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Santos AA, de Freitas Silva BS, Correia FFN, Mezaiko E, de Souza Roriz CF, Silva MAG, Freitas DQ, Yamamoto-Silva FP. Optimizing cone-beam computed tomography exposure for an effective radiation dose and image quality balance. Imaging Sci Dent 2024; 54:159-169. [PMID: 38948188 PMCID: PMC11211023 DOI: 10.5624/isd.20230251] [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: 11/21/2023] [Revised: 01/11/2024] [Accepted: 01/11/2024] [Indexed: 07/02/2024] Open
Abstract
Purpose The aim of this study was to evaluate the influence of different cone-beam computed tomography (CBCT) acquisition protocols on reducing the effective radiation dose while maintaining image quality. Materials and Methods The effective dose emitted by a CBCT device was calculated using thermoluminescent dosimeters placed in a Rando Alderson phantom. Image quality was assessed by 3 experienced evaluators. The relationship between image quality and confidence was evaluated using the Fisher exact test, and the agreement among raters was assessed using the kappa test. Multiple linear regression analysis was performed to investigate whether the technical parameters could predict the effective dose. P-values<0.05 were considered to indicate statistical significance. Results The optimized protocol (3 mA, 99 kVp, and 450 projection images) demonstrated good image quality and a lower effective dose for radiation-sensitive organs. Image quality and confidence had consistent values for all structures (P<0.05). Multiple linear regression analysis resulted in a statistically significant model. The milliamperage (b=0.504; t=3.406; P=0.027), kilovoltage peak (b=0.589; t=3.979; P=0.016) and number of projection images (b=0.557; t=3.762; P=0.020) were predictors of the effective dose. Conclusion Optimized CBCT acquisition protocols can significantly reduce the effective radiation dose while maintaining acceptable image quality by adjusting the milliamperage and projection images.
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Affiliation(s)
- Ananda Amaral Santos
- Department of Oral Radiology, University of Anápolis, Anápolis, GO, Brazil
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | - Brunno Santos de Freitas Silva
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
- Science Program in Dentistry, University of Anápolis, Anápolis, GO, Brazil
| | | | - Eleazar Mezaiko
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | | | - Maria Alves Garcia Silva
- Department of Oral Radiology, University of Anápolis, Anápolis, GO, Brazil
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | - Deborah Queiroz Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Fernanda Paula Yamamoto-Silva
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
- Science Program in Dentistry, University of Anápolis, Anápolis, GO, Brazil
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Schulze M, Hirt B, Reimann K. Flat panel CT versus multidetector CT in skull base imaging: are there differences in image quality? Head Face Med 2023; 19:50. [PMID: 37980498 PMCID: PMC10656997 DOI: 10.1186/s13005-023-00391-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 10/11/2023] [Indexed: 11/20/2023] Open
Abstract
BACKGROUND Purpose of this study was to compare image quality of the skull base in standard 20s protocol flat panel computed tomography (FPCT) with the new time and dose improved 10s protocol as well as with 128 slice multidetector computed tomography (MDCT). METHODS 10 whole skull preparations were scanned with either 128 slice MDCT(SOMATOM Definition AS+, Siemens, Erlangen) or FPCT (AXIOM-Artis, Siemens, Erlangen) using 10s or 20s protocol. RESULTS FPCT provides significantly better image quality and improved delimitation of clinically relevant structures in the anterior, temporal and posterior skull base compared to 128 slice MDCT. The 20s FPCT protocol yielded best delimitability of evaluated skull base structures. However, the shorter, dose saving 10s FPCT protocol was still significantly superior to 128 slice MDCT regarding delimitability of skull base structures and additionally showed no significant inferiority compared with the 20s FPCT protocol. CONCLUSIONS The 10s FPCT protocol yields a significantly better image quality at a comparable radiation dose exposure in imaging skull base structures compared to MDCT. TRIAL REGISTRATION 371/2017BO2.
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Affiliation(s)
- Maximilian Schulze
- Department of Neuroradiology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.
- Department of Neuroradiology, University Hospital Marburg, Philipps University Marburg, Baldingerstrasse, 35043, Marburg, Germany.
| | - Bernhard Hirt
- Institute of Clinical Anatomy and Cell Analysis, University of Tübingen, Elfriede-Aulhorn-Straße 8, 72076, Tübingen, Germany
| | - Katrin Reimann
- Department of Otolaryngology - Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Strasse 5, 72076, Tübingen, Germany
- Department of Otolaryngology - Head and Neck Surgery, Philipps-Universität Marburg, Baldingerstrasse, Marburg, 35043, Germany
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Khafaji M, Albadawi GH. Assessment of Scattered Dose to the Eye in Dentistry: A Systematic Review. Cureus 2023; 15:e43113. [PMID: 37560052 PMCID: PMC10407597 DOI: 10.7759/cureus.43113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2023] [Indexed: 08/11/2023] Open
Abstract
Cone-beam computed tomography (CBCT) is a tool for dental imaging of impactions, maxillofacial discrepancies, facial trauma, and tumors. In addition, It is used in treatment planning for dental implants, orthognathic surgery, and general maxillofacial surgery. There are no standardized methods for utilizing CBCT dosimetry, and there is no consensus among dental and medical physics health professionals regarding dental CBCT imaging procedures. The eyes and thyroid glands are radiosensitive organs that lie outside the primary beam but receive a significant amount of radiation due to scattered radiation. This study aimed to assess the dose to eye lens in patients imaged using CBCT. This review aims to evaluate the scattered doses to the eye from CBCT among adult patients seeking dental treatment. The search included published articles in the Web of Science, PubMed (MeSH and Web PubMed), Medline, and Google Scholar databases using the appropriate keywords from January 2010 to July 2022. The inclusion criteria were based on the method of dose measurement (phantom studies using Optically stimulated luminescence (OSL) and Thermoluminescent dosimeter (TLD), language, and type of protocol used. A literature search was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist and flow chart. Out of 653 articles identified, 5 met the inclusion criteria. The results show that the scattered radiation dose ranged between 0.103 mSv and 8.3 mSv. This variation exists due to the difference in the field of vision (FOV), phantom exposure, dosimeters used, degree of rotation in the protocol, and finally, the scanner used. The scattered dose to the eye from CBCT is higher than the background radiation, with huge variability in the range of the dose measured. Clear guidelines for utilizing CBCT should be implemented, and dose reference levels should be established for benchmarking and optimization in practice.
