Cone beam CT (CBCT) is becoming an increasingly utilized imaging modality for dental examinations in the UK. Previous studies have presented little information on patient dose for the range of fields of view (FOVs) that can be utilized. The purpose of the study was therefore to calculate the effective dose delivered to the patient during a selection of CBCT examinations performed in dentistry. In particular, the i-CAT CBCT scanner was investigated for several imaging protocols commonly used in clinical practice. A Rando phantom containing thermoluminescent dosemeters was scanned. Using both the 1990 and recently approved 2007 International Commission on Radiological Protection recommended tissue weighting factors, effective doses were calculated. The doses (E(1990), E(2007)) were: full FOV head (92.8 microSv, 206.2 microSv); 13 cm scan of the jaws (39.5 microSv, 133.9 microSv); 6 cm high-resolution mandible (47.2 microSv, 188.5 microSv); 6 cm high-resolution maxilla (18.5 microSv, 93.3 microSv); 6 cm standard mandible (23.9 microSv, 96.2 microSv); and 6 cm standard maxilla (9.7 microSv, 58.9 microSv). The doses from CBCT are low compared with conventional CT but significantly higher than conventional dental radiography techniques.
Diffusion weighted (DW) MRI facilitates non-invasive quantification of tissue microstructure and, in combination with appropriate signal processing, three-dimensional estimates of fibrous orientation. In recent years, attention has shifted from the diffusion tensor model, which assumes a unimodal Gaussian diffusion displacement profile to recover fibre orientation (with various well-documented limitations), towards more complex high angular resolution diffusion imaging (HARDI) analysis techniques.Spherical deconvolution (SD) approaches assume that the fibre orientation density function (fODF) within a voxel can be obtained by deconvolving a ‘common’ single fibre response function from the observed set of DW signals. In practice, this common response function is not known a priori and thus an estimated fibre response must be used. Here the establishment of this single-fibre response function is referred to as ‘calibration’. This work examines the vulnerability of two different SD approaches to inappropriate response function calibration: (1) constrained spherical harmonic deconvolution (CSHD)—a technique that exploits spherical harmonic basis sets and (2) damped Richardson–Lucy (dRL) deconvolution—a technique based on the standard Richardson–Lucy deconvolution.Through simulations, the impact of a discrepancy between the calibrated diffusion profiles and the observed (‘Target’) DW-signals in both single and crossing-fibre configurations was investigated. The results show that CSHD produces spurious fODF peaks (consistent with well known ringing artefacts) as the discrepancy between calibration and target response increases, while dRL demonstrates a lower over-all sensitivity to miscalibration (with a calibration response function for a highly anisotropic fibre being optimal). However, dRL demonstrates a reduced ability to resolve low anisotropy crossing-fibres compared to CSHD. It is concluded that the range and spatial-distribution of expected single-fibre anisotropies within an image must be carefully considered to ensure selection of the appropriate algorithm, parameters and calibration. Failure to choose the calibration response function carefully may severely impact the quality of any resultant tractography.
Under the conditions of this ex vivo study, CBCT was the most sensitive imaging technique in detecting vertical root fracture. The presence of gutta-percha reduced the accuracy, sensitivity and specificity of CBCT but not MDCT. The sensitivity of DR was reduced in the presence of gutta-percha. The use of MDCT as an alternative technique may be recommended when VRF are suspected in root filled teeth. However, as the radiation dose of MDCT is higher than CBCT, the technique could be considered at variance with the principles of ALARA.
The density response was subject to two effects. The first effect changes the whole slice uniformly and linearly depends on the total mass in the slice. The second effect exists when there is mass outside the field of view, dubbed the "exo-mass" effect. This effect lowers the measured CT number rapidly at the scan edge furthest from the exo-mass and raises it on the adjacent edge. The noise also depended quasi-linearly on the mass in the slice. Some general performance rules were drafted to describe these effects and a preliminary correction algorithm was constructed.
Extracorporeal shockwave lithotripsy provides a useful option for the management of salivary calculi, particularly for stones less than 7 mm in diameter.
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