Sensitivity Of Cone Beam Computed Tomography Research Articles

The utility of cone-beam computed tomography and multislice computed tomography scan for the evaluation of invasion versus erosion by mandibular squamous cell carcinoma as viewed on medical PACS

Introduction The degree of bone involvement in mandibular squamous cell carcinoma has a significant impact on surgical planning. The purpose of this study was to determine the utility of cone-beam computed tomography (CBCT) for the evaluation of invasion by mandibular squamous cell carcinoma. Methods A retrospective review was conducted to identify subjects treated for oral squamous cell carcinoma (OSCC). All subjects had OSCC adjacent or fixed to the mandible, received preoperative CBCT and multislice computed tomography scan (MSCT), and had resection specimens that included bone. Results Twenty-one subjects met the inclusion criteria. The sensitivity of CBCT was 100% (95% CI 0.75–1), the specificity was 75% (95% CI 0.35–0.97), the positive predictive value was 87% (95% CI 0.66–0.98), and the calculated test accuracy was 91%. The sensitivity of MSCT was 92% (95% CI 0.64–1), the specificity was 100% (95% CI 0.63–1), and the calculated test accuracy was 95%. Discussion CBCT provides meaningful data that may be useful in identifying bony involvement in patients with mandibular squamous cell carcinoma. The utility in delineating erosion versus invasion is limited.

Canal Transportation and Volumetric Dentin Removal Abilities of Ni-Ti Rotary File Systems in Curved Primary Root Canals: CBCT Study

Current improvements in nickel-titanium (Ni-Ti) rotary file systems have created a paradigm shift in the root canal therapy of primary teeth. Therefore, it is necessary to perform a comprehensive evaluation regarding the efficiencies of newly manufactured instruments for different parameters. The current study was conducted to evaluate the abilities of RaceEvo, R-Motion, ProTaper Gold (PTG) systems in curved primary root canals with regard to the patterns of canal transportation and volumetric dentin removal by using cone-beam computed tomography (CBCT). Two experimental sets were designed following the determination of experimental groups by using pre- and post-operative CBCT data: canal transportation and volumetric dentin removal. The highest amount of canal transportation was significantly detected in the PTG group in comparison to RaceEvo and R-Motion groups. When the mean values of volumetric dentin removal data were analyzed across all groups, the PTG group again exhibited the significantly highest value of dentin removal volumetrically, compared to RaceEvo, R-Motion and manual instrumentation groups. It is possible to state that R-Motion and RaceEvo rotary systems could be used as reliable alternatives without causing adverse mechanical effects and maintaining the original root canal anatomy of curved primary root canal systems compared with PTG rotary systems and manual instrumentation, with a high diagnostic sensitivity of CBCT in pediatric endodontics when the alternative methods are not adequate.

Assessment of the therapeutic accuracy of cone beam computed tomography-guided nasopharyngeal carcinoma radiotherapy.

The aim of the present study was to determine the ability of cone beam computed tomography (CBCT) to improve the accuracy of nasopharyngeal carcinoma (NPC) radiotherapy by analyzing the setup and inter-fraction errors at different levels and directions of the target volumes. A total of 113 patients with NPC who were undergoing intensity-modulated radiotherapy were recruited for the present study. Each patient had at least three CBCT exams prior to the start of radiation therapy. Three anatomic bony landmarks, including the upper neck, lower neck and head, were used to represent the different levels of assessment. The positioning errors were registered in three planes throughout the course of radiotherapy: The right-left (RL), superior-inferior (SI) and anterior-posterior (AP) directions. The planning CT images were matched with the CBCT images to determine the naso-pharynx shifts. A receiver operating characteristic curve was plotted to establish the specificity and sensitivity of CBCT. The planning target volume margin (MPTV) for the head was 0.9 mm, 1.4 mm for the upper neck and 2.0 mm for the lower neck. MPTVs of 1.5, 0.6 and 2.2 mm in the RL, SI and AP directions, respectively, were detected. In addition, there was evidence of setup errors in the three planes (RL, SI and AP) with the greatest error observed in the AP direction. Furthermore, the setup uncertainties in the neck region were greater than those of the head. In conclusion, CBCT could greatly improve the accuracy of radiotherapy by minimizing the setup errors and MPTV.

Comparison of Digital Diagnostic Value and Cone Beam Computed Tomography (CBCT) in Determining Vertical Root Fracture in SingleRoot Teeth

Objective: To compare the accuracy of digital radiography and CBCT for the diagnosis of vertical root fractures in single root teeth. Material and Methods: For this descriptive-analytic study, 50 non-fractured, single-root teeth were selected. The teeth were randomly divided into a control and an experimental group (25 teeth in each group). The teeth in the control group did not have vertical root fractures. In the test group, after preparing the access cavity, the root canal was cleared and loosened up to No. 80 file, then a vertical root fracture was created by one of the K-Reamers Nos. 90-130.The images were prepared by CBCT radiography in axial and cross-sectional slices and in digital radiography with PSP sensors at mesial, distal, and parallel angles. The Chi-square test was used to express the correlation of variables. Results: In the diagnosis of vertical root fractures, the sensitivity of CBCT in the axial section was 32% and in the cross-sectional slice it was 20%, whereas the specificity in both the sections was 100%. The sensitivity of the digital radiography in detecting vertical root fractures for parallel, mesial, and distal angles was 38%, 16%, and 24%, respectively. Conclusion: According to this study, the sensitivity, specificity, and accuracy of digital radiography and CBCT were not significantly different.

