics with Deep Learning. J Dent Res 2021; 100:943-949. [PMID: 33783247 PMCID: PMC8293763 DOI: 10.1177/00220345211005338] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Accurate segmentation of the jaw (i.e., mandible and maxilla) and the teeth in cone beam computed tomography (CBCT) scans is essential for orthodontic diagnosis and treatment planning. Although various (semi)automated methods have been proposed to segment the jaw or the teeth, there is still a lack of fully automated segmentation methods that can simultaneously segment both anatomic structures in CBCT scans (i.e., multiclass segmentation). In this study, we aimed to train and validate a mixed-scale dense (MS-D) convolutional neural network for multiclass segmentation of the jaw, the teeth, and the background in CBCT scans. Thirty CBCT scans were obtained from patients who had undergone orthodontic treatment. Gold standard segmentation labels were manually created by 4 dentists. As a benchmark, we also evaluated MS-D networks that segmented the jaw or the teeth (i.e., binary segmentation). All segmented CBCT scans were converted to virtual 3-dimensional (3D) models. The segmentation performance of all trained MS-D networks was assessed by the Dice similarity coefficient and surface deviation. The CBCT scans segmented by the MS-D network demonstrated a large overlap with the gold standard segmentations (Dice similarity coefficient: 0.934 ± 0.019, jaw; 0.945 ± 0.021, teeth). The MS-D network–based 3D models of the jaw and the teeth showed minor surface deviations when compared with the corresponding gold standard 3D models (0.390 ± 0.093 mm, jaw; 0.204 ± 0.061 mm, teeth). The MS-D network took approximately 25 s to segment 1 CBCT scan, whereas manual segmentation took about 5 h. This study showed that multiclass segmentation of jaw and teeth was accurate and its performance was comparable to binary segmentation. The MS-D network trained for multiclass segmentation would therefore make patient-specific orthodontic treatment more feasible by strongly reducing the time required to segment multiple anatomic structures in CBCT scans.
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Affiliation(s)
- H Wang
- Department of Oral and Maxillofacial Surgery/Pathology, 3D Innovation Lab, Amsterdam Movement Sciences, Amsterdam UMC, Academic Centre for Dentistry Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - J Minnema
- Department of Oral and Maxillofacial Surgery/Pathology, 3D Innovation Lab, Amsterdam Movement Sciences, Amsterdam UMC, Academic Centre for Dentistry Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - K J Batenburg
- Centrum Wiskunde and Informatica, Amsterdam, the Netherlands
| | - T Forouzanfar
- Department of Oral and Maxillofacial Surgery/Pathology, 3D Innovation Lab, Amsterdam Movement Sciences, Amsterdam UMC, Academic Centre for Dentistry Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - F J Hu
- Institute of Information Technology, Zhejiang Shuren University, Hangzhou, China
| | - G Wu
- Department of Oral and Maxillofacial Surgery/Pathology, 3D Innovation Lab, Amsterdam Movement Sciences, Amsterdam UMC, Academic Centre for Dentistry Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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199
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Terrabuio BR, Carvalho CG, Peralta-Mamani M, Santos PSDS, Rubira-Bullen IRF, Rubira CMF. Cone-beam computed tomography artifacts in the presence of dental implants and associated factors: an integrative review. Imaging Sci Dent 2021; 51:93-106. [PMID: 34235055 PMCID: PMC8219451 DOI: 10.5624/isd.20200320] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/18/2021] [Accepted: 01/27/2021] [Indexed: 12/16/2022] Open
Abstract
Purpose This study was conducted to review the literature regarding the types of cone-beam computed tomography (CBCT) artifacts around dental implants and the factors that influence their formation. Materials and Methods A search strategy was carried out in the PubMed, Embase, and Scopus databases to identify published between 2010 and 2020, and 9 studies were selected. The implants included 306 titanium, titanium-zirconium, and zirconia implants, as well as 5 titanium cylinders. Results The artifacts around the implants were the beam-hardening artifact, the streaking artifact, and band-like radiolucent areas. Some factors that influenced the formation of artifacts were the implant material, bone type, evaluated regions, distance, type of CBCT, field of view (FOV) size, milliamperage, peak kilovoltage (kVp), and voxel size. The beam-hardening artifact was the most widely reported, and it was minimized in protocols with a smaller FOV, larger voxels, and higher kVp. Conclusion The risk and benefit of these protocols in individuals with dental implants must be considered, and clinical examinations and complementary radiographs play an essential role in implantology.
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Affiliation(s)
- Bianca Rodrigues Terrabuio
- Department of Surgery, Stomatology, Pathology, and Radiology, Bauru School of Dentistry, University of São Paulo, SP, Brazil
| | - Caroline Gomes Carvalho
- Department of Surgery, Stomatology, Pathology, and Radiology, Bauru School of Dentistry, University of São Paulo, SP, Brazil
| | - Mariela Peralta-Mamani
- Department of Surgery, Stomatology, Pathology, and Radiology, Bauru School of Dentistry, University of São Paulo, SP, Brazil
| | - Paulo Sérgio da Silva Santos
- Department of Surgery, Stomatology, Pathology, and Radiology, Bauru School of Dentistry, University of São Paulo, SP, Brazil
| | | | - Cássia Maria Fischer Rubira
- Department of Surgery, Stomatology, Pathology, and Radiology, Bauru School of Dentistry, University of São Paulo, SP, Brazil
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200
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Caetano AP, Sousa TO, Oliveira MR, Evanglista K, Bueno JM, Silva MA. Accuracy of three cone-beam CT devices and two software systems in the detection of vertical root fractures. Dentomaxillofac Radiol 2021; 50:20200334. [PMID: 33259236 DOI: 10.1259/dmfr.20200334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this study was to compare the accuracy of vertical root fracture (VRF) detection using three tomography devices and two software systems in teeth with different endodontic fillings. METHODS The sample consisted of 45 premolars divided into 3 groups: No filling (NF, n=15); Gutta percha (GP, n=15) and Metallic Post (MP, n=15). Cone-beam computed tomography (CBCT) images were acquired in Kodak 9000 3D, Orthopantomography 300 (OP300) and PreXion 3D devices, before and after induced root fractures. Two oral radiologists analyzed all images using InVivoDental and e-Vol DX software systems. The analysis was repeated after 15 days in 30% of the sample. Data analysis compared receiver operating characteristic (ROC) curves, as well the areas under the ROC curves. Accuracy, sensitivity, specificity, positive and negative predictive value were calculated according to each tomographic device and software. Intra- and interexaminer reliability were tested using the Kappa coefficient. RESULTS The highest accuracy was seen in the image set from the PreXion 3D, using InVivo (0.96) or e-Vol DX (0.92) in image analysis. The OP300 device presented a similar performance of the PreXion 3D in teeth with different endodontic fillings. When using e-Vol DX, the accuracy of Kodak 9000 3D improved from 0.62 to 0.74. CONCLUSIONS The PreXion 3D device is the most accurate when detecting VRF, with a performance similar to the OP300 in endodontic filled teeth. Kodak 9000 3D is indicated for teeth without fillings, with better accuracy using e-Vol DX software.
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Affiliation(s)
- Aline Pf Caetano
- Faculty of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | - Mariana R Oliveira
- Faculty of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Karine Evanglista
- Faculty of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Juliano M Bueno
- São Leopoldo Mandic, Private Practioner, Goiânia, Goiás, Brazil
| | - Maria Ag Silva
- Faculty of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
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