Digital Radiographic Image Processing and Analysis

Diagnosis of Odontogenic Maxillary Sinusitis by Cone-beam Computed Tomography: A Critical Review

INTRODUCTION

This review aims to provide an up-to-date overview of the current applications of cone-beam computed tomography (CBCT) and other imaging modalities in diagnosing odontogenic maxillary sinusitis (OMS). Furthermore, the clinical operation procedures of radiography modalities in OMS diagnosis were summarized, with the goal of assisting clinicians in improving OMS diagnostic accuracy in clinical practice.

METHOD

A comprehensive review of researches that discussed the applications of radiography modalities in the diagnosis of OMS was conducted. Pertinent information was evaluated and organized for this review.

RESULTS

Cone-beam computed tomography (CBCT) offers a superior, high-resolution, and three-dimensional view of the maxillary tooth-bone-sinus complex compared to conventional radiography modalities. It enables a better understanding and classification of the spatial relationships between root apices/periapical lesions and maxillary sinus. The use of CBCT, combined with the advantages of other radiography modalities and proper image interpretation, is indispensable to enhance OMS diagnostic accuracy and mitigate the risk of missed or misdiagnosis.

CONCLUSION

The significance of CBCT in the diagnosis of oral and maxillofacial conditions has garnered widespread recognition. It provides highly precise diagnostic information and classification basis for OMS. The clinical operation procedures for imaging examination are essential in ensuring the consistency and reliability of the diagnosis.

Diagnostic Imaging of Oral and Maxillofacial Anatomy and Pathology

This article describes the technical principles and indications for the most often encountered diagnostic imaging modalities in veterinary dentistry and oral surgery; with extensive coverage of intraoral (and extraoral) dental radiographic imaging and interpretation through detailed example figures of common dental and maxillofacial diseases in the dog and cat. Multidetector/multislice computed tomography (MDCT/MSCT) and emergent technologies such as cone-beam computed tomography (CBCT) are presented here in detail. Magnetic resonance imaging (MRI) and diagnostic ultrasound, which are used less frequently, are briefly discussed.

Dental cone beam CT: An updated review

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.

Aggregation of Region-based and Boundary-based Knowledge Biased Segmentation for Osteoporosis Detection from X-Ray, Dual X-Ray and CT Images

BACKGROUND

Osteoporosis is a term used to represent the reduced bone density, which is caused by insufficient bone tissue production to balance the old bone tissue removal. Medical Imaging procedures such as X-Ray, Dual X-Ray and Computed Tomography (CT) scans are used widely in osteoporosis diagnosis. There are several existing procedures in practice to assist osteoporosis diagnosis, which can operate using a single imaging method.

OBJECTIVE

The purpose of this proposed work is to introduce a framework to assist the diagnosis of osteoporosis based on consenting all these X-Ray, Dual X-Ray and CT scan imaging techniques. The proposed work named "Aggregation of Region-based and Boundary-based Knowledge biased Segmentation for Osteoporosis Detection from X-Ray, Dual X-Ray and CT images" (ARBKSOD) is the integration of three functional modules.

METHODS

Fuzzy Histogram Medical Image Classifier (FHMIC), Log-Gabor Transform based ANN Training for osteoporosis detection (LGTAT) and Knowledge biased Osteoporosis Analyzer (KOA).

RESULTS

Together, all these three modules make the proposed method ARBKSOD scored the maximum accuracy of 93.11%, the highest precision value of 93.91% while processing the 6th image batch, the highest sensitivity of 92.93%, the highest specificity of 93.79% is observed during the experiment by ARBKSOD while processing the 6th image batch. The best average processing time of 10244 mS is achieved by ARBKSOD while processing the 7th image batch.

CONCLUSION

Together, all these three modules make the proposed method ARBKSOD to produce a better result.

Intra- and Interobserver Agreement during the Assessment of the Different Stages of Root Development Using 4 Radiographic Classifications

INTRODUCTION

This study analyzed intra- and interobserver agreements during radiographic assessment of the different stages of root development using the dichotomous, Moorrees, Demirjian, and Cvek classifications, as well as the effect of the observer's level of experience on the result.

METHODS

Two hundred eighty-five digital periapical radiographs were examined via visual inspection by 3 experienced and 3 nonexperienced observers (n = 6) under strict technological and viewing conditions. After observer calibration, determination of the presence or absence of an open apex and the assignment of a root development stage according to the different subdivisions of the 4 indexes were performed. This evaluation was carried out by each observer in duplicate in the first round (n = 8) and repeated in the second round (n = 8). The 16 examinations performed by each observer (N = 96) were analyzed to determine the percentage of concordance followed by intraobserver, interobserver, and global observer agreement using the kappa coefficient and a weighted kappa. Additionally, to determine the level of concordance between the visual determination of an open or closed apex and the apical foramen width measured in millimeters, a dichotomized kappa coefficient was applied.

RESULTS

A good level of global observer agreement was found for the dichotomous, Demirjian, and Cvek classifications. However, a significantly low percentage of total concordance and global observer agreement (6.66% and 0.498, respectively) was obtained using the Moorrees classification, which was more pronounced among nonexperienced observers (0.247). Apical foramen width measurements indicated the presence of 143 roots with an open apex (50.2%) and 142 with a closed apex (49.8%), and the dichotomized kappa coefficient test revealed a good level of agreement during the visual determination of an open or closed apex (range, 0.611-0.636).

CONCLUSIONS

The classifications of Cvek and Demirjian provided reliable results when determining the different stages of root development. In contrast, the Moorrees classification provided the lowest agreement values, with a significant negative effect among nonexperienced observers. Finally, the visual estimation of the presence (or absence) of an open apex provided a good level of concordance with the radiographic apical foramen width.

Influence of the image file format of digital periapical radiographs on the diagnosis of external and internal root resorptions

OBJECTIVES

To evaluate the influence of different image file formats of digital radiographic images on the diagnosis of external (ERR) and internal root resorption (IRR).

MATERIALS AND METHODS

Thirty-four human teeth were selected. For ERR, 20 teeth were used (10 control and 10 with simulated ERR), and for IRR, 14 teeth were used (before and after IRR simulation). Digital periapical radiographs were acquired using the Digora Toto system and exported in four different image file formats: TIFF, BMP, PNG, and JPEG, totaling 192 radiographs. Five examiners evaluated the images using the JPEGView software and scored the detection of ERR or IRR on a 5-point scale. Sensitivity, specificity, accuracy, and the area under the ROC curve were obtained for the diagnosis of ERR and IRR in the different image file formats. Two-way ANOVA compared the diagnostic values between the file formats and the Kappa test assessed intra- and inter-examiner agreement. The significance level was set at 5% (α = 0.05).

RESULTS

The mean values of intra-examiner agreement were substantial (0.740) for ERR and almost perfect (0.836) for IRR and, inter-examiner was fair (0.263) and moderate (0.421), respectively. No statistically significant differences were found among the different file formats for the diagnostic values of ERR and IRR.

CONCLUSION

The file format of digital radiographs does not influence the diagnosis of ERR and IRR.

CLINICAL RELEVANCE

Digital radiographic images may be susceptible to computational factors; however, they can be stored in multiple file formats without affecting the diagnosis of dental root resorptions.