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Image quality optimization using a narrow vertical detector dental cone-beam CT
摘要： Objectives: To determine the optimised kV setting for a narrow detector cone-beam CT (CBCT) unit. Methods: Clinical (CL) and quantitative (QUANT) evaluations of image quality were performed using an anthropomorphic phantom. Technical (TECH) evaluation was performed with a polymethyl methacrylate phantom. Images were obtained using a PaX-i3D Green CBCT (Vatech, Hwaseong, Korea) device, with a large 21x19 and a medium 12x9 cm field of view, and high-dose (HD– ranging from 85 to 110 kV) and low-dose (LD– ranging from 75 to 95 kV) protocols, totalling four groups (21x19 cm HD, 21x19 cm LD, 12x9 cm HD, 12x9 cm LD). The radiation dose within each group was fixed by adapting the mA according to a predetermined dose-area product. For CL evaluation, three observers assessed images based on overall quality, sharpness, contrast, artefacts, and noise. For QUANT evaluation, mean grey value shift, % increase of standard deviation (SD), % of beam-hardening and contrast-to-noise ratio (CNR) were calculated. For TECH evaluation, segmentation accuracy, CNR, metal artefact SD, metal object area, and sharpness were measured. Representative parameters were chosen for CL, QUANT and TECH evaluations to determine the optimal kV based on biplot graphs. kV values of the same protocol were compared by bootstrapping approach. The ones that had statistical differences with the best kV were considered as worse quality. Results: Overall, kV values within the same group showed similar quality (p>0.05), except for 110 kV in 21x19 cm HD and 85 kV in 12x9 cm HD of CL score; also 85, 90 kV in 21x19 cm HD and 75, 80 kV in 21x19 cm LD of QUANT score which were worse (p<0.05). Conclusion: At a constant dose, low and high kV protocols yield acceptable image quality for a narrow-detector CBCT unit.
关键词： Image Quality,Computed-assisted image analysis,Phantoms,Imaging,Optimization,Cone-beam computed tomography
更新于2025-09-23 15:23:52
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Effect of Object Position in Cone Beam Computed Tomography Field of View for Detection of Root Fractures in Teeth with Intra-Canal Posts
摘要： Background: Vertical root fracture (VRF) is a common problem in endodontically treated teeth. Due to its poor prognosis, a reliable technique must be used to make an accurate diagnosis. Cone beam computed tomography (CBCT) has been recently introduced for maxillofacial imaging. Despite the high diagnostic value of this method, metal artifacts resulting from intra-canal posts still make the detection of VRFs challenging. Objectives: This study aimed to assess the effect of object position in the field of view (FOV) of CBCT on detection of VRFs in teeth with intra-canal posts. Materials and Methods: The crowns of 60 extracted premolar teeth were cut at the level of cementoenamel junction (CEJ). Root canals were filled with gutta-percha and filling of the coronal 2/3 of the root canals was subsequently removed to fabricate intra-canal cast posts. The teeth were randomly divided into two groups of 30. Fracture was induced in group one using an Instron machine. Group two was considered as the control group with no fracture. All teeth were then randomly positioned and scanned in five different positions starting at the center of the FOV as well as right, left anterior and posterior relative to the center (3, 9, 12, and 6 O’clock) via the New Tom VGI CBCT unit. Two observers evaluated images for VRFs. Sensitivity and specificity of fracture diagnosis in each position was calculated in comparison with the gold standard. Wilcoxon test was used for data analysis. Results: Considering deterministic and probabilistic diagnostic parameters, probabilistic sensitivity was similar in all positions; but probabilistic specificity of the center position (65.1%) was significantly higher than that of 6 and 12 O’clock positions. Considering the deterministic diagnostic parameters, the overall sensitivity and specificity values decreased in all positions in FOV, but sensitivity of the center position of FOV was significantly higher than that of other positions; specificity was significantly higher at the 3 O’clock position (58.5%). Conclusion: Concerning the positions in FOV, the center position is suitable for detection of VRF in teeth with intra-canal posts due to significantly higher sensitivity at this position. The 3 O’clock position would be suitable for assessment of intact teeth without fractures due to significantly higher specificity at this position.
