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Sample records for 3-dimensional cone-beam computed

  1. Panoramic cone beam computed tomography

    SciTech Connect

    Chang Jenghwa; Zhou Lili; Wang Song; Clifford Chao, K. S.

    2012-05-15

    Purpose: Cone-beam computed tomography (CBCT) is the main imaging tool for image-guided radiotherapy but its functionality is limited by a small imaging volume and restricted image position (imaged at the central instead of the treatment position for peripheral lesions to avoid collisions). In this paper, the authors present the concept of ''panoramic CBCT,'' which can image patients at the treatment position with an imaging volume as large as practically needed. Methods: In this novel panoramic CBCT technique, the target is scanned sequentially from multiple view angles. For each view angle, a half scan (180 deg. + {theta}{sub cone} where {theta}{sub cone} is the cone angle) is performed with the imaging panel positioned in any location along the beam path. The panoramic projection images of all views for the same gantry angle are then stitched together with the direct image stitching method (i.e., according to the reported imaging position) and full-fan, half-scan CBCT reconstruction is performed using the stitched projection images. To validate this imaging technique, the authors simulated cone-beam projection images of the Mathematical Cardiac Torso (MCAT) thorax phantom for three panoramic views. Gaps, repeated/missing columns, and different exposure levels were introduced between adjacent views to simulate imperfect image stitching due to uncertainties in imaging position or output fluctuation. A modified simultaneous algebraic reconstruction technique (modified SART) was developed to reconstruct CBCT images directly from the stitched projection images. As a gold standard, full-fan, full-scan (360 deg. gantry rotation) CBCT reconstructions were also performed using projection images of one imaging panel large enough to encompass the target. Contrast-to-noise ratio (CNR) and geometric distortion were evaluated to quantify the quality of reconstructed images. Monte Carlo simulations were performed to evaluate the effect of scattering on the image quality and

  2. Cone Beam Computed Tomography - Know its Secrets

    PubMed Central

    Kumar, Mohan; Shanavas, Muhammad; Sidappa, Ashwin; Kiran, Madhu

    2015-01-01

    Cone-beam computed tomography (CBCT) is an advanced imaging modality that has high clinical applications in the field of dentistry. CBCT proved to be a successful investigative modality that has been used for dental and maxillofacial imaging. Radiation exposure dose from CBCT is 10 times less than from conventional CT scans during maxillofacial exposure. Furthermore, CBCT is highly accurate and can provide a three-dimensional volumetric data in axial, sagittal and coronal planes. This article describes the basic technique, difference in CBCT from CT and main clinical applications of CBCT. PMID:25859112

  3. Skeletal dosimetry in cone beam computed tomography.

    PubMed

    Walters, B R B; Ding, G X; Kramer, R; Kawrakow, I

    2009-07-01

    Cone beam computed tomography (CBCT) is a relatively new patient imaging technique that has proved invaluable for treatment target verification and patient positioning during image-guided radiotherapy (IGRT). It has been shown that CBCT results in additional dose to bone that may amount to 10% of the prescribed dose. In this study, voxelized human phantoms, FAX06 (adult female) and MAX06 (adult male), are used together with phase-space data collected from a realistic model of a CBCT imager to calculate dose in the red bone marrow (RBM) and bone surface cells (BSCs), the two organs at risk within the bone spongiosa, during simulated head and neck, chest and pelvis CBCT scans. The FAX06/MAX06 phantoms model spongiosa based on micro-CT images, filling the relevant phantom voxels, which are 0.12 x 0.12 x 0.12 cm3, with 17 x 17 x 17 microm3 microvoxels to form a micromatrix of trabecular bone and bone marrow. FAX06/ MAX06 have already been implemented in an EGSnrc-based Monte Carlo code to simulate radiation transport in the phantoms; however, this study required significant modifications of the code to allow use of phase-space data from a simulated CBCT imager as a source and to allow scoring of total dose, RBM dose and BSC dose on a voxel-by-voxel basis. In simulated CBCT scans, the BSC dose is significantly greater than the dose to other organs at risk. For example, in a simulated head and neck scan, the average BSC dose is 25% higher than the average dose to eye lens (approximately 8.3 cGy), and 80% greater than the average dose to brain (5.7 cGy). Average dose to RBM, on the other hand, is typically only approximately 50% of the average BSC dose and less than the dose to other organs at risk (54% of the dose to eye lens and 76% of dose to brain in a head and neck scan). Thus, elevated dose in bone due to CBCT results in elevated BSC dose. This is potentially of concern when using CBCT in conjunction with radiotherapy treatment. PMID:19673190

  4. Skeletal dosimetry in cone beam computed tomography

    SciTech Connect

    Walters, B. R. B.; Ding, G. X.; Kramer, R.; Kawrakow, I.

    2009-07-15

    Cone beam computed tomography (CBCT) is a relatively new patient imaging technique that has proved invaluable for treatment target verification and patient positioning during image-guided radiotherapy (IGRT). It has been shown that CBCT results in additional dose to bone that may amount to 10% of the prescribed dose. In this study, voxelized human phantoms, FAX06 (adult female) and MAX06 (adult male), are used together with phase-space data collected from a realistic model of a CBCT imager to calculate dose in the red bone marrow (RBM) and bone surface cells (BSCs), the two organs at risk within the bone spongiosa, during simulated head and neck, chest and pelvis CBCT scans. The FAX06/MAX06 phantoms model spongiosa based on micro-CT images, filling the relevant phantom voxels, which are 0.12x0.12x0.12 cm{sup 3}, with 17x17x17 {mu}m{sup 3} microvoxels to form a micromatrix of trabecular bone and bone marrow. FAX06/MAX06 have already been implemented in an EGSnrc-based Monte Carlo code to simulate radiation transport in the phantoms; however, this study required significant modifications of the code to allow use of phase-space data from a simulated CBCT imager as a source and to allow scoring of total dose, RBM dose and BSC dose on a voxel-by-voxel basis. In simulated CBCT scans, the BSC dose is significantly greater than the dose to other organs at risk. For example, in a simulated head and neck scan, the average BSC dose is 25% higher than the average dose to eye lens ({approx}8.3 cGy), and 80% greater than the average dose to brain (5.7 cGy). Average dose to RBM, on the other hand, is typically only {approx}50% of the average BSC dose and less than the dose to other organs at risk (54% of the dose to eye lens and 76% of dose to brain in a head and neck scan). Thus, elevated dose in bone due to CBCT results in elevated BSC dose. This is potentially of concern when using CBCT in conjunction with radiotherapy treatment.

  5. Endodontic applications of cone beam computed tomography.

    PubMed

    McClammy, Thomas V

    2014-07-01

    Cone-beam CT (CBCT) has made a dramatic contribution and has been quickly adopted in endodontics. It is a game changer in research and clinical applications. Although CBCT and its application in implantology is well known, the surgical placement of implants is now a factor in endodontics. This article illustrates unique applications of CBCT in implantology in a specialty endodontic facility. Endodontics creates the foundation for restorative dentistry for a healthy tooth, a well-treated endodontically treated tooth, or a well-placed dental implant. CBCT helps make this possible and predictable. PMID:24993923

  6. Cone beam computed tomography in Endodontics - a review.

    PubMed

    Patel, S; Durack, C; Abella, F; Shemesh, H; Roig, M; Lemberg, K

    2015-01-01

    Cone beam computed tomography (CBCT) produces undistorted three-dimensional information of the maxillofacial skeleton, including the teeth and their surrounding tissues with a lower effective radiation dose than computed tomography. The aim of this paper is to: (i) review the current literature on the applications and limitations of CBCT; (ii) make recommendations for the use of CBCT in Endodontics; (iii) highlight areas of further research of CBCT in Endodontics. PMID:24697513

  7. Legal considerations in the use of cone beam computer tomography imaging.

    PubMed

    Zinman, Edwin J; White, Stuart C; Tetradis, Sotirios

    2010-01-01

    Cone beam computed tomography imaging represents a paradigm shift for enhancing diagnosis and treatment planning. Questions regarding cone beam computed tomography's associated legal responsibility are addressed, including cone beam computed tomography necessity, recognition of pathosis in the scan's entire volume, adequate training, informed consent and/or refusal and current court status of cone beam computed tomography. Judicious selection and prudent use of cone beam computed tomography technology to protect and promote patient safety and efficacious treatment complies with the standard of care. PMID:20178227

  8. Cone Beam Computed Tomography for the Dental Implant Patient.

    PubMed

    Klokkevold, Perry R

    2015-09-01

    Cone beam computed tomography offers many advantages over 2-D imaging for the evaluation of potential implant sites. With the use of CBCT scans becoming more commonplace, it is important for clinicians to be knowledgeable and to use this new technology appropriately and judiciously. The purpose of this article is to describe the advantages and limitations of CBCT imaging for the presurgical and postsurgical evaluations of implant treatment and assessment of implant-related complications. PMID:26820009

  9. Use of Cone Beam Computed Tomography in Endodontics

    PubMed Central

    Scarfe, William C.; Levin, Martin D.; Gane, David; Farman, Allan G.

    2009-01-01

    Cone Beam Computed Tomography (CBCT) is a diagnostic imaging modality that provides high-quality, accurate three-dimensional (3D) representations of the osseous elements of the maxillofacial skeleton. CBCT systems are available that provide small field of view images at low dose with sufficient spatial resolution for applications in endodontic diagnosis, treatment guidance, and posttreatment evaluation. This article provides a literature review and pictorial demonstration of CBCT as an imaging adjunct for endodontics. PMID:20379362

  10. Use of cone-beam computed tomography in early detection of implant failure.

    PubMed

    Yepes, Juan F; Al-Sabbagh, Mohanad

    2015-01-01

    Preimplant planning with complex imaging techniques has long been a recommended practice for assessing the quality and quantity of alveolar bone before dental implant placement. When maxillofacial imaging is necessary, static film or digital images lack the depth and dimension offered by computed tomography. Cone-beam computed tomography (CBCT) offers the dentist not only a radiographic volumetric view of alveolar bone but also a 3-dimensional reconstruction. This article reviews the use of CBCT for assessing implant placement and early detection of failure, and compares the performance of CBCT with that of other imaging modalities in the early detection of implant failure. PMID:25434558

  11. Radiological protection in computed tomography and cone beam computed tomography.

    PubMed

    Rehani, M M

    2015-06-01

    The International Commission on Radiological Protection (ICRP) has sustained interest in radiological protection in computed tomography (CT), and ICRP Publications 87 and 102 focused on the management of patient doses in CT and multi-detector CT (MDCT) respectively. ICRP forecasted and 'sounded the alarm' on increasing patient doses in CT, and recommended actions for manufacturers and users. One of the approaches was that safety is best achieved when it is built into the machine, rather than left as a matter of choice for users. In view of upcoming challenges posed by newer systems that use cone beam geometry for CT (CBCT), and their widened usage, often by untrained users, a new ICRP task group has been working on radiological protection issues in CBCT. Some of the issues identified by the task group are: lack of standardisation of dosimetry in CBCT; the false belief within the medical and dental community that CBCT is a 'light', low-dose CT whereas mobile CBCT units and newer applications, particularly C-arm CT in interventional procedures, involve higher doses; lack of training in radiological protection among clinical users; and lack of dose information and tracking in many applications. This paper provides a summary of approaches used in CT and MDCT, and preliminary information regarding work just published for radiological protection in CBCT. PMID:25816279

  12. Fundamentals of cone beam computed tomography for a prosthodontist.

    PubMed

    John, George Puthenpurayil; Joy, Tatu Elenjickal; Mathew, Justin; Kumar, Vinod R B

    2015-01-01

    Cone beam computed tomography (CBCT, also referred to as C-arm computed tomography [CT], cone beam volume CT, or flat panel CT) is a medical imaging technique of X-ray CT where the X-rays are divergent, forming a cone.[1] CBCT systems have been designed for imaging hard tissues of the maxillofacial region. CBCT is capable of providing sub-millimeter resolution in images of high diagnostic quality, with short scanning times (10-70 s) and radiation dosages reportedly up to 15-100 times lower than those of conventional CT scans. Increasing availability of this technology provides the dental clinician with an imaging modality capable of providing a three-dimensional representation of the maxillofacial skeleton with minimal distortion. The aim of this article is to sensitize the Prosthodontist to CBCT technology, provide an overview of currently available maxillofacial CBCT systems and review the specific application of various CBCT display modes to clinical Prosthodontic practice. A MEDLINE search for relevant articles in this specific area of interest was conducted. The selected articles were critically reviewed and the data acquired were systematically compiled. PMID:26929479

  13. Fundamentals of cone beam computed tomography for a prosthodontist

    PubMed Central

    John, George Puthenpurayil; Joy, Tatu Elenjickal; Mathew, Justin; Kumar, Vinod R. B.

    2015-01-01

    Cone beam computed tomography (CBCT, also referred to as C-arm computed tomography [CT], cone beam volume CT, or flat panel CT) is a medical imaging technique of X-ray CT where the X-rays are divergent, forming a cone.[1] CBCT systems have been designed for imaging hard tissues of the maxillofacial region. CBCT is capable of providing sub-millimeter resolution in images of high diagnostic quality, with short scanning times (10–70 s) and radiation dosages reportedly up to 15–100 times lower than those of conventional CT scans. Increasing availability of this technology provides the dental clinician with an imaging modality capable of providing a three-dimensional representation of the maxillofacial skeleton with minimal distortion. The aim of this article is to sensitize the Prosthodontist to CBCT technology, provide an overview of currently available maxillofacial CBCT systems and review the specific application of various CBCT display modes to clinical Prosthodontic practice. A MEDLINE search for relevant articles in this specific area of interest was conducted. The selected articles were critically reviewed and the data acquired were systematically compiled. PMID:26929479

  14. Clinical utility of dental cone-beam computed tomography: current perspectives

    PubMed Central

    Jaju, Prashant P; Jaju, Sushma P

    2014-01-01

    Panoramic radiography and computed tomography were the pillars of maxillofacial diagnosis. With the advent of cone-beam computed tomography, dental practice has seen a paradigm shift. This review article highlights the potential applications of cone-beam computed tomography in the fields of dental implantology and forensic dentistry, and its limitations in maxillofacial diagnosis. PMID:24729729

  15. Fossa navicularis magna detection on cone-beam computed tomography.

    PubMed

    Syed, Ali Z; Mupparapu, Mel

    2016-03-01

    Herein, we report and discuss the detection of fossa navicularis magna, a close radiographic anatomic variant of canalis basilaris medianus of the basiocciput, as an incidental finding in cone-beam computed tomography (CBCT) imaging. The CBCT data of the patients in question were referred for the evaluation of implant sites and to rule out pathology in the maxilla and mandible. CBCT analysis showed osseous, notch-like defects on the inferior aspect of the clivus in all four cases. The appearance of fossa navicularis magna varied among the cases. In some, it was completely within the basiocciput and mimicked a small rounded, corticated, lytic defect, whereas it appeared as a notch in others. Fossa navicularis magna is an anatomical variant that occurs on the inferior aspect of the clivus. The pertinent literature on the anatomical variations occurring in this region was reviewed. PMID:27051639

  16. Fossa navicularis magna detection on cone-beam computed tomography

    PubMed Central

    Mupparapu, Mel

    2016-01-01

    Herein, we report and discuss the detection of fossa navicularis magna, a close radiographic anatomic variant of canalis basilaris medianus of the basiocciput, as an incidental finding in cone-beam computed tomography (CBCT) imaging. The CBCT data of the patients in question were referred for the evaluation of implant sites and to rule out pathology in the maxilla and mandible. CBCT analysis showed osseous, notch-like defects on the inferior aspect of the clivus in all four cases. The appearance of fossa navicularis magna varied among the cases. In some, it was completely within the basiocciput and mimicked a small rounded, corticated, lytic defect, whereas it appeared as a notch in others. Fossa navicularis magna is an anatomical variant that occurs on the inferior aspect of the clivus. The pertinent literature on the anatomical variations occurring in this region was reviewed. PMID:27051639

  17. Applications of cone beam computed tomography for a prosthodontist.

    PubMed

    John, George Puthenpurayil; Joy, Tatu Elenjickal; Mathew, Justin; Kumar, Vinod R B

    2016-01-01

    Cone beam computed tomography (CBCT) is a medical imaging technique of X-ray computed tomography where the X-rays are divergent, forming a cone. CBCT systems have been designed for imaging hard tissues of the maxillofacial region. The increasing availability of this technology provides the dental clinician with an imaging modality capable of providing a three-dimensional representation of the maxillofacial skeleton with minimal distortion. This article is intended to elaborate and enunciate on the various applications and benefits of CBCT, in the realm of maxillofacial prosthodontics, over and beyond its obvious benefits in the rehabilitation of patients with implants. With the onus of meticulous reconstruction of near ideal occlusion resting on the prosthodontist, CBCT provides a unique imaging option, which can be a boon in various aspects of prosthodontic practice - from imaging of the temporomandibular joint for accurate movement simulation, to template assisted maxillofacial reconstruction or even over denture therapy. CBCT could play a crucial role in lessening the burden of a hectic prosthodontic routine for the clinician and critically contribute to accurate and effective treatment for the patient. Apart from the authors' clinical experiences shared here, a web-based search for relevant articles in this specific area of interest was also conducted. The selected articles were critically reviewed and the data acquired were systematically compiled. PMID:27134420

  18. Can Dental Cone Beam Computed Tomography Assess Bone Mineral Density?

    PubMed Central

    2014-01-01

    Mineral density distribution of bone tissue is altered by active bone modeling and remodeling due to bone complications including bone disease and implantation surgery. Clinical cone beam computed tomography (CBCT) has been examined whether it can assess oral bone mineral density (BMD) in patient. It has been indicated that CBCT has disadvantages of higher noise and lower contrast than conventional medical computed tomography (CT) systems. On the other hand, it has advantages of a relatively lower cost and radiation dose but higher spatial resolution. However, the reliability of CBCT based mineral density measurement has not yet been fully validated. Thus, the objectives of this review are to discuss 1) why assessment of BMD distribution is important and 2) whether the clinical CBCT can be used as a potential tool to measure the BMD. Brief descriptions of image artefacts associated with assessment of gray value, which has been used to account for mineral density, in CBCT images are provided. Techniques to correct local and conversion errors in obtaining the gray values in CBCT images are also introduced. This review can be used as a quick reference for users who may encounter these errors during analysis of CBCT images. PMID:25006568

  19. Cone Beam Computed Tomographic Assessment of Bifid Mandibular Condyle

    PubMed Central

    Khojastepour, Leila; Kolahi, Shirin; Panahi, Nazi

    2015-01-01

    Objectives: Differential diagnosis of bifid mandibular condyle (BMC) is important, since it may play a role in temporomandibular joint (TMJ) dysfunctions and joint symptoms. In addition, radiographic appearance of BMC may mimic tumors and/or fractures. The aim of this study was to evaluate the prevalence and orientation of BMC based on cone beam computed tomography (CBCT) scans. Materials and Methods: This cross-sectional study was performed on CBCT scans of paranasal sinuses of 425 patients. In a designated NNT station, all CBCT scans were evaluated in the axial, coronal and sagittal planes to find the frequency of BMC. The condylar head horizontal angulations were also determined in the transverse plane. T-test was used to compare the frequency of BMC between the left and right sides and between males and females. Results: Totally, 309 patients with acceptable visibility of condyles on CBCT scans were entered in the study consisting of 170 (55%) females and 139 (45%) males with a mean age of 39.43±9.7 years. The BMC was detected in 14 cases (4.53%). Differences between males and females, sides and horizontal angulations of condyle of normal and BMC cases were not significant. Conclusion: The prevalence of BMC in the studied population was 4.53%. No significant difference was observed between males and females, sides or horizontal angulations of the involved and uninvolved condyles.

  20. Cone-beam computed tomography findings of impacted upper canines

    PubMed Central

    Bastos, Luana Costa; Oliveira-Santos, Christiano; da Silva, Silvio José Albergaria; Neves, Frederico Sampaio; Campos, Paulo Sérgio Flores

    2014-01-01

    Purpose To describe the features of impacted upper canines and their relationship with adjacent structures through three-dimensional cone-beam computed tomography (CBCT) images. Materials and Methods Using the CBCT scans of 79 upper impacted canines, we evaluated the following parameters: gender, unilateral/bilateral occurrence, location, presence and degree of root resorption of adjacent teeth (mild, moderate, or severe), root dilaceration, dental follicle width, and presence of other associated local conditions. Results Most of the impacted canines were observed in females (56 cases), unilaterally (51 cases), and at a palatine location (53 cases). Root resorption in adjacent teeth and root dilaceration were observed in 55 and 47 impacted canines, respectively. In most of the cases, the width of the dental follicle of the canine was normal; it was abnormally wide in 20 cases. A statistically significant association was observed for all variables, except for root dilaceration (p=0.115) and the side of impaction (p=0.260). Conclusion Root resorption of adjacent teeth was present in most cases of canine impaction, mostly affecting adjacent lateral incisors to a mild degree. A wide dental follicle of impacted canines was not associated with a higher incidence of external root resorption of adjacent teeth. PMID:25473636

  1. Rare Root Canal Configuration of Bilateral Maxillary Second Molar Using Cone-beam Computed Tomographic Scanning.

    PubMed

    Zeng, Chang; Shen, Ya; Guan, Xiaoyue; Wang, Xin; Fan, Mingwen; Li, Yuhong

    2016-04-01

    The aim of this article was to present a right maxillary second molar with an unusual root canal morphology of 4 roots and 5 canals as confirmed by cone-beam computed tomographic (CBCT) imaging. The tooth had a C-shaped mesiobuccal root (CBCT imaging revealed that the root was closer to the palate than the buccal side) with 2 canals, 2 fused distobuccal roots with 2 separate canals, and 1 normal bulky palatal root with 1 canal. After thoroughly examining the rare anatomy, root canal treatment was applied on the tooth. This article shows the complexity of maxillary second molar variation and shows the significance of CBCT imaging in the confirmation of the 3-dimensional anatomy of teeth and endodontic treatment. PMID:26920931

  2. Assessment of liver ablation using cone beam computed tomography

    PubMed Central

    Abdel-Rehim, Mohamed; Ronot, Maxime; Sibert, Annie; Vilgrain, Valérie

    2015-01-01

    AIM: To investigate the feasibility and accuracy of cone beam computed tomography (CBCT) in assessing the ablation zone after liver tumor ablation. METHODS: Twenty-three patients (17 men and 6 women, range: 45-85 years old, mean age 65 years) with malignant liver tumors underwent ultrasound-guided percutaneous tumor ablation [radiofrequency (n = 14), microwave (n = 9)] followed by intravenous contrast-enhanced CBCT. Baseline multidetector computed tomography (MDCT) and peri-procedural CBCT images were compared. CBCT image quality was assessed as poor, good, or excellent. Image fusion was performed to assess tumor coverage, and quality of fusion was rated as bad, good, or excellent. Ablation zone volumes on peri-procedural CBCT and post-procedural MDCT were compared using the non-parametric paired Wilcoxon t-test. RESULTS: Rate of primary ablation effectiveness was 100%. There were no complications related to ablation. Local tumor recurrence and new liver tumors were found 3 mo after initial treatment in one patient (4%). The ablation zone was identified in 21/23 (91.3%) patients on CBCT. The fusion of baseline MDCT and peri-procedural CBCT images was feasible in all patients and showed satisfactory tumor coverage (at least 5-mm margin). CBCT image quality was poor, good, and excellent in 2 (9%), 8 (35%), and 13 (56%), patients respectively. Registration quality between peri-procedural CBCT and post-procedural MDCT images was good to excellent in 17/23 (74%) patients. The median ablation volume on peri-procedural CBCT and post-procedural MDCT was 30 cm3 (range: 4-95 cm3) and 30 cm3 (range: 4-124 cm3), respectively (P-value > 0.2). There was a good correlation (r = 0.79) between the volumes of the two techniques. CONCLUSION: Contrast-enhanced CBCT after tumor ablation of the liver allows early assessment of the ablation zone. PMID:25593467

  3. Cone-Beam Computed Tomography-Guided Percutaneous Radiologic Gastrostomy

    SciTech Connect

    Moehlenbruch, Markus; Nelles, Michael; Thomas, Daniel; Willinek, Winfried; Gerstner, Andreas; Schild, Hans H.; Wilhelm, Kai

    2010-04-15

    The purpose of this study was to investigate the feasibility of a flat-detector C-arm-guided radiographic technique (cone-beam computed tomography [CBCT]) for percutaneous radiologic gastrostomy (PRG) insertion. Eighteen patients (13 men and 5 women; mean age 62 years) in whom percutaneous endoscopic gastrostomy (PEG) had failed underwent CBCT-guided PRG insertion. PEG failure or unsuitability was caused by upper gastrointestinal tract obstruction in all cases. Indications for gastrostomy were esophageal and head and neck malignancies, respectively. Before the PRG procedure, initial C-arm CBCT scans were acquired. Three- and 2-dimensional soft-tissue reconstructions of the epigastrium region were generated on a dedicated workstation. Subsequently, gastropexy was performed with T-fasteners after CBCT-guided puncture of the stomach bubble, followed by insertion of an 14F balloon-retained catheter through a peel-away introducer. Puncture of the stomach bubble and PRG insertion was technically successful in all patients without alteration of the epigastric region. There was no malpositioning of the tube or other major periprocedural complications. In 2 patients, minor complications occurred during the first 30 days of follow-up (PRG malfunction: n = 1; slight infection: n = 1). Late complications, which were mainly tube disturbances, were observed in 2 patients. The mean follow-up time was 212 days. CBCT-guided PRG is a safe, well-tolerated, and successful method of gastrostomy insertion in patients in whom endoscopic gastrostomy is not feasible. CBCT provides detailed imaging of the soft tissue and surrounding structures of the epigastric region in one diagnostic tour and thus significantly improves the planning of PRG procedures.

