Analysis of intensity variability in multislice and cone beam computed tomography. Clin Oral Implants Res

Oral Imaging Center, Faculty of Medicine, K.U. Leuven, Belgium.
Clinical Oral Implants Research (Impact Factor: 3.89). 08/2011; 22(8):873-9. DOI: 10.1111/j.1600-0501.2010.02076.x
Source: PubMed


The aim of this study was to evaluate the variability of intensity values in cone beam computed tomography (CBCT) imaging compared with multislice computed tomography Hounsfield units (MSCT HU) in order to assess the reliability of density assessments using CBCT images.
A quality control phantom was scanned with an MSCT scanner and five CBCT scanners. In one CBCT scanner, the phantom was scanned repeatedly in the same and in different positions. Images were analyzed using registration to a mathematical model. MSCT images were used as a reference.
Density profiles of MSCT showed stable HU values, whereas in CBCT imaging the intensity values were variable over the profile. Repositioning of the phantom resulted in large fluctuations in intensity values.
The use of intensity values in CBCT images is not reliable, because the values are influenced by device, imaging parameters and positioning.

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    • "When it comes to the assessment of bone density, crucial differences exist between MCT and CBCT. The measurements of bone density in CBCT are not easily comparable, because the grey values in CBCT are influenced by different factors, such as the CBCT device, the exposure parameters, and the position of the region of interest within the field of view (Nackaerts et al. 2011). Although attempts have been made to correct for grey value variability, no reliable system has been developed so far. "
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    ABSTRACT: To examine the literature on novel digital imaging techniques for the assessment of outcomes in oral rehabilitation with dental implants. An electronic search of Medline and Embase databases including studies published prior to 28th December 2014 was performed and supplemented by a manual search. A synthesis of the publications was presented describing the use of computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography, optical scanning, spectrophotometry or optical coherence tomography (OCT) related to the outcome measures in implant therapy. Most of the digital imaging techniques have not yet sufficiently been validated to be used for outcome measures in implant dentistry. In clinical research, cone beam CT (CBCT) is increasingly being used for 3D assessment of bone and soft tissue following augmentation procedures and implant placement. Currently, there are no effective methods for the reduction of artifacts around implants in CBCT. Optical scanning is being used for the 3D assessment of changes in the soft tissue contour. The combination of optical scan with pre-operative CBCT allows the determination of the implant position and its spatial relation to anatomical structures. Spectrophotometry is the method most commonly used to objectively assess the color match of reconstructions and peri-implant mucosa to natural dentition and gingiva. New optical imaging techniques may be considered possible approaches for monitoring peri-implant soft tissue health. MRI and ultrasonography appear promising non-ionizing radiation imaging modalities for the assessment of soft tissue and bone defect morphologies. Optical scanners and OCT may represent efficient clinical methods for accurate assessment of the misfit between the reconstructions and the implants. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
    No preview · Article · May 2015 · Clinical Oral Implants Research
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    • "Previous studies have indicated that the image quality of dental CT is less stable than that of traditional computed tomography, and that the Hounsfield unit scale is not a suitable image unit in dental CT. Moreover, the image quality can be affected by the scanning position [19], [32]. Nevertheless, flat panel detectors have been used in most dental CT devices recently, which has substantially improved the image quality of dental CT [24]. "
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    ABSTRACT: Objective The objective of this study was to evaluate the relationship between the trabecular bone microarchitecture and cortical bone morphology by using micro-computed tomography (micro-CT) and dental cone-beam computed tomography (dental CT). Materials and Methods Sixteen femurs and eight fifth lumbar vertebrae were collected from eight male Sprague Dawley rats. Four trabecular bone microarchitecture parameters related to the fifth lumbar vertebral body (percent bone volume [BV/TV], trabecular thickness [TbTh], trabecular separation [TbSp], and trabecular number [TbN]) were calculated using micro-CT. In addition, the volumetric cancellous bone grayscale value (vCanGrayscale) of the fifth lumbar vertebral body was measured using dental CT. Furthermore, four cortical bone morphology parameters of the femoral diaphysis (total cross-sectional area [TtAr], cortical area [CtAr], cortical bone area fraction [CtAr/TtAr], and cortical thickness [CtTh]) were calculated using both micro-CT and dental CT. Pearson analysis was conducted to calculate the correlation coefficients (r) of the micro-CT and dental CT measurements. Paired-sample t tests were used to compare the differences between the measurements of the four cortical bone morphology parameters obtained using micro-CT and dental CT. Results High correlations between the vCanGrayscale measured using dental CT and the trabecular bone microarchitecture parameters (BV/TV [r = 0.84] and TbTh [r = 0.84]) measured using micro-CT were observed. The absolute value of the four cortical bone morphology parameters may be different between the dental CT and micro-CT approaches. However, high correlations (r ranged from 0.71 to 0.90) among these four cortical bone morphology parameters measured using the two approaches were obtained. Conclusion We observed high correlations between the vCanGrayscale measured using dental CT and the trabecular bone microarchitecture parameters (BV/TV and TbTh) measured using micro-CT, in addition to high correlations between the cortical bone morphology measured using micro-CT and dental CT. Further experiments are necessary to validate the use of dental CT on human bone.
    Full-text · Article · Sep 2014 · PLoS ONE
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    • "CBCT-derived density measurements are influenced by the scanning device, cone angle, imaging parameters, and position of the evaluated area.20,21 Density measurements are reportedly not consistent within one CBCT image, and the discrepancy could be related to the mass of the object within and outside the field of view or the content of the mass.20,22 "
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    ABSTRACT: The purpose of this study was to quantitatively evaluate the cortical bone densities of the maxillary and mandibular alveolar processes in adults with different vertical facial types using cone-beam computed tomography (CBCT) images. CBCT images (n = 142) of adult patients (20-45 years) were classified into hypodivergent, normodivergent, and hyperdivergent groups on the basis of linear and angular S-N/Go-Me measurements. The cortical bone densities (in Hounsfield units) at maxillary and mandibular interdental sites from the distal aspect of the canine to the mesial aspect of the second molar were measured on the images. On the maxillary buccal side, female subjects in the hyperdivergent group showed significantly decreased bone density, while in the posterior region, male subjects in the hyperdivergent group displayed significantly decreased bone density when compared with corresponding subjects in the other groups (p<0.001). Furthermore, the subjects in the hyperdivergent group had significantly lower bone densities on the mandibular buccal side than hypodivergent subjects. The maxillary palatal bone density did not differ significantly among groups, but female subjects showed significantly denser palatal cortical bone. No significant difference in bone density was found between the palatal and buccal sides in the maxillary premolar region. Overall, the palatal cortical bone was denser anteriorly and buccal cortical bone was denser posteriorly. Adults with the hyperdivergent facial type tend to have less-dense buccal cortical bone in the maxillary and mandibular alveolar processes. Clinicians should be aware of the variability of cortical bone densities at mini-implant placement sites.
    Full-text · Article · Jan 2014 · Korean Journal of Orthodontics
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