1
|
Savoldi F, Dagassan-Berndt D, Patcas R, Mak WS, Kanavakis G, Verna C, Gu M, Bornstein MM. The use of CBCT in orthodontics with special focus on upper airway analysis in patients with sleep-disordered breathing. Dentomaxillofac Radiol 2024; 53:178-188. [PMID: 38265247 PMCID: PMC11003665 DOI: 10.1093/dmfr/twae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/14/2023] [Accepted: 12/29/2023] [Indexed: 01/25/2024] Open
Abstract
Applications of cone-beam CT (CBCT) in orthodontics have been increasingly discussed and evaluated in science and practice over the last two decades. The present work provides a comprehensive summary of current consolidated practice guidelines, cutting-edge innovative applications, and future outlooks about potential use of CBCT in orthodontics with a special focus on upper airway analysis in patients with sleep-disordered breathing. The present scoping review reveals that clinical applications of CBCT in orthodontics are broadly supported by evidence for the diagnosis of dental anomalies, temporomandibular joint disorders, and craniofacial malformations. On the other hand, CBCT imaging for upper airway analysis-including soft tissue diagnosis and airway morphology-needs further validation in order to provide better understanding regarding which diagnostic questions it can be expected to answer. Internationally recognized guidelines for CBCT use in orthodontics are existent, and similar ones should be developed to provide clear indications about the appropriate use of CBCT for upper airway assessment, including a list of specific clinical questions justifying its prescription.
Collapse
Affiliation(s)
- Fabio Savoldi
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Dorothea Dagassan-Berndt
- Center for Dental Imaging, University Center for Dental Medicine Basel UZB, University of Basel, Basel, 4058, Switzerland
| | - Raphael Patcas
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, 8032, Switzerland
| | - Wing-Sze Mak
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong SAR
| | - Georgios Kanavakis
- Department of Pediatric Oral Health and Orthodontics, University Center for Dental Medicine Basel UZB, University of Basel, Basel, 4058, Switzerland
| | - Carlalberta Verna
- Department of Pediatric Oral Health and Orthodontics, University Center for Dental Medicine Basel UZB, University of Basel, Basel, 4058, Switzerland
| | - Min Gu
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Michael M Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, 4058, Switzerland
| |
Collapse
|
2
|
Savoldi F, Fung KK, Mak WS, Kan EY, Yang Y, Kwok KL, Gu M. Are the severity of obstruction and the apnea-hypopnea index related to orofacial anatomy in children with obstructive sleep apnea? a kinetic MRI study. Dentomaxillofac Radiol 2023:20220422. [PMID: 37192022 DOI: 10.1259/dmfr.20220422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023] Open
Abstract
OBJECTIVES The proportionality between anatomical characteristics and disease severity in children and adolescents with obstructive sleep apnea (OSA) has not been well characterized. The present study investigated the relationship between the dentoskeletal and oropharyngeal features of young patients with OSA and either the apnea-hypopnea index (AHI) or the amount of upper airway obstruction. METHODS MRI of 25 patients (8- to 18-year-old) with OSA (mean AHI = 4.3 events/h) was retrospectively analyzed. Sleep kinetic MRI (kMRI) was used to assess airway obstruction, and static MRI (sMRI) was used to assess dentoskeletal, soft tissue, and airway parameters. Factors related to AHI and obstruction severity were identified with multiple linear regression (significance level α = 0.05). RESULTS As evidenced by kMRI, circumferential obstruction was present in 44% of patients, while laterolateral and anteroposterior was present in 28%; as evidenced by kMRI, obstructions were retropalatal in 64% of cases and retroglossal in 36% (no nasopharyngeal obstructions); kMRI showed a higher prevalence of retroglossal obstructions compared to sMRI(p = 0.037); the main obstruction airway area was not related to AHI; the maxillary skeletal width was related to AHI (β = -0.512, p = 0.007) and obstruction severity (β = 0.625, p = 0.002); and the retropalatal width was related to AHI (β = -0.384, p = 0.024) and obstruction severity (β = 0.519, p = 0.006). CONCLUSIONS In children and adolescents, the severity of OSA and obstruction were inversely proportional to the maxillary basal width and retropalatal airway width. Further studies are needed to assess the benefits of targeted clinical treatments widening the transverse dimension of these structures.