关键词： Post and Core Technique,Position,Tooth Fracture,Cone-Beam Computed Tomography
更新于2025-09-23 15:23:52
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Treating cerebrovascular diseases in hybrid operating room equipped with a robotic angiographic fluoroscopy system: level of necessity and 5-year experiences
摘要： Background A hybrid operating room (OR) equipped with robotic angiographic fluoroscopy system has become prevalent in neurosurgery. The level of necessity of the hybrid OR in treating cerebrovascular diseases (CVD) is rarely discussed. Objective The authors proposed a scoring and classification system to evaluate the cerebrovascular procedures according to the level of treatment necessity for CVD in a hybrid OR and shared our 5-year experiences. Methods From December 2009 to January 2016, the registry of cerebrovascular procedures performed in the hybrid OR was retrieved. A scoring system was used to evaluate the importance of the surgical and interventional components of a cerebrovascular procedure performed in the hybrid OR. The score of either component ranged from 1, 1.5, to 2 (1 = no role, 1.5 = supplementary or informative, 2 = important or therapeutic). The total score of a procedure was by multiplying two individual scores. Levels of necessity were classified into level A (important), level B (beneficial), and level C (replaceable). Results A total of 1027 cerebrovascular procedures were performed during this period: diagnostic angiography in 328, carotid artery stenting in 286, aneurysm coiling in 128, intra-operative DSA in 101, aspiration of ICH under image guidance in 79, intra-arterial thrombolysis/thrombectomy in 51, intracranial angioplasty/stenting in 30, hybrid surgery/serial procedures in 19, and rescue surgery during embolization in 5. According to the scoring system, hybrid surgery and serial procedures scored the highest points (2 × 2). The percentages distributed at each level: levels A (2.3%), B (17.5%), and C (80.2%). Conclusion This study conveys a concept of what a hybrid OR equipped with robotic angiographic fluoroscopy system is capable of and its potential. For cerebrovascular diseases, hybrid OR exerts its value via hybrid surgery or avoiding patient transportation in serial procedures (level A), via providing real-time high-quality angiography and image guidance (level B), which constituted about 20% of the cases. The subspecialty of the group using the hybrid OR directly reflects on the number of procedures categorized in each level. In a hybrid OR, innovative treatment strategies for difficult-to-treat CVD can be developed.
关键词： Cone-beam computed tomography,Endovascular,Hybrid surgery,Robotic angiographic fluoroscopy system,Cerebrovascular disease,Hybrid operating room,Digital subtraction angiography
更新于2025-09-23 15:22:29
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Assessment of CT numbers in limited and medium field-of-view scans taken using Accuitomo 170 and Veraviewepocs 3De cone-beam computed tomography scanners
摘要： Purpose: To assess the influence of anatomic location on the relationship between computed tomography (CT) number and X-ray attenuation in limited and medium field-of-view (FOV) scans. Materials and Methods: Tubes containing solutions with different concentrations of K2HPO4 were placed in the tooth sockets of a human head phantom. Cone-beam computed tomography (CBCT) scans were acquired, and CT numbers of the K2HPO4 solutions were measured. The relationship between CT number and K2HPO4 concentration was examined by linear regression analyses. Then, the variation in CT number according to anatomic location was examined. Results: The relationship between K2HPO4 concentration and CT number was strongly linear. The slopes of the linear regressions for the limited FOVs were almost 2-fold lower than those for the medium FOVs. The absolute CT number differed between imaging protocols and anatomic locations. Conclusion: There is a strong linear relationship between X-ray attenuation and CT number. The specific imaging protocol and anatomic location of the object strongly influence this relationship.