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Affiliation(s)
- Mawya Khafaji
- Radiology, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
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4
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Hackenbroch C, Strobel JRB, Lorenz KJ, Beer M, Schüle S. Dose development in sinonasal imaging over the last decade - a retrospective patient study. Head Face Med 2023; 19:28. [PMID: 37430304 PMCID: PMC10332007 DOI: 10.1186/s13005-023-00378-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 07/01/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Computed tomography (CT) has become the primary imaging modality for visualization of the paranasal sinuses. In this retrospective, single center patient study the radiation dose development in the past 12 years in CT imaging of the paranasal sinuses was assessed. METHODS The computed tomography dose index (CTDIVol) and dose length product (DLP) of a total of 1246 patients (average age: 41 ± 18 years, 361 females, 885 males) were evaluated, who received imaging of the paranasal sinuses either for chronic sinusitis diagnostic, preoperatively or posttraumatically. Scans were performed on three different CT scanners (Somatom Definition AS, Somatom Definition AS+, Somatom Force, all from Siemens Healthineers) and on one CBCT (Morita) ranging from 2010 to 2022. Reconstruction techniques were filtered back projection and three generations of iterative reconstruction (IRIS, SAFIRE, ADMIRE, all from Siemens Healthineers). Group comparisons were performed using either parametrical (ANOVA) or non-parametrical tests (Kruskal-Wallis Test), where applicable. RESULTS Over the past 12 years, there was a 73%, 54%, and 66% CTDIVol reduction and a significant (p < 0.001) 72%, 33%, and 67% DLP reduction in assessing the paranasal sinuses for chronic sinusitis, preoperatively and posttraumatically, respectively. CONCLUSION Technological developments in CT imaging, both hardware and software based, have led to a significant reduction in dose exposure in recent years. Particularly in imaging of the paranasal sinuses, the reduction of radiation exposure is of great interest due to the often young patient age and radiation-sensitive organs in the area of radiation exposure.
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Affiliation(s)
- Carsten Hackenbroch
- Department of Diagnostic and Interventional Radiology and Neuroradiology, German Armed Forces Hospital Ulm, Ulm, Baden-Wurttemberg, Germany.
- Department of Radiology, University Hospital of Ulm, Ulm, Baden-Wurttemberg, Germany.
| | - Joachim Rudolf Balthasar Strobel
- Department of Diagnostic and Interventional Radiology and Neuroradiology, German Armed Forces Hospital Ulm, Ulm, Baden-Wurttemberg, Germany
| | - Kai Johannes Lorenz
- Department of Otorhinolaryngology and Head and Neck Surgery, German Armed Forces Central Hospital Koblenz, Koblenz, Rhineland-Palatinate, Germany
| | - Meinrad Beer
- Department of Radiology, University Hospital of Ulm, Ulm, Baden-Wurttemberg, Germany
| | - Simone Schüle
- Department of Diagnostic and Interventional Radiology and Neuroradiology, German Armed Forces Hospital Ulm, Ulm, Baden-Wurttemberg, Germany
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Stapedius muscle: Don't mistake it for a branch of the facial nerve in images. Auris Nasus Larynx 2023:S0385-8146(23)00036-6. [PMID: 36894377 DOI: 10.1016/j.anl.2023.02.003] [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: 11/19/2022] [Revised: 02/15/2023] [Accepted: 02/20/2023] [Indexed: 03/09/2023]
Abstract
OBJECTIVE The relationship between the stapedius muscle and the vertical part of the facial nerve is important for surgery. The study aims to understand the spatial relationship between the stapedius muscle and the vertical part of the facial nerve in ultra-high-resolution computed tomography (U-HRCT) images. METHODS A total of 105 ears from the heads of 54 human cadavers were analyzed using U-HRCT. The location and direction of the stapedius muscle were evaluated with the facial nerve as the reference. The integrity of the bony septum between the two structures and the distance between the transverse sections were examined. Paired Student's t-test and the nonparametric Wilcoxon test were applied. RESULTS The lower end of the stapedius muscle emerged at the upper (45 ears), middle (40 ears), or lower (20 ears) level of the facial nerve and was positioned medial (32 ears), medial posterior (61 ears), posterior (11 ears), or lateral posterior (1 ear) to the facial nerve. The bony septum was not continuous in 99 ears. The distance between the midpoints of the two structures was 1.75 mm (IQR=1.55-2.16 mm). CONCLUSION The spatial relationship between the stapedius muscle and the facial nerve was varied. They were close to each other and in most cases the bony septum was not intact. Preoperative familiarity with the relationship between the two structures is helpful for avoiding unwanted injury to the facial nerve in surgery.
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Schüle S, Strobel JRB, Lorenz KJ, Beer M, Hackenbroch C. Tin filter compared to low kV protocols - optimizing sinonasal imaging in computed tomography. PLoS One 2023; 18:e0279907. [PMID: 36607911 PMCID: PMC9821404 DOI: 10.1371/journal.pone.0279907] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 12/18/2022] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES Paranasal sinus imaging due to chronic inflammatory disease is one of the most common examinations in head and neck radiology with CT imaging considered the current gold standard. In this phantom study we analyzed different low dose CT protocols in terms of image quality, radiation exposure and subjective evaluation in order to establish an optimized scanning protocol. METHODS In a phantom study, an Alderson phantom was scanned using 12 protocols between 70-120 kV and 25-200 mAs with and without tin filtration. For all datasets, iterative reconstruction was used. Data were objectively evaluated (image noise, (dose-weighted) contrast-to-noise ratio) and for subjective evaluation an online survey using a Likert scale was performed to reach a large group of clinically experienced reader (n = 62). The protocol was considered diagnostically insufficient if the median score was 4 and above and if more than 10% of raters scored 4 and above on the Likert scale. For an interreader agreement an ICC was calculated. To compare clinical value in relation to the applied dose and the objective image parameters, we calculated a figure of merit (FOM) and ranked the protocols accordingly. RESULTS There was an overall moderate agreement between the 62 readers for the 12 examined CT protocols. In this phantom study, protocols with 100 kV with spectral shaping and 50-100 mAs obtained the best results for its combination of dose, image quality and clinical information value for diagnosing sinusitis (FOM 1st- 2nd place) with the 70 kV and 50 mAs as a good alternative as well (Sinusitis: FOM shared 2nd). For preoperative planning, where a higher dose is necessary, 100 kV with spectral shaping and 100 mAs achieved the overall best results (FOM 1st place) with 70 kV and 50 mAs ranking 4th. CONCLUSION 100-kV protocols with spectral shaping or low kV protocols (70 kV) with a similarly low dose showed the best figure of merit for imaging sinonasal disease and preoperative planning. With modern scanner technology available, spectral shaping or low KV protocols should be used for sinusitis imaging.