  4. Radiation Exposure of Abdominal Cone Beam Computed Tomography

    SciTech Connect

    Sailer, Anna M.; Schurink, Geert Willem H.; Wildberger, Joachim E. Graaf, Rick de Zwam, Willem H. van Haan, Michiel W. de Kemerink, Gerrit J. Jeukens, Cécile R. L. P. N.

    2015-02-15

    PurposeTo evaluate patients radiation exposure of abdominal C-arm cone beam computed tomography (CBCT).MethodsThis prospective study was approved by the institutional review board; written, informed consent was waived. Radiation exposure of abdominal CBCT was evaluated in 40 patients who underwent CBCT during endovascular interventions. Dose area product (DAP) of CBCT was documented and effective dose (ED) was estimated based on organ doses using dedicated Monte Carlo simulation software with consideration of X-ray field location and patients’ individual body weight and height. Weight-dependent ED per DAP conversion factors were calculated. CBCT radiation dose was compared to radiation dose of procedural fluoroscopy. CBCT dose-related risk for cancer was assessed.ResultsMean ED of abdominal CBCT was 4.3 mSv (95 % confidence interval [CI] 3.9; 4.8 mSv, range 1.1–7.4 mSv). ED was significantly higher in the upper than in the lower abdomen (p = 0.003) and increased with patients’ weight (r = 0.55, slope = 0.045 mSv/kg, p < 0.001). Radiation exposure of CBCT corresponded to the radiation exposure of on average 7.2 fluoroscopy minutes (95 % CI 5.5; 8.8 min) in the same region of interest. Lifetime risk of exposure related cancer death was 0.033 % or less depending on age and weight.ConclusionsMean ED of abdominal CBCT was 4.3 mSv depending on X-ray field location and body weight.

  5. Cone beam computed tomography: Development of system characterization metrics and applications

    NASA Astrophysics Data System (ADS)

    Betancourt Benitez, Jose Ricardo

    Cone beam computed tomography has emerged as a promising medical imaging tool due to its short scanning time, large volume coverage and its isotropic spatial resolution in three dimensions among other characteristics. However, due to its inherent three-dimensionality, it is important to understand and characterize its physical characteristics to be able to improve its performance and extends its applications in medical imaging. One of the main components of a Cone beam computed tomography system is its flat panel detector. Its physical characteristics were evaluated in terms of spatial resolution, linearity, image lag, noise power spectrum and detective quantum efficiency. After evaluating the physical performance of the flat panel detector, metrics to evaluate the image quality of the system were developed and used to evaluate the systems image quality. Especially, the modulation transfer function and the noise power spectrum were characterized and evaluated for a PaxScan 4030CB FPD-based cone beam computed tomography system. Finally, novel applications using cone beam computed tomography images were suggested and evaluated for its practical application. For example, the characterization of breast density was evaluated and further studies were suggested that could impact the health system related to breast cancer. Another novel application was the utilization of cone beam computed tomography for orthopedic imaging. In this thesis, an initial assessment of its practical application was perform. Overall, three cone beam computed tomography systems were evaluated and utilized for different novel applications that would advance the field of medical imaging.

  6. Rotational artifacts in on-board cone beam computed tomography

    NASA Astrophysics Data System (ADS)

    Ali, E. S. M.; Webb, R.; Nyiri, B. J.

    2015-02-01

    Rotational artifacts in image guidance systems lead to registration errors that affect non-isocentric treatments and dose to off-axis organs-at-risk. This study investigates a rotational artifact in the images acquired with the on-board cone beam computed tomography system XVI (Elekta, Stockholm, Sweden). The goals of the study are to identify the cause of the artifact, to characterize its dependence on other quantities, and to investigate possible solutions. A 30 cm diameter cylindrical phantom is used to acquire clockwise and counterclockwise scans at five speeds (120 to 360 deg min-1) on six Elekta linear accelerators from three generations (MLCi, MLCi2 and Agility). Additional scans are acquired with different pulse widths and focal spot sizes for the same mAs. Image quality is evaluated using a common phantom with an in-house three dimensional contrast transfer function attachment. A robust, operator-independent analysis is developed which quantifies rotational artifacts with 0.02° accuracy and imaging system delays with 3 ms accuracy. Results show that the artifact is caused by mislabelling of the projections with a lagging angle due to various imaging system delays. For the most clinically used scan speed (360 deg min-1), the artifact is ˜0.5°, which corresponds to ˜0.25° error per scan direction with the standard Elekta procedure for angle calibration. This leads to a 0.5 mm registration error at 11 cm off-center. The artifact increases linearly with scan speed, indicating that the system delay is independent of scan speed. For the most commonly used pulse width of 40 ms, this delay is 34 ± 1 ms, part of which is half the pulse width. Results are consistent among the three linac generations. A software solution that corrects the angles of individual projections is shown to eliminate the rotational error for all scan speeds and directions. Until such a solution is available from the manufacturer, three clinical solutions are presented, which reduce the

  7. Cone beam computed tomography radiation dose and image quality assessments.

    PubMed

    Lofthag-Hansen, Sara

    2010-01-01

    Diagnostic radiology has undergone profound changes in the last 30 years. New technologies are available to the dental field, cone beam computed tomography (CBCT) as one of the most important. CBCT is a catch-all term for a technology comprising a variety of machines differing in many respects: patient positioning, volume size (FOV), radiation quality, image capturing and reconstruction, image resolution and radiation dose. When new technology is introduced one must make sure that diagnostic accuracy is better or at least as good as the one it can be expected to replace. The CBCT brand tested was two versions of Accuitomo (Morita, Japan): 3D Accuitomo with an image intensifier as detector, FOV 3 cm x 4 cm and 3D Accuitomo FPD with a flat panel detector, FOVs 4 cm x 4 cm and 6 cm x 6 cm. The 3D Accuitomo was compared with intra-oral radiography for endodontic diagnosis in 35 patients with 46 teeth analyzed, of which 41 were endodontically treated. Three observers assessed the images by consensus. The result showed that CBCT imaging was superior with a higher number of teeth diagnosed with periapical lesions (42 vs 32 teeth). When evaluating 3D Accuitomo examinations in the posterior mandible in 30 patients, visibility of marginal bone crest and mandibular canal, important anatomic structures for implant planning, was high with good observer agreement among seven observers. Radiographic techniques have to be evaluated concerning radiation dose, which requires well-defined and easy-to-use methods. Two methods: CT dose index (CTDI), prevailing method for CT units, and dose-area product (DAP) were evaluated for calculating effective dose (E) for both units. An asymmetric dose distribution was revealed when a clinical situation was simulated. Hence, the CTDI method was not applicable for these units with small FOVs. Based on DAP values from 90 patient examinations effective dose was estimated for three diagnostic tasks: implant planning in posterior mandible and

  8. Asymptomatic radiopaque lesions of the jaws: a radiographic study using cone-beam computed tomography.

    PubMed

    Araki, Masao; Matsumoto, Naoyuki; Matsumoto, Kunihito; Ohnishi, Masaaki; Honda, Kazuya; Komiyama, Kazuo

    2011-12-01

    Panoramic radiography and cone-beam computed tomography (CT) were used to analyze asymptomatic radiopaque lesions in the jaw bones and determine the diagnostic relevance of the lesions based on their relationships to teeth and site of origin. One hundred radiopaque lesions detected between 1998 and 2002 were examined by both panoramic radiography and cone-beam CT. On the basis of panoramic radiographs, the region was classified as periapical, body, or edentulous, and the site was classified as molar or premolar. Follow-up data from medical records were available for only 36 of these cases. The study protocol for simultaneous use of cone-beam CT was approved by the ethics review board of our institution. A large majority of radiopaque lesions were observed in premolar and molar sites of the mandible; 60% of lesions were periapical, 24% were in the body, and 16% were in the edentulous region. An interesting type of radiopaque lesion, which we named a pearl shell structure (PSS), was observed on cone-beam CT in 34 of the 100 lesions. The PSS is a distinctive structure, and this finding on cone-beam CT likely represents the start of bone formation before bone sclerosis. PMID:22167028

  9. Contours identification of elements in a cone beam computed tomography for investigating maxillary cysts

    NASA Astrophysics Data System (ADS)

    Chioran, Doina; Nicoarǎ, Adrian; Roşu, Şerban; Cǎrligeriu, Virgil; Ianeş, Emilia

    2013-10-01

    Digital processing of two-dimensional cone beam computer tomography slicesstarts by identification of the contour of elements within. This paper deals with the collective work of specialists in medicine and applied mathematics in computer science on elaborating and implementation of algorithms in dental 2D imagery.

  10. Quantitative cone beam X-ray luminescence tomography/X-ray computed tomography imaging

    SciTech Connect

    Chen, Dongmei; Zhu, Shouping Chen, Xueli; Chao, Tiantian; Cao, Xu; Zhao, Fengjun; Huang, Liyu; Liang, Jimin

    2014-11-10

    X-ray luminescence tomography (XLT) is an imaging technology based on X-ray-excitable materials. The main purpose of this paper is to obtain quantitative luminescence concentration using the structural information of the X-ray computed tomography (XCT) in the hybrid cone beam XLT/XCT system. A multi-wavelength luminescence cone beam XLT method with the structural a priori information is presented to relieve the severe ill-posedness problem in the cone beam XLT. The nanophosphors and phantom experiments were undertaken to access the linear relationship of the system response. Then, an in vivo mouse experiment was conducted. The in vivo experimental results show that the recovered concentration error as low as 6.67% with the location error of 0.85 mm can be achieved. The results demonstrate that the proposed method can accurately recover the nanophosphor inclusion and realize the quantitative imaging.

  11. Tetrahedron-based orthogonal simultaneous scan for cone-beam computed tomography

    PubMed Central

    Ye, Ivan B.; Wang, Ge

    2013-01-01

    In this article, a cone-beam computed tomography scanning mode is designed using four x-ray sources and a spherical sample. The x-ray sources are mounted at the vertices of a regular tetrahedron. On the circumsphere of the tetrahedron, four detection panels are mounted opposite of each vertex. To avoid x-ray interference, the largest half angle of each x-ray cone beam is 27°22′, while the radius of the largest ball fully covered by all the cone beams is 0.460, when the radius of the circumsphere is 1. A proposed scanning scheme consists of two rotations about orthogonal axes, such that, each quarter turn provides sufficient data for theoretically exact and stable reconstruction. This design can be used in biomedical or industrial settings, such as when a sequence of reconstructions of an object is desired. PMID:24058220

  12. A review of setup error in supine breast radiotherapy using cone-beam computed tomography.

    PubMed

    Batumalai, Vikneswary; Holloway, Lois; Delaney, Geoff P

    2016-01-01

    Setup error in breast radiotherapy (RT) measured with 3-dimensional cone-beam computed tomography (CBCT) is becoming more common. The purpose of this study is to review the literature relating to the magnitude of setup error in breast RT measured with CBCT. The different methods of image registration between CBCT and planning computed tomography (CT) scan were also explored. A literature search, not limited by date, was conducted using Medline and Google Scholar with the following key words: breast cancer, RT, setup error, and CBCT. This review includes studies that reported on systematic and random errors, and the methods used when registering CBCT scans with planning CT scan. A total of 11 relevant studies were identified for inclusion in this review. The average magnitude of error is generally less than 5mm across a number of studies reviewed. The common registration methods used when registering CBCT scans with planning CT scan are based on bony anatomy, soft tissue, and surgical clips. No clear relationships between the setup errors detected and methods of registration were observed from this review. Further studies are needed to assess the benefit of CBCT over electronic portal image, as CBCT remains unproven to be of wide benefit in breast RT. PMID:27311516

  13. Prevalence and Morphologic Characteristics of Ponticulus Posticus: Analysis Using Cone-Beam Computed Tomography

    PubMed Central

    Sekerci, Ahmet Ercan; Soylu, Emrah; Arikan, Mehtap Payveren; Ozcan, Gozde; Amuk, Mehmet; Kocoglu, Fatma

    2015-01-01

    Objective This study evaluated the prevalence and morphologic characteristics of ponticulus posticus (PP) by using cervical 3-dimensional (3-D) cone-beam computed tomography (CBCT) scan images. Methods This was a retrospective study conducted by selecting cervical 3-D CBCT images of 698 patients, which were examined for the presence and types of PP. Results In 257 patients, 438 PPs, complete or partial, bilateral or unilateral, were identified on the 698 cervical 3-D CBCT scans; therefore, the prevalence was 36.8%. Bilateral complete PP and partial PP were observed in 6.3% and 16.2% of subjects, respectively. There was a significant difference in the prevalence between males and females (P = .001) and between the right and left sides between males and females, but not between age groups. Conclusion Ponticulus posticus is a relatively common anomaly in this Turkish sample, which may have implications for those who perform clinical procedures on the upper cervical spine. PMID:26778928

  14. Cone-beam computed tomography: An inevitable investigation in cleidocranial dysplasia

    PubMed Central

    Gupta, Nandita S.; Gogri, Ajas A.; Kajale, Manasi M.; Kadam, Sonali G.

    2015-01-01

    Cleidocranial dysplasia is a heritable skeletal dysplasia and one of the most common features of this syndrome is multiple impacted supernumerary teeth. Cone-beam computed tomography, the most recent advancement in maxillofacial imaging, provides the clinician to view the morphology of the skull and the dentition in all three dimensions and help in treatment planning for the patient. PMID:26097368

  15. Task-driven imaging in cone-beam computed tomography

    NASA Astrophysics Data System (ADS)

    Gang, G. J.; Stayman, J. W.; Ouadah, S.; Ehtiati, T.; Siewerdsen, J. H.

    2015-03-01

    Purpose: Conventional workflow in interventional imaging often ignores a wealth of prior information of the patient anatomy and the imaging task. This work introduces a task-driven imaging framework that utilizes such information to prospectively design acquisition and reconstruction techniques for cone-beam CT (CBCT) in a manner that maximizes task-based performance in subsequent imaging procedures. Methods: The framework is employed in jointly optimizing tube current modulation, orbital tilt, and reconstruction parameters in filtered back-projection reconstruction for interventional imaging. Theoretical predictors of noise and resolution relates acquisition and reconstruction parameters to task-based detectability. Given a patient-specific prior image and specification of the imaging task, an optimization algorithm prospectively identifies the combination of imaging parameters that maximizes task-based detectability. Initial investigations were performed for a variety of imaging tasks in an elliptical phantom and an anthropomorphic head phantom. Results: Optimization of tube current modulation and view-dependent reconstruction kernel was shown to have greatest benefits for a directional task (e.g., identification of device or tissue orientation). The task-driven approach yielded techniques in which the dose and sharp kernels were concentrated in views contributing the most to the signal power associated with the imaging task. For example, detectability of a line pair detection task was improved by at least three fold compared to conventional approaches. For radially symmetric tasks, the task-driven strategy yielded results similar to a minimum variance strategy in the absence of kernel modulation. Optimization of the orbital tilt successfully avoided highly attenuating structures that can confound the imaging task by introducing noise correlations masquerading at spatial frequencies of interest. Conclusions: This work demonstrated the potential of a task

  16. Task-driven imaging in cone-beam computed tomography

    PubMed Central

    Gang, G. J.; Stayman, J. W.; Ouadah, S.; Ehtiati, T.; Siewerdsen, J. H.

    2015-01-01

    Purpose Conventional workflow in interventional imaging often ignores a wealth of prior information of the patient anatomy and the imaging task. This work introduces a task-driven imaging framework that utilizes such information to prospectively design acquisition and reconstruction techniques for cone-beam CT (CBCT) in a manner that maximizes task-based performance in subsequent imaging procedures. Methods The framework is employed in jointly optimizing tube current modulation, orbital tilt, and reconstruction parameters in filtered backprojection reconstruction for interventional imaging. Theoretical predictors of noise and resolution relates acquisition and reconstruction parameters to task-based detectability. Given a patient-specific prior image and specification of the imaging task, an optimization algorithm prospectively identifies the combination of imaging parameters that maximizes task-based detectability. Initial investigations were performed for a variety of imaging tasks in an elliptical phantom and an anthropomorphic head phantom. Results Optimization of tube current modulation and view-dependent reconstruction kernel was shown to have greatest benefits for a directional task (e.g., identification of device or tissue orientation). The task-driven approach yielded techniques in which the dose and sharp kernels were concentrated in views contributing the most to the signal power associated with the imaging task. For example, detectability of a line pair detection task was improved by at least three fold compared to conventional approaches. For radially symmetric tasks, the task-driven strategy yielded results similar to a minimum variance strategy in the absence of kernel modulation. Optimization of the orbital tilt successfully avoided highly attenuating structures that can confound the imaging task by introducing noise correlations masquerading at spatial frequencies of interest. Conclusions This work demonstrated the potential of a task

  17. Comparison of Swedish and Norwegian Use of Cone-Beam Computed Tomography: a Questionnaire Study

    PubMed Central

    Strindberg, Jerker Edén; Hol, Caroline; Torgersen, Gerald; Møystad, Anne; Nilsson, Mats; Hellén-Halme, Kristina

    2015-01-01

    ABSTRACT Objectives Cone-beam computed tomography in dentistry can be used in some countries by other dentists than specialists in radiology. The frequency of buying cone-beam computed tomography to examine patients is rapidly growing, thus knowledge of how to use it is very important. The aim was to compare the outcome of an investigation on the use of cone-beam computed tomography in Sweden with a previous Norwegian study, regarding specifically technical aspects. Material and Methods The questionnaire contained 45 questions, including 35 comparable questions to Norwegian clinics one year previous. Results were based on inter-comparison of the outcome from each of the two questionnaire studies. Results Responses rate was 71% in Sweden. There, most of cone-beam computed tomography (CBCT) examinations performed by dental nurses, while in Norway by specialists. More than two-thirds of the CBCT units had a scout image function, regularly used in both Sweden (79%) and Norway (75%). In Sweden 4% and in Norway 41% of the respondents did not wait for the report from the radiographic specialist before initiating treatment. Conclusions The bilateral comparison showed an overall similarity between the two countries. The survey gave explicit and important knowledge of the need for education and training of the whole team, since radiation dose to the patient could vary a lot for the same kind of radiographic examination. It is essential to establish quality assurance protocols with defined responsibilities in the team in order to maintain high diagnostic accuracy for all examinations when using cone-beam computed tomography for patient examinations. PMID:26904179

  18. Cone-beam computed tomography analysis of curved root canals after mechanical preparation with three nickel-titanium rotary instruments

    PubMed Central

    Elsherief, Samia M.; Zayet, Mohamed K.; Hamouda, Ibrahim M.

    2013-01-01

    Cone beam computed tomography is a 3-dimensional high resolution imaging method. The purpose of this study was to compare the effects of 3 different NiTi rotary instruments used to prepare curved root canals on the final shape of the curved canals and total amount of root canal transportation by using cone-beam computed tomography. A total of 81 mesial root canals from 42 extracted human mandibular molars, with a curvature ranging from 15 to 45 degrees, were selected. Canals were randomly divided into 3 groups of 27 each. After preparation with Protaper, Revo-S and Hero Shaper, the amount of transportation and centering ability that occurred were assessed by using cone beam computed tomography. Utilizing pre- and post-instrumentation radiographs, straightening of the canal curvatures was determined with a computer image analysis program. Canals were metrically assessed for changes (surface area, changes in curvature and transportation) during canal preparation by using software SimPlant; instrument failures were also recorded. Mean total widths and outer and inner width measurements were determined on each central canal path and differences were statistically analyzed. The results showed that all instruments maintained the original canal curvature well with no significant differences between the different files (P = 0.226). During preparation there was failure of only one file (the protaper group). In conclusion, under the conditions of this study, all instruments maintained the original canal curvature well and were safe to use. Areas of uninstrumented root canal wall were left in all regions using the various systems. PMID:23885273

  19. 3D Algebraic Iterative Reconstruction for Cone-Beam X-Ray Differential Phase-Contrast Computed Tomography

    PubMed Central

    Fu, Jian; Hu, Xinhua; Velroyen, Astrid; Bech, Martin; Jiang, Ming; Pfeiffer, Franz

    2015-01-01

    Due to the potential of compact imaging systems with magnified spatial resolution and contrast, cone-beam x-ray differential phase-contrast computed tomography (DPC-CT) has attracted significant interest. The current proposed FDK reconstruction algorithm with the Hilbert imaginary filter will induce severe cone-beam artifacts when the cone-beam angle becomes large. In this paper, we propose an algebraic iterative reconstruction (AIR) method for cone-beam DPC-CT and report its experiment results. This approach considers the reconstruction process as the optimization of a discrete representation of the object function to satisfy a system of equations that describes the cone-beam DPC-CT imaging modality. Unlike the conventional iterative algorithms for absorption-based CT, it involves the derivative operation to the forward projections of the reconstructed intermediate image to take into account the differential nature of the DPC projections. This method is based on the algebraic reconstruction technique, reconstructs the image ray by ray, and is expected to provide better derivative estimates in iterations. This work comprises a numerical study of the algorithm and its experimental verification using a dataset measured with a three-grating interferometer and a mini-focus x-ray tube source. It is shown that the proposed method can reduce the cone-beam artifacts and performs better than FDK under large cone-beam angles. This algorithm is of interest for future cone-beam DPC-CT applications. PMID:25775480

  20. Effectiveness of limited cone-beam computed tomography in the detection of horizontal root fracture.

    PubMed

    Kamburoğlu, Kivanç; Ilker Cebeci, A R; Gröndahl, Hans Göran

    2009-06-01

    To compare the diagnostic accuracy of conventional film radiography, charge coupled device (CCD) and photostimulable phosphor plate (PSP) digital images and limited cone-beam computed tomography in detecting simulated horizontal root fracture. Root fractures were created in the horizontal plane in 18 teeth by a mechanical force and fragments were relocated. Another 18 intact teeth with no horizontal root fracture served as a control group. Thirty-six teeth were placed in the respective empty maxillary anterior sockets of a human dry skull in groups three by three. Intraoral radiographs were obtained in three different vertical views by utilizing Eastman Kodak E-speed film, CCD sensor, RVG 5.0 Trophy and a PSP sensor Digora, Optime. Cone beam CT images were taken with a unit (3D Accuitomo; J Morita MFG. Corp, Kyoto, Japan). Three dental radiologists separately examined the intraoral film, PSP, CCD and cone beam CT images for the presence of horizontal root fracture. Specificity and sensitivity for each radiographic technique were calculated. Kappa statistics was used for assessing the agreement between observers. Chi-square statistics was used to determine whether there were differences between the systems. Results were considered significant at P < 0.05. Cone beam CT images revealed significantly higher sensitivities (P < 0.05) than the intraoral systems between which no significant differences were found. Specificities did not show any statistically significant differences between any of the four systems. The kappa values for inter-observer agreement between observers (four pairs) ranged between 0.82-0.90 for the 3DX evaluations and between 0.63-0.71 for the different types of intraoral images. Limited cone beam CT, outperformed the two-dimensional intraoral, conventional as well as digital, radiographic methods in detecting simulated horizontal root fracture. PMID:19583573

  1. Evaluation of the Upper Airway Morphology: The Role of Cone Beam Computed Tomography.

    PubMed

    White, Susan M; Huang, Chien-Jung; Huang, Shao-Ching; Sun, Zhengzheng; Eldredge, Jeff D; Mallya, Sanjay M

    2015-09-01

    Cone beam computed tomography (CBCT) has several applications in dentomaxillofacial diagnosis. Frequently, the imaged volume encompasses the upper airway. This article provides a systematic approach to airway analysis and the implications of the anatomic and pathologic alterations. It discusses the role of CBCT in management of obstructive sleep apnea (OSA) patients. This paper also highlights technological advances that combine CBCT imaging with computational modeling of the airway and the potential clinical applications of such technologies. PMID:26820010

  2. Comparative study of mandibular linear measurements obtained by cone beam computed tomography and digital calipers

    PubMed Central

    Tarazona-Álvarez, Pablo; Romero-Millán, Javier; Peñarrocha-Oltra, David; Fuster-Torres, María Á.; Tarazona, Beatriz

    2014-01-01

    Objectives: Cone beam computed tomography (CBCT) is an innovative dental of imaging system characterized by rapid volumetric imaging with patient exposure to a single dose of radiation. The present study was carried out to compare the linear measurements obtained with CBCT and digital caliper in 20 mandibles from human cadavers. Study design: A total of 4800 linear measurements were measured between different mandibular anatomical points with CBCT and digital caliper. The real measurements were defined as those obtained with the digital caliper. Posteriorly, the mandibles were scanned to obtain the CBCT images, with software-based measurements of the distances. Results: The measurements obtained with the digital caliper were greater. The CBCT technique underestimated distances greater than 100 mm. Conclusions: CBCT allows to obtain linear mandibular anatomical measurements equivalent to those obtained with digital caliper. The differences existing between both methods were clinically acceptable. Key words:Computed tomography, cone beam CT, accuracy, reliability, digital caliper. PMID:25136429

  3. Cone beam computed tomography and intraoral radiography for diagnosis of dental abnormalities in dogs and cats

    PubMed Central

    Silva, Luiz Antonio F.; Barriviera, Mauricio; Januário, Alessandro L.; Bezerra, Ana Cristina B.; Fioravanti, Maria Clorinda S.