关键词： Image Processing, Computer-Assisted,Imaging, Three-Dimensional,Cone-Beam Computed Tomography
更新于2025-09-23 15:22:29
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Effect of object position in the field of view and application of a metal artifact reduction algorithm on the detection of vertical root fractures on cone-beam computed tomography scans: An <i>in vitro</i> study
摘要： Purpose: To assess the effects of object position in the field of view (FOV) and application of a metal artifact reduction (MAR) algorithm on the diagnostic accuracy of cone-beam computed tomography (CBCT) for the detection of vertical root fractures (VRFs). Materials and Methods: Sixty human single-canal premolars received root canal treatment. VRFs were induced in 30 endodontically treated teeth. The teeth were then divided into 4 groups, with 2 groups receiving metal posts and the remaining 2 only having an empty post space. The roots from different groups were mounted in a phantom made of cow rib bone, and CBCT scans were obtained for the 4 different groups. Three observers evaluated the images independently. Results: The highest frequency of correct diagnoses of VRFs was obtained with the object positioned centrally in the FOV, using the MAR algorithm. Peripheral positioning of the object without the MAR algorithm yielded the highest sensitivity for the first observer (66.7%). For the second and third observers, a central position improved sensitivity, with or without the MAR algorithm. In the presence of metal posts, central positioning of the object in the FOV significantly increased the diagnostic sensitivity and accuracy compared to peripheral positioning. Conclusion: Diagnostic accuracy was higher with central positioning than with peripheral positioning, irrespective of whether the MAR algorithm was applied. However, the effect of the MAR algorithm was more significant with central positioning than with peripheral positioning of the object in the FOV. The clinical experience and expertise of the observers may serve as a confounder in this respect.
关键词： Cone-Beam Computed Tomography,Artifact,Diagnosis,Tooth Fracture
更新于2025-09-23 15:22:29
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Performance of Cone Beam Computed Tomography Systems in Visualizing the Cortical Plate in 3D Image Reconstruction: An Study
摘要： Introduction: Cortical bone is an important anatomical structure and its thickness needs to be determined prior to many dental procedures to ensure treatment success. Imaging modalities are necessarily used in dentistry for treatment planning and dental procedures. Three-dimensional image reconstruction not only provides visual information but also enables accurate measurement of anatomical structures; thus, it is necessarily required for maxillofacial examination and in case of skeletal problems in this region. Aims: This study aimed to assess the ability of three Cone Beam Computed Tomography (CBCT) systems including Cranex 3D, NewTom 3G and 3D Promax for Three-Dimensional (3D) image reconstruction of the cortical plate with variable thicknesses. Methods: Depending on the cortical bone thickness, samples were evaluated in three groups of ≤ 0.5 mm, 0.6 -1 mm and 1.1-1.5 mm cortical bone thickness. The CBCT scans were obtained from each sample using three systems, their respective FOVs, and 3D scans were reconstructed using their software programs. Two observers viewed the images twice with a two-week interval. The ability of each system in the 3D reconstruction of different thicknesses of cortical bone was determined based on its visualization on the scans. The data were analyzed using SPSS and Kappa test. Results: The three systems showed the greatest difference in the 3D reconstruction of cortical bone with < 0.5 mm thickness. Cranex 3D with 4×6 cm2 FOV had the highest and 3D Promax with 8×8 cm2 FOV had the lowest efficacy for 3D reconstruction of cortical bone. Cranex 3D with 4×6 cm2 and 6×8 cm2 FOVs and NewTom 3G with 5×5 cm2 and 8×5 cm2 FOVs showed significantly higher efficacy for 3D reconstruction of cortical bone with 0.6-1mm thickness while 3D Promax followed by NewTom 3G with 8×8 cm2 FOV had the lowest efficacy for this purpose. Conclusion: Most CBCT systems have high efficacy for 3D image reconstruction of cortical bone with thicknesses over 1 mm while they have poor efficacy for image reconstruction of cortical bone with less than 0.5 mm thickness. Thus, for accurate visualization of anatomical structures on CBCT scans, systems with smaller FOVs and consequently smaller voxel size are preferred.
