Image quality assessment of low-dose protocols in cone beam computed tomography of the anterior maxilla

Ihlis, Randi Lynds; Kadesjö, Nils; Tsilingaridis, Georgios; Benchimol, Daniel; Shi, Xie‐Qi

doi:10.1016/j.oooo.2021.10.001

Cited by 10 publications

(11 citation statements)

References 28 publications

(30 reference statements)

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“…13,15 Furthermore, there are recommendations to use low-dose protocols but without specifying resolution and other settings. 19 In the present study, the ULD and SD protocols did not exhibit any statistically significant difference in structure visibility in CBCT evaluation of an alveolar cleft before or after bone grafts. An unexpected tendency that ULD protocol had slightly higher scores in the visibility of cortical bone, trabecular bone, and periodontal space was noticed (Fig.…”

Section: Discussioncontrasting

confidence: 43%

“…Our results are in line with two previous in vitro studies. 18,19 Oenning et al compared low dose protocols in a preclinical setting using one pediatric anthromorphic phantom with different exposure settings of CBCT and concluded that a 45% decrease in radiation dose did not reduce the image quality. An in vitro study verified the image quality of the ULD protocol for structure visibility in the maxillary front region using eight phantoms.…”

Section: Discussionmentioning

confidence: 99%

“…An in vitro study verified the image quality of the ULD protocol for structure visibility in the maxillary front region using eight phantoms. 19 A drawback of an in vitro study design is the complexity of mimicking a clinical diagnostic question, such as the alveolar cleft, which is closely associated with the expected image quality. To our knowledge, the present study is the first clinical randomized controlled trial testing low-dose protocols for cleft assessment.…”

Section: Discussionmentioning

confidence: 99%

“…13,15 Furthermore, there are recommendations to use low-dose protocols but without specifying resolution and other settings. 19…”

Section: Discussionmentioning

confidence: 99%

“…18 A recent study from our group demonstrated that low-dose CBCT provides diagnostically acceptable image quality for evaluating anatomical landmarks in the anterior part of the maxilla. 19 The promising results from this in vitro study pave the way for verifying low-dose CBCT for clinical use in children.…”

mentioning

confidence: 83%

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Low-dose cone-beam computed tomography for assessment of alveolar clefts, a randomized controlled trial in image quality

Lemberger

Regnstrand

Karsten

et al. 2023

Plastic &Amp; Reconstructive Surgery

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rofacial cleft deformities are congenital malformations developing during early pregnancy if the maxillary prominences do not fuse completely. 1 An alveolar cleft can be anything from a small slit to a large defect that extends through the alveolus into the nose. For optimal treatment, the cleft is bone grafted in the mixed dentition age to provide bone support for the erupting dentition in the cleft region. 2 Subsequently, a harvested autogenous bone from the iliac, chin, or tibia is often used to reconstruct the cleft in the maxilla. 3,4 Background: Children born with an alveolar cleft receive bone grafts for improved function and aesthetics. The cleft area is examined radiologically before and after bone graft. Optimizing radiographic examination protocols is essential to protect these patients from possible delayed radiation injury later in life. This study investigates whether image quality of cone-beam computed tomography (CBCT) exposed with an ultra-low-dose (ULD) protocol is comparable to the clinical default protocol, the standard dose (SD) protocol, in visualizing details of importance in bone grafting of alveolar clefts. Methods: In this randomized controlled study, 72 patients with unilateral or bilateral alveolar clefts between 9 and 19 years (mean age, 9.5 years) were randomized 1:1 with either a ULD or an SD CBCT examination protocol. The CBCT scans were conducted with a Planmeca ProMax Mid scanner with an 8 × 5-cm field of view. Two experienced radiologists blindly evaluated the images and visibility of cortical bone border, trabecular bone, tooth anatomy, root development, periodontal space, and cleft width. The visibility was categorized as unacceptable, acceptable, or excellent. Results: Mann-Whitney U test showed no significant differences in structure visibility between ULD and SD protocols regarding anatomical structures of interest: cortical bone border (P = 0.07), trabecular bone (P = 0.64), tooth anatomy (P = 0.09), root development (P = 0.57), periodontal space (P = 0.38), and cleft width (P = 0.44). Conclusions: ULD and standard CBCT protocols provide comparable image quality in terms of structure visibility in the examination of alveolar clefts. The ULD protocol is preferred to the SD protocol because of the lower radiation dose without compromising diagnostic information of CBCT images.