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Affiliation(s)
- Simone Schüle
- Department of Diagnostic and Interventional Radiology and Neuroradiology, German Armed Forces Hospital Ulm, Ulm, Baden-Wurttemberg, Germany
| | - Joachim Rudolf Balthasar Strobel
- Department of Diagnostic and Interventional Radiology and Neuroradiology, German Armed Forces Hospital Ulm, Ulm, Baden-Wurttemberg, Germany
| | - Kai Johannes Lorenz
- Department of Otorhinolaryngology and Head and Neck Surgery, German Armed Forces Central Hospital Koblenz, Koblenz, Rhineland-Palatinate, Germany
| | - Meinrad Beer
- Department of Radiology, University Hospital of Ulm, Ulm, Baden-Wurttemberg, Germany
| | - Carsten Hackenbroch
- Department of Diagnostic and Interventional Radiology and Neuroradiology, German Armed Forces Hospital Ulm, Ulm, Baden-Wurttemberg, Germany
- Department of Radiology, University Hospital of Ulm, Ulm, Baden-Wurttemberg, Germany
- * E-mail:
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7
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Muñoz-Galván A, Fiori-Chíncaro GA, Agudelo-Botero AM. [Applications of cone beam computed tomography of the craneofacial structure in medical specialties. A review]. REVISTA CIENTÍFICA ODONTOLÓGICA 2022; 10:e100. [PMID: 38389916 PMCID: PMC10880726 DOI: 10.21142/2523-2754-1001-2022-100] [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: 09/02/2021] [Accepted: 01/01/2022] [Indexed: 02/24/2024] Open
Abstract
Cone-beam computed tomography (CBCT) of the craniofacial structure has demonstrated its usefulness in the dental area during the last decades, thus it has become a fundamental tool in the diagnosis, planning, and evaluation of treatment, and although it was not developed for the exclusive use in dentistry, as it is commonly considered, it is used in other areas such as medicine. It is specifically used in the head and neck area where different medical specialties interact, and at the same time these interact with dental specialties, so knowing the advantages of CBCT over different imaging technologies in the medical area is necessary. The purpose of this review was to describe the applications of observation, diagnosis, planning, and evolution of treatments using maxillofacial HSCT in different medical specialties. This work highlights the use of TCHC in different medical applications and highlights where it is most useful compared to other technologies.
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Affiliation(s)
- Agustín Muñoz-Galván
- Division de Radiologia Bucal y Maxilofacial, Universidad Cientifica del Sur. Lima, Peru. Universidad Científica del Sur Division de Radiologia Bucal y Maxilofacial Universidad Cientifica del Sur Lima Peru
| | - Gustavo Adolfo Fiori-Chíncaro
- Instituto Latinoamericano de Altos Estudios en Estomatologia (ILAE). Lima, Peru. , Instituto Latinoamericano de Altos Estudios en Estomatologia (ILAE) Lima Peru
| | - Ana María Agudelo-Botero
- Instituto Latinoamericano de Altos Estudios en Estomatologia (ILAE). Lima, Peru. , Instituto Latinoamericano de Altos Estudios en Estomatologia (ILAE) Lima Peru
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Yang TW, Lin YY, Hsu SC, Chu KCW, Hsiao CW, Hsu CW, Bai CH, Chang CK, Hsu YP. Diagnostic performance of cone-beam computed tomography for scaphoid fractures: a systematic review and diagnostic meta-analysis. Sci Rep 2021; 11:2587. [PMID: 33510347 PMCID: PMC7843979 DOI: 10.1038/s41598-021-82351-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 01/19/2021] [Indexed: 12/19/2022] Open
Abstract
Scaphoid fractures are the most common carpal fractures. Diagnosing scaphoid fractures is challenging. Recently, cone-beam computed tomography (CBCT) has been shown to be a promising strategy for diagnosing scaphoid fractures. The diagnostic performance of CBCT remains inconclusive in the literature. Through a systematic review and meta-analysis, our study aims to determine the diagnostic performance of CBCT for diagnosing scaphoid fractures. Five databases were searched up to March 25, 2020. We included prospective and retrospective studies describing the diagnostic accuracy of CBCT for scaphoid fractures in adult patients. QUADAS-2 tool was used to assess the quality of the included studies. Four studies (n = 350) were included in the meta-analysis. Three of the four studies had high bias risk. The result showed that CBCT had a pooled sensitivity of 0.88 and a pooled specificity of 0.99 for scaphoid fracture diagnosis. The heterogeneities of sensitivity and specificity were substantial. The area under the summary receiver operating characteristic curve was 0.98. No significant publication bias was observed. The result suggested that the diagnostic performance of CBCT for scaphoid fracture was excellent. The certainty of current evidence is low. Further well-designed studies with large sample sizes are warranted to confirm this finding.
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Affiliation(s)
- Ta-Wei Yang
- Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan.,National Defense Medical Center, Taipei, Taiwan
| | - Yen-Yue Lin
- Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan.,National Defense Medical Center, Taipei, Taiwan
| | - Shih-Chang Hsu
- Emergency Department, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Karen Chia-Wen Chu
- Emergency Department, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chih-Wei Hsiao
- National Defense Medical Center, Taipei, Taiwan.,Department of Orthopedic Surgery, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan
| | - Chin-Wang Hsu
- Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Orthopedic Surgery, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan
| | - Chyi-Huey Bai
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Cheng-Kuang Chang
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yuan-Pin Hsu
- Emergency Department, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. .,Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. .,Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
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9
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French Otorhinolaryngology Society (SFORL) good practice guidelines for dental implant surgery close to the maxillary sinus. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 137:53-58. [PMID: 31837968 DOI: 10.1016/j.anorl.2019.11.002] [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: 11/21/2022]
Abstract
OBJECTIVES To draw up guidelines for ENT management associated with dental implant surgery with or without sinus lift. MATERIALS AND METHODS The methodology followed the rules of laid down by the French Health Authority (HAS): "Methodological bases for drawing up professional recommendations by formalized consensus". The chosen method was the RAND/UCLA "RAND appropriateness method" (short version). RESULTS In the pre-implantation check-up, it is recommended to systematically screen for sinonasal pathology on medical interview and to favor 3D CT or cone-beam imaging. It is recommended that imaging include the entire maxillary sinus when the patient does not have sinonasal history or functional signs on interview. Otherwise, examination of all sinonasal cavities is recommended. This attitude enables simultaneous analysis of maxillary infrastructure for pre-implantation work-up and assessment of sinonasal cavity status. Sinus mucosal incidentalomas are very common in the healthy population and must be assessed with reference to the clinical, endoscopic and radiological context. CONCLUSION This formalized expert consensus establishes a common base of knowledge, to clarify the issues and clinical situations and to standardize practices.