    2011-01-01

    The development of veterinary dentistry has substantially improved the ability to diagnose canine and feline dental abnormalities. Consequently, examinations previously performed only on humans are now available for small animals, thus improving the diagnostic quality. This has increased the need for technical qualification of veterinary professionals and increased technological investments. This study evaluated the use of cone beam computed tomography and intraoral radiography as complementary exams for diagnosing dental abnormalities in dogs and cats. Cone beam computed tomography was provided faster image acquisition with high image quality, was associated with low ionizing radiation levels, enabled image editing, and reduced the exam duration. Our results showed that radiography was an effective method for dental radiographic examination with low cost and fast execution times, and can be performed during surgical procedures. PMID:22122905

  4. Cracked Tooth: A Report of Two Cases and Role of Cone Beam Computed Tomography in Diagnosis

    PubMed Central

    Kalyan Chakravarthy, Pishipati Vinayak; Telang, Lahari Ajay; Nerali, Jayashri; Telang, Ajay

    2012-01-01

    Cracked tooth is a distinct type of longitudinal tooth fracture which occurs very commonly and its diagnosis can be challenging. This type of fracture tends to grow and change over time. Clinical diagnosis is difficult because the signs and symptoms are variable or nonspecific and may even resemble post-treatment disease following root canal treatment or periodontal disease. This variety and unpredictability make the cracked tooth a challenging diagnostic entity. The use of cone beam computed tomography (CBCT) in diagnosis of complex endodontic cases has been well documented in the literature. In this paper we present two cases of cracked tooth and emphasise on the timely use of cone beam computed tomography as an aid in diagnosis and as a prognostic determinant. PMID:23198164

  5. C-arm cone-beam computed tomography in interventional oncology: technical aspects and clinical applications

    PubMed Central

    Floridi, Chiara; Radaelli, Alessandro; Abi-Jaoudeh, Nadine; Grass, Micheal; Lin, Ming De; Chiaradia, Melanie; Geschwind, Jean-Francois; Kobeiter, Hishman; Squillaci, Ettore; Maleux, Geert; Giovagnoni, Andrea; Brunese, Luca; Wood, Bradford; Carrafiello, Gianpaolo; Rotondo, Antonio

    2014-01-01

    C-arm cone-beam computed tomography (CBCT) is a new imaging technology integrated in modern angiographic systems. Due to its ability to obtain cross-sectional imaging and the possibility to use dedicated planning and navigation software, it provides an informed platform for interventional oncology procedures. In this paper, we highlight the technical aspects and clinical applications of CBCT imaging and navigation in the most common loco-regional oncological treatments. PMID:25012472

  6. History of imaging in orthodontics from Broadbent to cone-beam computed tomography.

    PubMed

    Hans, Mark G; Palomo, J Martin; Valiathan, Manish

    2015-12-01

    The history of imaging and orthodontics is a story of technology informing biology. Advances in imaging changed our thinking as our understanding of craniofacial growth and the impact of orthodontic treatment deepened. This article traces the history of imaging in orthodontics from the invention of the cephalometer by B. Holly Broadbent in 1930 to the introduction of low-cost, low-radiation-dose cone-beam computed tomography imaging in 2015. PMID:26672697

  7. Evidence and Professional Guidelines for Appropriate Use of Cone Beam Computed Tomography.

    PubMed

    Mallya, Sanjay M

    2015-09-01

    Cone beam computed tomography (CBCT) has applications in several aspects of dentistry. To appropriately use this technology, clinicians should be able to identify those situations where the information from CBCT is likely to provide useful information, and where this additional information translates into enhanced diagnoses, treatment plans and treatment outcomes. This article summarizes current evidence and recommendations from professional societies that guide safe and effective use of this technology for enhanced patient care. PMID:26820008

  8. The Applications of Cone-Beam Computed Tomography in Endodontics: A Review of Literature

    PubMed Central

    Kiarudi, Amir Hosein; Eghbal, Mohammad Jafar; Safi, Yaser; Aghdasi, Mohammad Mehdi; Fazlyab, Mahta

    2015-01-01

    By producing undistorted three-dimensional images of the area under examination, cone-beam computed tomography (CBCT) systems have met many of the limitations of conventional radiography. These systems produce images with small field of view at low radiation doses with adequate spatial resolution that are suitable for many applications in endodontics from diagnosis to treatment and follow-up. This review article comprehensively assembles all the data from literature regarding the potential applications of CBCT in endodontics. PMID:25598804

  9. CoBRA: Cone beam Computed Tomography (CT) reconstruction code in Interactive Data Language (IDL)

    SciTech Connect

    Sheats, M.J.; Stupin, D.M.

    1997-10-01

    In support of stockpile stewardship and other important missions, Los Alamos is continually looking for fast and effective ways of inspecting and evaluating industrial parts. Thus, Los Alamos is continually striving to improve our radiography and computed tomography (CT) capabilities. Cormack and Hounsfield received the Nobel Prize in 1979 for their pioneering work in computed tomography that led to the development of medical scanners. Copley et al. provides a good history of the development of industrial CT systems. The early systems collect data via a single detector or linear detector array. While CT offers greatly increased spatial resolutions over radiography, CT inspections with a linear array are slow and costly. To improve the viability of CT for NDT applications, Feldkamp, Davis, and Kress reported a cone beam reconstruction technique that speeds up the CT process by using image data rather than data collected by a linear array. Because it potentially offers processing speeds up to 10 times faster than CT systems that use a linear array, we are building a cone beam CT for use with our 20 MV x-ray source and Los Alamos Neutron Science Center (LANSCE) neutron sources. Our software, called CoBRA, is a portable cone beam reconstruction code for CT applications that efficiently and rapidly reconstructs large data sets. CoBRA applications include both x-ray and neutron inspections using x-ray phosphor screens coupled to either a CCD camera or flat-panel amorphous silicon arrays. Photographs of two amorphous silicon arrays.

  10. Measurement of breast tissue composition with dual energy cone-beam computed tomography: A postmortem study

    SciTech Connect

    Ding Huanjun; Ducote, Justin L.; Molloi, Sabee

    2013-06-15

    Purpose: To investigate the feasibility of a three-material compositional measurement of water, lipid, and protein content of breast tissue with dual kVp cone-beam computed tomography (CT) for diagnostic purposes. Methods: Simulations were performed on a flat panel-based computed tomography system with a dual kVp technique in order to guide the selection of experimental acquisition parameters. The expected errors induced by using the proposed calibration materials were also estimated by simulation. Twenty pairs of postmortem breast samples were imaged with a flat-panel based dual kVp cone-beam CT system, followed by image-based material decomposition using calibration data obtained from a three-material phantom consisting of water, vegetable oil, and polyoxymethylene plastic. The tissue samples were then chemically decomposed into their respective water, lipid, and protein contents after imaging to allow direct comparison with data from dual energy decomposition. Results: Guided by results from simulation, the beam energies for the dual kVp cone-beam CT system were selected to be 50 and 120 kVp with the mean glandular dose divided equally between each exposure. The simulation also suggested that the use of polyoxymethylene as the calibration material for the measurement of pure protein may introduce an error of -11.0%. However, the tissue decomposition experiments, which employed a calibration phantom made out of water, oil, and polyoxymethylene, exhibited strong correlation with data from the chemical analysis. The average root-mean-square percentage error for water, lipid, and protein contents was 3.58% as compared with chemical analysis. Conclusions: The results of this study suggest that the water, lipid, and protein contents can be accurately measured using dual kVp cone-beam CT. The tissue compositional information may improve the sensitivity and specificity for breast cancer diagnosis.

  11. Measurement of breast tissue composition with dual energy cone-beam computed tomography: A postmortem study

    PubMed Central

    Ding, Huanjun; Ducote, Justin L.; Molloi, Sabee

    2013-01-01

    Purpose: To investigate the feasibility of a three-material compositional measurement of water, lipid, and protein content of breast tissue with dual kVp cone-beam computed tomography (CT) for diagnostic purposes. Methods: Simulations were performed on a flat panel-based computed tomography system with a dual kVp technique in order to guide the selection of experimental acquisition parameters. The expected errors induced by using the proposed calibration materials were also estimated by simulation. Twenty pairs of postmortem breast samples were imaged with a flat-panel based dual kVp cone-beam CT system, followed by image-based material decomposition using calibration data obtained from a three-material phantom consisting of water, vegetable oil, and polyoxymethylene plastic. The tissue samples were then chemically decomposed into their respective water, lipid, and protein contents after imaging to allow direct comparison with data from dual energy decomposition. Results: Guided by results from simulation, the beam energies for the dual kVp cone-beam CT system were selected to be 50 and 120 kVp with the mean glandular dose divided equally between each exposure. The simulation also suggested that the use of polyoxymethylene as the calibration material for the measurement of pure protein may introduce an error of −11.0%. However, the tissue decomposition experiments, which employed a calibration phantom made out of water, oil, and polyoxymethylene, exhibited strong correlation with data from the chemical analysis. The average root-mean-square percentage error for water, lipid, and protein contents was 3.58% as compared with chemical analysis. Conclusions: The results of this study suggest that the water, lipid, and protein contents can be accurately measured using dual kVp cone-beam CT. The tissue compositional information may improve the sensitivity and specificity for breast cancer diagnosis. PMID:23718593

  12. Liabilities and risks of using cone beam computed tomography.

    PubMed

    Friedland, Bernard; Miles, Dale A

    2014-07-01

    The use of conebeam computed tomography (CBCT) carries with it medicolegal risks of which the practitioner should be aware. These include licensing and malpractice liability concerns. A practitioner who intends to take and/or use CBCT scans should seek advice from his malpractice carrier before doing so. All scans should be read by someone competent to interpret them. Using the services of an out-of-state radiologist to read scans poses its own set of risks. Consultation with a malpractice carrier and dental boards is advisable in this situation. PMID:24993928

  13. X-ray cone-beam computed tomography: principles, applications, challenges and solutions

    NASA Astrophysics Data System (ADS)

    Noo, Frederic

    2010-03-01

    In the nineties, x-ray computed tomography, commonly referred to as CT, seemed to be on the track to become old technology, bound to be replaced by more sophisticated techniques such as magnetic resonance imaging, due in particular to the harmful effects of x-ray radiation exposure. Yet, the new century brought with it new technology that allowed a complete change in trends and re-affirmed CT as an essential tool in radiology. For instance, the popularity of CT in 2007 was such that approximately 68.7 million CT examinations were performed in the United States, which was nearly 2.5 times the number of magnetic resonance (MRI) examinations. More than that, CT has expanded beyond its conventional diagnostic role; CT is now used routinely in interventional radiology and also in radiation therapy treatment. The technology advances that allowed the revival of CT are those that made fast, accurate cone-beam data acquisition possible. Nowadays, cone-beam data acquisition allows scanning large volumes with isotropic sub-millimeter spatial resolution in a very fast time, which can be as short as 500ms for cardiac imaging. The principles of cone-beam imaging will be first reviewed. Then a discussion of its applications will be given. Old and new challenges will be presented along the way with current solutions.

  14. Phantom dosimetry and image quality of i-CAT FLX cone-beam computed tomography

    PubMed Central

    Ludlow, John B.; Walker, Cameron

    2013-01-01

    Introduction Increasing use of cone-beam computed tomography in orthodontics has been coupled with heightened concern with the long-term risks of x-ray exposure in orthodontic populations. An industry response to this has been to offer low-exposure alternative scanning options in newer cone-beam computed tomography models. Methods Effective doses resulting from various combinations of field size, and field location comparing child and adult anthropomorphic phantoms using the recently introduced i-CAT FLX cone-beam computed tomography unit were measured with Optical Stimulated Dosimetry using previously validated protocols. Scan protocols included High Resolution (360° rotation, 600 image frames, 120 kVp, 5 mA, 7.4 sec), Standard (360°, 300 frames, 120 kVp, 5 mA, 3.7 sec), QuickScan (180°, 160 frames, 120 kVp, 5 mA, 2 sec) and QuickScan+ (180°, 160 frames, 90 kVp, 3 mA, 2 sec). Contrast-to-noise ratio (CNR) was calculated as a quantitative measure of image quality for the various exposure options using the QUART DVT phantom. Results Child phantom doses were on average 36% greater than Adult phantom doses. QuickScan+ protocols resulted in significantly lower doses than Standard protocols for child (p=0.0167) and adult (p=0.0055) phantoms. 13×16 cm cephalometric fields of view ranged from 11–85 μSv in the adult phantom and 18–120 μSv in the child for QuickScan+ and Standard protocols respectively. CNR was reduced by approximately 2/3rds comparing QuickScan+ to Standard exposure parameters. Conclusions QuickScan+ effective doses are comparable to conventional panoramic examinations. Significant dose reductions are accompanied by significant reductions in image quality. However, this trade-off may be acceptable for certain diagnostic tasks such as interim assessment of treatment results. PMID:24286904

  15. Florid cemento-osseous dysplasia: A rare case report evaluated with cone-beam computed tomography.

    PubMed

    Yildirim, Eren; Bağlar, Serdar; Ciftci, Mehmet Ertugrul; Ozcan, Erdal

    2016-01-01

    A 29-year-old systemically healthy female patient presented to our department. Cone-beam computed tomographic images showed multiple well-defined sclerotic masses with radiolucent border in both right and left molar regions of the mandible. These sclerotic masses were surrounded by a thin radiolucent border. We diagnosed the present pathology as florid cemento-osseous dysplasia and decided to follow the patient without taking biopsy. For the patient, who did not have any clinical complaints, radiographic followupis recommended twice a year. The responsibility of the dentist is to ensure the follow-up of the diagnosed patients and take necessary measures for preventing the infections. PMID:27601835

  16. Florid cemento-osseous dysplasia: A rare case report evaluated with cone-beam computed tomography

    PubMed Central

    Yildirim, Eren; Bağlar, Serdar; Ciftci, Mehmet Ertugrul; Ozcan, Erdal

    2016-01-01

    A 29-year-old systemically healthy female patient presented to our department. Cone-beam computed tomographic images showed multiple well-defined sclerotic masses with radiolucent border in both right and left molar regions of the mandible. These sclerotic masses were surrounded by a thin radiolucent border. We diagnosed the present pathology as florid cemento-osseous dysplasia and decided to follow the patient without taking biopsy. For the patient, who did not have any clinical complaints, radiographic followupis recommended twice a year. The responsibility of the dentist is to ensure the follow-up of the diagnosed patients and take necessary measures for preventing the infections. PMID:27601835

  17. Cone beam computed tomography aided diagnosis and treatment of endodontic cases: Critical analysis

    PubMed Central

    Yılmaz, Funda; Kamburoglu, Kıvanç; Yeta, Naz Yakar; Öztan, Meltem Dartar

    2016-01-01

    Although intraoral radiographs still remain the imaging method of choice for the evaluation of endodontic patients, in recent years, the utilization of cone beam computed tomography (CBCT) in endodontics showed a significant jump. This case series presentation shows the importance of CBCT aided diagnosis and treatment of complex endodontic cases such as; root resorption, missed extra canal, fusion, oblique root fracture, non-diagnosed periapical pathology and horizontal root fracture. CBCT may be a useful diagnostic method in several endodontic cases where intraoral radiography and clinical examination alone are unable to provide sufficient information. PMID:27551342

  18. Cone-beam computed tomography: Time to move from ALARA to ALADA

    PubMed Central

    Jaju, Sushma P.

    2015-01-01

    Cone-beam computed tomography (CBCT) is routinely recommended for dental diagnosis and treatment planning. CBCT exposes patients to less radiation than does conventional CT. Still, lack of proper education among dentists and specialists is resulting in improper referral for CBCT. In addition, aiming to generate high-quality images, operators may increase the radiation dose, which can expose the patient to unnecessary risk. This letter advocates appropriate radiation dosing during CBCT to the benefit of both patients and dentists, and supports moving from the concept of "as low as reasonably achievable" (ALARA) to "as low as diagnostically acceptable" (ALADA). PMID:26730375

  19. Cone-beam computed tomography: Time to move from ALARA to ALADA.

    PubMed

    Jaju, Prashant P; Jaju, Sushma P

    2015-12-01

    Cone-beam computed tomography (CBCT) is routinely recommended for dental diagnosis and treatment planning. CBCT exposes patients to less radiation than does conventional CT. Still, lack of proper education among dentists and specialists is resulting in improper referral for CBCT. In addition, aiming to generate high-quality images, operators may increase the radiation dose, which can expose the patient to unnecessary risk. This letter advocates appropriate radiation dosing during CBCT to the benefit of both patients and dentists, and supports moving from the concept of "as low as reasonably achievable" (ALARA) to "as low as diagnostically acceptable" (ALADA). PMID:26730375

  20. Cone beam computed tomography aided diagnosis and treatment of endodontic cases: Critical analysis.

    PubMed

    Yılmaz, Funda; Kamburoglu, Kıvanç; Yeta, Naz Yakar; Öztan, Meltem Dartar

    2016-07-28

    Although intraoral radiographs still remain the imaging method of choice for the evaluation of endodontic patients, in recent years, the utilization of cone beam computed tomography (CBCT) in endodontics showed a significant jump. This case series presentation shows the importance of CBCT aided diagnosis and treatment of complex endodontic cases such as; root resorption, missed extra canal, fusion, oblique root fracture, non-diagnosed periapical pathology and horizontal root fracture. CBCT may be a useful diagnostic method in several endodontic cases where intraoral radiography and clinical examination alone are unable to provide sufficient information. PMID:27551342

  1. Stray light in cone beam optical computed tomography: II. Reduction using a convergent light source

    NASA Astrophysics Data System (ADS)

    Dekker, Kurtis H.; Battista, Jerry J.; Jordan, Kevin J.

    2016-04-01

    Optical cone beam computed tomography (CBCT) using a broad beam and CCD camera is a fast method for densitometry of 3D optical gel dosimeters. However, diffuse light sources introduce considerable stray light into the imaging system, leading to underestimation of attenuation coefficients and non-uniformities in CT images unless corrections are applied to each projection image. In this study, the light source of a commercial optical CT scanner is replaced with a convergent cone beam source consisting of almost exclusively image forming primary rays. The convergent source is achieved using a small isotropic source and a Fresnel lens. To characterize stray light effects, full-field cone beam CT imaging is compared to fan beam CT (FBCT) using a 1 cm high fan beam aperture centered on the optic axis of the system. Attenuating liquids are scanned within a large 96 mm diameter uniform phantom and in a small 13.5 mm diameter finger phantom. For the uniform phantom, cone and fan beam CT attenuation coefficients agree within a maximum deviation of (1  ±  2)% between mean values over a wide range from 0.036 to 0.43 cm-1. For the finger phantom, agreement is found with a maximum deviation of (4  ±  2)% between mean values over a range of 0.1-0.47 cm-1. With the convergent source, artifacts associated with refractive index mismatch and vessel optical features are more pronounced. Further optimization of the source size to achieve a balance between quantitative accuracy and artifact reduction should enable practical, accurate 3D dosimetry, avoiding time consuming 3D scatter measurements.

  2. Stray light in cone beam optical computed tomography: II. Reduction using a convergent light source.

    PubMed

    Dekker, Kurtis H; Battista, Jerry J; Jordan, Kevin J

    2016-04-01

    Optical cone beam computed tomography (CBCT) using a broad beam and CCD camera is a fast method for densitometry of 3D optical gel dosimeters. However, diffuse light sources introduce considerable stray light into the imaging system, leading to underestimation of attenuation coefficients and non-uniformities in CT images unless corrections are applied to each projection image. In this study, the light source of a commercial optical CT scanner is replaced with a convergent cone beam source consisting of almost exclusively image forming primary rays. The convergent source is achieved using a small isotropic source and a Fresnel lens. To characterize stray light effects, full-field cone beam CT imaging is compared to fan beam CT (FBCT) using a 1 cm high fan beam aperture centered on the optic axis of the system. Attenuating liquids are scanned within a large 96 mm diameter uniform phantom and in a small 13.5 mm diameter finger phantom. For the uniform phantom, cone and fan beam CT attenuation coefficients agree within a maximum deviation of (1  ±  2)% between mean values over a wide range from 0.036 to 0.43 cm(-1). For the finger phantom, agreement is found with a maximum deviation of (4  ±  2)% between mean values over a range of 0.1-0.47 cm(-1). With the convergent source, artifacts associated with refractive index mismatch and vessel optical features are more pronounced. Further optimization of the source size to achieve a balance between quantitative accuracy and artifact reduction should enable practical, accurate 3D dosimetry, avoiding time consuming 3D scatter measurements. PMID:26988107

  3. Cone Beam Computed Tomography Image Guidance System for a Dedicated Intracranial Radiosurgery Treatment Unit

    SciTech Connect

    Ruschin, Mark; Radiation Medicine Program, Princess Margaret Hospital, Toronto, Ontario ; Komljenovic, Philip T.; Ansell, Steve; Menard, Cynthia; Radiation Medicine Program, Princess Margaret Hospital, Toronto, Ontario ; Bootsma, Gregory; Cho, Young-Bin; Chung, Caroline; Jaffray, David; Radiation Medicine Program, Princess Margaret Hospital, Toronto, Ontario

    2013-01-01

    Purpose: Image guidance has improved the precision of fractionated radiation treatment delivery on linear accelerators. Precise radiation delivery is particularly critical when high doses are delivered to complex shapes with steep dose gradients near critical structures, as is the case for intracranial radiosurgery. To reduce potential geometric uncertainties, a cone beam computed tomography (CT) image guidance system was developed in-house to generate high-resolution images of the head at the time of treatment, using a dedicated radiosurgery unit. The performance and initial clinical use of this imaging system are described. Methods and Materials: A kilovoltage cone beam CT system was integrated with a Leksell Gamma Knife Perfexion radiosurgery unit. The X-ray tube and flat-panel detector are mounted on a translational arm, which is parked above the treatment unit when not in use. Upon descent, a rotational axis provides 210 Degree-Sign of rotation for cone beam CT scans. Mechanical integrity of the system was evaluated over a 6-month period. Subsequent clinical commissioning included end-to-end testing of targeting performance and subjective image quality performance in phantoms. The system has been used to image 2 patients, 1 of whom received single-fraction radiosurgery and 1 who received 3 fractions, using a relocatable head frame. Results: Images of phantoms demonstrated soft tissue contrast visibility and submillimeter spatial resolution. A contrast difference of 35 HU was easily detected at a calibration dose of 1.2 cGy (center of head phantom). The shape of the mechanical flex vs scan angle was highly reproducible and exhibited <0.2 mm peak-to-peak variation. With a 0.5-mm voxel pitch, the maximum targeting error was 0.4 mm. Images of 2 patients were analyzed offline and submillimeter agreement was confirmed with conventional frame. Conclusions: A cone beam CT image guidance system was successfully adapted to a radiosurgery unit. The system is capable of

  4. Scattering-compensated cone beam x-ray luminescence computed tomography

    NASA Astrophysics Data System (ADS)

    Gao, Peng; Rong, Junyan; Pu, Huangsheng; Liu, Wenlei; Liao, Qimei; Lu, Hongbing

    2016-04-01

    X-ray luminescence computed tomography (XLCT) opens new possibilities to perform molecular imaging with x-ray. It is a dual modality imaging technique based on the principle that some nanophosphors can emit near-infrared (NIR) light when excited by x-rays. The x-ray scattering effect is a great issue in both CT and XLCT reconstruction. It has been shown that if the scattering effect compensated, the reconstruction average relative error can be reduced from 40% to 12% in the in the pencil beam XLCT. However, the scattering effect in the cone beam XLCT has not been proved. To verify and reduce the scattering effect, we proposed scattering-compensated cone beam x-ray luminescence computed tomography using an added leading to prevent the spare x-ray outside the irradiated phantom in order to decrease the scattering effect. Phantom experiments of two tubes filled with Y2O3:Eu3+ indicated that the proposed method could reduce the scattering by a degree of 30% and can reduce the location error from 1.8mm to 1.2mm. Hence, the proposed method was feasible to the general case and actual experiments and it is easy to implement.