关键词： Cone-Beam Computed Tomography (CBCT),Imaging,Computer-assisted,Image processing,Three-dimensional,Cortical bone
更新于2025-09-23 15:22:29
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Pre- and post-contrast versus post-contrast cone-beam breast CT: can we reduce radiation exposure while maintaining diagnostic accuracy?
摘要： Objectives To evaluate whether post-contrast cone-beam breast CT (CBBCT) alone is comparable to the current standard of combined pre- and post-contrast CBBCT regarding diagnostic accuracy and superior regarding radiation exposure. Material and methods This study included 49 women (61 breasts) with median age 57.9 years and BI-RADS 4/5 lesions diagnosed on mammography/ultrasound in density type c/d breasts. Two radiologists rated post-contrast CBBCT and pre- and post-contrast CBBCT with subtraction images on the BI-RADS scale separately for calculation of inter- and intra-observer agreement and in consensus for diagnostic accuracy assessment. Sensitivity, specificity, and area under the curve (AUC) were compared via McNemar test and DeLong method, respectively. Subtraction imaging misregistration were measured from 1 (no artifacts) to 4 (artifacts with width > 4 mm). Results A total of 100 lesion (51 malignant; 6 high risk; 43 benign) were included. AUC, sensitivity, and specificity showed no significant differences comparing post-contrast CBBCT alone versus pre- and post-contrast CBBCT (AUC 0.84 vs. 0.83, p = 0.643; sensitivity 0.89 vs. 0.85, p = 0.158; specificity 0.73 vs. 0.76, p = 0.655). Inter- and intra-observer agreement was excellent (intra-class correlation coefficient ICC = 0.76, ICC = 0.83, respectively). Radiation dose was significantly lower for post-contrast CBBCT alone versus pre- and post-contrast CBBCT (median average glandular radiation dose 5.9 mGy vs. 11.7 mGy, p < 0.001). High-degree misregistrations were evident in the majority of subtraction images (level 1/2/3/4 16.9%/27.1%/16.9%/39%), in particular for bilateral exams (3.2%/29.2%/8.3%/58.3%). Conclusion Diagnostic accuracy of post-contrast CBBCT alone is comparable to pre- and post-contrast CBBCT in type c/d breasts, while yielding a significant twofold radiation dose reduction.
关键词： Contrast media,Breast,Radiation dosage,Cone-beam computed tomography
更新于2025-09-23 15:21:21
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Computed tomography criteria for the use of advanced localization techniques in minimally invasive thoracoscopic lung resection
摘要： Background: The significant improvement of patient outcomes from minimally invasive lung surgery has led to the development of advanced lung nodule localization techniques to help manage patients with small suspicious lung nodules or to help resect patients with small pulmonary metastases. However, there are no clear computed tomography (CT) criteria to guide the use of advanced localization techniques for this group of patients. Methods: We conducted a retrospective chart review of patients who had undergone initial wedge resection of single or multiple lung nodules. We collected demographics, surgical information and surgical outcomes as well as CT scan features. Multiple logistic regression was performed to determine which factors were most predictive of the need for advanced localization techniques. Results: A total of 45 patients (73%) were resected by direct identification alone while 17 patients (27%) required advanced localization techniques. Of those requiring advanced localization, 11 patients had cone beam CT, 3 patients had transbronchial localization using electromagnetic navigation and 3 patients had preoperative CT guided wire localization. Patients requiring advanced localization had significantly smaller lung nodules at 0.8 cm compared to 1.4 cm (P=0.01), nodules that were further away from the pleura at 1.3 cm compared 0.1 cm (P<0.001) and were more likely to have ground glass nodules (P=0.01) compared to patients who were resected by direct identification alone. Multiple logistic regression confirmed that nodule size, distance to pleura and ground glass attenuation were predictive factors for requiring advanced localizing techniques. Every patient was treated with minimally invasive lung resection. A 1.3-cm or greater solitary pulmonary nodule less than 5 mm from the pleura can be removed without advanced techniques with a 96% success rate. Conclusions: Overall, in patients undergoing resection of a suspicious primary or metastatic lung nodule, advanced localization techniques should be considered in those with small non-solid nodules, which are not near the pleural surface on CT scan.