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10
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Ghanbarnezhad Farshi R, Mesbahi A, Johari M, Kara Ü, Gharehaghaji N. Dosimetry of Critical Organs in Maxillofacial Imaging with Cone-beam Computed Tomography. J Biomed Phys Eng 2019; 9:51-60. [PMID: 30881934 PMCID: PMC6409370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 01/21/2017] [Indexed: 06/09/2023]
Abstract
BACKGROUND While the benefits of cone-beam computed tomography (CBCT) are well known in maxillofacial imaging, the use of this modality is not risk-free. OBJECTIVE The aim of this study was to evaluate the exposure doses received by patients during maxillofacial imaging with CBCT. METHODS Entrance surface dose (ESD) was measured by using thermoluminescent dosimeters (TLDs) attached to the eyes lids, parotid glands and thyroid of 64 patients in two imaging centers (A and B). Phantom dosimetry was performed by a cylindrical poly-methyl methacrylate (PMMA) head-size phantom and an ionization chamber for different exposure parameters. NewTom VGi and Planmeca Promax 3D CBCT scanners were used at centers A and B, respectively. RESULTS The mean ESD of the eyes, parotid glands and thyroid were 2.57, 2.33 and 0.28 mGy in center A, 0.35, 2.11 and 0.37 mGy in center B, respectively. ESD of the eyes revealed a significant difference in two centers; in center B, it was 86.4% lower than center A. In the phantom dosimetry, the measured doses of NewTom VGi were 2.63 and 2.08 mGy, respectively by changing field of view (FOV) size from 8×8 cm2 (height × diameter) to 6×6 cm2. For Planmeca Promax 3D, it ranged from 0.98 to 3.24 mGy depending on exposure parameters. CONCLUSION There is a wide range of radiation doses dependent on the units, patients and selected scan parameters. Inappropriate selection of exposure settings, especially FOV size, can seriously increase patient dose.
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Affiliation(s)
- R Ghanbarnezhad Farshi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Medical Physics Department, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - A Mesbahi
- Medical Physics Department, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - M Johari
- Department of Oral & Maxillofacial Radiology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ü Kara
- Vocational School of Health Services, Suleyman Demirel University, Isparta, Turkey
| | - N Gharehaghaji
- Radiology Department, Paramedical Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
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Nascimento HAR, Andrade MEA, Frazão MAG, Nascimento EHL, Ramos-Perez FMM, Freitas DQ. Dosimetry in CBCT with Different Protocols: Emphasis on Small FOVs Including Exams for TMJ. Braz Dent J 2018; 28:511-516. [PMID: 29160405 DOI: 10.1590/0103-6440201701525] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 05/22/2017] [Indexed: 11/22/2022] Open
Abstract
This study aimed to estimate the absorbed dose in cone beam computed tomography (CBCT) exams according to different exposure parameters and size and position of the field of view (FOV). In addition was compared the absorbed dose of two smaller FOV scans with that of a larger FOV scan for evaluation of temporomandibular joint (TMJ), as it is a bilateral structure. CBCT scans were obtained on OP300 Maxio unit varying scanning mode (standard, high and endo) as well as size (5x5, 6x8 and 8x15 cm) and positioning of FOV. With a small FOV, different areas were scanned (maxilla or mandible, anterior or posterior and TMJ). Absorbed doses were determined using thermoluminescent dosimeters on the skin surface of sensitive organs of an anthropomorphic phantom. Endo mode showed the highest dose, followed by the high and standard modes in all FOV positions. With small FOV, doses were higher in the posterior region, especially in the mandible. Dose reduction occurred when small FOVs were used, but it was not proportional to FOV size reduction. For TMJ, the dose in a single acquisition with large FOV was greater than two acquisitions with small FOV, but lower than two acquisitions with medium FOV (6x8 cm). In conclusion, scanning mode, size and FOV position have great influence on the absorbed dose. Small FOV decreases the dose, but there is no linear relation between FOV size and dose. For bilateral exams of TMJ, double acquisition with small FOVs produces decrease in absorbed dose relative to a large FOV.
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Affiliation(s)
- Helena Aguiar Ribeiro Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, UNICAMP - Universidade de Campinas, Piracicaba, SP, Brazil
| | | | | | - Eduarda Helena Leandro Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, UNICAMP - Universidade de Campinas, Piracicaba, SP, Brazil
| | - Flavia Maria Moraes Ramos-Perez
- Department of Clinical and Preventive Dentistry, School of Dentistry, UFPE - Universidade Federal de Pernambuco, Recife, PE, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, UNICAMP - Universidade de Campinas, Piracicaba, SP, Brazil
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Accuracy of Bone Measurements in the Vicinity of Titanium Implants in CBCT Data Sets: A Comparison of Radiological and Histological Findings in Minipigs. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3848207. [PMID: 28798929 PMCID: PMC5536141 DOI: 10.1155/2017/3848207] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 05/30/2017] [Accepted: 06/12/2017] [Indexed: 02/07/2023]
Abstract
Purpose The aim of this animal study was the determination of accuracy of bone measurements in CBCT (cone-beam computed tomography) in close proximity to titanium implants. Material and Methods Titanium implants were inserted in eight Göttingen minipigs. 60 implants were evaluated histologically in ground section specimen and radiologically in CBCT in regard to thickness of the buccal bone. With random intercept models, the difference of histologic measurements and CBCT measurements of bone thickness was calculated. Results The mean histological thickness of the buccal bone was 5.09 mm (CI 4.11–6.08 mm). The four raters measured slightly less bone in CBCT than it was found in histology. The random effect was not significant (p value 1.000). Therefore, the Intraclass Correlation Coefficient (ICC) was 98.65% (CI 100.00–96.99%). Conclusion CBCT is an accurate technique to measure even thin bone structures in the vicinity of titanium implants.