  5. Comparative study of a low-Z cone-beam computed tomography system

    NASA Astrophysics Data System (ADS)

    Roberts, D. A.; Hansen, V. N.; Thompson, M. G.; Poludniowski, G.; Niven, A.; Seco, J.; Evans, P. M.

    2011-07-01

    Computed tomography images have been acquired using an experimental (low atomic number (Z) insert) megavoltage cone-beam imaging system. These images have been compared with standard megavoltage and kilovoltage imaging systems. The experimental system requires a simple modification to the 4 MeV electron beam from an Elekta Precise linac. Low-energy photons are produced in the standard medium-Z electron window and a low-Z carbon electron absorber located after the window. The carbon electron absorber produces photons as well as ensuring that all remaining electrons from the source are removed. A detector sensitive to diagnostic x-ray energies is also employed. Quantitative assessment of cone-beam computed tomography (CBCT) contrast shows that the low-Z imaging system is an order of magnitude or more superior to a standard 6 MV imaging system. CBCT data with the same contrast-to-noise ratio as a kilovoltage imaging system (0.15 cGy) can be obtained in doses of 11 and 244 cGy for the experimental and standard 6 MV systems, respectively. Whilst these doses are high for everyday imaging, qualitative images indicate that kilovoltage like images suitable for patient positioning can be acquired in radiation doses of 1-8 cGy with the experimental low-Z system.

  6. Planar cone-beam computed tomography with a flat-panel detector

    NASA Astrophysics Data System (ADS)

    Kim, S. H.; Kim, D. W.; Youn, H.; Kim, D.; Kam, S.; Jeon, H.; Kim, H. K.

    2015-12-01

    For a dedicated x-ray inspection of printed-circuit boards (PCBs), a bench-top planar cone-beam computed tomography (pCT) system with a flat-panel detector has been built in the laboratory. The system adopts the tomosynthesis technique that can produce cross-sectional images parallel to the axis of rotation for a limited angular range. For the optimal operation of the system and further improvement in the next design, we have evaluated imaging performances, such as modulation-transfer function, noise-power spectrum, and noise-equivalent number of quanta. The performances are comparatively evaluated with the coventional cone-beam CT (CBCT) acquisition for various scanning angular ranges, applied tube voltages, and geometrical magnification factors. The pCT scan shows a poorer noise performance than the conventional CBCT scan because of less number of projection views used for reconstruction. However, the pCT shows a better spatial-resolution performance than the CBCT. Because the image noise can be compensated by an elevated exposure level during scanning, the pCT can be a useful modality for the PCB inspection that requires higher spatial-resolution performance.

  7. In Vitro Detection of Dental Root Fractures with Cone Beam Computed Tomography (CBCT)

    PubMed Central

    Fisekcioglu, Erdogan; Dolekoglu, Semanur; Ilguy, Mehmet; Ersan, Nilufer; Ilguy, Dilhan

    2014-01-01

    Background: Since the diagnosis of non-displaced longitudinal fractures present difficulties for the dentist, three-dimensional evaluation is necessary. Objectives: The aim of this study is to demonstrate the accuracy of cone beam computed tomography (CBCT) in detecting dental root fractures in vitro. Materials and Methods: An in vitro model consisting of 210 recently extracted human mandibular teeth was used. Root fractures were created by mechanical force. The teeth were placed randomly in the empty dental alveoli of a dry human mandible and 15 different dental arcs were created. Images were taken with a unit Iluma ultra cone-beam CT scanner (Imtec Corporation, Germany). Three dental radiologists separately evaluated the images. Results: According to the fracture types and fracture presence, there was an overall statistically significant agreement between the key and readings. Kappa values for intra observer agreement ranged between 0.705 and 0.804 indicating that each observer gave acceptable ratings for the type and presence of fractures. Conclusions: Detailed information about root fractures may be obtained using CBCT. PMID:24693295

  8. Iterative image reconstruction for limited-angle inverse helical cone-beam computed tomography.

    PubMed

    Yu, Wei; Zeng, Li

    2016-01-01

    Helical trajectory satisfying the condition of exact reconstruction, has been widely utilized in the commercial computed tomography (CT). While limited by the scanning environment in some practical applications, the conventional helical cone-beam CT imaging is hard to complete, thus, developing an imaging system suited for long-object may be valuable. Three-dimensional C-arm CT is an innovative imaging technique which has been greatly concerned. Since there is a high degree of freedom of C-arm, more flexible image acquisition trajectories for 3D imaging can be achieved. In this work, a fast iterative reconstruction algorithm based on total variation minimization is developed for a trajectory of limited-angle inverse helical cone-beam CT, which can be applied to detect long-object without slip-ring technology. The experimental results show that the developed algorithm can yield reconstructed images of low noise level and high image quality. SCANNING 38:4-13, 2016. © 2015 Wiley Periodicals, Inc. PMID:26130367

  9. Accurate technique for complete geometric calibration of cone-beam computed tomography systems.

    PubMed

    Cho, Youngbin; Moseley, Douglas J; Siewerdsen, Jeffrey H; Jaffray, David A

    2005-04-01

    Cone-beam computed tomography systems have been developed to provide in situ imaging for the purpose of guiding radiation therapy. Clinical systems have been constructed using this approach, a clinical linear accelerator (Elekta Synergy RP) and an iso-centric C-arm. Geometric calibration involves the estimation of a set of parameters that describes the geometry of such systems, and is essential for accurate image reconstruction. We have developed a general analytic algorithm and corresponding calibration phantom for estimating these geometric parameters in cone-beam computed tomography (CT) systems. The performance of the calibration algorithm is evaluated and its application is discussed. The algorithm makes use of a calibration phantom to estimate the geometric parameters of the system. The phantom consists of 24 steel ball bearings (BBs) in a known geometry. Twelve BBs are spaced evenly at 30 deg in two plane-parallel circles separated by a given distance along the tube axis. The detector (e.g., a flat panel detector) is assumed to have no spatial distortion. The method estimates geometric parameters including the position of the x-ray source, position, and rotation of the detector, and gantry angle, and can describe complex source-detector trajectories. The accuracy and sensitivity of the calibration algorithm was analyzed. The calibration algorithm estimates geometric parameters in a high level of accuracy such that the quality of CT reconstruction is not degraded by the error of estimation. Sensitivity analysis shows uncertainty of 0.01 degrees (around beam direction) to 0.3 degrees (normal to the beam direction) in rotation, and 0.2 mm (orthogonal to the beam direction) to 4.9 mm (beam direction) in position for the medical linear accelerator geometry. Experimental measurements using a laboratory bench Cone-beam CT system of known geometry demonstrate the sensitivity of the method in detecting small changes in the imaging geometry with an uncertainty of 0

  10. Cone Beam Computed Tomography (CBCT) in the Field of Interventional Oncology of the Liver.

    PubMed

    Bapst, Blanche; Lagadec, Matthieu; Breguet, Romain; Vilgrain, Valérie; Ronot, Maxime

    2016-01-01

    Cone beam computed tomography (CBCT) is an imaging modality that provides computed tomographic images using a rotational C-arm equipped with a flat panel detector as part of the Angiography suite. The aim of this technique is to provide additional information to conventional 2D imaging to improve the performance of interventional liver oncology procedures (intraarterial treatments such as chemoembolization or selective internal radiation therapy, and percutaneous tumor ablation). CBCT provides accurate tumor detection and targeting, periprocedural guidance, and post-procedural evaluation of treatment success. This technique can be performed during intraarterial or intravenous contrast agent administration with various acquisition protocols to highlight liver tumors, liver vessels, or the liver parenchyma. The purpose of this review is to present an extensive overview of published data on CBCT in interventional oncology of the liver, for both percutaneous ablation and intraarterial procedures. PMID:26178776

  11. Patient radiation dose and protection from cone-beam computed tomography

    PubMed Central

    2013-01-01

    After over one decade development, cone beam computed tomography (CBCT) has been widely accepted for clinical application in almost every field of dentistry. Meanwhile, the radiation dose of CBCT to patient has also caused broad concern. According to the literature, the effective radiation doses of CBCTs in nowadays market fall into a considerably wide range that is from 19 µSv to 1073 µSv and closely related to the imaging detector, field of view, and voxel sizes used for scanning. To deeply understand the potential risk from CBCT, this report also reviewed the effective doses from literatures on intra-oral radiograph, panoramic radiograph, lateral and posteroanterior cephalometric radiograph, multi-slice CT, and so on. The protection effect of thyroid collar and leaded glasses were also reviewed. PMID:23807928

  12. Multiple idiopathic external and internal resorption: Case report with cone-beam computed tomography findings

    PubMed Central

    Uzuntas, Ceren Feriha; Kurt, Hakan

    2014-01-01

    Root resorption is loss of dental hard tissue as a result of clastic activities. The dental hard tissue of permanent teeth does not normally undergo resorption, except in cases of inflammation or trauma. However, there are rare cases of tooth resorption of an unknown cause, known as "idiopathic root resorption." This report would discuss a rare case of multiple idiopathic resorption in the permanent maxillary and mandibular teeth of an otherwise healthy 36-year-old male patient. In addition to a clinical examination, the patient was imaged using conventional radiography and cone-beam computed tomography (CBCT). The examinations revealed multiple external and internal resorption of the teeth in all four quadrants of the jaws with an unknown cause. Multiple root resorption is a rare clinical phenomenon that should be examined using different radiographic modalities. Cross-sectional CBCT is useful in the diagnosis and examination of such lesions. PMID:25473640

  13. Cone Beam Computed Tomographic Evaluation and Diagnosis of Mandibular First Molar with 6 Canals

    PubMed Central

    Pasha, Shiraz; Chaitanya, Bathula Vimala; Somisetty, Kusum Valli

    2016-01-01

    Root canal treatment of tooth with aberrant root canal morphology is very challenging. So thorough knowledge of both the external and internal anatomy of teeth is an important aspect of root canal treatment. With the advancement in technology it is imperative to use modern diagnostic tools such as magnification devices, CBCT, microscopes, and RVG to confirm the presence of these aberrant configurations. However, in everyday endodontic practice, clinicians have to treat teeth with atypical configurations for root canal treatment to be successful. This case report presents the management of a mandibular first molar with six root canals, four in mesial and two in distal root, and also emphasizes the use and importance of Cone Beam Computed Tomography (CBCT) as a diagnostic tool in endodontics. PMID:26904310

  14. Unilateral Fusion of Maxillary Lateral Incisor: Diagnosis Using Cone Beam Computed Tomography

    PubMed Central

    Castro, Iury Oliveira; Estrela, Carlos; Souza, Vinícius Rezende; Lopes, Lawrence Gonzaga; de Souza, João Batista

    2014-01-01

    Objective. The objective of this paper is to report a dental fusion case focusing on clinical and radiographic features for the diagnosis. Method. To report a case of right maxillary lateral incisor fusion and a supernumerary tooth, the anatomy of the root canal and dental united portion were assessed by cone beam computed tomography (CBCT). Results. The clinical examination showed dental juxtaposition with the absence of interdental papilla and esthetic impairment in the right maxillary lateral incisor region. The periapical radiography did not provide enough information for the differential diagnosis due to the inherent limitations of this technique. CBCT confirmed the presence of tooth fusion. Conclusion. CBCT examination supports the diagnosis and provides both the identification of changes in tooth development and the visualization of their extent and limits. PMID:25587463

  15. Practical geometric calibration for helical cone-beam industrial computed tomography.

    PubMed

    Zhang, Feng; Yan, Bin; Li, Lei; Xi, Xiaoqi; Jiang, Hua

    2014-01-01

    In helical cone-beam industrial computed tomography (ICT), the reconstructed images may be interfered by geometry artifacts due to the presence of mechanical misalignments. To obtain artifact-free reconstruction images, a practical geometric calibration method for helical scan is investigated based on Noo's analytic geometric calibration method for circular scan. The presented method is implemented by first dividing the whole ascending path of helical scan into several pieces, then acquiring the projections of a dedicated calibration phantom in circular scan at each section point, of which geometry parameters are calculated using Noo's analytic method. At last, the geometry parameters of each projection in a piece can be calculated by those of the two end points of the piece. We performed numerical simulations and real data experiments to study the performance of the presented method. The experimental results indicated that the method can obtain high-precision geometry parameters of helical scan and give satisfactory reconstruction images. PMID:24463383

  16. Cone Beam Computed Tomography Findings in Calcifying Cystic Odontogenic Tumor Associated with Odontome: A Case Report

    PubMed Central

    Phulambrikar, Tushar; Vilas Kant, Sanchita; Kode, Manasi; Magar, Shaliputra

    2015-01-01

    The calcifying cystic odontogenic tumor (CCOT) is a rare cystic odontogenic neoplasm frequently found in association with odontome. This report documents a case of CCOT associated with an odontome arising in the anterior maxilla in a 28-year-old man. Conventional radiographs showed internal calcification within the lesion but were unable to visualize its relation with the adjacent structures and its accurate extent. In this case cone beam computed tomography (CBCT) could accurately reveal the extent and the internal structure of the lesion which aided the presumptive diagnosis of the lesion as CCOT. This advanced imaging technique proved to be extremely useful in the radiographic assessment and management of this neoplasm of the maxilla. PMID:26636128

  17. Endodontic management of mandibular first molar with seven canals using cone-beam computed tomography

    PubMed Central

    Banode, Ankur Mahesh; Gade, Vandana; Patil, Sanjay; Gade, Jaykumar

    2016-01-01

    The endodontic treatment of a mandibular molar with aberrant canal configuration can be diagnostically and clinically challenging. Successful endodontic therapy thus depends on the clinician's ability to anticipate and look for these aberrant variations. A mandibular first molar with seven canals represents a rare anatomical variant, particularly when four canals are found in distal root. Based on in vitro studies, its incidence is reported to be between 0.2% and 3%. With the advent of cone-beam computed tomography (CBCT) as an adjunctive diagnostic aid, the determination of root canal anatomy in teeth with complex canal configurations has become more precise. The present case report discusses successful nonsurgical management of radix entomolaris along with middle mesial canal and middle distal canal in mandibular first molar with seven canals (four canals in distal and three in mesial) employing CBCT as an adjunctive diagnostic aid to conventional radiography. PMID:27307680

  18. Responsible use of cone beam computed tomography: minimising medico-legal risks.

    PubMed

    Noffke, C E E; Farman, A G; Van der Linde, A; Nel, S

    2013-07-01

    This communication highlights some of the ethical and possible legal responsibilities which pertain to the taking, reading, reporting, and communication of findings from cone-beam computed tomography (CBCT) scans. The importance of knowledge of head and neck anatomy and pathology to reduce the likelihood of incorrect interpretation is emphasised. Failure to detect critical findings in any diagnostic image can potentially result in medico-legal consequences. CBCT is no exception to this rule. Dental schools are advised to include CBCT imaging as a diagnostic tool in their under- and postgraduate curricula thereby equipping graduates to use 3D imaging in general and CBCT in particular. Existing dental practitioners are advised to seek continuing education on 3D imaging as part of their required lifelong learning. PMID:23971277

  19. Cone-beam computed tomography exploration and surgical management of palatal, inverted, and impacted mesiodens

    PubMed Central

    Omami, Mounir; Chokri, Abdellatif; Hentati, Hajer; Selmi, Jamil

    2015-01-01

    Supernumerary teeth are extra teeth or toothlike structures which may have either erupted or unerupted in addition to the 20 deciduous teeth and the 32 permanent teeth. Mesiodens is one of these located in the midline between the two central incisors. Their presence may give rise to a variety of clinical problems. This paper describes a rare case of palatal placed, inverted and impacted mesiodens associated to two supernumerary teeth which were detected during a radiographic examination for delayed eruption of permanent central incisors in the case of a healthy 8-year-old girl monitored at the oral surgery service while discussing the usefulness of cone beam computed tomography for accurate diagnosis and management. PMID:26604591

  20. Endodontic management of mandibular first molar with seven canals using cone-beam computed tomography.

    PubMed

    Banode, Ankur Mahesh; Gade, Vandana; Patil, Sanjay; Gade, Jaykumar

    2016-01-01

    The endodontic treatment of a mandibular molar with aberrant canal configuration can be diagnostically and clinically challenging. Successful endodontic therapy thus depends on the clinician's ability to anticipate and look for these aberrant variations. A mandibular first molar with seven canals represents a rare anatomical variant, particularly when four canals are found in distal root. Based on in vitro studies, its incidence is reported to be between 0.2% and 3%. With the advent of cone-beam computed tomography (CBCT) as an adjunctive diagnostic aid, the determination of root canal anatomy in teeth with complex canal configurations has become more precise. The present case report discusses successful nonsurgical management of radix entomolaris along with middle mesial canal and middle distal canal in mandibular first molar with seven canals (four canals in distal and three in mesial) employing CBCT as an adjunctive diagnostic aid to conventional radiography. PMID:27307680

  1. Rare appearance of an odontogenic myxoma in cone-beam computed tomography: a case report

    PubMed Central

    Dabbaghi, Arash; Nikkerdar, Nafiseh; Bayati, Soheyla; Golshah, Amin

    2016-01-01

    Odontogenic myxoma (OM) is an infiltrative benign bone tumor that occurs almost exclusively in the facial skeleton. The radiographic characteristics of odontogenic myxoma may produce several patterns, making diagnosis difficult. Cone-beam computed tomography (CBCT) may prove extremely useful in clarifying the intraosseous extent of the tumor and its effects on surrounding structures. Here, we report a case of odontogenic myxoma of the mandible in a 27-year-old female. The patient exhibited a slight swelling in the left mandible. Surgical resection was performed. No recurrence was noted. In the CBCT sections, we observed perforation of the cortical plate and radiopaque line that extended from the periosteum, resembling "sunray" appearance—a rare feature of OM—which could not be assessed by panoramic radiography. PMID:27092217

  2. Rare appearance of an odontogenic myxoma in cone-beam computed tomography: a case report.

    PubMed

    Dabbaghi, Arash; Nikkerdar, Nafiseh; Bayati, Soheyla; Golshah, Amin

    2016-01-01

    Odontogenic myxoma (OM) is an infiltrative benign bone tumor that occurs almost exclusively in the facial skeleton. The radiographic characteristics of odontogenic myxoma may produce several patterns, making diagnosis difficult. Cone-beam computed tomography (CBCT) may prove extremely useful in clarifying the intraosseous extent of the tumor and its effects on surrounding structures. Here, we report a case of odontogenic myxoma of the mandible in a 27-year-old female. The patient exhibited a slight swelling in the left mandible. Surgical resection was performed. No recurrence was noted. In the CBCT sections, we observed perforation of the cortical plate and radiopaque line that extended from the periosteum, resembling "sunray" appearance-a rare feature of OM-which could not be assessed by panoramic radiography. PMID:27092217

  3. Evaluation of Radiation Dose and Image Quality for the Varian Cone Beam Computed Tomography System

    SciTech Connect

    Cheng, Harry C.Y.; Wu, Vincent W.C.; Liu, Eva S.F.; Kwong, Dora L.W.

    2011-05-01

    Purpose: To compare the image quality and dosimetry on the Varian cone beam computed tomography (CBCT) system between software Version 1.4.13 and Version 1.4.11 (referred to as 'new' and 'old' protocols, respectively, in the following text). This study investigated organ absorbed dose, total effective dose, and image quality of the CBCT system for the head-and-neck and pelvic regions. Methods and Materials: A calibrated Farmer chamber and two standard cylindrical Perspex CT dosimetry phantoms with diameter of 16 cm (head phantom) and 32 cm (body phantom) were used to measure the weighted cone-beam computed tomography dose index (CBCTDIw) of the Varian CBCT system. The absorbed dose of different organs was measured in a female anthropomorphic phantom with thermoluminescent dosimeters (TLD) and the total effective dose was estimated according to International Commission on Radiological Protection (ICRP) Publication 103. The dose measurement and image quality were studied for head-and-neck and pelvic regions, and comparison was made between the new and old protocols. Results: The values of the new CBCTDIw head-and-neck and pelvic protocols were 36.6 and 29.4 mGy, respectively. The total effective doses from the new head-and-neck and pelvic protocols were 1.7 and 8.2 mSv, respectively. The absorbed doses of lens for the new 200{sup o} and old 360{sup o} head-and-neck protocols were 3.8 and 59.4 mGy, respectively. The additional secondary cancer risk from daily CBCT might be up to 2.8%. Conclusions: The new Varian CBCT provided volumetric information for image guidance with acceptable image quality and lower radiation dose. This imaging tool gave a better standard for patient daily setup verification.

  4. Anatomical and Morphological Characterization of the Nasopalatine Canal: A Cone-Beam Computed Tomography Study.

    PubMed

    Rodricks, D; Gupta, A; Phulambrikar, T; Singh, S K; Sharma, B K; Agrawal, P

    2016-04-01

    The anterior maxilla, also called pre-maxilla, is an area frequently requiring surgical interventions. Rehabilitation of this area remains a complex restorative challenge. The most prominent anatomical structure within the anterior maxilla is the Nasopalatine Canal. Thorough knowledge about this anatomical structure plays an important role in the successful outcomes of surgical procedures. This retrospective study was done to evaluate the anatomy and morphology of the Nasopalatine Canal using cone-beam computed tomography (CBCT). The study included 125 subjects aged between 15 and 78 years who were divided into the following 5 groups: i) 15-30 years, ii) 30-45 years, iii) 45-60 years, iv) 60-75 years, v) ≥75 years in the Department of Oral Medicine & Radiology, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India from January 2012 to January 2015. Cone-beam computed tomography (CBCT) was performed using a standard exposure and patient positioning protocol. The data of the CBCT images were sliced in three dimensions. Image planes on the three axes (X, Y, and Z) were sequentially analyzed for the location, morphology and dimensions of the Nasopalatine Canal. The correlation of age and gender with all the variables were evaluated. ANOVA and Z-test was used. P value <0.05 was considered statistically significant. Males and females showed significant differences in the length of the canal and anterior bone width in the sagittal sections. Inverted L was identified as a new dimension to the morphological shape of Nasopalatine Canal in central Madhya Pradesh population. The present study highlighted important variability observed in the anatomy and morphology of the Nasopalatine Canal. PMID:27277370

  5. Evaluation of mini-implant sites in the posterior maxilla using traditional radiographs and cone-beam computed tomography

    PubMed Central

    Abbassy, Mona A.; Sabban, Hanady M.; Hassan, Ali H.; Zawawi, Khalid H.

    2015-01-01

    Objectives: To evaluate the accuracy of using routine 2-dimensional (2D) radiographs (panoramic and periapical) when evaluating the position of orthodontic temporary anchorage devices (mini-implants) in the maxilla, and to compare the results to 3-dimensional cone-beam computed tomography (CBCT). Methods: This cross-sectional study was conducted at King Abdulaziz University, Faculty of Dentistry, Jeddah, Kingdom of Saudi Arabia from February 2014 to January 2015. Panoramic and periapical radiographs were used to examine the position of mini-implants in relation to the adjacent roots. Rating of mini-implants position was performed by 82 dentists from different specialties, using 2 D images according to the following criteria: 1) away from the root; 2) mini-implant tip appears touching the lamina dura; and 3) mini-implant overlays the lamina dura. The results were compared with CBCT findings. Results: There was no difference between dentists from different specialties when rating the position of the mini-implants (Cronbach’s alpha=0.956). The accuracy of the periapical images was 45.1%, while the panoramic images 33.6%. However, both panoramic and periapical radiographs were significantly inaccurate when assessing the mini-implant position when compared with the CBCT findings (p=0.0001). Conclusion: Three-dimensional CBCT technology allows better visualization of mini-implant placement. The use of CBCT when assessing the position of mini-implants is recommended. PMID:26593168

  6. Case History Report: Cone Beam Computed Tomography for Implant Insertion Guidance in the Presence of a Dense Bone Island.