Accuracy of CBCT as modality to identify the presence of secondary mesiobuccal root canal in the maxillary first molar

Introduction: Successful endodontic treatment requires the clinician to be able to locate, disinfect, and obturate all canals presence in the root canal system to remove the infection and prevent re-infection. However, some canals, such as secondary mesiobuccal (MB) root canal often missed upon examination and the treatment. The success of locating these canals is determined by the methods used, a periapical radiograph and Cone Beam Computed Tomography (CBCT). The purpose of this study was to examine the sensitivity and accuracy of the periapical radiograph (PA) and CBCT on determining the presence of the secondary MB root canal. Methods: As much as 40 intact crown and intact radicular of the maxillary first molars, without root caries, root restoration, and endodontic treated, were taken as the samples. The presence of a secondary MB root canal was evaluated by a PA radiograph, CBCT, and clinical sectioning. Samples were undergone each test and sectioned after being completed the radiographic evaluation steps. Results: CBCT radiograph was successfully identifying 62.5% secondary MB root canal presence, whilst the PA radiograph has detected only 20% of the samples. The sensitivity of CBCT and PA radiograph was compared with the gold standard method, resulting 86.2 and 27.6% respectively. The statistical analysis showed that there was no significant difference between CBCT test and the gold standard (p=0.00). Conclusion: CBCT was proven to be a reliable method to detect the presence of secondary MB root canals due to its accuracy as high as the clinical sectioning compared to the PA radiograph.

Comparison of Ultrasonography, Magnetic Resonance Imaging and Cone Beam Computed Tomography for Detection of Foreign Bodies in Maxillofacial Region.

Foreign Bodies (FBs) entrapped in the maxillofacial region have a high prevalence due to trauma and accidents. Accurate localization of FBs and verifying their type and size are critical to assist the surgeon in their fast retrieval with minimal tissue damage. To assess and compare the imaging modalities including MRI, ultrasonography and Cone Beam Computed Tomography (CBCT) for detection of different types of FBs. In this study, four types of FBs including pieces of normal glass, barium glass, wood and pebbles with equal sizes were placed randomly in two sheep heads in different locations such as upper lip, maxillary sinus and body of mandible as FBs and subjected to MRI, ultrasound and CBCT. The images were interpreted by expert observers and the data was analysed using the stata 11 software, kappa test and chi-square test. Sensitivity of CBCT, MRI and ultrasound for detecting foreign bodies was 79.19%, 20.83% and 33.33%, respectively. None of the imaging modalities could clearly visualize wooden FBs. Among different FBs, pebbles and barium glass were detected more accurately by radiographic imaging technique. The sensitivity of CBCT, ultrasound and MRI for pebbles was 100%, 33.33% and 16.67%, respectively. The sensitivity of CBCT, ultrasound and MRI for barium glass was 100%, 33.33% and 41.69%, respectively. The sensitivity of CBCT, ultrasound and MRI for wood was 33.33%, 33.33% and 16.67%, respectively. Specificity of all three imaging modalities was 100%. Diagnostic accuracy of all three imaging modalities was higher for detection of FBs in the upper lip than those in the body of mandible, and FBs in the latter location had higher detection accuracy than those in the maxillary sinus. Among the three imaging modalities, CBCT had the highest diagnostic sensitivity for the examined FBs. The highest diagnostic sensitivity was noted for pebbles and barium glass.

Detection of artificially induced vertical root fractures of different widths by cone beam computed tomography invitro and invivo.

To compare the diagnostic accuracy of cone beam computed tomography (CBCT) for the detection of artificially induced vertical root fractures (VRFs) of different widths invitro and invivo. Vertical root fractures were induced in 25 extracted nonendodontically treated single-rooted human teeth (maxillary first premolars, maxillary canines and mandibular incisors). Twenty teeth without VRFs served as a control group. CBCT scanning (3D Accuitomo 170) was performed invitro and invivo. For the invivo scanning, teeth were autoclaved, embedded into bite plates, placed in sterile plastic bags and then inserted into the mouths of volunteers. Teeth with VRFs were sectioned into axial slices and examined using a stereomicroscope to measure the widths of the VRFs. Five observers assessed the presence of VRFs using axial CBCT. Values for sensitivity, specificity, accuracy and interexaminer agreement were calculated. The accuracy, specificity and sensitivity of CBCT were significantly higher invitro than invivo for VRFs with widths 50-150μm (P<0.05). The sensitivity and accuracy of CBCT were significantly higher for the detection of VRFs with widths greater than 150μm invivo and invitro (P<0.05). The accuracy of CBCT invivo was 0.29 and 0.8 for fracture widths ranging from 50 to 150μm and wider than 150μm, respectively. No significant differences in CBCT specificity were found between VRF widths both invitro and invivo. The interexaminer reliability of the raters revealed a kappa value of 0.72, demonstrating substantial agreement. The detectability of VRFs by CBCT invitro and invivo was dependent upon fracture width. The accuracy of CBCT in detecting VRFs of 50-300μm width invivo was significantly lower compared to the invitro accuracy.