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Almashraqi AA, Ahmed EA, Mohamed NS, Barngkgei IH, Elsherbini NA, Halboub ES. Evaluation of different low-dose multidetector CT and cone beam CT protocols in maxillary sinus imaging: part I-an in vitro study. Dentomaxillofac Radiol 2017; 46:20160323. [PMID: 28266870 DOI: 10.1259/dmfr.20160323] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This in vitro study aimed to assess radiation dose and image quality of different low-dose multidetector CT (MDCT) and CBCT imaging protocols in comparison with the standard MDCT protocol for maxillary sinus imaging. METHODS Effective dose (E) and image quality of 10 MDCT (changing effective milliampere second starting from 141.3 EmAs to 20 EmAs) and 3 CBCT protocols (changing milliampere second and voxel size) were assessed throughout scanning an anthropomorphic head and neck Alderson Rando phantom. E values were calculated using thermoluminescent dosemeters (TLDs) fixed at 6 sensitive organs (14 sites) on the Rando phantom. Image quality was assessed objectively (by calculating the standard deviation values of the radiographic density of water) and subjectively (by assessing the diagnostic image quality using a four-graded scale: 1 = very good, 2 = good, 3 = acceptable and 4 = unacceptable). RESULTS Two MDCT protocols (120 kV/32 EmA and 120 kV/25 EmA) had lower radiation doses with statistically significant differences (p < 0.001) compared with that of the standard MDCT protocol (120 kV/141.3 EmA), and they preserved a good diagnostic image quality. One CBCT protocol (120 kV/20 mA) had a reasonable radiation dose and good image quality. There were no statistically significant differences between the above-mentioned lower dose MDCT and CBCT protocols (p > 0.05) with respect to the radiation dose and image quality. CONCLUSIONS The low-dose MDCT and CBCT protocols are viable methods for maxillary sinus examination as evaluated using the above-mentioned phantom that yield a good diagnostic image quality using E approximately 7 and 11 times lower than that of the standard MDCT, respectively. These findings were evaluated in the in vivo part of this project.
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Affiliation(s)
- Abeer A Almashraqi
- 1 Department of Oral Radiology, Faculty of Dentistry, Ibb University, Ibb, Yemen.,2 Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Eman A Ahmed
- 3 Department of Oral and Maxillofacial Radiology, College of Oral and Dental Medicine, Cairo University, Cairo, Egypt.,4 Department of Oral and Maxillofacial Radiology, Faculty of Oral and Dental Surgery, Misr University for Science and Technology, Giza, Egypt
| | - Nashwa S Mohamed
- 3 Department of Oral and Maxillofacial Radiology, College of Oral and Dental Medicine, Cairo University, Cairo, Egypt.,5 Department of Oral and Maxillofacial Radiology, Faculty of Oral and Dental Medicine, Misr International University, Cairo, Egypt
| | - Imad H Barngkgei
- 6 Department of Oral Medicine, Faculty of Dentistry, Damascus University, Damascus, Syria.,7 Department of Oral Medicine, Faculty of Dentistry, Syrian Private University, Damascus, Syria
| | - Nader A Elsherbini
- 8 Department of Medical Radiation Physics, Kasr Al-Aini Center of Oncology and Nuclear Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Esam S Halboub
- 2 Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia.,9 Department of Oral Medicine and Diagnosis, Faculty of Dentistry, Sana'a University, Sana'a, Yemen
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Ali IK, Sansare K, Karjodkar FR, Salve P, Vanga K, Pawar AM. Maxillofacial trauma patterns associated with external auditory canal fractures: Cone beam computed tomography analysis. Dent Traumatol 2017; 33:276-280. [PMID: 28296040 DOI: 10.1111/edt.12336] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND/AIMS There is a paucity of literature on external auditory canal (EAC) fractures secondary to maxillofacial trauma, with most of the literature on EAC fractures consisting of isolated case reports. To the authors' best knowledge, this is the first study to use cone beam computed tomography to evaluate the EAC region. The aim of this study was to assess the prevalence of external auditory canal (EAC) fracture following maxillofacial trauma and to evaluate the association between EAC fracture and other maxillofacial fractures and the region of trauma. MATERIALS AND METHODS One hundred patients were prospectively evaluated over 6 months from February to August 2016. The patients were referred for CBCT regarding temporomandibular joint or condylar fractures following maxillofacial trauma. Two observers (both experienced radiologists) assessed the EAC and associated fractures in the maxillofacial region. RESULTS External auditory canal (EAC) fracture was confirmed in 32% of the patients. Of the EAC fractures, 68.75% and 31.25% were associated with mandibular fractures and non-mandibular fractures, respectively. Of the EAC fractures, 68.75% were single fractures and 31.25% of patients had multiple comminuted fractures. Significant association was observed on cross-tabulation of the fractured region and region of trauma with the presence of EAC fracture using chi-square test. CONCLUSION External auditory canal (EAC) fracture is associated with maxillofacial fractures with increased incidence in mandibular fractures compared to non-mandibular fractures.
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Affiliation(s)
- Ibrahim K Ali
- Department of Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Kaustubh Sansare
- Department of Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Freny R Karjodkar
- Department of Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Prashant Salve
- Department of Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Kavita Vanga
- Department of Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Ajinkya M Pawar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, Maharashtra, India
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Dillenseger JP, Gros CI, Sayeh A, Rasamimanana J, Lawniczak F, Leminor JM, Matern JF, Constantinesco A, Bornert F, Choquet P. Image quality evaluation of small FOV and large FOV CBCT devices for oral and maxillofacial radiology. Dentomaxillofac Radiol 2016; 46:20160285. [PMID: 27580474 DOI: 10.1259/dmfr.20160285] [Citation(s) in RCA: 8] [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
OBJECTIVES Quantitative and qualitative image quality evaluation of two different dental CBCT scanners. METHODS Two CBCT systems were evaluated in this study: one small field-of-view (FOV) (50-mm diameter) system that also allows two-dimensional (2D) dental panoramic imaging and one large FOV CBCT system (60-180-mm diameter). These devices were all tested with installed acquisition default modes and proprietary reconstruction software, enabling high-resolution bone imaging. Quantitative analyses were carried out to measure spatial resolution, linearity and homogeneity. Small-size phantoms and a human dry skull were used to evaluate intrinsic performances. Visual qualitative analyses of specific anatomical parts were blindly performed by 10 operators. RESULTS Concerning spatial resolution, small-voxel size protocols provide equivalent results on the two apparatus. In terms of linearity, all systems are highly linear (0.98 < r2 < 0.99) over the range of signal intensities encountered. Our results, coming from either phantoms or the dry skull, demonstrate that the small FOV CBCT suffers from a lack of homogeneity. CONCLUSIONS For limited oral and maxillofacial volume imaging (diameter < 50 mm), the polyvalent small FOV CBCT (2D and three-dimensional imaging) system used in this study could reach performances similar to those of the large FOV CBCT.