    PubMed

    Li, Ze-jian; Lai, Ren-fa; Feng, Zhi-qiang

    2016-01-01

    This article describes the use of cone beam computed tomography (CBCT) to diagnose a dense bone island (DBI) to facilitate implant insertion guidance in a patient followed up for 4 years. Suitable image-directed preplanning and periodic review by CBCT scanning is recommended when a jaw DBI is encountered in treatment planning for implant placement. PMID:26929962

  7. Small field dose delivery evaluations using cone beam optical computed tomography-based polymer gel dosimetry

    PubMed Central

    Olding, Timothy; Holmes, Oliver; DeJean, Paul; McAuley, Kim B.; Nkongchu, Ken; Santyr, Giles; Schreiner, L. John

    2011-01-01

    This paper explores the combination of cone beam optical computed tomography with an N-isopropylacrylamide (NIPAM)-based polymer gel dosimeter for three-dimensional dose imaging of small field deliveries. Initial investigations indicate that cone beam optical imaging of polymer gels is complicated by scattered stray light perturbation. This can lead to significant dosimetry failures in comparison to dose readout by magnetic resonance imaging (MRI). For example, only 60% of the voxels from an optical CT dose readout of a 1 l dosimeter passed a two-dimensional Low's gamma test (at a 3%, 3 mm criteria, relative to a treatment plan for a well-characterized pencil beam delivery). When the same dosimeter was probed by MRI, a 93% pass rate was observed. The optical dose measurement was improved after modifications to the dosimeter preparation, matching its performance with the imaging capabilities of the scanner. With the new dosimeter preparation, 99.7% of the optical CT voxels passed a Low's gamma test at the 3%, 3 mm criteria and 92.7% at a 2%, 2 mm criteria. The fitted interjar dose responses of a small sample set of modified dosimeters prepared (a) from the same gel batch and (b) from different gel batches prepared on the same day were found to be in agreement to within 3.6% and 3.8%, respectively, over the full dose range. Without drawing any statistical conclusions, this experiment gives a preliminary indication that intrabatch or interbatch NIPAM dosimeters prepared on the same day should be suitable for dose sensitivity calibration. PMID:21430853

  8. Region-of-interest cone beam computed tomography (ROI CBCT) with a high resolution CMOS detector

    NASA Astrophysics Data System (ADS)

    Jain, A.; Takemoto, H.; Silver, M. D.; Nagesh, S. V. S.; Ionita, C. N.; Bednarek, D. R.; Rudin, S.

    2015-03-01

    Cone beam computed tomography (CBCT) systems with rotational gantries that have standard flat panel detectors (FPD) are widely used for the 3D rendering of vascular structures using Feldkamp cone beam reconstruction algorithms. One of the inherent limitations of these systems is limited resolution (<3 lp/mm). There are systems available with higher resolution but their small FOV limits them to small animal imaging only. In this work, we report on region-of-interest (ROI) CBCT with a high resolution CMOS detector (75 μm pixels, 600 μm HR-CsI) mounted with motorized detector changer on a commercial FPD-based C-arm angiography gantry (194 μm pixels, 600 μm HL-CsI). A cylindrical CT phantom and neuro stents were imaged with both detectors. For each detector a total of 209 images were acquired in a rotational protocol. The technique parameters chosen for the FPD by the imaging system were used for the CMOS detector. The anti-scatter grid was removed and the incident scatter was kept the same for both detectors with identical collimator settings. The FPD images were reconstructed for the 10 cm x10 cm FOV and the CMOS images were reconstructed for a 3.84 cm x 3.84 cm FOV. Although the reconstructed images from the CMOS detector demonstrated comparable contrast to the FPD images, the reconstructed 3D images of the neuro stent clearly showed that the CMOS detector improved delineation of smaller objects such as the stent struts (~70 μm) compared to the FPD. Further development and the potential for substantial clinical impact are suggested.

  9. Patient dose and image quality from mega-voltage cone beam computed tomography imaging

    SciTech Connect

    Gayou, Olivier; Parda, David S.; Johnson, Mark; Miften, Moyed

    2007-02-15

    The evolution of ever more conformal radiation delivery techniques makes the subject of accurate localization of increasing importance in radiotherapy. Several systems can be utilized including kilo-voltage and mega-voltage cone-beam computed tomography (MV-CBCT), CT on rail or helical tomography. One of the attractive aspects of mega-voltage cone-beam CT is that it uses the therapy beam along with an electronic portal imaging device to image the patient prior to the delivery of treatment. However, the use of a photon beam energy in the mega-voltage range for volumetric imaging degrades the image quality and increases the patient radiation dose. To optimize image quality and patient dose in MV-CBCT imaging procedures, a series of dose measurements in cylindrical and anthropomorphic phantoms using an ionization chamber, radiographic films, and thermoluminescent dosimeters was performed. Furthermore, the dependence of the contrast to noise ratio and spatial resolution of the image upon the dose delivered for a 20-cm-diam cylindrical phantom was evaluated. Depending on the anatomical site and patient thickness, we found that the minimum dose deposited in the irradiated volume was 5-9 cGy and the maximum dose was between 9 and 17 cGy for our clinical MV-CBCT imaging protocols. Results also demonstrated that for high contrast areas such as bony anatomy, low doses are sufficient for image registration and visualization of the three-dimensional boundaries between soft tissue and bony structures. However, as the difference in tissue density decreased, the dose required to identify soft tissue boundaries increased. Finally, the dose delivered by MV-CBCT was simulated using a treatment planning system (TPS), thereby allowing the incorporation of MV-CBCT dose in the treatment planning process. The TPS-calculated doses agreed well with measurements for a wide range of imaging protocols.

  10. Radiation doses in cone-beam breast computed tomography: A Monte Carlo simulation study

    SciTech Connect

    Yi Ying; Lai, Chao-Jen; Han Tao; Zhong Yuncheng; Shen Youtao; Liu Xinming; Ge Shuaiping; You Zhicheng; Wang Tianpeng; Shaw, Chris C.

    2011-02-15

    Purpose: In this article, we describe a method to estimate the spatial dose variation, average dose and mean glandular dose (MGD) for a real breast using Monte Carlo simulation based on cone beam breast computed tomography (CBBCT) images. We present and discuss the dose estimation results for 19 mastectomy breast specimens, 4 homogeneous breast models, 6 ellipsoidal phantoms, and 6 cylindrical phantoms. Methods: To validate the Monte Carlo method for dose estimation in CBBCT, we compared the Monte Carlo dose estimates with the thermoluminescent dosimeter measurements at various radial positions in two polycarbonate cylinders (11- and 15-cm in diameter). Cone-beam computed tomography (CBCT) images of 19 mastectomy breast specimens, obtained with a bench-top experimental scanner, were segmented and used to construct 19 structured breast models. Monte Carlo simulation of CBBCT with these models was performed and used to estimate the point doses, average doses, and mean glandular doses for unit open air exposure at the iso-center. Mass based glandularity values were computed and used to investigate their effects on the average doses as well as the mean glandular doses. Average doses for 4 homogeneous breast models were estimated and compared to those of the corresponding structured breast models to investigate the effect of tissue structures. Average doses for ellipsoidal and cylindrical digital phantoms of identical diameter and height were also estimated for various glandularity values and compared with those for the structured breast models. Results: The absorbed dose maps for structured breast models show that doses in the glandular tissue were higher than those in the nearby adipose tissue. Estimated average doses for the homogeneous breast models were almost identical to those for the structured breast models (p=1). Normalized average doses estimated for the ellipsoidal phantoms were similar to those for the structured breast models (root mean square (rms

  11. SADMFR guidelines for the use of Cone-Beam Computed Tomography/ Digital Volume Tomography.

    PubMed

    Dula, Karl; Bornstein, Michael M; Buser, Daniel; Dagassan-Berndt, Dorothea; Ettlin, Dominik A; Filippi, Andreas; Gabioud, François; Katsaros, Christos; Krastl, Gabriel; Lambrecht, J Thomas; Lauber, Roland; Luebbers, Heinz-Theo; Pazera, Pawel; Türp, Jens C

    2014-01-01

    Cone-Beam Computed Tomography (CBCT) has been introduced in 1998. This radiological imaging procedure has been provided for dentistry and is comparable to computed tomography (CT) in medicine. It is expected that CBCT will have the same success in dental diagnostic imaging as computed tomography had in medicine. Just as CT is responsible for a significant rise in radiation dose to the population from medical X-ray diagnostics, CBCT studies will be accompanied by a significant increase of the dose to our patients by dentistry. Because of the growing concern for an uncritical and consequently rapidly increasing use of CBCT the Swiss Society of Dentomaxillofacial Radiology convened a first consensus conference in 2011 to formulate indications for CBCT, which can be used as guidelines. In this meeting, oral and maxillofacial surgery, orthodontics and temporomandibular joint disorders and diseases were treated and the most important and most experienced users of DVT in these areas were asked to participate. In general, a highly restrictive use of CBCT is required. Justifying main criterion for CBCT application is that additional, therapy-relevant information is expected that should lead to a significant benefit in patient care. All users of CBCT should have completed a structured, high-level training, just like that offered by the Swiss Society of Dentomaxillofacial Radiology. PMID:25428284

  12. Respiratory motion guided four dimensional cone beam computed tomography: encompassing irregular breathing.

    PubMed

    O'Brien, Ricky T; Cooper, Benjamin J; Kipritidis, John; Shieh, Chun-Chien; Keall, Paul J

    2014-02-01

    Four dimensional cone beam computed tomography (4DCBCT) images suffer from angular under sampling and bunching of projections due to a lack of feedback between the respiratory signal and the acquisition system. To address this problem, respiratory motion guided 4DCBCT (RMG-4DCBCT) regulates the gantry velocity and projection time interval, in response to the patient's respiratory signal, with the aim of acquiring evenly spaced projections in a number of phase or displacement bins during the respiratory cycle. Our previous study of RMG-4DCBCT was limited to sinusoidal breathing traces. Here we expand on that work to provide a practical algorithm for the case of real patient breathing data. We give a complete description of RMG-4DCBCT including full details on how to implement the algorithms to determine when to move the gantry and when to acquire projections in response to the patient's respiratory signal. We simulate a realistic working RMG-4DCBCT system using 112 breathing traces from 24 lung cancer patients. Acquisition used phase-based binning and parameter settings typically used on commercial 4DCBCT systems (4 min acquisition time, 1200 projections across 10 respiratory bins), with the acceleration and velocity constraints of current generation linear accelerators. We quantified streaking artefacts and image noise for conventional and RMG-4DCBCT methods by reconstructing projection data selected from an oversampled set of Catphan phantom projections. RMG-4DCBCT allows us to optimally trade-off image quality, acquisition time and image dose. For example, for the same image quality and acquisition time as conventional 4DCBCT approximately half the imaging dose is needed. Alternatively, for the same imaging dose, the image quality as measured by the signal to noise ratio, is improved by 63% on average. C-arm cone beam computed tomography systems, with an acceleration up to 200°/s(2), a velocity up to 100°/s and the acquisition of 80 projections per second

  13. Optimizing Cone Beam Computed Tomography (CBCT) System for Image Guided Radiation Therapy

    NASA Astrophysics Data System (ADS)

    Park, Chun Joo

    Cone Beam Computed Tomography (CBCT) system is the most widely used imaging device in image guided radiation therapy (IGRT), where set of 3D volumetric image of patient can be reconstructed to identify and correct position setup errors prior to the radiation treatment. This CBCT system can significantly improve precision of on-line setup errors of patient position and tumor target localization prior to the treatment. However, there are still a number of issues that needs to be investigated with CBCT system such as 1) progressively increasing defective pixels in imaging detectors by its frequent usage, 2) hazardous radiation exposure to patients during the CBCT imaging, 3) degradation of image quality due to patients' respiratory motion when CBCT is acquired and 4) unknown knowledge of certain anatomical features such as liver, due to lack of soft-tissue contrast which makes tumor motion verification challenging. In this dissertation, we explore on optimizing the use of cone beam computed tomography (CBCT) system under such circumstances. We begin by introducing general concept of IGRT. We then present the development of automated defective pixel detection algorithm for X-ray imagers that is used for CBCT imaging using wavelet analysis. We next investigate on developing fast and efficient low-dose volumetric reconstruction techniques which includes 1) fast digital tomosynthesis reconstruction using general-purpose graphics processing unit (GPGPU) programming and 2) fast low-dose CBCT image reconstruction based on the Gradient-Projection-Barzilai-Borwein formulation (GP-BB). We further developed two efficient approaches that could reduce the degradation of CBCT images from respiratory motion. First, we propose reconstructing four dimensional (4D) CBCT and DTS using respiratory signal extracted from fiducial markers implanted in liver. Second, novel motion-map constrained image reconstruction (MCIR) is proposed that allows reconstruction of high quality and high phase

  14. Analysis of bite marks in foodstuffs by computer tomography (cone beam CT)--3D reconstruction.

    PubMed

    Marques, Jeidson; Musse, Jamilly; Caetano, Catarina; Corte-Real, Francisco; Corte-Real, Ana Teresa

    2013-12-01

    The use of three-dimensional (3D) analysis of forensic evidence is highlighted in comparison with traditional methods. This three-dimensional analysis is based on the registration of the surface from a bitten object. The authors propose to use Cone Beam Computed Tomography (CBCT), which is used in dental practice, in order to study the surface and interior of bitten objects and dental casts of suspects. In this study, CBCT is applied to the analysis of bite marks in foodstuffs, which may be found in a forensic case scenario. 6 different types of foodstuffs were used: chocolate, cheese, apple, chewing gum, pizza and tart (flaky pastry and custard). The food was bitten into and dental casts of the possible suspects were made. The dental casts and bitten objects were registered using an x-ray source and the CBCT equipment iCAT® (Pennsylvania, EUA). The software InVivo5® (Anatomage Inc, EUA) was used to visualize and analyze the tomographic slices and 3D reconstructions of the objects. For each material an estimate of its density was assessed by two methods: HU values and specific gravity. All the used materials were successfully reconstructed as good quality 3D images. The relative densities of the materials in study were compared. Amongst the foodstuffs, the chocolate had the highest density (median value 100.5 HU and 1,36 g/cm(3)), while the pizza showed to have the lowest (median value -775 HU and 0,39 g/cm(3)), on both scales. Through tomographic slices and three-dimensional reconstructions it was possible to perform the metric analysis of the bite marks in all the foodstuffs, except for the pizza. These measurements could also be obtained from the dental casts. The depth of the bite mark was also successfully determined in all the foodstuffs except for the pizza. Cone Beam Computed Tomography has the potential to become an important tool for forensic sciences, namely for the registration and analysis of bite marks in foodstuffs that may be found in a crime

  15. Compensation for displacement of the focal point in cone beam single photon emission computed tomography reconstruction.

    PubMed

    Cao, Z; Qian, L

    1997-04-01

    This study examined the effects of focal point displacement on image quality in cone beam single photon emission computed tomography (SPECT). A new image reconstruction algorithm that accounts for the focal point shift was derived and three shift geometries were investigated. The geometries included a lateral shift with a fixed focal length but off-center focusing, a linear axial shift with a variable focal length that depends linearly on the distance between a bin of the detector and the center of the detector, and a random axial shift with a randomly varying focal length. Computer simulation was conducted to evaluate the shift effects with a phantom that was composed of 118 small spherical sources. The results demonstrated that the lateral shift of the focal point was more critical to image quality than was the axial shift. With a 0.64 cm (1 pixel) lateral shift, noticeable artifacts was observed, while an axial shift resulted in minimal changes in image quality until it reached 8 cm (12.5 pixels). The derived reconstruction algorithm eliminated most of the artifacts caused by a fixed lateral shift or a linear axial shift of the focal point, but failed to do so for a random axial shift since the linear distribution assumed in image reconstruction did not match the random shift occurred in acquisition of the data. PMID:9291002

  16. Imaging characteristics of distance-driven method in a prototype cone-beam computed tomography (CBCT)

    NASA Astrophysics Data System (ADS)

    Choi, Sunghoon; Kim, Ye-seul; Lee, Haenghwa; Lee, Donghoon; Seo, Chang-Woo; Kim, Hee-Joung

    2016-03-01

    Cone-beam computed tomography (CBCT) has widely been used and studied in both medical imaging and radiation therapy. The aim of this study was to evaluate our newly developed CBCT system by implementing a distance-driven system modeling technique in order to produce excellent and accurate cross-sectional images. For the purpose of comparing the performance of the distance-driven methods, we also performed pixel-driven and ray-driven techniques when conducting forward- and back-projection schemes. We conducted the Feldkamp-Davis-Kress (FDK) algorithm and simultaneous algebraic reconstruction technique (SART) to retrieve a volumetric information of scanned chest phantom. The results indicated that contrast-to-noise (CNR) of the reconstructed images by using FDK and SART showed 8.02 and 15.78 for distance-driven, whereas 4.02 and 5.16 for pixel-driven scheme and 7.81 and 13.01 for ray-driven scheme, respectively. This could demonstrate that distance-driven method described more closely the chest phantom compared to pixel- and ray-driven. However, both elapsed time for modeling a system matrix and reconstruction time took longer time when performing the distance-driven scheme. Therefore, future works will be directed toward reducing computational time to acceptable limits for real applications.

  17. Radiation dose evaluation of dental cone beam computed tomography using an anthropomorphic adult head phantom

    NASA Astrophysics Data System (ADS)

    Wu, Jay; Shih, Cheng-Ting; Ho, Chang-hung; Liu, Yan-Lin; Chang, Yuan-Jen; Min Chao, Max; Hsu, Jui-Ting

    2014-11-01

    Dental cone beam computed tomography (CBCT) provides high-resolution tomographic images and has been gradually used in clinical practice. Thus, it is important to examine the amount of radiation dose resulting from dental CBCT examinations. In this study, we developed an in-house anthropomorphic adult head phantom to evaluate the level of effective dose. The anthropomorphic phantom was made of acrylic and filled with plaster to replace the bony tissue. The contour of the head was extracted from a set of adult computed tomography (CT) images. Different combinations of the scanning parameters of CBCT were applied. Thermoluminescent dosimeters (TLDs) were used to measure the absorbed doses at 19 locations in the head and neck regions. The effective doses measured using the proposed phantom at 65, 75, and 85 kVp in the D-mode were 72.23, 100.31, and 134.29 μSv, respectively. In the I-mode, the effective doses were 108.24, 190.99, and 246.48 μSv, respectively. The maximum percent error between the doses measured by the proposed phantom and the Rando phantom was l4.90%. Therefore, the proposed anthropomorphic adult head phantom is applicable for assessing the radiation dose resulting from clinical dental CBCT.

  18. Evaluation of enamel pearls by cone-beam computed tomography (CBCT)

    PubMed Central

    Akgül, Nilgün; Caglayan, Fatma; Durna, Nurhan; Sümbüllü, Muhammed A.; Akgül, Hayati M.; Durna, Dogan

    2012-01-01

    Objective: The aim of this study was to evaluate the frequency of enamel pearls according to population, sex and tooth groups on Cone-Beam Computed Tomography (CBCT) or Dental Volumetric Tomography (DVT) scans of patients, retrospectively. Study Design: In this study, 15185 teeth belonging to 768 patients, 430 female and 338 male, was performed cross-sectional examination by CBCT. The volumetric Computed Tomography used in the study is Newton FP based on flat-panel. The data were analyzed with Pearson chi-squared test. Results: Enamel pearls were detected in 36 subjects (4.69%). Of these enamel pearls, 19 were detected in male and 17 were in male. There was no statistically a significant association between prevalence of enamel pearls and sex. All of enamel pearls were detected in molar teeth, for prevalence 0.83%. Conclusion: All of enamel pearls are found upper and lower molar teeth, especially the most commonly in maxillary second and third molars. Key words: Enamel pearls, ectopic mineralization, radiography, CBCT, DVT. PMID:22143707

  19. Cone beam computed tomography of plastinated hearts for instruction of radiological anatomy.

    PubMed

    Chang, Chih-Wei; Atkinson, Gregory; Gandhi, Niket; Farrell, Michael L; Labrash, Steven; Smith, Alice B; Norton, Neil S; Matsui, Takashi; Lozanoff, Scott

    2016-09-01

    Radiological anatomy education is an important aspect of the medical curriculum. The purpose of this study was to establish and demonstrate the use of plastinated anatomical specimens, specifically human hearts, for use in radiological anatomy education. Four human hearts were processed with routine plastination procedures at room temperature. Specimens were subjected to cone beam computed tomography and a graphics program (ER3D) was applied to generate 3D cardiac models. A comparison was conducted between plastinated hearts and their corresponding computer models based on a list of morphological cardiac features commonly studied in the gross anatomy laboratory. Results showed significant correspondence between plastinations and CBCT-generated 3D models (98 %; p < .01) for external structures and 100 % for internal cardiac features, while 85 % correspondence was achieved between plastinations and 2D CBCT slices. Complete correspondence (100 %) was achieved between key observations on the plastinations and internal radiological findings typically required of medical student. All pathologic features seen on the plastinated hearts were also visualized internally with the CBCT-generated models and 2D slices. These results suggest that CBCT-derived slices and models can be successfully generated from plastinated material and provide accurate representations for radiological anatomy education. PMID:26905076

  20. Imaging doses in radiation therapy from kilovoltage cone-beam computed tomography

    NASA Astrophysics Data System (ADS)

    Hyer, Daniel Ellis

    Advances in radiation treatment delivery, such as intensity modulated radiation therapy (IMRT), have made it possible to deliver large doses of radiation with a high degree of conformity. While highly conformal treatments offers the advantage of sparing surrounding normal tissue, this benefit can only be realized if the patient is accurately positioned during each treatment fraction. The need to accurately position the patient has led to the development and use of gantry mounted kilovoltage cone-beam computed tomography (kV-CBCT) systems. These systems are used to acquire high resolution volumetric images of the patient which are then digitally registered with the planning CT dataset to confirm alignment of the patient on the treatment table. While kV-CBCT is a very useful tool for aligning the patient prior to treatment, daily use in a high fraction therapy regimen results in a substantial radiation dose. In order to quantify the radiation dose associated with CBCT imaging, an anthropomorphic phantom representing a 50th percentile adult male and a fiber-optic coupled (FOC) dosimetry system were both constructed as part of this dissertation. These tools were then used to directly measure organ doses incurred during clinical protocols for the head, chest, and pelvis. For completeness, the dose delivered from both the X-ray Volumetric Imager (XVI, Elekta Oncology Systems, Crawley, UK) and the On-Board Imager (OBI, Varian Medical Systems, Palo Alto, CA) were investigated. While this study provided a direct measure of organ doses for estimating risk to the patient, a practical method for estimating organ doses that could be performed with phantoms and dosimeters currently available at most clinics was also desired. To accomplish this goal, a 100 mm pencil ion chamber was used to measure the "cone beam dose index" (CBDI) inside standard CT dose index (CTDI) acrylic phantoms. A weighted CBDI (CBDIw), similar to the weighted CT dose index (CTDIw), was then calculated to

  1. Detection model modeling and application for batch scans of cone-beam computed tomography

    NASA Astrophysics Data System (ADS)

    Huang, Kuidong; Zhang, Dinghua; Li, Mingjun; Wang, Kuyu

    2009-07-01

    Aiming at the artifact corrections for batch scans in Cone-Beam Computed Tomography (CBCT) system, the concept of detection model is proposed. Expressing the prior knowledge of CT system and scanned object properties by the detection model, the rapid artifact corrections are achieved based on the object knowledge, which can save the machine consumption, enhance the detection efficiency and improve the correction effect. Based on the Digital Radiography (DR) imaging conditions remained basically unchanged in the batch scans, the modeling method of detection model is established by getting the relevant information through the detected scanning for one of a batch of parts. Finally, the processing flow of CBCT scans and artifact corrections of a batch of parts based on the detection model is given, and some key problems in the flow are discussed to improve the practical operability of the method. The experimental result shows that the modeling method of detection model is feasible, and the rapid CBCT scans and effective artifact corrections can be realized based on the obtained detection model.

  2. Detectability of hepatic tumors during 3D post-processed ultrafast cone-beam computed tomography

    NASA Astrophysics Data System (ADS)

    Paul, Jijo; Vogl, Thomas J.; Chacko, Annamma

    2015-10-01

    To evaluate hepatic tumor detection using ultrafast cone-beam computed tomography (UCBCT) cross-sectional and 3D post-processed image datasets. 657 patients were examined using UCBCT during hepatic transarterial chemoembolization (TACE), and data were collected retrospectively from January 2012 to September 2014. Tumor detectability, diagnostic ability, detection accuracy and sensitivity were examined for different hepatic tumors using UCBCT cross-sectional, perfusion blood volume (PBV) and UCBCT-MRI (magnetic resonance imaging) fused image datasets. Appropriate statistical tests were used to compare collected sample data. Fused image data showed the significantly higher (all P  <  0.05) diagnostic ability for hepatic tumors compared to UCBCT or PBV image data. The detectability of small hepatic tumors (<5 mm) was significantly reduced (all P  <  0.05) using UCBCT cross-sectional images compared to MRI or fused image data; however, PBV improved tumor detectability using a color display. Fused image data produced 100% tumor sensitivity due to the simultaneous availability of MRI and UCBCT information during tumor diagnosis. Fused image data produced excellent hepatic tumor sensitivity, detectability and diagnostic ability compared to other datasets assessed. Fused image data is extremely reliable and useful compared to UCBCT cross-sectional or PBV image datasets to depict hepatic tumors during TACE. Partial anatomical visualization on cross-sectional images was compensated by fused image data during tumor diagnosis.