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Section: Discussioncontrasting

confidence: 43%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…13,15 Furthermore, there are recommendations to use low-dose protocols but without specifying resolution and other settings. 19…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 83%

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Low-dose cone-beam computed tomography for assessment of alveolar clefts, a randomized controlled trial in image quality

Lemberger

Regnstrand

Karsten

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Assessment of cone-beam CT technical image quality indicators and radiation dose for optimal STL model used in visual surgical planning

Koivisto,

Wolff,

Pauwels

et al. 2024

Dentomaxillofacial Radiology

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Objectives The aim of this study was to identify cone-beam computed tomography (CBCT) protocols that offer an optimal balance between effective dose (ED) and 3D model for orthognathic virtual surgery planning, using CT as a reference, and to assess whether such protocols can be defined based on technical image quality metrics. Methods Eleven CBCT (VISO G7, Planmeca Oy, Helsinki, Finland) scan protocols were selected out of 32 candidate protocols, based on ED and technical image quality measurements. Next, an anthropomorphic RANDO SK150 phantom was scanned using these 11 CBCT protocols and 2 CT scanners for bone quantity assessments. The resulting DICOM (Digital Imaging and Communications in Medicine) files were converted into Standard Tessellation Language (STL) models that were used for bone volume and area measurements in the predefined orbital region to assess the validity of each CBCT protocol for virtual surgical planning. Results The highest CBCT bone volume and area of the STL models were obtained using normal dose protocol (F2) and ultra-low dose protocol (J13), which resulted in 48% and 96% of the mean STL bone volume and 48% and 95% of the bone area measured on CT scanners, respectively. Conclusions The normal dose CBCT protocol “F2” offered optimal bone area and volume balance for STL. The optimal CBCT protocol can be defined using contrast-to-noise ratio and modulation transfer function values that were similar to those of the reference CT scanners’. CBCT scanners with selected protocols can offer a viable alternative to CT scanners for acquiring STL models for virtual surgical planning at a lower effective dose.

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In vitro accuracy of ultra-low dose cone-beam CT for detection of proximal caries

Taeby,

Seyyedi,

Mostafavi

2024

Dentomaxillofacial Radiology

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Objectives This study aimed to assess the accuracy of ultra-low dose (ULD) cone-beam computed tomography (CBCT) for detection of proximal caries. Methods This in vitro study evaluated 104 molar and premolar teeth. The teeth were mounted in dry skulls and underwent CBCT with four protocols of high-resolution (HR), normal (NORM), ULD-HR, and ULD-NORM; 78 CBCT images were scored by three observers for presence and penetration depth of caries twice with a 2-week interval using a 5-point Likert scale. The teeth were then sectioned and observed under a stereomicroscope (gold standard). The four protocols were compared with each other and with the gold standard. The receiver operating characteristic (ROC) curve was drawn, and the area under the curve (AUC) was calculated and compared by the Chi-square test (alpha = 0.05). Results The interobserver agreement ranged from 0.5233 to 0.6034 for ULD-NORM, 0.5380 to 0.6279 for NORM, 0.5856 to 0.6300 for ULD-HR, and 0.6614 to 0.7707 for HR images. The intra-observer agreement ranged from 0.6027 to 0.8812 for ULD-HR, 0.7083 to 0.7556 for HR, 0.6076 to 0.9452 for ULD-NORM, and 0.7012 to 0.9221 for NORM images. Comparison of AUC revealed no significant difference between NORM and ULD-NORM (P > 0.05), or HR and ULD-HR (P > 0.05). The highest AUC belonged to HR (0.8529) and the lowest to NORM (0.7774). Conclusions Considering the significant reduction in radiation dose in ULD CBCT and its acceptable diagnostic accuracy for detection of proximal caries, this protocol may be used for detection of proximal carious lesions and assessment of their depth.

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Image quality assessment of low-dose protocols in cone beam computed tomography of the anterior maxilla

Cited by 10 publications

References 28 publications

Low-dose cone-beam computed tomography for assessment of alveolar clefts, a randomized controlled trial in image quality

Low-dose cone-beam computed tomography for assessment of alveolar clefts, a randomized controlled trial in image quality

Assessment of cone-beam CT technical image quality indicators and radiation dose for optimal STL model used in visual surgical planning

In vitro accuracy of ultra-low dose cone-beam CT for detection of proximal caries

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