Abstract
The purpose of this study was to analyze the effectiveness of newly developed dental dual-energy (DE) cone-beam computed tomography (CBCT) to compare both the voxel values in hard bone tissue of DE-CBCT and multidetector computed tomography (MDCT) images, collected in a clinical trial conducted at Seoul National University Dental Hospital. A software implemented as a scripted module of a three-dimensional (3D) slicer was developed to register the volume data from the MDCT space to DE-CBCT, locate the same 3D regions of interest (ROIs) in each image space, and extract the statistics of the ROIs. The mean values were paired and used as representative values of the ROIs. A scatter plot with the line of equality and Bland–Altman (BA) plot of difference for a pair of measured means were used for statistical analysis. Of the ROI pairs, 96% were within ±15% from the identity line, and more than 95% of the measured ROI pairs were within the limits of agreement of the 95% confidence intervals (CIs), with the CI of the limits in BA plots. The newly developed dental DE-CBCT showed a level of voxel value accuracy similar to that of MDCT.
Highlights
X-ray radiographs, such as panoramic and cephalometric images, and three-dimensional (3D) computed tomography (CT) or cone-beam computed tomography (CBCT) imaging are widely used in dentistry [1,2,3]
Whereas X-ray radiographs are projected images, in which the internal information of a subject is integrated along the beam trajectory, and is not adequate for assessing bone quality, CT or CBCT images represent the density of the subject and can be used to assess bone quality
Users or clinicians could select the region of interest (ROI) to assess the Hounsfield units (HUs) values on their image viewer and the bone quality classification of the voxels in the regions of interest (ROIs) provided in the DICOM viewer
Summary
X-ray radiographs, such as panoramic and cephalometric images, and three-dimensional (3D) computed tomography (CT) or cone-beam computed tomography (CBCT) imaging are widely used in dentistry [1,2,3] These X-ray-based modalities provide information on the morphology and internal structure of the dental hard tissues and alveolar bone. Dental CBCTs are inferior to clinical CTs in terms of tube current, peak tube voltage, detector acquisition rate, and signal collection efficiency. These physical limitations result in inaccurate voxel values and bone density assessments [18]. A feasibility study was conducted to measure bone density directly and quantitatively from CBCT images using modified GAN [21]
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