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Affiliation(s)
- Jean-Philippe Dillenseger
- 1 Imagerie Préclinique, Pôle d'imagerie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,2 Icube, équipe MMB, CNRS, Université de Strasbourg, Strasbourg, France.,3 Fédération de Médecine Translationnelle de Strasbourg, Faculté de Médecine, Université de Strasbourg, Strasbourg, France
| | - Catherine-Isabelle Gros
- 3 Fédération de Médecine Translationnelle de Strasbourg, Faculté de Médecine, Université de Strasbourg, Strasbourg, France.,4 Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France
| | - Amira Sayeh
- 4 Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France
| | | | - Fabrice Lawniczak
- 5 Icube, équipe Mécaflu, Université de Strasbourg, Strasbourg, France
| | - Jean-Marie Leminor
- 2 Icube, équipe MMB, CNRS, Université de Strasbourg, Strasbourg, France.,3 Fédération de Médecine Translationnelle de Strasbourg, Faculté de Médecine, Université de Strasbourg, Strasbourg, France.,6 Institut d'Anatomie Normale, Université de Strasbourg, Strasbourg, France
| | - Jean-François Matern
- 1 Imagerie Préclinique, Pôle d'imagerie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - André Constantinesco
- 1 Imagerie Préclinique, Pôle d'imagerie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Fabien Bornert
- 3 Fédération de Médecine Translationnelle de Strasbourg, Faculté de Médecine, Université de Strasbourg, Strasbourg, France.,4 Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France
| | - Philippe Choquet
- 1 Imagerie Préclinique, Pôle d'imagerie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,2 Icube, équipe MMB, CNRS, Université de Strasbourg, Strasbourg, France.,3 Fédération de Médecine Translationnelle de Strasbourg, Faculté de Médecine, Université de Strasbourg, Strasbourg, France
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Shen EC, Fu E, Peng M, Hsieh YD, Tu HP, Fu MW. Bifid mandibular canals and their cortex thicknesses: A comparison study on images obtained from cone-beam and multislice computed tomography. J Dent Sci 2016; 11:170-174. [PMID: 30894967 PMCID: PMC6395192 DOI: 10.1016/j.jds.2016.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 01/27/2016] [Indexed: 11/19/2022] Open
Abstract
Background/purpose High prevalence of bifid mandibular canals has been visualized with various types of computerized tomography (CT). Along the canals, a various ranged corticalization was recently reported. The depiction of the fine anatomic structures on multislice and cone-beam CT images was compared. Material and methods The presence or absence of the bifid canal was assessed on 327 images obtained by multislice CT (MSCT; n = 173) or by cone-beam CT (CBCT; n = 154), according to the configuration. The cortex thickness and distribution were also assessed. Results The prevalence of bifid canal detected by CBCT was significantly greater than that detected by MSCT (42.2% vs. 18.7% for hemi-mandibles and 58.4% vs. 30.6% for patients). Cortical thickness recorded by CBCT was significantly thinner than that recorded by MSCT (0.48 mm vs. 0.65 mm, P < 0.001); however, the distributions of corticalization detected by the two tomography methods were similar. There was a significant association of cortex thickness with CT type and corticalization degree (R2 = 0.530, P < 0.001). Conclusion Thinner cortices, but greater prevalence of bifid canals recorded by CBCT, compared to MSCT, suggests that clinicians should be cautious when using CT to interpret this fine anatomic structure.
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Affiliation(s)
- E-Chin Shen
- Department of Periodontology, School of Dentistry, National Defense Medical Center and Tri-Service General Hospital, Taipei City, Taiwan, ROC
- Dental Department, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan, ROC
- Corresponding author. Department of Periodontology, School of Dentistry, National Defense Medical Center and Tri-Service General Hospital, P.O. Box 90048-507, Number 161, Section 6, Minquan East Road, Taipei, Taiwan, ROC.
| | - Earl Fu
- Department of Periodontology, School of Dentistry, National Defense Medical Center and Tri-Service General Hospital, Taipei City, Taiwan, ROC
| | - Michelle Peng
- Department of Periodontology, School of Dentistry, National Defense Medical Center and Tri-Service General Hospital, Taipei City, Taiwan, ROC
| | - Yao-Dung Hsieh
- Department of Periodontology, School of Dentistry, National Defense Medical Center and Tri-Service General Hospital, Taipei City, Taiwan, ROC
- Department of Dentistry, Kaohsiung Veterans General Hospital, Taiwan, ROC
| | - Hsiao-Pei Tu
- Department of Periodontology, School of Dentistry, National Defense Medical Center and Tri-Service General Hospital, Taipei City, Taiwan, ROC
| | - Min-Wen Fu
- Department of Periodontology, School of Dentistry, National Defense Medical Center and Tri-Service General Hospital, Taipei City, Taiwan, ROC
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Veldhoen S, Schöllchen M, Hanken H, Precht C, Henes FO, Schön G, Nagel HD, Schumacher U, Heiland M, Adam G, Regier M. Performance of cone-beam computed tomography and multidetector computed tomography in diagnostic imaging of the midface: A comparative study on Phantom and cadaver head scans. Eur Radiol 2016; 27:790-800. [PMID: 27169574 DOI: 10.1007/s00330-016-4387-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 03/01/2016] [Accepted: 04/25/2016] [Indexed: 11/27/2022]
Abstract
PURPOSE To compare multidetector computed tomography (MDCT) and cone-beam computed tomography (CBCT) regarding radiation, resolution, image noise, and image quality. METHODS CBCT and 256-MDCT were compared based on three scan protocols: Standard-dose (≈24 mGy), reduced-dose (≈9 mGy), and low-dose (≈4 mGy). MDCT images were acquired in standard- and high-resolution mode (HR-MDCT) and reconstructed using filtered back projection (FBP) and iterative reconstruction (IR). Spatial resolution in linepairs (lp) and objective image noise (OIN) were assessed using dedicated phantoms. Image quality was assessed in scans of 25 cadaver heads using a Likert scale. RESULTS OIN was markedly higher in FBP-MDCT when compared to CBCT. IR lowered the OIN to comparable values in standard-mode MDCT only. CBCT provided a resolution of 13 lp/cm at standard-dose and 11 lp/cm at reduced-dose vs. 11 lp/cm and 10 lp/cm in HR-MDCT. Resolution of 10 lp/cm was observed for both devices using low-dose settings. Quality scores of MDCT and CBCT did not differ at standard-dose (CBCT, 3.4; MDCT, 3.3-3.5; p > 0.05). Using reduced- and low-dose protocols, CBCT was superior (reduced-dose, 3.2 vs. 2.8; low dose, 3.0 vs. 2.3; p < 0.001). CONCLUSION Using the low-dose protocol, the assessed CBCT provided better objective and subjective image quality and equality in resolution. Similar image quality, but better resolution using CBCT was observed at higher exposure settings. KEY POINTS • The assessed CBCT device provided better image quality at lower doses. • Objective and subjective image quality were comparable using higher exposure settings. • CBCT showed superior spatial resolution in standard-dose and reduced-dose settings. • Modern noise-reducing tools are used in CBCT devices currently. • MDCT should be preferred for assessment of soft-tissue injuries and oncologic imaging.