  3. Comparing the Coronal Flaring Efficacy of Five Different Instruments Using Cone-Beam Computed Tomography

    PubMed Central

    Homayoon, Amin; Hamidi, Mahmood Reza; Haddadi, Azam; Madani, Zahra Sadat; Moudi, Ehsan; Bijani, Ali

    2015-01-01

    Introduction: Fearless removal of tooth structure during canal preparation and shaping has negative effects on the prognosis of treatment. On the other hand, sufficient pre-enlargement facilitates exact measurement of the apical size. The present in vitro study aimed to compare the efficacy of Gates-Glidden drills, K3, ProTaper, FlexMaster and RaCe instruments in dentin removal during coronal flaring using cone-beam computed tomography (CBCT). Methods and Materials: A total of 40 mandibular molars were selected and the coronal areas of their mesiobuccal and mesiolingual root canals were randomly prepared with either mentioned instruments. Pre- and post-instrumentation CBCT images were taken and the thickness of canal walls was measured in 1.5- and 3-mm distances from the furcation area. Data were analyzed using the one-way ANOVA. Tukey’s post hoc tests were used for two-by-two comparisons. Results: At 1.5-mm distance, there was no significant difference between different instruments. However, at 3-mm distances, Gates-Glidden drills removed significantly more dentin compared to FlexMaster files (mean=0.18 mm) (P<0.02); however, two-by-two comparisons did not reveal any significant differences between the other groups. Conclusion: All tested instruments can be effectively used in clinical settings for coronal pre-enlargement. PMID:26525955

  4. Accuracy and reliability of stitched cone-beam computed tomography images

    PubMed Central

    Egbert, Nicholas; Cagna, David R.; Wicks, Russell A.

    2015-01-01

    Purpose This study was performed to evaluate the linear distance accuracy and reliability of stitched small field of view (FOV) cone-beam computed tomography (CBCT) reconstructed images for the fabrication of implant surgical guides. Materials and Methods Three gutta percha points were fixed on the inferior border of a cadaveric mandible to serve as control reference points. Ten additional gutta percha points, representing fiduciary markers, were scattered on the buccal and lingual cortices at the level of the proposed complete denture flange. A digital caliper was used to measure the distance between the reference points and fiduciary markers, which represented the anatomic linear dimension. The mandible was scanned using small FOV CBCT, and the images were then reconstructed and stitched using the manufacturer's imaging software. The same measurements were then taken with the CBCT software. Results The anatomic linear dimension measurements and stitched small FOV CBCT measurements were statistically evaluated for linear accuracy. The mean difference between the anatomic linear dimension measurements and the stitched small FOV CBCT measurements was found to be 0.34 mm with a 95% confidence interval of +0.24 - +0.44 mm and a mean standard deviation of 0.30 mm. The difference between the control and the stitched small FOV CBCT measurements was insignificant within the parameters defined by this study. Conclusion The proven accuracy of stitched small FOV CBCT data sets may allow image-guided fabrication of implant surgical stents from such data sets. PMID:25793182

  5. Evaluation of accuracy of cone beam computed tomography for measurement of periodontal defects: A clinical study

    PubMed Central

    Banodkar, Akshaya Bhupesh; Gaikwad, Rajesh Prabhakar; Gunjikar, Tanay Udayrao; Lobo, Tanya Arthur

    2015-01-01

    Aims: The aim of the present study was to evaluate the accuracy of Cone Beam Computed Tomography (CBCT) measurements of alveolar bone defects caused due to periodontal disease, by comparing it with actual surgical measurements which is the gold standard. Materials and Methods: Hundred periodontal bone defects in fifteen patients suffering from periodontitis and scheduled for flap surgery were included in the study. On the day of surgery prior to anesthesia, CBCT of the quadrant to be operated was taken. After reflection of the flap, clinical measurements of periodontal defect were made using a reamer and digital vernier caliper. The measurements taken during surgery were then compared to the measurements done with CBCT and subjected to statistical analysis using the Pearson's correlation test. Results: Overall there was a very high correlation of 0.988 between the surgical and CBCT measurements. In case of type of defects the correlation was higher in horizontal defects as compared to vertical defects. Conclusions: CBCT is highly accurate in measurement of periodontal defects and proves to be a very useful tool in periodontal diagnosis and treatment assessment. PMID:26229268

  6. Cone beam computed tomography study of apical root resorption induced by Herbst appliance

    PubMed Central

    SCHWARTZ, João Paulo; RAVELI, Taísa Boamorte; ALMEIDA, Kélei Cristina de Mathias; SCHWARTZ-FILHO, Humberto Osvaldo; RAVELI, Dirceu Barnabé

    2015-01-01

    Objective This study evaluated the frequency of root resorption during the orthodontic treatment with Herbst appliance by Cone Beam Computed Tomography (CBCT). Material and Methods The sample comprised 23 patients (11 men, 12 women; mean ages 15.76±1.75 years) with Class II division 1 malocclusion, treated with Herbst appliance. CBCT was obtained before treatment (T0) and after Herbst treatment (T1). All the dental roots, except third molars, were evaluated, and apical root resorption was determined using the axial guided navigation method. Paired t-tests and Wilcoxon T Test were used to compare the dependent samples in parametric and nonparametric cases, respectively. Chi-Square Test with Yates’ correction was used to evaluate the relationship between apical root resorption and gender. Results were considered at a significance level of 5%. Results Apical resorption was detected by CBCT in 57.96% of 980 roots that underwent Herbst appliance treatment. All patients had minimal resorption and there was no statistical significance between the genders. Conclusion CBCT three-dimensional evaluation showed association between Herbst appliance and minimal apical root resorption, mostly in the anchoring teeth, without clinical significance. PMID:26537718

  7. Mandibular incisive canal in Han Chinese using cone beam computed tomography.

    PubMed

    Kong, N; Hui, M; Miao, F; Yuan, H; Du, Y; Chen, N

    2016-09-01

    The aim of this study was to provide reference information for implantology and chin bone harvesting in people of Han Chinese ethnicity by studying the mandibular incisive canal (MIC) using cone beam computed tomography (CBCT). Fifty subjects were included in the study. CBCT scans were obtained for all subjects, and 22 also underwent panoramic radiography to evaluate the visibility of the MIC. The CBCT data of the 50 subjects were reconstructed to measure MIC diameter, length, and location within the mandible. A MIC was identified in 38.6% of panoramic radiographs, with good clarity in 13.6%, while a MIC was identified in 100% of CBCT images, with good clarity in 63.6%. The diameter of the MIC decreased from origin to end. The left and right average MIC lengths were 17.84mm and 17.73mm, respectively. The MIC was close to the buccal cortical border and lower margin of the mandible. In conclusion, the MIC is an anatomical structure in the mandible that can be identified reliably with CBCT. On insertion, implants should be inclined slightly towards the lingual aspect of the anterior mandible to protect the MIC. The chin bone harvesting depth should be limited to 4mm; the harvesting site can be adjusted to the region above or below the MIC. PMID:27184354

  8. Evaluation of the validity of the Bolton Index using cone-beam computed tomography (CBCT)

    PubMed Central

    Llamas, José M.; Cibrián, Rosa; Gandía, José L.; Paredes, Vanessa

    2012-01-01

    Aims: To evaluate the reliability and reproducibility of calculating the Bolton Index using cone-beam computed tomography (CBCT), and to compare this with measurements obtained using the 2D Digital Method. Material and Methods: Traditional study models were obtained from 50 patients, which were then digitized in order to be able to measure them using the Digital Method. Likewise, CBCTs of those same patients were undertaken using the Dental Picasso Master 3D® and the images obtained were then analysed using the InVivoDental programme. Results: By determining the regression lines for both measurement methods, as well as the difference between both of their values, the two methods are shown to be comparable, despite the fact that the measurements analysed presented statistically significant differences. Conclusions: The three-dimensional models obtained from the CBCT are as accurate and reproducible as the digital models obtained from the plaster study casts for calculating the Bolton Index. The differences existing between both methods were clinically acceptable. Key words:Tooth-size, digital models, bolton index, CBCT. PMID:22549690

  9. Accuracy and reliability of linear measurements using tangential projection and cone beam computed tomography

    PubMed Central

    Sheikhi, Mahnaz; Dakhil-Alian, Mansour; Bahreinian, Zahra

    2015-01-01

    Background: Providing a cross-sectional image is essential for preimplant assessments. Computed tomography (CT) and cone beam CT (CBCT) images are very expensive and provide high radiation dose. Tangential projection is a very simple, available, and low-dose technique that can be used in the anterior portion of mandible. The purpose of this study was to evaluate the accuracy of tangential projection in preimplant measurements in comparison to CBCT. Materials and Methods: Three dry edentulous human mandibles were examined in five points at intercanine region using tangential projection and CBCT. The height and width of the ridge were measured twice by two observers. The mandibles were then cut, and real measurements were obtained. The agreement between real measures and measurements obtained by either technique, and inter- and intra-observer reliability were tested. Results: The measurement error was less than 0.12 for tangential technique and 0.06 for CBCT. The agreement between the real measures and measurements from radiographs were higher than 0.87. Tangential projection slightly overestimated the distances, while there was a slight underestimation in CBCT results. Conclusion: Considering the low cost, low radiation dose, simplicity and availability, tangenital projection would be adequate for preimplant assessment in edentulous patients when limited numbers of implants are required in the anterior mandible. PMID:26005469

  10. Accuracy and precision of cone beam computed tomography in periodontal defects measurement (systematic review).

    PubMed

    Anter, Enas; Zayet, Mohammed Khalifa; El-Dessouky, Sahar Hosny

    2016-01-01

    Systematic review of literature was made to assess the extent of accuracy of cone beam computed tomography (CBCT) as a tool for measurement of alveolar bone loss in periodontal defect. A systematic search of PubMed electronic database and a hand search of open access journals (from 2000 to 2015) yielded abstracts that were potentially relevant. The original articles were then retrieved and their references were hand searched for possible missing articles. Only articles that met the selection criteria were included and criticized. The initial screening revealed 47 potentially relevant articles, of which only 14 have met the selection criteria; their CBCT average measurements error ranged from 0.19 mm to 1.27 mm; however, no valid meta-analysis could be made due to the high heterogeneity between the included studies. Under the limitation of the number and strength of the available studies, we concluded that CBCT provides an assessment of alveolar bone loss in periodontal defect with a minimum reported mean measurements error of 0.19 ± 0.11 mm and a maximum reported mean measurements error of 1.27 ± 1.43 mm, and there is no agreement between the studies regarding the direction of the deviation whether over or underestimation. However, we should emphasize that the evidence to this data is not strong. PMID:27563194

  11. Normal Variations of Sphenoid Sinus and the Adjacent Structures Detected in Cone Beam Computed Tomography

    PubMed Central

    Rahmati, Azadeh; Ghafari, Roshanak; AnjomShoa, Maryam

    2016-01-01

    Statement of the Problem The sphenoid sinus is a common target of paranasal surgery. Functional endoscopic sinus surgery is likely to endanger the anatomic variations of vital structures adjacent to the sphenoid sinus. Purpose The aim of this study was to determine the variations of sphenoid sinus and the related structures by using cone-beam computed tomography (CBCT). Materials and Method In this descriptive-analytic study, CBCT images of 103 patients aged above 20-years were selected (206 sides). Degree of pneumatization of sphenoid sinus, pneumatization of the anterior clinoid process, pterygoid process, protrusion of optic canal, vidian canal, and foramen rotundum, as well as prevalence of sinus septa were recorded. Examinations were performed using On-Demand software (Version 1); data were analyzed by using chi-square test. Results There was a statistically significant correlation between the pterygoid pneumatization and vidian canal protrusion (p< 0.001), and foramen rotundum protrusion (p< 0.001). The optic canal protrusion was found to be significantly associated with the anterior clinoid pneumatization and pterygoid process (p< 0.001). Statistically significant relationship was also observed between the carotid canal protrusion and pterygoid process pneumatization (p< 0.001). Conclusion The anatomical variations of the sphenoid sinus tend to give rise to a complexity of symptoms and potentially serious complications. This variability necessitates a comprehensive understanding of the regional sphenoid sinus anatomy by a detailed CBCT sinus examination. PMID:26966706

  12. Feasibility of using respiratory correlated mega voltage cone beam computed tomography to measure tumor motion.

    PubMed

    Chen, Mingqing; Siochi, R Alfredo

    2011-01-01

    The purpose of this study was to test the feasibility of using respiratory correlated mega voltage cone-beam computed tomography (MVCBCT), taken during patient localization, to quantify the size and motion of lung tumors. An imaging phantom was constructed of a basswood frame embedded with six different-sized spherical pieces of paraffin wax. The Quasar respiratory motion phantom was programmed to move the imaging phantom using typical respiratory motion. The moving imaging phantom was scanned using various MVCBCT imaging parameters, including two beam line types, two protocols with different ranges of rotation and different imaging doses. A static phantom was also imaged as a control. For all the 3D volumetric images, the contours of the six spherical inserts were measured manually. Compared with the nominal sphere diameter, the average relative error in the size of the respiratory correlated MVCBCT spheres ranged from 5.3% to 12.6% for the four largest spheres, ranging in size from 3.6 cc to 29 cc. Larger errors were recorded for the two smallest inserts. The average relative error in motion was 5.1% smaller than the programmed amplitude of 3.0 cm. We are able to conclude that it is feasible to use respiratory correlated MVCBCT to quantify tumor motion for lung cancer patients. PMID:21587196

  13. Fractionated changes in prostate cancer radiotherapy using cone-beam computed tomography

    SciTech Connect

    Huang, Tzung-Chi; Chou, Kuei-Ting; Yang, Shih-Neng; Chang, Chih-Kai; Liang, Ji-An; Zhang, Geoffrey

    2015-10-01

    The high mobility of the bladder and the rectum causes uncertainty in radiation doses prescribed to patients with prostate cancer who undergo radiotherapy (RT) multifraction treatments. The purpose of this study was to estimate the dose received by the bladder, rectum, and prostate from multifraction treatments using daily cone-beam computed tomography (CBCT). Overall, 28 patients with prostate cancer who planned to receive radiation treatments were enrolled in the study. The acquired CBCT before the treatment delivery was registered with the planning CT to map the dose distribution used in the treatment plan for estimating the received dose during clinical treatment. For all 28 patients with 112 data sets, the mean percentage differences (± standard deviation) in the volume and radiation dose were 44% (± 41) and 18% (± 17) for the bladder, 20% (± 21) and 2% (± 2) for the prostate, and 36% (± 29) and 22% (± 15) for the rectum, respectively. Substantial differences between the volumes and radiation dose and those specified in treatment plans were observed. Besides the use of image-guided RT to improve patient setup accuracy, further consideration of large changes in bladder and rectum volumes is strongly suggested when using external beam radiation for prostate cancer.

  14. Developments of metal artifact reduction methods of cone-beam computed tomography

    NASA Astrophysics Data System (ADS)

    Shih, Kun-Long; Jin, Shih-Chun D.; Chen, Jyh-Cheng

    2014-09-01

    While clinical applications of cone-beam computed tomography (CBCT) have expanded, current CBCT technology has limitations due to the streak artifacts caused by metallic objects. The aim of this work was to develop an efficient and accurate metal data interpolation in sinogram domain to achieve artifact suppression and to improve CT image quality. In this study, we propose three interpolation methods for the metal projection data. Metal objects are segmented in raw data and replacement of the segmented regions by new values is done using three interpolation schemes, (1) replacing the raw data by the simple threshold value (thresholding method), (2) reducing the raw data to half of the value which is over threshold value (modification method), (3) using the inpainting interpolation (inpainting method). Our references are the CBCT images of the phantoms without the metal implants. The performance was evaluated by comparing the differences of root mean square error (RMSE) before and after metal artifact reduction (MAR). All the metal artifacts were reduced effectively. Metal artifacts reduction using method (1) performs the best, which improve the differences of RMSE more than 60%. This study indicates that metal artifacts can be reduced effectively by manipulating metal projection data.

  15. Hybrid simulation of scatter intensity in industrial cone-beam computed tomography

    NASA Astrophysics Data System (ADS)

    Thierry, R.; Miceli, A.; Hofmann, J.; Flisch, A.; Sennhauser, U.

    2009-01-01

    A cone-beam computed tomography (CT) system using a 450 kV X-ray tube has been developed to challenge the three-dimensional imaging of parts of the automotive industry in short acquisition time. Because the probability of detecting scattered photons is high regarding the energy range and the area of detection, a scattering correction becomes mandatory for generating reliable images with enhanced contrast detectability. In this paper, we present a hybrid simulator for the fast and accurate calculation of the scattering intensity distribution. The full acquisition chain, from the generation of a polyenergetic photon beam, its interaction with the scanned object and the energy deposit in the detector is simulated. Object phantoms can be spatially described in form of voxels, mathematical primitives or CAD models. Uncollided radiation is treated with a ray-tracing method and scattered radiation is split into single and multiple scattering. The single scattering is calculated with a deterministic approach accelerated with a forced detection method. The residual noisy signal is subsequently deconvoluted with the iterative Richardson-Lucy method. Finally the multiple scattering is addressed with a coarse Monte Carlo (MC) simulation. The proposed hybrid method has been validated on aluminium phantoms with varying size and object-to-detector distance, and found in good agreement with the MC code Geant4. The acceleration achieved by the hybrid method over the standard MC on a single projection is approximately of three orders of magnitude.

  16. Assessment of Mandibular Distraction Regenerate Using Ultrasonography and Cone Beam Computed Tomography: A Clinical Study.

    PubMed

    Dabas, Jitender; Mohanty, Sujata; Chaudhary, Zainab; Rani, Amita

    2016-03-01

    Distraction osteogenesis (DO) is becoming a popular method of reconstruction for maxillofacial bony deformities or defects secondary to trauma or surgical tumor ablation. However, the technique is very sensitive in terms of the rate and rhythm of distraction. Because of this, there is a need for monitoring of the distraction regenerate during the distraction as well as the consolidation period. The present study was conducted to assess the regenerate using two imaging modalities, namely, ultrasonography (USG) and cone beam computed tomography (CBCT) to determine their relative efficacies and to weigh their clinical usefulness in assessment of DO regenerate. The study was conducted on 12 patients (18 sites) who underwent mandibular distraction for correction of facial deformities. The results showed that overall USG correlated better with the condition of regenerate (r = 0.606) as compared with CBCT (r = 0.476). However, USG was less effective as compared with CBCT in assessing the regenerate once corticomedullary differentiation occurred in the bone. PMID:26889351

  17. Accuracy and precision of cone beam computed tomography in periodontal defects measurement (systematic review)

    PubMed Central

    Anter, Enas; Zayet, Mohammed Khalifa; El-Dessouky, Sahar Hosny

    2016-01-01

    Systematic review of literature was made to assess the extent of accuracy of cone beam computed tomography (CBCT) as a tool for measurement of alveolar bone loss in periodontal defect. A systematic search of PubMed electronic database and a hand search of open access journals (from 2000 to 2015) yielded abstracts that were potentially relevant. The original articles were then retrieved and their references were hand searched for possible missing articles. Only articles that met the selection criteria were included and criticized. The initial screening revealed 47 potentially relevant articles, of which only 14 have met the selection criteria; their CBCT average measurements error ranged from 0.19 mm to 1.27 mm; however, no valid meta-analysis could be made due to the high heterogeneity between the included studies. Under the limitation of the number and strength of the available studies, we concluded that CBCT provides an assessment of alveolar bone loss in periodontal defect with a minimum reported mean measurements error of 0.19 ± 0.11 mm and a maximum reported mean measurements error of 1.27 ± 1.43 mm, and there is no agreement between the studies regarding the direction of the deviation whether over or underestimation. However, we should emphasize that the evidence to this data is not strong. PMID:27563194

  18. Bilateral and pseudobilateral tonsilloliths: Three dimensional imaging with cone-beam computed tomography

    PubMed Central

    Mısırlıoglu, Melda; Nalcaci, Rana; Yardımcı, Selmi

    2013-01-01

    Purpose Tonsilloliths are calcifications found in the crypts of the palatal tonsils and can be detected on routine panoramic examinations. This study was performed to highlight the benefits of cone-beam computed tomography (CBCT) in the diagnosis of tonsilloliths appearing bilaterally on panoramic radiographs. Materials and Methods The sample group consisted of 7 patients who had bilateral radiopaque lesions at the area of the ascending ramus on panoramic radiographs. CBCT images for every patient were obtained from both sides of the jaw to determine the exact locations of the lesions and to rule out other calcifications. The calcifications were evaluated on the CBCT images using Ez3D2009 software. Additionally, the obtained images in DICOM format were transferred to ITK SNAP 2.4.0 pc software for semiautomatic segmentation. Segmentation was performed using contrast differences between the soft tissues and calcifications on grayscale images, and the volume in mm3 of the segmented three dimensional models were obtained. Results CBCT scans revealed that what appeared on panoramic radiographs as bilateral images were in fact unilateral lesions in 2 cases. The total volume of the calcifications ranged from 7.92 to 302.5mm3. The patients with bilaterally multiple and large calcifications were found to be symptomatic. Conclusion The cases provided the evidence that tonsilloliths should be considered in the differential diagnosis of radiopaque masses involving the mandibular ramus, and they highlight the need for a CBCT scan to differentiate pseudo- or ghost images from true bilateral pathologies. PMID:24083209

  19. Evaluation of canalis basilaris medianus using cone-beam computed tomography

    PubMed Central

    Zahedpasha, Samir; Rathore, Sonali A.; Mupparapu, Mel

    2016-01-01

    The aim of this report is to present two cases of canalis basilaris medianus as identified on cone-beam computed tomography (CBCT) in the base of the skull. The CBCT data sets were sent for radiographic consultation. In both cases, multi-planar views revealed an osseous defect in the base of the skull in the clivus region, the sagittal view showed a unilateral, well-defined, non-corticated, track-like low-attenuation osseous defect in the clivus. The appearance of the defect was highly reminiscent of a fracture of the clivus. The borders of osseous defect were smooth, and no other radiographic signs suggestive of osteolytic destructive processes were noted. Based on the overall radiographic examination, a radiographic impression of canalis basilaris medianus was made. Canalis basilaris medianus is a rare anatomical variant and is generally observed on the clivus. Due to its potential association with meningitis, it should be recognized and reported to avoid potential complications. PMID:27358822

  20. View-dependent geometric calibration for offset flat-panel cone beam computed tomography systems

    NASA Astrophysics Data System (ADS)

    Nguyen, Van-Giang

    2016-04-01

    Geometric parameters that define the geometry of imaging systems are crucial for image reconstruction and image quality in x-ray computed tomography (CT). The problem of determining geometric parameters for an offset flat-panel cone beam CT (CBCT) system, a recently introduced modality with a large field of view, with the assumption of an unstable mechanism and geometric parameters that vary in each view, is considered. To accurately and rapidly find the geometric parameters for each projection view, we use the projection matrix method and design a dedicated phantom that is partially visible in all projection views. The phantom consists of balls distributed symmetrically in a cylinder to ensure the inclusion of the phantom in all views, and a large portion of the phantom is covered in the projection image. To efficiently use calibrated geometric information in the reconstruction process and get rid of approximation errors, instead of decomposing the projection matrix into actual geometric parameters that are manually corrected before being used in reconstruction, as in conventional methods, we directly use the projection matrix and its pseudo-inverse in projection and backprojection operations of reconstruction algorithms. The experiments illustrate the efficacy of the proposed method with a real offset flat-panel CBCT system in dental imaging.

  1. Breast density measurement: 3D cone beam computed tomography (CBCT) images versus 2D digital mammograms

    NASA Astrophysics Data System (ADS)

    Han, Tao; Lai, Chao-Jen; Chen, Lingyun; Liu, Xinming; Shen, Youtao; Zhong, Yuncheng; Ge, Shuaiping; Yi, Ying; Wang, Tianpeng; Yang, Wei T.; Shaw, Chris C.