关键词： computed tomography guided localization (CT guided localization),navigation bronchoscopy,cone beam computed tomography (cone beam CT),lung cancer,Lung nodule
更新于2025-09-19 17:15:36
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Root canal morphology of permanent teeth in a Malaysian subpopulation using cone-beam computed tomography
摘要： Background: To determine the root canal morphology of human permanent maxillary and mandibular teeth in a Malaysian subpopulation using cone-beam computed tomography (CBCT). Methods: A total of 208 CBCT images were examined retrospectively. Prevalence of an extra root/canal and internal morphology based on Vertucci’s classification were observed in human maxillary and mandibular permanent teeth. Variations in the external and internal morphology were compared in relation to gender and tooth side (left vs right) using Pearson Chi-square and Fisher’s exact tests with significance level set at p < 0.05. Results: In the maxillary arch, the prevalence of three canals were observed in 0.3% of first premolars and two canals in 46.5% of second premolars. Males displayed significantly higher prevalence of two canals in maxillary second premolars than females (p < 0.05). The prevalence of a second mesiobuccal canal in maxillary first and second molars were 36.3 and 8.5%, respectively. Males displayed significantly higher prevalence of a second mesiobuccal canal in maxillary second molars than females (p < 0.05). The prevalence of a second palatal canal in maxillary first and second molars were 0.9 and 0.6%, respectively. In the mandibular arch, the prevalence of two canals were observed in 5.1% of central incisors, 12.3% of lateral incisors, 6.1% of canines, 18.7% of first premolars and 0.5% of second premolars. The prevalence of a middle mesial canal, second distal canal and extra root (radix entomolaris) were detected in 1.9, 19.5 and 21.4% of mandibular first molars, respectively. The prevalence of a C-shaped canal was observed in 48.7% of mandibular second molars. Females displayed significantly higher prevalence of a C-shaped canal in the right mandibular second molars than males (p < 0.05). No other statistically significant differences in root anatomy and root canal morphology were observed in relation to gender and tooth side. Conclusions: Wide variations in the root canal morphology exist among Malaysians. CBCT is a clinically useful tool in the identification of external and internal morphological variations in the human teeth.
关键词： Root canal,Cone-beam computed tomography,Malaysian,Morphology
更新于2025-09-19 17:15:36
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Dimensional accuracy of cone beam CT with varying angulation of the jaw to the X-ray beam
摘要： Objectives: CBCT machines do not always allow for patients to be scanned in the ideal position for image acquisition. This study aimed to investigate the influence of the position/angulation of the mandible relative to the x-ray beam of a CBCT machine. Methods: Five sequential CBCT scans were captured of a human mandible at each angulation. The 0° occlusal plane was captured as the reference followed by 10°, 20°, 30° and 40° using a coronal and sagittal positioning. Inspection software utilized a best fit alignment to automatically calculate the three-dimensional variation at 15 standardized points of interest. Results: Statistically significant differences were found between the dimensional accuracy of CBCT scans taken at 10° (0.0263mm) of coronal angulation, as well as those taken at 20° (-0.0173mm) and 30° (0.0352mm) of sagittal angulations (P <0.001, 0.016, and <0.001, respectively). The largest deviations in accuracy included an overall maximum deviation of 0.490mm. Conclusion: The position of the mandible with respect to the x-ray beam has a clinically insignificant effect on dimensional accuracy, up to the maximum angle of 40° assessed.
关键词： Imaging,Three-Dimensional,Dimensional Measurement Accuracy,Cone-Beam Computed Tomography
更新于2025-09-19 17:15:36