Collapse
Affiliation(s)
- Fabio Savoldi
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong, Hong Kong SAR, PRC
| | - Kevin Kf Fung
- Department of Radiology, Hong Kong Children's Hospital, Hong Kong, Hong Kong SAR, PRC
| | - Wing-Sze Mak
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong, Hong Kong SAR, PRC
| | - Elaine Yl Kan
- Department of Radiology, Hong Kong Children's Hospital, Hong Kong, Hong Kong SAR, PRC
| | - Yanqi Yang
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong, Hong Kong SAR, PRC
| | - Ka-Li Kwok
- Department of Paediatrics, Kwong Wah Hospital, Hong Kong, Hong Kong SAR, PRC
| | - Min Gu
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong, Hong Kong SAR, PRC
| |
Collapse
|
3
|
Fung WY, Fung EPY, Kwok KM, Chan SK, Wong LKM, Mak WS, Cho DHY. Tomosynthesis-guided Vacuum-assisted Breast Biopsy of Sonographically Occult Non-calcified Breast Lesions Detected on Tomosynthesis. Hong Kong Journal of Radiology 2022. [DOI: 10.12809/hkjr2117182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- WY Fung
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - EPY Fung
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - KM Kwok
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - SK Chan
- Department of Pathology, Kwong Wah Hospital, Hong Kong
| | - LKM Wong
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - WS Mak
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - DHY Cho
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| |
Collapse
|
4
|
Tsui HL, Fung EPY, Kwok KM, Wong LKM, Lo LW, Mak WS. Magnetic Marker Wireless Localisation versus Radioguided Localisation of Nonpalpable Breast Lesions. Hong Kong Journal of Radiology 2022. [DOI: 10.12809/hkjr2117267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- HL Tsui
- Department of Radiology and Organ Imaging, United Christian Hospital, Hong Kong
| | - EPY Fung
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - KM Kwok
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - LKM Wong
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - LW Lo
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - WS Mak
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| |
Collapse
|
5
|
Wong WL, Wong LKM, Fung EPY, Kwok KM, Mak WS, Lam HS. Factors Affecting Accuracy of Stereotactic Radioisotope-guided Occult Lesion Localisation for Breast Lesions. Hong Kong Journal of Radiology 2022. [DOI: 10.12809/hkjr2117148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- WL Wong
- Department of Radiology and Organ Imaging, United Christian Hospital, Hong Kong
| | - LKM Wong
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - EPY Fung
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - KM Kwok
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - WS Mak
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - HS Lam
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| |
Collapse
|
6
|
Cheung WP, Lo LW, Wong KM, Mak WS, Kwok KM, Fung EPY. Imaging Findings of Progressing Rosai–Dorfman Disease of the Breast: a Case Report and Literature Review. Hong Kong Journal of Radiology 2021. [DOI: 10.12809/hkjr2117156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- WP Cheung
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - LW Lo
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - KM Wong
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - WS Mak
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - KM Kwok
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - EPY Fung
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| |
Collapse
|
7
|
Chau CM, Fung EPY, Wong CW, Kwok KM, Leung AYH, Wong LKM, Wong KCK, Mak WS, Lam HS, Cho DHY. Ultrasound-guided Vacuum-assisted Excision of Papillary Breast Lesions as an Alternative to Surgical Excision: 7-year Experience. Hong Kong Journal of Radiology 2020. [DOI: 10.12809/hkjr2017066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- CM Chau
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - EPY Fung
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - CW Wong
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - KM Kwok
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - AYH Leung
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - LKM Wong
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - KCK Wong
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - WS Mak
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - HS Lam