    2009-02-01

    Breast density has been recognized as one of the major risk factors for breast cancer. However, breast density is currently estimated using mammograms which are intrinsically 2D in nature and cannot accurately represent the real breast anatomy. In this study, a novel technique for measuring breast density based on the segmentation of 3D cone beam CT (CBCT) images was developed and the results were compared to those obtained from 2D digital mammograms. 16 mastectomy breast specimens were imaged with a bench top flat-panel based CBCT system. The reconstructed 3D CT images were corrected for the cupping artifacts and then filtered to reduce the noise level, followed by using threshold-based segmentation to separate the dense tissue from the adipose tissue. For each breast specimen, volumes of the dense tissue structures and the entire breast were computed and used to calculate the volumetric breast density. BI-RADS categories were derived from the measured breast densities and compared with those estimated from conventional digital mammograms. The results show that in 10 of 16 cases the BI-RADS categories derived from the CBCT images were lower than those derived from the mammograms by one category. Thus, breasts considered as dense in mammographic examinations may not be considered as dense with the CBCT images. This result indicates that the relation between breast cancer risk and true (volumetric) breast density needs to be further investigated.

  2. Scatter correction for kilovoltage cone-beam computed tomography (CBCT) images using Monte Carlo simulations

    NASA Astrophysics Data System (ADS)

    Jarry, G.; Graham, S. A.; Jaffray, D. A.; Moseley, D. J.; Verhaegen, F.

    2006-03-01

    In this work Monte Carlo (MC) simulations are used to correct kilovoltage (kV) cone-beam computed tomographic (CBCT) projections for scatter radiation. All images were acquired using a kV CBCT bench-top system composed of an x-ray tube, a rotation stage and a flat-panel imager. The EGSnrc MC code was used to model the system. BEAMnrc was used to model the x-ray tube while a modified version of the DOSXYZnrc program was used to transport the particles through various phantoms and score phase space files with identified scattered and primary particles. An analytical program was used to read the phase space files and produce image files. The scatter correction was implemented by subtracting Monte Carlo predicted scatter distribution from measured projection images; these projection images were then reconstructed. Corrected reconstructions showed an important improvement in image quality. Several approaches to reduce the simulation time were tested. To reduce the number of simulated scatter projections, the effect of varying the projection angle on the scatter distribution was evaluated for different geometries. It was found that the scatter distribution does not vary significantly over a 30-degree interval for the geometries tested. It was also established that increasing the size of the voxels in the voxelized phantom does not affect the scatter distribution but reduces the simulation time. Different techniques to smooth the scatter distribution were also investigated.

  3. Assessment of maxillary third molars with panoramic radiography and cone-beam computed tomography

    PubMed Central

    Jung, Yun-Hoa

    2015-01-01

    Purpose This study investigated maxillary third molars and their relation to the maxillary sinus using panoramic radiography and cone-beam computed tomography (CBCT). Materials and Methods A total of 395 maxillary third molars in 234 patients were examined using panoramic radiographs and CBCT images. We examined the eruption level of the maxillary third molars, the available retromolar space, the angulation, the relationship to the second molars, the number of roots, and the relationship between the roots and the sinus. Results Females had a higher frequency of maxillary third molars with occlusal planes apical to the cervical line of the second molar (Level C) than males. All third molars with insufficient retromolar space were Level C. The most common angulation was vertical, followed by buccoangular. Almost all of the Level C molars were in contact with the roots of the second molar. Erupted teeth most commonly had three roots, and completely impacted teeth most commonly had one root. The superimposition of one third of the root and the sinus floor was most commonly associated with the sinus floor being located on the buccal side of the root. Conclusion Eruption levels were differently distributed according to gender. A statistically significant association was found between the eruption level and the available retromolar space. When panoramic radiographs showed a superimposition of the roots and the sinus floor, expansion of the sinus to the buccal side of the root was generally observed in CBCT images. PMID:26730371

  4. Digital panoramic radiography versus cone beam computed tomography in the delineation of maxillomandibular tumors.

    PubMed

    Almeida-Barros, Renata Quirino de; Abilio, Vanessa Maria Freire; Yamamoto, Angela Toshie Araki; Melo, Daniela Pita de; Godoy, Gustavo Pina; Bento, Patricia Meira

    2015-01-01

    This research aimed to compare the efficacy of digital panoramic radiography (DPR) with that of cone beam computed tomography (CBCT) for delineation of odontogenic and nonodontogenic tumors. From November 2009 through March 2011, 23 tumors in the maxillomandibular complex were diagnosed by histopathological examination. All DPRs and CBCTs were obtained and analyzed by a single previously calibrated radiologist, who considered the following radiographic aspects: clarity of the lesion edges, relation with dental elements, involvement of adjacent anatomical structures, cortical bone expansion and disruption, and, if present, type of involved anatomical structures and site of bone expansion and disruption. Of 23 patients, 15 (65.2%) were male and 8 (34.8%) were female. The tumor was classified as odontogenic in 73.9% of patients and nonodontogenic in 26.1% of patients. Analysis revealed that 56.5% of the tumors were located in the mandible, 34.8% in the maxilla, and 8.7% in both arches. For all analyzed variables, CBCTs offered more accurate details than did DPRs. Panoramic radiography should not be the examination of choice to visualize lesions in the maxillomandibular complex. PMID:26545285

  5. Analysis of Interfraction Prostate Motion Using Megavoltage Cone Beam Computed Tomography

    SciTech Connect

    Bylund, Kevin C. Bayouth, John E.; Smith, Mark C.; Hass, A. Curtis; Bhatia, Sudershan K.; Buatti, John M..

    2008-11-01

    Purpose: Determine the degree of interfraction prostate motion and its components measured by using daily megavoltage (MV) cone beam computed tomography (CBCT) imaging. Methods and Materials: A total of 984 daily MV CBCT images from 24 patients undergoing definitive intensity-modulated radiotherapy for localized prostate cancer were analyzed retrospectively. Pretreatment couch shifts, based on physician registration of MV CBCT to planning CT data sets, were used as a measure of daily interfraction motion. Off-line bony registration was performed to separate bony misalignment from internal organ motion. Interobserver and intraobserver variation studies were performed on 20 MV CBCT images. Results: Mean interfraction prostate motion was 6.7 mm, with the greatest single-axis deviation in the anterior-posterior (AP) direction. The largest positional inaccuracy was accounted for by systematic deviations in bony misalignment, whereas random deviations occurred from bony misalignment and internal prostate motion. In the aggregate, AP motion did not correlate with days elapsed since beginning therapy or on average with rectal size at treatment planning. Interobserver variation was greatest in the AP direction, decreased in experienced observers, and further decreased in intraobserver studies. Mean interfraction motion during the first 6 days of therapy, when used as a subsequent offset, reduced acceptable AP planning target volume margins by 50%. Conclusion: The MV CBCT is a practical direct method of daily localization that shows significant interfraction motion with respect to conventional three-dimensional conformal and intensity-modulated radiotherapy margins, similar to that measured in other modalities.

  6. A cone beam computed tomography inspection method for fuel rod cladding tubes

    NASA Astrophysics Data System (ADS)

    Fu, Jian; Tan, Renbo; Wang, Qianli; Deng, Jingshan; Liu, Ming

    2012-10-01

    Fuel rods in nuclear power plants consist of UO2 pellets enclosed in Zirconium alloy (Zircaloy) cladding tube, which is composed of a body and a plug. The body is manufactured separately from the plug and, before its use, the plug is welded with the body. It is vitally important for the welding zone to remain free from defects after the fuel pellets are loaded into the cladding tube to prevent the radioactive fission products from leaking. X-ray computed tomography (CT) is in principle a feasible inspection method for the welding zone, but it faces several challenges due to the high attenuation of Zircaloy. In this paper, a cone beam CT method is proposed to address these issues and perform the welding flaw inspection. A Zircaloy compensator is adopted to narrow the signal range, a structure-based background removal technique to reveal the defects, a linear extension technique to determine the reference X-ray intensity signal and FDK algorithm to reconstruct the slice images. A prototype system, based on X-ray tube source and flat panel detector, has been developed and the experiments in this system have demonstrated that the welding void and the incomplete joint penetrations could be detected by this method. This approach may find applications in the quality control of nuclear fuel rods.

  7. Temporomandibular joint osteoarthritis: cone beam computed tomography findings, clinical features, and correlations.

    PubMed

    Cömert Kiliç, S; Kiliç, N; Sümbüllü, M A

    2015-10-01

    The aim of this study was to determine the prevalence of and associations between clinical signs and symptoms and cone beam computed tomography (CBCT) findings of temporomandibular joint osteoarthritis (TMJ-OA). Seventy-six patients (total 117 TMJ) with osteoarthritis were included in this study. Clinical signs and symptoms and CBCT findings were reviewed retrospectively. A considerable decrease in mandibular motions and mastication efficiency, and considerable increase in joint sounds and general pain complaints were observed. The most frequent condylar bony changes were erosion (110 joints, 94.0%), followed by flattening (108 joints, 92.3%), osteophytes (93 joints, 79.5%), hypoplasia (22 joints, 18.8%), sclerosis (14 joints, 12.0%), and subchondral cyst (four joints, 3.4%). Flattening of the articular eminence and pneumatization were each observed in five joints. Forty-one patients had bilateral degeneration and 35 had unilateral degeneration. Hypermobility was detected in 47 degenerative joints. Masticatory efficiency was negatively correlated with both condylar flattening and sclerosis, and general pain complaints was positively correlated with condylar flattening. Condylar erosion, flattening, osteophytes, pain, joint sounds, reduced jaw movements, and worsened mastication were common findings in TMJ-OA in the present study. Poor correlations were found between osseous changes and clinical signs and symptoms of TMJ-OA. CBCT is a powerful diagnostic tool for the diagnosis of TMJ-OA. PMID:26194774

  8. Accuracy of digital periapical radiography and cone-beam computed tomography in detecting external root resorption

    PubMed Central

    Geha, Hassem; Sankar, Vidya; Teixeira, Fabricio B.; McMahan, Clyde Alex; Noujeim, Marcel

    2015-01-01

    Purpose The purpose of this study was to evaluate and compare the efficacy of cone-beam computed tomography (CBCT) and digital intraoral radiography in diagnosing simulated small external root resorption cavities. Materials and Methods Cavities were drilled in 159 roots using a small spherical bur at different root levels and on all surfaces. The teeth were imaged both with intraoral digital radiography using image plates and with CBCT. Two sets of intraoral images were acquired per tooth: orthogonal (PA) which was the conventional periapical radiograph and mesioangulated (SET). Four readers were asked to rate their confidence level in detecting and locating the lesions. Receiver operating characteristic (ROC) analysis was performed to assess the accuracy of each modality in detecting the presence of lesions, the affected surface, and the affected level. Analysis of variation was used to compare the results and kappa analysis was used to evaluate interobserver agreement. Results A significant difference in the area under the ROC curves was found among the three modalities (P=0.0002), with CBCT (0.81) having a significantly higher value than PA (0.71) or SET (0.71). PA was slightly more accurate than SET, but the difference was not statistically significant. CBCT was also superior in locating the affected surface and level. Conclusion CBCT has already proven its superiority in detecting multiple dental conditions, and this study shows it to likewise be superior in detecting and locating incipient external root resorption. PMID:26389057

  9. The evaluation of palatal bone thickness for implant insertion with cone beam computed tomography.

    PubMed

    Sumer, A P; Caliskan, A; Uzun, C; Karoz, T B; Sumer, M; Cankaya, S

    2016-02-01

    The palate is an alternative anchoring site for orthodontic implants and screws. The use of osseointegrated implants in the intermaxillary suture has recently been described as a fast, effective, and low-cost technique for patients with atrophy of the maxillae. The aim of this study was to use cone beam computed tomography (CBCT) to evaluate the thickness of the bone surrounding the intermaxillary suture in relation to the insertion of osseointegrated implants. CBCT images of 144 patients (72 males, 72 females) aged 35-86 years were evaluated. The vertical bone height of the intermaxillary suture was measured using coronal and sagittal Images 5, 10, 15, 20, and 25 mm posterior to the incisive foramen. The mean bone thicknesses from the anterior to the posterior region were 5.59, 4.38, 3.91, 3.95, and 3.94 mm, respectively. Bone thickness was significantly different among the five anteroposterior areas of the suture, but there were no significant differences between males and females, or among age groups. The highest part of the intermaxillary suture was in the anterior region. Three-dimensional imaging is recommended to accurately identify palate bone thickness for implant placement. PMID:26458537

  10. SADMFR Guidelines for the Use of Cone-Beam Computed Tomography/Digital Volume Tomography.

    PubMed

    Dula, Karl; Benic, Goran I; Bornstein, Michael; Dagassan-Berndt, Dorothea; Filippi, Andreas; Hicklin, Stefan; Kissling-Jeger, Franziska; Luebbers, Heinz-Theo; Sculean, Anton; Sequeira-Byron, Patrick; Walter, Clemens; Zehnder, Matthias

    2015-01-01

    In 2011, the first consensus conference on guidelines for the use of cone-beam computed tomography (CBCT) was convened by the Swiss Society of Dentomaxillofacial Radiology (SGDMFR). This conference covered topics of oral and maxillofacial surgery, temporomandibular joint dysfunctions and disorders, and orthodontics. In 2014, a second consensus conference was convened on guidelines for the use of CBCT in endodontics, periodontology, reconstructive dentistry and pediatric dentistry. The guidelines are intended for all dentists in order to facilitate the decision as to when the use of CBCT is justified. As a rule, the use of CBCT is considered restrictive, since radiation protection reasons do not allow its routine use. CBCT should therefore be reserved for complex cases where its application can be expected to provide further information that is relevant to the choice of therapy. In periodontology, sufficient information is usually available from clinical examination and periapical radiographs; in endodontics alternative methods can often be used instead of CBCT; and for implant patients undergoing reconstructive dentistry, CT is of interest for the workflow from implant planning to the superstructure. For pediatric dentistry no application of CBCT is seen for caries diagnosis. PMID:26399521

  11. Management of Oehler's Type III Dens Invaginatus Using Cone Beam Computed Tomography.

    PubMed

    Ranganathan, Jaya; Rangarajan Sundaresan, Mohan Kumar; Ramasamy, Srinivasan

    2016-01-01

    Dens Invaginatus is a dental malformation that poses diagnostic difficulties in the clinical context. This anomaly may increase the risk of pulp disease and can potentially complicate endodontic procedure due to the aberrant root canal anatomy. Compared to conventional radiographs, three-dimensional images obtained with Cone Beam Computed Tomography (CBCT) are invaluable in the diagnosis of the extent of this anomaly and in the appropriate treatment planning. Oehler's classification (1957) for Dens Invaginatus (DI) into three types depending on the depth of the invagination has been used for treatment planning. Of the three types Type III DI is characterized by infolding of the enamel into the tooth up to the root apex and is considered as the most severe variant of DI and hence the most challenging to treat endodontically, due to the morphological complexities. This report describes a case of Oehler's Type III DI in a necrotic permanent maxillary lateral incisor in which CBCT images played a key role in diagnosis and treatment planning. The case was managed successfully by a combination of nonsurgical and surgical endodontic therapy with orthograde and retrograde thermoplastic gutta percha obturation. PMID:27069697

  12. Diagnostic Accuracy of Cone-Beam Computed Tomography and Periapical Radiography in Internal Root Resorption

    PubMed Central

    Madani, Zahrasadat; Moudi, Ehsan; Bijani, Ali; Mahmoudi, Elham

    2016-01-01

    Introduction: The aim of this study was to compare the diagnostic value of cone-beam computed tomography (CBCT) and periapical (PA) radiography in detecting internal root resorption. Methods and Materials: Eighty single rooted human teeth with visible pulps in PA radiography were split mesiodistally along the coronal plane. Internal resorption like lesions were created in three areas (cervical, middle and apical) in labial wall of the canals in different diameters. PA radiography and CBCT images were taken from each tooth. Two observers examined the radiographs and CBCT images to evaluate the presence of resorption cavities. The data were statistically analyzed and degree of agreement was calculated using Cohen’s kappa (k) values. Results: The mean±SD of agreement coefficient of kappa between the two observers of the CBCT images was calculated to be 0.681±0.047. The coefficients for the direct, mesial and distal PA radiography were 0.405±0.059, 0.421±0.060 and 0.432±0.056, respectively (P=0.001). The differences in the diagnostic accuracy of resorption of different sizes were statistically significant (P<0.05); however, the PA radiography and CBCT, had no statistically significant differences in detection of internal resorption lesions in the cervical, middle and apical regions. Conclusion: Though, CBCT has a higher sensitivity, specificity, positive predictive value and negative predictive value in comparison with conventional radiography, this difference was not significant. PMID:26843878

  13. Cone-beam computed tomography as a surgical guide to impacted anterior teeth

    PubMed Central

    Jeremias, Fabiano; Fragelli, Camila Maria Bullio; Mastrantonio, Simone Di Salvo; dos Santos-Pinto, Lourdes; dos Santos-Pinto, Ary; Pansani, Cyneu Aguiar

    2016-01-01

    Surgical procedure for removal of impacted teeth is a challenge for clinicians as it involves accuracy in the diagnosis and localization of the dental elements. The cone-beam computed tomography (CBCT), compared to the conventional radiography, has a greater potential to provide complementary information because of its three-dimensional (3D) images, reducing the possibility of failures in surgical procedures. Two 10-year-old boys presented with aesthetic issues associated with the juxtaposition of ectopic teeth with the permanent ones. Both two-dimensional and 3D preoperative radiographic diagnostic sets were produced. The occlusal and panoramic radiographs were not enough for proper localization of impacted incisors. Thus, the CBCT was used as a surgical guide. After 2 years of longitudinal following, no lesion was recorded, and the orthodontic treatment has proven successful. In all cases, CBCT contributed to both diagnosis and correct localization of supernumerary teeth, aiding the professional in the treatment planning, and consequently in the clinical success. The surgeries were completely safe, avoiding damage in noble structures, and providing a better recovering of the patients. PMID:26962322

  14. Validation of cone-beam computed tomography as a predictor of osteoporosis using the Klemetti classification.

    PubMed

    Alonso, Maria Beatriz Carrazzone Cal; Vasconcelos, Taruska Ventorini; Lopes, Luciana Jácome; Watanabe, Plauto Christopher Aranha; Freitas, Deborah Queiroz

    2016-05-31

    This study aimed at evaluating the validity of cone-beam computed tomography (CBCT) for assessing mandibular bone quality using the Klemetti classification. The morphology of the endosteal mandibular cortex of 30 (60 hemi-mandibles) postmenopausal women between the ages of 45 and 80 years was evaluated based on the Klemetti classification in panoramic radiographs used as reference images. Afterwards, panoramic reconstruction and cross-sectional slices of CBCT examinations of these patients were analyzed and categorized according to the same classification. All the images were assessed by two oral radiologists. The McNemar-Bowker test compared the agreement between the CBCT images and the reference images. No differences were found between the diagnostic results based on panoramic radiography and panoramic reconstruction. However, the mean scores for the cross-sectional evaluation were higher, and the results, statistically different from the others. Based on the disagreement found between the panoramic radiographs and the CBCT cross-sectional slices, the Klemetti classification is not an adequate means of assessing bone quality with CBCT. On the other hand, the higher values found for the cross-sectional slices could be associated with better visibility on the CBCT images. PMID:27253142

  15. Cone-beam computed tomography as a surgical guide to impacted anterior teeth.

    PubMed

    Jeremias, Fabiano; Fragelli, Camila Maria Bullio; Mastrantonio, Simone Di Salvo; Dos Santos-Pinto, Lourdes; Dos Santos-Pinto, Ary; Pansani, Cyneu Aguiar

    2016-01-01

    Surgical procedure for removal of impacted teeth is a challenge for clinicians as it involves accuracy in the diagnosis and localization of the dental elements. The cone-beam computed tomography (CBCT), compared to the conventional radiography, has a greater potential to provide complementary information because of its three-dimensional (3D) images, reducing the possibility of failures in surgical procedures. Two 10-year-old boys presented with aesthetic issues associated with the juxtaposition of ectopic teeth with the permanent ones. Both two-dimensional and 3D preoperative radiographic diagnostic sets were produced. The occlusal and panoramic radiographs were not enough for proper localization of impacted incisors. Thus, the CBCT was used as a surgical guide. After 2 years of longitudinal following, no lesion was recorded, and the orthodontic treatment has proven successful. In all cases, CBCT contributed to both diagnosis and correct localization of supernumerary teeth, aiding the professional in the treatment planning, and consequently in the clinical success. The surgeries were completely safe, avoiding damage in noble structures, and providing a better recovering of the patients. PMID:26962322

  16. Selective doxorubicin drug eluting beads chemoembolization of hypovascular hepatocellular carcinoma using cone beam computed tomography.

    PubMed

    Kalra, Naveen; Mahajan, Divyesh; Chawla, Yogesh; Khandelwal, N

    2012-10-01

    Hepatocellular carcinoma (HCC) of the liver is the third most common cause of cancer-related deaths in the world. Only one-third of patients with HCC are suitable candidates for hepatic resection. Transarterial chemoembolization (TACE) is performed in unresectable HCC. Drug-eluting beads (DEB) TACE is a modification of TACE, in which doxorubicin beads are used as embolizing material. These beads deliver the drug and embolize the vessels; however, it carries the risk of non-target embolization and it is difficult in cases with absent arterial blush on digital subtraction angiography (DSA). This is resolved using C-arm cone-beam computed tomography in the DSA suite. It identifies the tumor-feeding vessels, their area of supply, and differentiates between tumor and normal liver parenchyma. In addition, it is very useful in the embolization of hypovascular HCC. It helps and guides the radiologist in performing TACE effectively and also prevents non-target embolization of normal liver parenchyma. PMID:23833414

  17. Three-dimensional maxillary and mandibular regional superimposition using cone beam computed tomography: a validation study.