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Affiliation(s)
- Simon Veldhoen
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg, Martinistrasse 52, D-20246, Hamburg, Germany.
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, D-97080, Würzburg, Germany.
| | - Maximilian Schöllchen
- Department of Oral- and Maxillofacial Surgery, University Medical Center Hamburg, Hamburg, Germany
| | - H Hanken
- Department of Oral- and Maxillofacial Surgery, University Medical Center Hamburg, Hamburg, Germany
| | - C Precht
- Department of Oral- and Maxillofacial Surgery, University Medical Center Hamburg, Hamburg, Germany
| | - F O Henes
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg, Martinistrasse 52, D-20246, Hamburg, Germany
| | - G Schön
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg, Hamburg, Germany
| | - H D Nagel
- Science and Technology for Radiology, Buchholz, Germany
| | - U Schumacher
- Institute of Anatomy, University Medical Center Hamburg, Hamburg, Germany
| | - M Heiland
- Department of Oral- and Maxillofacial Surgery, University Medical Center Hamburg, Hamburg, Germany
| | - G Adam
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg, Martinistrasse 52, D-20246, Hamburg, Germany
| | - M Regier
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg, Martinistrasse 52, D-20246, Hamburg, Germany
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Hwang JJ, Park H, Jeong HG, Han SS. Change in Image Quality According to the 3D Locations of a CBCT Phantom. PLoS One 2016; 11:e0153884. [PMID: 27093639 PMCID: PMC4836729 DOI: 10.1371/journal.pone.0153884] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 04/05/2016] [Indexed: 12/22/2022] Open
Abstract
A patient's position changes in every CBCT scan despite patient alignment protocols. However, there have been studies to determine image quality differences when an object is located at the center of the field of view (FOV). To evaluate changes in the image quality of the CBCT scan according to different object positions, the image quality indexes of the Alphard 3030 (Alphard Roentgen Ind., Ltd., Kyoto, Japan) and the Rayscan Symphony (RAY Ind., Ltd., Suwon, Korea) were measured using the Quart DVT_AP phantom at the center of the FOV and 6 peripheral positions under four types of exposure conditions. Anterior, posterior, right, left, upper, and lower positions 1 cm offset from the center of the FOV were used for the peripheral positions. We evaluated and compared the voxel size, homogeneity, contrast to noise ratio (CNR), and the 10% point of the modulation transfer function (MTF10%) of the center and periphery. Because the voxel size, which is determined by the Nyquist frequency, was within tolerance, other image quality indexes were not influenced by the voxel size. For the CNR, homogeneity, and MTF10%, there were peripheral positions which showed considerable differences with statistical significance. The average difference between the center and periphery was up to 31.27% (CNR), 70.49% (homogeneity), and 13.64% (MTF10%). Homogeneity was under tolerance at some of the peripheral locations. Because the CNR, homogeneity, and MTF10% were significantly affected by positional changes of the phantom, an object's position can influence the interpretation of follow up CBCT images. Therefore, efforts to locate the object in the same position are important.
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Affiliation(s)
- Jae Joon Hwang
- Department of Oral and Maxillofacial Radiology, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hyok Park
- Department of Oral and Maxillofacial Radiology, College of Dentistry, Yonsei University, Seoul, Korea
| | - Ho-Gul Jeong
- Department of Oral and Maxillofacial Radiology, College of Dentistry, Yonsei University, Seoul, Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, College of Dentistry, Yonsei University, Seoul, Korea
- * E-mail:
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Detterbeck A, Hofmeister M, Hofmann E, Haddad D, Weber D, Hölzing A, Zabler S, Schmid M, Hiller KH, Jakob P, Engel J, Hiller J, Hirschfelder U. MRI vs. CT for orthodontic applications: comparison of two MRI protocols and three CT (multislice, cone-beam, industrial) technologies. J Orofac Orthop 2016; 77:251-61. [DOI: 10.1007/s00056-016-0028-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 11/13/2015] [Indexed: 10/21/2022]
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20
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Visualisation of passive middle ear implants by cone beam and multi-detector computed tomography: a comparative in vitro study. Eur Radiol 2016; 26:4538-4544. [DOI: 10.1007/s00330-016-4312-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 02/24/2016] [Accepted: 02/26/2016] [Indexed: 11/25/2022]
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21
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Comparison of digital dental images yielded by digital dental casts, cone-beam computed tomography, and multislice computed tomography for measurement of dental area. Oral Radiol 2016. [DOI: 10.1007/s11282-016-0242-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lell MM, May MS, Brand M, Eller A, Buder T, Hofmann E, Uder M, Wuest W. Imaging the Parasinus Region with a Third-Generation Dual-Source CT and the Effect of Tin Filtration on Image Quality and Radiation Dose. AJNR Am J Neuroradiol 2015; 36:1225-30. [PMID: 25814658 DOI: 10.3174/ajnr.a4270] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 12/14/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE CT is the imaging technique of choice in the evaluation of midface trauma or inflammatory disease. We performed a systematic evaluation of scan protocols to optimize image quality and radiation exposure on third-generation dual-source CT. MATERIALS AND METHODS CT protocols with different tube voltage (70-150 kV), current (25-300 reference mAs), prefiltration, pitch value, and rotation time were systematically evaluated. All images were reconstructed with iterative reconstruction (Advanced Modeled Iterative Reconstruction, level 2). To individually compare results with otherwise identical factors, we obtained all scans on a frozen human head. Conebeam CT was performed for image quality and dose comparison with multidetector row CT. Delineation of important anatomic structures and incidental pathologic conditions in the cadaver head was evaluated. RESULTS One hundred kilovolts with tin prefiltration demonstrated the best compromise between dose and image quality. The most dose-effective combination for trauma imaging was Sn100 kV/250 mAs (volume CT dose index, 2.02 mGy), and for preoperative sinus surgery planning, Sn100 kV/150 mAs (volume CT dose index, 1.22 mGy). "Sn" indicates an additional prefiltration of the x-ray beam with a tin filter to constrict the energy spectrum. Exclusion of sinonasal disease was possible with even a lower dose by using Sn100 kV/25 mAs (volume CT dose index, 0.2 mGy). CONCLUSIONS High image quality at very low dose levels can be achieved by using a Sn100-kV protocol with iterative reconstruction. The effective dose is comparable with that of conventional radiography, and the high image quality at even lower radiation exposure favors multidetector row CT over conebeam CT.