Comparison of the accuracy of cone-beam computed tomography, photostimulable phosphor imaging plate, charge coupled device, and conventional intraoral radiography in the diagnosis of internal root resorption: an in vitro study

Objective: Various radiographic methods are used to identify the internal root resorption. The aim of this study was to assess and compare the diagnostic accuracy of cone-beam computed tomography (CBCT), photostimulable phosphor (PSP) imaging plate, charge coupled device (CCD), and conventional intraoral radiography (CIR), for internal root resorption.Methods: This experimental study was conducted in Hamadan in 2012. Fifty seven carries-free anterior teeth were divided into three intervention groups of 15 teeth and one control group of 12 teeth. Teeth were split into two parts using a disk. Cavities of 0.5, 1 and 1.5 mm in depth were created in root canal of teeth to simulate internal root resorption artificially. Finally, the teeth fragments were fused. All teeth were examined with four different procedures and the results were compared with known simulated internal root resorption as the gold standard to determine the sensitivity and specificity of the procedures.Results: The sensitivity of CBCT, PSP, CCD, and CIR for diagnosis internal root resorption of 0.5 mm in depth was 93%, 73%, 60%, and 53% respectively. The sensitivity of all four procedures for diagnosis of internal root resorption with 1 and 1.5 mm in depth was the same and equal to 100%. Specificity of the four radiology procedures for diagnosis of internal root resorption of any depth was 100%, 100%, 83% and 75% respectively.Conclusion: CBCT provides the most accurate information on the depth and location of root resorption followed by the PSP and CCD respectively. Accordingly, conventional intraoral radiography was the least accurate procedure.

Comparison between cone beam computed tomography and multislice computed tomography in diagnostic accuracy of maxillofacial fractures in dried human skull: an in vitro study

The aim of this study was to compare the accuracy of cone beam computed tomography (CBCT) and multislice computed tomography (MSCT) in diagnosing factitious fractures in maxillofacial region as well as to investigate the influence of field of view (FOV) size on the interpretation of maxillofacial fractures in CBCT. Simulated fractures were created in the right and left sides of five dried human skulls using a micro-saw 20mm blade without displacement. The skulls were scanned with a spiral 16-slice MSCT scanner and a CBCT device with two FOVs (6×6, 15×15). Three observers assessed and interpreted the images judging whether fracture was present or absent. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the area under the receiver operating characteristic (ROC) curve were calculated. The sensitivity of CBCT 6×6, CBCT 15×15, and MSCT was 87.5%, 70.7%, and 49.7% and the specificity of three modalities was 91.7%, 88.0%, and 98.3%, respectively. The area under ROC curve was 0.90 (95% CI: 0.85, 0.94) for CBCT with FOV 6×6, 0.79 (95% CI: 0.75, 0.85) for CBCT with FOV 15×15, and 0.74 (95% CI: 0.69, 0.79) for MSCT. The Kappa value for interobserver agreement was highest for CBCT 6×6 among imaging modalities. CBCT with small FOV had higher diagnostic accuracy in detecting simulated maxillofacial fractures than MSCT. However, additional evidence based on in vivo studies is needed to confirm the superiority of CBCT on MSCT in diagnosis of maxillofacial traumatic fractures.

Evaluation of three imaging techniques for the detection of vertical root fractures in the absence and presence of gutta-percha root fillings

To compare the accuracy of digital radiography (DR), multidetector computed tomography (MDCT) and cone beam computed tomography (CBCT) in detecting vertical root fractures (VRF) in the absence and presence of gutta-percha root filling. The root canals of 100 extracted human single-rooted teeth were prepared and randomly divided into four groups: two experimental groups with artificially fractured root and two intact groups as controls. In one experimental and one control group, a size 40, 0.04 taper gutta-percha cone was inserted in the root canals. Then DR, MDCT and CBCT were performed and the images evaluated. Statistical analyses of sensitivity, specificity and accuracy of each imaging technique in the presence and absence of gutta-percha were calculated and compared. In the absence of gutta-percha, the specificity of DR, MDCT and CBCT was similar. CBCT was the most accurate and sensitive imaging technique (P < 0 .05). In the presence of gutta-percha, the accuracy of MDCT was higher than the other imaging techniques (P < 0.05). The sensitivity of CBCT and MDCT was significantly higher than that of DR (P < 0.05), whereas CBCT was the least specific technique. 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.