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - DHY Cho
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| |
Collapse
|
8
|
Cheung WP, Wong KC, Mak WS, Kwong CYY, Kan EYL. Medical Pulmonary Diseases That Cause Neonatal Respiratory Distress: A Radiological Pictorial Essay. Hong Kong Journal of Radiology 2020. [DOI: 10.12809/hkjr2017051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- WP Cheung
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Yaumatei, Hong Kong
| | - KC Wong
- Department of Radiology, Hong Kong Children’s Hospital, Kowloon Bay, Hong Kong
| | - WS Mak
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Yaumatei, Hong Kong
| | - CYY Kwong
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Yaumatei, Hong Kong
| | - EYL Kan
- Department of Radiology, Hong Kong Children’s Hospital, Kowloon Bay, Hong Kong
| |
Collapse
|
9
|
To VYK, Wong KM, Mak WS, Kwok KM, Wong CW. Stereotactic-guided Vacuum-assisted Breast Biopsy in the Asian Population: What Factors Affect Marker Migration? Hong Kong J Radiol 2017. [DOI: 10.12809/hkjr1615395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
10
|
Lam MC, Wong KML, Mak WS, Kwok KMK, Lam HS, Wong CW. Breast Sonoelastography: Our Preliminary Experience in 155 Lesions. Hong Kong J Radiol 2017. [DOI: 10.12809/hkjr1615379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
11
|
Kwok KM, Wong LKM, Mak WS, Lam MC, Chan SK, Wong CW. Mucinous Breast Carcinoma: Magnetic Resonance Imaging and Pathological Correlation. Hong Kong J Radiol 2015. [DOI: 10.12809/hkjr1514284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
12
|
Kung BT, Mak WS, Lau SMJ, Auyong TK, Tong CM. Promising Role of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Human Immunodeficiency Virus Associated Non-Hodgkin's Lymphoma. World J Nucl Med 2015; 14:53-6. [PMID: 25709547 PMCID: PMC4337010 DOI: 10.4103/1450-1147.150551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This case report explores the potential role of FDG PET/CT in HIV -associated systemic non-Hodgkin's lymphoma (HIV-NHLs). In our locality, there are a cumulative total of 5523 reported HIV infections cases since 1984. We reported a case of HIV-related Burkitt's lymphoma (BL) and a case of diffuse large B-cell lymphoma (DLBCL) that underwent PET/CT examination in our PET centre. In HIV-NHLs patients, we must be reminded that not all hypermetabolic foci represent lymphomatous lesions. There is a close correlation between the pattern of lymphoid tissue activation in FDG PET/CT and HIV progression in patients without HIV-related malignancy. The unique patterns of lymphoid tissue activation observed in HIV-infected patients have great clinical implications. Secondly, HIV-infected patients are prone to suffer from opportunistic infections due to immunosuppression, particularly in those with high levels of HIV viral loads. FDG PET/CT cannot reliably differentiate metabolic active lymphoma from other benign diseases such as inflammation in the context of low CD4 count and high viral loads. In those cases, benign markedly hypermetabolic foci can be erroneously interpreted as lymphoma, particularly in those normal-sized lymph nodes. Furthermore, FDG PET/CT may be useful for assessing the efficacy of HAART in suppressing HIV replication and detecting its complication such as lipodystrophy. FDG PET/CT may play a potential useful role in staging and management of HIV -associated systemic non-Hodgkin's lymphoma. Plasma variables such as viral loads and CD4 count must be taken into account during image interpretation. FDG PET/CT as a potential useful tool for diagnosis, treatment response assessment and disease relapse detection in HIV -associated systemic non-Hodgkin's lymphoma worth to be further explored.
Collapse
Affiliation(s)
- Boom Ting Kung
- Nuclear Medicine Unit and PDY Clinical PET Centre, Jordan, Kowloon, Hong Kong, China
| | - W S Mak
- Department of Medicine, Division of Haematology and Medical Oncology, Queen Elizabeth Hospital, Jordan, Kowloon, Hong Kong, China
| | - S M J Lau
- Department of Medicine, Division of Haematology and Medical Oncology, Queen Elizabeth Hospital, Jordan, Kowloon, Hong Kong, China
| | - T K Auyong
- Nuclear Medicine Unit and PDY Clinical PET Centre, Jordan, Kowloon, Hong Kong, China
| | - C M Tong
- Nuclear Medicine Unit and PDY Clinical PET Centre, Jordan, Kowloon, Hong Kong, China
| |
Collapse
|