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Affiliation(s)
- M M Lell
- From the Departments of Radiology (M.M.L., M.S.M., M.B., A.E., M.U., W.W.) Imaging Science Institute (M.M.L., M.U.), University Erlangen, Erlangen, Germany.
| | - M S May
- From the Departments of Radiology (M.M.L., M.S.M., M.B., A.E., M.U., W.W.)
| | - M Brand
- From the Departments of Radiology (M.M.L., M.S.M., M.B., A.E., M.U., W.W.)
| | - A Eller
- From the Departments of Radiology (M.M.L., M.S.M., M.B., A.E., M.U., W.W.)
| | - T Buder
- Department I (T.B.), Institute of Anatomy
| | - E Hofmann
- Orthodontics and Orofacial Orthopedics (E.H.)
| | - M Uder
- From the Departments of Radiology (M.M.L., M.S.M., M.B., A.E., M.U., W.W.) Imaging Science Institute (M.M.L., M.U.), University Erlangen, Erlangen, Germany
| | - W Wuest
- From the Departments of Radiology (M.M.L., M.S.M., M.B., A.E., M.U., W.W.)
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Dillenseger JP, Matern JF, Gros CI, Bornert F, Goetz C, Le Minor JM, Constantinesco A, Choquet P. MSCT versus CBCT: evaluation of high-resolution acquisition modes for dento-maxillary and skull-base imaging. Eur Radiol 2014; 25:505-15. [PMID: 25249315 DOI: 10.1007/s00330-014-3439-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 08/19/2014] [Accepted: 09/08/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Our aim was to conduct a quantitative and qualitative evaluation of high-resolution skull-bone imaging for dentistry and otolaryngology using different architectures of recent X-ray computed tomography systems. MATERIAL AND METHODS Three multi-slice computed tomography (MSCT) systems and one Cone-beam computed tomography (CBCT) system were used in this study. All apparatuses were tested with installed acquisition modes and proprietary reconstruction software enabling high-resolution bone imaging. Quantitative analyses were performed with small fields of view with the preclinical vmCT phantom, which permits to measure spatial resolution, geometrical accuracy, linearity and homogeneity. Ten operators performed visual qualitative analyses on the vmCT phantom images, and on dry human skull images. RESULTS Quantitative analysis showed no significant differences between protocols in terms of linearity and geometric accuracy. All MSCT systems present a better homogeneity than the CBCT. Both quantitative and visual analyses demonstrate that CBCT acquisitions are not better than the collimated helical MSCT mode. CONCLUSION Our results demonstrate that current high-resolution MSCT protocols could exceed the performance of a previous generation CBCT system for spatial resolution and image homogeneity. KEY POINTS • Quantitative evaluation is a prerequisite for comparison of imaging equipment. • Bone imaging quality could be objectively assessed with a phantom and dry skull. • The current MSCT shows better image quality than a dental CBCT system. • CBCT remains a work-in-progress technology.
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Affiliation(s)
- Jean-Philippe Dillenseger
- Imagerie Préclinique-UF6237, Pôle d'imagerie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
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Hofmann E, Schmid M, Lell M, Hirschfelder U. Cone beam computed tomography and low-dose multislice computed tomography in orthodontics and dentistry: a comparative evaluation on image quality and radiation exposure. J Orofac Orthop 2014; 75:384-98. [PMID: 25158951 DOI: 10.1007/s00056-014-0232-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 02/03/2014] [Indexed: 01/02/2023]
Abstract
OBJECTIVES The goal of the present work was to assess various computed tomography (CT) systems in term of image quality and organ doses, namely five cone-beam CT (CBCT) scanners operated at standard settings and three multislice CT (MSCT) scanners operated at greatly dose-reduced settings. MATERIALS AND METHODS Radiographic volume scans were taken on a complete human cadaveric head specimen and the image quality of each was rated by four experienced examiners according to specific skeletal structures and bone-soft tissue interfaces. Radiation doses were captured by a head-and-neck phantom (Rando; Alderson Research Laboratories). Standard protocols were used for the CBCT scans. For the MSCT scans, tube voltage and current were adjusted to minimize radiation without compromising image quality. RESULTS Interobserver agreement was close to perfect, with iota coefficients of 0.931 (95% CI 0.807-0.978) between groups 1 and 2 and 0.959 (95% CI 0.869-1.000) between groups 1 and 3. Ratings of image quality in terms of skeletal-structure representation were slightly better for the CBCT than the MSCT scanners, although these differences were not statistically significant. The two groups of scanners applied considerably different organ doses: the lowest dose (0.03 mSv) was measured on the bone surface with a CBCT unit (Picasso Trio® from Vatech) and the highest dose (8.30 mSv) in the vicinity of the eye lens with another CBCT unit (3D Accuitomo 170® from J. Morita). CONCLUSION The various systems tested offer similar imaging quality but demonstrated distinct differences in organ dose levels. The decision on which approach to take is not between CBCT and MSCT but rather between specific models and parameter settings. If these are optimized, MSCT images providing useful clinical information can be obtained at much reduced levels of radiation. Depending on the model and setting used, MSCT radiation levels may even be lower than during CBCT scans.
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Affiliation(s)
- E Hofmann
- Department of Orthodontics and Orofacial Orthopedics, Zahnklinik 3 - Kieferorthopädie, Universitätsklinikum Erlangen, Glückstr. 11, 91054, Erlangen, Germany,
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