    PubMed

    Koerich, L; Burns, D; Weissheimer, A; Claus, J D P

    2016-05-01

    This study aimed to validate a novel method for fast regional superimposition of cone beam computed tomography (CBCT) scans. The method can be used with smaller field of view scans, thereby allowing for a lower radiation dose. This retrospective study used two dry skulls and secondary data from 15 patients who had more than one scan taken using the same machine. Two observers tested two types of regional voxel-based superimposition: maxillary and mandibular. The registration took 10-15s. Three-dimensional surface models of the maxillas and mandibles were generated via standardized threshold segmentation, and the accuracy and reproducibility of the superimpositions were assessed using the iterative closest point technique to measure the root mean square (RMS) distance between the images. Five areas were measured and a RMS≤0.25 was considered successful. Descriptive statistics and the intra-class correlation coefficient (ICC) were used to compare the intra-observer measurement reproducibility. The ICC was ≥0.980 for all of the variables and the highest RMS found was 0.241. The inter-observer reproducibility was assessed case by case and was perfect (RMS 0) for 68% (23 out of 34) of the superimpositions done and not clinically significant (RMS≤0.25) for the other 32%. The method is fast, accurate, and reproducible and is an alternative to cranial base superimposition. PMID:26794399

  18. Cone-beam computed tomography evaluation of Pont's index predictability for Malay population in orthodontics

    PubMed Central

    Alam, Mohammad Khursheed; Shahid, Fazal; Purmal, Kathiravan; Khamis, Mohd Fadhli

    2015-01-01

    Introduction: In orthodontic treatment, three-dimensional (3D) dental casts has a significant role in diagnosis and treatment planning. The aim of this study was to evaluate Pont's index predictability in orthodontics. Materials and Methods: Premolar arch width, molar arch width and mesiodistal width of the maxillary incisors were measured three-dimensionally to assess shape of dental arches. The data source was cone beam computed tomography (CBCT) high volumetric data acquisitions from Malay ethnic background. Arch widths were measured and recorded from 53 subjects (32 male and 21 female with the mean age, 25.81), both the maxillary and mandibular arches, to obtain CBCT high volumetric data. All measurements were obtained through CBCT Planmeca Romexis TM Software 2.3.1.R (Helsinki, Finland). Results: Pont's formula overestimated the upper and lower interpremolar distance, with mean differences of 8.35 ± 3 mm and 12.02 ± 3.20 mm, respectively. Furthermore, the formula overestimated the upper and lower intermolar distance, with mean differences of 7.87 ± 3 mm and 16.14 ± 5.86 mm, respectively. Conclusions: The results indicate that Pont's index is not practical for use with the Malaysian population since the index overestimated interpremolar and intermolar widths. This raises questions whether the index is a true predictor of arch width measurements. PMID:26604597

  19. Management of Oehler's Type III Dens Invaginatus Using Cone Beam Computed Tomography

    PubMed Central

    Ranganathan, Jaya; Rangarajan Sundaresan, Mohan Kumar; Ramasamy, Srinivasan

    2016-01-01

    Dens Invaginatus is a dental malformation that poses diagnostic difficulties in the clinical context. This anomaly may increase the risk of pulp disease and can potentially complicate endodontic procedure due to the aberrant root canal anatomy. Compared to conventional radiographs, three-dimensional images obtained with Cone Beam Computed Tomography (CBCT) are invaluable in the diagnosis of the extent of this anomaly and in the appropriate treatment planning. Oehler's classification (1957) for Dens Invaginatus (DI) into three types depending on the depth of the invagination has been used for treatment planning. Of the three types Type III DI is characterized by infolding of the enamel into the tooth up to the root apex and is considered as the most severe variant of DI and hence the most challenging to treat endodontically, due to the morphological complexities. This report describes a case of Oehler's Type III DI in a necrotic permanent maxillary lateral incisor in which CBCT images played a key role in diagnosis and treatment planning. The case was managed successfully by a combination of nonsurgical and surgical endodontic therapy with orthograde and retrograde thermoplastic gutta percha obturation. PMID:27069697

  20. The relationship between dental implant stability and trabecular bone structure using cone-beam computed tomography

    PubMed Central

    2016-01-01

    Purpose The objective of this study was to investigate the relationships between primary implant stability as measured by impact response frequency and the structural parameters of trabecular bone using cone-beam computed tomography(CBCT), excluding the effect of cortical bone thickness. Methods We measured the impact response of a dental implant placed into swine bone specimens composed of only trabecular bone without the cortical bone layer using an inductive sensor. The peak frequency of the impact response spectrum was determined as an implant stability criterion (SPF). The 3D microstructural parameters were calculated from CT images of the bone specimens obtained using both micro-CT and CBCT. Results SPF had significant positive correlations with trabecular bone structural parameters (BV/TV, BV, BS, BSD, Tb.Th, Tb.N, FD, and BS/BV) (P<0.01) while SPF demonstrated significant negative correlations with other microstructural parameters (Tb.Sp, Tb.Pf, and SMI) using micro-CT and CBCT (P<0.01). Conclusions There was an increase in implant stability prediction by combining BV/TV and SMI in the stepwise forward regression analysis. Bone with high volume density and low surface density shows high implant stability. Well-connected thick bone with small marrow spaces also shows high implant stability. The combination of bone density and architectural parameters measured using CBCT can predict the implant stability more accurately than the density alone in clinical diagnoses. PMID:27127692

  1. Configuration of the inferior alveolar canal as detected by cone beam computed tomography

    PubMed Central

    Nair, Umadevi P; Yazdi, Mehran H; Nayar, Gautam M; Parry, Heath; Katkar, Rujuta A; Nair, Madhu K

    2013-01-01

    Aims: The aim of this study is to evaluate the course of the inferior alveolar canal (IAC) including its frequently seen variations in relation to root apices and the cortices of the mandible at fixed pre-determined anatomic reference points using cone beam volumetric computed tomography (CBVCT). Material and Methods: This retrospective study utilized CBVCT images from 44 patients to obtain quantifiable data to localize the IAC. Measurements to the IAC were made from the buccal and lingual cortical plates (BCP/LCP), inferior border of the mandible and the root apices of the mandibular posterior teeth and canine. Descriptive analysis was used to map out the course of the IAC. Results: IACs were noted to course superiorly toward the root apices from the second molar to the first premolar and closer to the buccal cortical plate anteriorly. The canal was closest to the LCP at the level of the second molar. In 32.95% of the cases, the canal was seen at the level of the canine. Conclusions: This study indicates that caution needs to be exercised during endodontic surgical procedures in the mandible even at the level of the canine. CBVCT seems to provide an optimal, low-dose, 3D imaging modality to help address the complexities in canal configuration. PMID:24347885

  2. Detection of vertical root fracture using cone beam computed tomography: report of two cases.

    PubMed

    Tang, Lu; Zhou, Xue-dong; Wang, Yao; Zhang, Lan; Zheng, Qing-hua; Huang, Ding-ming

    2011-12-01

    Vertical root fractures (VRFs) often occur in endodontically treated teeth and in patients older than 40 years of age. However, VRFs in teeth without endodontic treatment are relatively uncommon. VRFs are difficult to diagnose as the symptoms are non-specific or often delayed. The most common radiographic findings are thickening of the periodontal ligament, deep, localized, vertical bone loss, and localized periradicular bone loss. The explicit feature for detecting VRFs is direct visualization of a radiolucent fracture line on radiographs. However, the fracture line can be difficult to directly visualize in conventional diagnostic methods such as periapical radiographs. If unrecognized, VRFs can lead to frustration and inappropriate endodontic treatment. The two cases reported here demonstrate that the use of cone beam computed tomography (CBCT) successfully diagnoses VRFs on teeth without representative clinical and periapical radiographic findings. The clear fracture line can be discerned from the images of CBCT. Thus, CBCT imaging is useful in rapid diagnosis of VRFs and designing of further treatment. PMID:21752189

  3. Detection of vertical root fractures in endodontically treated teeth by a cone beam computed tomography scan.

    PubMed

    Hassan, Bassam; Metska, Maria Elissavet; Ozok, Ahmet Rifat; van der Stelt, Paul; Wesselink, Paul Rudolf

    2009-05-01

    Our aim was to compare the accuracy of cone beam computed tomography (CBCT) scans and periapical radiographs (PRs) in detecting vertical root fractures (VRFs) and to assess the influence of root canal filling (RCF) on fracture visibility. Eighty teeth were endodontically prepared and divided into four groups. The teeth in groups A and B were artificially fractured, and teeth in groups C and D were not. Groups A and C were root filled. Four observers evaluated the CBCT scans and PR images. Sensitivity and specificity for VRF detection of CBCT were 79.4% and 92.5% and for PR were 37.1% and 95%, respectively. The specificity of CBCT was reduced (p = 0.032) by the presence of RCF, but its overall accuracy was not influenced (p = 0.654). Both the sensitivity (p = 0.006) and overall accuracy (p = 0.008) of PRs were reduced by the presence of RCF. The results showed an overall higher accuracy for CBCT (0.86) scans than PRs (0.66) for detecting VRF. PMID:19410091

  4. Evaluation of canalis basilaris medianus using cone-beam computed tomography.

    PubMed

    Syed, Ali Z; Zahedpasha, Samir; Rathore, Sonali A; Mupparapu, Mel

    2016-06-01

    The aim of this report is to present two cases of canalis basilaris medianus as identified on cone-beam computed tomography (CBCT) in the base of the skull. The CBCT data sets were sent for radiographic consultation. In both cases, multi-planar views revealed an osseous defect in the base of the skull in the clivus region, the sagittal view showed a unilateral, well-defined, non-corticated, track-like low-attenuation osseous defect in the clivus. The appearance of the defect was highly reminiscent of a fracture of the clivus. The borders of osseous defect were smooth, and no other radiographic signs suggestive of osteolytic destructive processes were noted. Based on the overall radiographic examination, a radiographic impression of canalis basilaris medianus was made. Canalis basilaris medianus is a rare anatomical variant and is generally observed on the clivus. Due to its potential association with meningitis, it should be recognized and reported to avoid potential complications. PMID:27358822

  5. Image-Guided Radiotherapy for Liver Cancer Using Respiratory-Correlated Computed Tomography and Cone-Beam Computed Tomography

    SciTech Connect

    Guckenberger, Matthias Sweeney, Reinhart A.; Wilbert, Juergen; Krieger, Thomas; Richter, Anne; Baier, Kurt; Mueller, Gerd; Sauer, Otto; Flentje, Michael

    2008-05-01

    Purpose: To evaluate a novel four-dimensional (4D) image-guided radiotherapy (IGRT) technique in stereotactic body RT for liver tumors. Methods and Materials: For 11 patients with 13 intrahepatic tumors, a respiratory-correlated 4D computed tomography (CT) scan was acquired at treatment planning. The target was defined using CT series reconstructed at end-inhalation and end-exhalation. The liver was delineated on these two CT series and served as a reference for image guidance. A cone-beam CT scan was acquired after patient positioning; the blurred diaphragm dome was interpreted as a probability density function showing the motion range of the liver. Manual contour matching of the liver structures from the planning 4D CT scan with the cone-beam CT scan was performed. Inter- and intrafractional uncertainties of target position and motion range were evaluated, and interobserver variability of the 4D-IGRT technique was tested. Results: The workflow of 4D-IGRT was successfully practiced in all patients. The absolute error in the liver position and error in relation to the bony anatomy was 8 {+-} 4 mm and 5 {+-} 2 mm (three-dimensional vector), respectively. Margins of 4-6 mm were calculated for compensation of the intrafractional drifts of the liver. The motion range of the diaphragm dome was reproducible within 5 mm for 11 of 13 lesions, and the interobserver variability of the 4D-IGRT technique was small (standard deviation, 1.5 mm). In 4 patients, the position of the intrahepatic lesion was directly verified using a mobile in-room CT scanner after application of intravenous contrast. Conclusion: The results of our study have shown that 4D image guidance using liver contour matching between respiratory-correlated CT and cone-beam CT scans increased the accuracy compared with stereotactic positioning and compared with IGRT without consideration of breathing motion.

  6. Identification and Endodontic Management of Middle Mesial Canal in Mandibular Second Molar Using Cone Beam Computed Tomography.

    PubMed

    Paul, Bonny; Dube, Kavita

    2015-01-01

    Endodontic treatments are routinely done with the help of radiographs. However, radiographs represent only a two-dimensional image of an object. Failure to identify aberrant anatomy can lead to endodontic failure. This case report presents the use of three-dimensional imaging with cone beam computed tomography (CBCT) as an adjunct to digital radiography in identification and management of mandibular second molar with three mesial canals. PMID:26664763

  7. Identification and Endodontic Management of Middle Mesial Canal in Mandibular Second Molar Using Cone Beam Computed Tomography

    PubMed Central

    Paul, Bonny; Dube, Kavita

    2015-01-01

    Endodontic treatments are routinely done with the help of radiographs. However, radiographs represent only a two-dimensional image of an object. Failure to identify aberrant anatomy can lead to endodontic failure. This case report presents the use of three-dimensional imaging with cone beam computed tomography (CBCT) as an adjunct to digital radiography in identification and management of mandibular second molar with three mesial canals. PMID:26664763

  8. Assessment of the Airway Characteristics in Children with Cleft Lip and Palate using Cone Beam Computed Tomography

    PubMed Central

    Marwah, Nikhil

    2016-01-01

    ABSTRACT Objective: The aim of our study is to use cone beam computed tomography (CBCT) to assess the dimensional changes in the nasopharyngeal soft-tissue characteristics in children of Indian origin with repaired cleft lip and palate (CLP) and to compare the results with patients with ideal occlusion. Materials and methods: A sample of 20 children (10 girls, 10 boys) with repaired CLP was selected. Cone beam computed tomography scans were taken to measure the nasopharyngeal airway changes in terms of linear measurements and sagittal cross-sectional areas. Error analysis was performed to prevent systematic or random errors. Independent means t-tests and Pearson correlation analysis were used to evaluate sex differences and the correlations among the variables. Results: Nasopharyngeal soft-tissue characteristics were different in the control and the study groups. Subjects with repaired CLP had lesser lower aerial width, lower adenoidal width and lower airway width. The upper airway width was also significantly lesser. The retropalatal and the total airway area were significantly greater in the control group. Conclusion: The narrow pharyngeal airway in patients with CLP might result in functional impairment of breathing in patients. Further investigations are necessary to clarify the relationship between pharyngeal structure and airway function in patients with CLP. How to cite this article: Agarwal A, Marwah N. Assessment of the Airway Characteristics in Children with Cleft Lip and Palate using Cone Beam Computed Tomography. Int J Clin Pediatr Dent 2016;9(1):5-9. PMID:27274147

  9. Applications of linac-mounted kilovoltage Cone-beam Computed Tomography in modern radiation therapy: A review

    PubMed Central

    Srinivasan, Kavitha; Mohammadi, Mohammad; Shepherd, Justin

    2014-01-01

    Summary The use of Cone-beam Computed Tomography (CBCT) in radiotherapy is increasing due to the widespread implementation of kilovoltage systems on the currently available linear accelerators. Cone beam CT acts as an effective Image-Guided Radiotherapy (IGRT) tool for the verification of patient position. It also opens up the possibility of real-time re-optimization of treatment plans for Adaptive Radiotherapy (ART). This paper reviews the most prominent applications of CBCT (linac-mounted) in radiation therapy, focusing on CBCT-based planning and dose calculation studies. This is followed by a concise review of the main issues associated with CBCT, such as imaging artifacts, dose and image quality. It explores how medical physicists and oncologists can best apply CBCT for therapeutic applications. PMID:25006356

  10. Cone-beam Computed Tomography-guided Stereotactic Liver Punctures: A Phantom Study

    SciTech Connect

    Toporek, Grzegorz Wallach, Daphne Weber, Stefan; Bale, Reto; Widmann, Gerlig

    2013-12-15

    Purpose: Images from computed tomography (CT), combined with navigation systems, improve the outcomes of local thermal therapies that are dependent on accurate probe placement. Although the usage of CT is desired, its availability for time-consuming radiological interventions is limited. Alternatively, three-dimensional images from C-arm cone-beam CT (CBCT) can be used. The goal of this study was to evaluate the accuracy of navigated CBCT-guided needle punctures, controlled with CT scans. Methods: Five series of five navigated punctures were performed on a nonrigid phantom using a liver specific navigation system and CBCT volumetric dataset for planning and navigation. To mimic targets, five titanium screws were fixed to the phantom. Target positioning accuracy (TPE{sub CBCT}) was computed from control CT scans and divided into lateral and longitudinal components. Additionally, CBCT-CT guidance accuracy was deducted by performing CBCT-to-CT image coregistration and measuring TPE{sub CBCT-CT} from fused datasets. Image coregistration was evaluated using fiducial registration error (FRE{sub CBCT-CT}) and target registration error (TRE{sub CBCT-CT}). Results: Positioning accuracies in lateral directions pertaining to CBCT (TPE{sub CBCT} = 2.1 {+-} 1.0 mm) were found to be better to those achieved from previous study using CT (TPE{sub CT} = 2.3 {+-} 1.3 mm). Image coregistration error was 0.3 {+-} 0.1 mm, resulting in an average TRE of 2.1 {+-} 0.7 mm (N = 5 targets) and average Euclidean TPE{sub CBCT-CT} of 3.1 {+-} 1.3 mm. Conclusions: Stereotactic needle punctures might be planned and performed on volumetric CBCT images and controlled with multidetector CT with positioning accuracy higher or similar to those performed using CT scanners.

  11. Bone mineral density in cone beam computed tomography: Only a few shades of gray

    PubMed Central

    Campos, Marcio José da Silva; de Souza, Thainara Salgueiro; Mota Júnior, Sergio Luiz; Fraga, Marcelo Reis; Vitral, Robert Willer Farinazzo

    2014-01-01

    Cone beam computed tomography (CBCT) has often been used to determine the quality of craniofacial bone structures through the determination of mineral density, which is based on gray scales of the images obtained. However, there is no consensus regarding the accuracy of the determination of the gray scales in these exams. This study aims to provide a literature review concerning the reliability of CBCT to determine bone mineral density. The gray values obtained with CBCT show a linear relationship with the attenuation coefficients of the materials, Hounsfield Units values obtained with medical computed tomography, and density values from dual energy X-ray absorciometry. However, errors are expected when CBCT images are used to define the quality of the scanned structures because these images show inconsistencies and arbitrariness in the gray values, particularly when related to abrupt change in the density of the object, X-ray beam hardening effect, scattered radiation, projection data discontinuity-related effect, differences between CBCT devices, changes in the volume of the field of view (FOV), and changes in the relationships of size and position between the FOV and the object evaluated. A few methods of mathematical correction of the gray scales in CBCT have been proposed; however, they do not generate consistent values that are independent of the devices and their configurations or of the scanned objects. Thus, CBCT should not be considered the examination of choice for the determination of bone and soft tissue mineral density at the current stage, particularly when values obtained are to be compared to predetermined standard values. Comparisons between symmetrically positioned structures inside the FOV and in relation to the exomass of the object, as it occurs with the right and left sides of the skull, seem to be viable because the effects on the gray scale in the regions of interest are the same. PMID:25170398

  12. Observation of the pulp horn by swept source optical coherence tomography and cone beam computed tomography

    NASA Astrophysics Data System (ADS)

    Iino, Yoshiko; Yoshioka, Toshihiko; Hanada, Takahiro; Ebihara, Arata; Sunakawa, Mitsuhiro; Sumi, Yasunori; Suda, Hideaki

    2015-02-01

    Cone-beam computed tomography (CBCT) is one of the most useful diagnostic techniques in dentistry but it involves ionizing radiation, while swept source optical coherence tomography (SS-OCT) has been introduced recently as a nondestructive, real-time, high resolution imaging technique using low-coherence interferometry, which involves no ionizing radiation. The purpose of this study was to evaluate the ability of SS-OCT to detect the pulp horn (PH) in comparison with that of CBCT. Ten extracted human mandibular molars were used. After horizontally removing a half of the tooth crown, the distance from the cut dentin surface to PH was measured using microfocus computed tomography (Micro CT) (SL) as the gold standard, by CBCT (CL) and by SS-OCT (OL). In the SS-OCT images, only when PH was observed beneath the overlying dentin, the distance from the cut dentin surface to PH was recorded. If the pulp was exposed, it was defined as pulp exposure (PE). The results obtained by the above three methods were statistically analyzed by Spearman's rank correlation coefficient at a significance level of p < 0.01. SS-OCT detected the presence of PH when the distance from the cut dentin surface to PH determined by SL was 2.33 mm or less. Strong correlations of the measured values were found between SL and CL (r=0.87), SL and OL (r=0.96), and CL and OL (r=0.86). The results showed that SS-OCT images correlated closely with CBCT images, suggesting that SS-OCT can be a useful tool for the detection of PH.

  13. Radiological Protection in Cone Beam Computed Tomography (CBCT). ICRP Publication 129.

    PubMed

    Rehani, M M; Gupta, R; Bartling, S; Sharp, G C; Pauwels, R; Berris, T; Boone, J M

    2015-07-01

    The objective of this publication is to provide guidance on radiological protection in the new technology of cone beam computed tomography (CBCT). Publications 87 and 102 dealt with patient dose management in computed tomography (CT) and multi-detector CT. The new applications of CBCT and the associated radiological protection issues are substantially different from those of conventional CT. The perception that CBCT involves lower doses was only true in initial applications. CBCT is now used widely by specialists who have little or no training in radiological protection. This publication provides recommendations on radiation dose management directed at different stakeholders, and covers principles of radiological protection, training, and quality assurance aspects. Advice on appropriate use of CBCT needs to be made widely available. Advice on optimisation of protection when using CBCT equipment needs to be strengthened, particularly with respect to the use of newer features of the equipment. Manufacturers should standardise radiation dose displays on CBCT equipment to assist users in optimisation of protection and comparisons of performance. Additional challenges to radiological protection are introduced when CBCT-capable equipment is used for both fluoroscopy and tomography during the same procedure. Standardised methods need to be established for tracking and reporting of patient radiation doses from these procedures. The recommendations provided in this publication may evolve in the future as CBCT equipment and applications evolve. As with previous ICRP publications, the Commission hopes that imaging professionals, medical physicists, and manufacturers will use the guidelines and recommendations provided in this publication for implementation of the Commission's principle of optimisation of protection of patients and medical workers, with the objective of keeping exposures as low as reasonably achievable, taking into account economic and societal factors, and

  14. Intravenous contrast media application using cone-beam computed tomography in a rabbit model

    PubMed Central

    Kim, Min-Sung; Kim, Bok-Yeol; Choi, Hwa-Young; Choi, Yoon-Joo; Oh, Song-Hee; Kang, Ju-Hee; Lee, Sae-Rom; Kang, Ju-Han; Kim, Gyu-Tae; Choi, Yong-Suk

    2015-01-01

    Purpose This study was performed to evaluate the feasibility of visualizing soft tissue lesions and vascular structures using contrast-enhanced cone-beam computed tomography (CE-CBCT) after the intravenous administration of a contrast medium in an animal model. Materials and Methods CBCT was performed on six rabbits after a contrast medium was administered using an injection dose of 2 mL/kg body weight and an injection rate of 1 mL/s via the ear vein or femoral vein under general anesthesia. Artificial soft tissue lesions were created through the transplantation of autologous fatty tissue into the salivary gland. Volume rendering reconstruction, maximum intensity projection, and multiplanar reconstruction images were reconstructed and evaluated in order to visualize soft tissue contrast and vascular structures. Results The contrast enhancement of soft tissue was possible using all contrast medium injection parameters. An adequate contrast medium injection parameter for facilitating effective CE-CBCT was a 5-mL injection before exposure combined with a continuous 5-mL injection during scanning. Artificial soft tissue lesions were successfully created in the animals. The CE-CBCT images demonstrated adequate opacification of the soft tissues and vascular structures. Conclusion Despite limited soft tissue resolution, the opacification of vascular structures was observed and artificial soft tissue lesions were visualized with sufficient contrast to the surrounding structures. The vascular structures and soft tissue lesions appeared well delineated in the CE-CBCT images, which was probably due to the superior spatial resolution of CE-CBCT compared to other techniques, such as multislice computed tomography. PMID:25793181

  15. Effect of Field of View on Detection of Condyle Bone Defects Using Cone Beam Computed Tomography.

    PubMed

    Salemi, Fatemeh; Shokri, Abbas; Maleki, Fatemeh Hafez; Farhadian, Maryam; Dashti, Gholamreza; Ostovarrad, Farzane; Ranjzad, Hadi

    2016-05-01

    In maxillofacial imaging, cone beam computed tomography (CBCT) is currently the modality of choice for assessment of bony structures of the temporomandibular joint (TMJ). Factors affecting the quality of CBCT images can change its diagnostic accuracy. This study aimed to assess the effect of field of view (FOV) and defect size on the accuracy of CBCT scans for detection of bone defects of the TMJs. This study was conducted on 12 sound TMJs of 6 human dry skulls. Erosions and osteophytes were artificially induced in 0.5, 1, and 1.5-mm sizes on the anterior-superior part of the condyle; CBCT scans were obtained with 6, 9, and 12-inch FOVs by NewTom 3G CBCT system. Two maxillofacial radiologists evaluated the presence/absence and type of defects on CBCT scans. The Cohen kappa was calculated to assess intra- and interobserver reliability. The Mann-Whitney U test was applied to compare the diagnostic accuracy of different FOVs.In comparison of 6- and 12-inch, 9- and 12-inch FOVs in detection of different sizes of erosive lesions, difference was significant (P <0.05), whereas difference between 6- and 9 inch just in 0.5-mm erosive lesion was significant (P = 0.04). In comparison of 6- and 12-inch FOVs in detection of different sizes of osteophyte lesion, difference was significant (P < 0.05), whereas between 6- and 9-inch FOVs statistically significant difference was not observed (P > 0.05). The highest and the lowest diagnostic accuracy of CBCT scans for condyle defects were obtained with 6-inch and 12-inch FOVs, respectively. Diagnostic accuracy of CBCT scans increased with an increase in size of bone defects. PMID:27092920

  16. Cone Beam Computed Tomography Number Errors and Consequences for Radiotherapy Planning: An Investigation of Correction Methods

    SciTech Connect

    Poludniowski, Gavin G.; Evans, Philip M.; Webb, Steve

    2012-09-01

    Purpose: The potential of keV cone beam computed tomography (CBCT) for guiding adaptive replanning is well-known. There are impediments to this, one being CBCT number accuracy. The purpose of this study was to investigate CBCT number correction methods and the affect of residual inaccuracies on dose deposition. Four different correction strategies were applied to the same patient data to compare performance and the sophistication of correction-method needed for acceptable dose errors. Methods and Materials: Planning CT and CBCT reconstructions were used for 12 patients (6 brain, 3 prostate, and 3 bladder cancer patients). All patients were treated using Elekta linear accelerators and XVI imaging systems. Two of the CBCT number correction methods investigated were based on an algorithm previously proposed by the authors but only previously applied to phantoms. Two further methods, based on an approach previously suggested in the research literature, were also examined. Dose calculations were performed using scans of a 'worst' subset of patients using the Pinnacle{sup 3} version 9.0 treatment planning system and the patients' clinical plans. Results: All mean errors in CBCT number were <50 HU, and all correction methods performed well or adequately in dose calculations. The worst single dose discrepancy identified for any of the examined methods or patients was 3.0%. Mean errors in the doses to treatment volumes or organs at risk were negatively correlated with the mean error in CT number. That is, a mean CT number that was too large, averaged over the entire CBCT volume, implied an underdosing in a volume-of-interest and vice versa. Conclusions: Results suggest that (1) the correction of CBCT numbers to within a mean error of 50 HU in the scan volume provides acceptable discrepancies in dose (<3%) and (2) this is achievable with even quite unsophisticated correction methods.

  17. Cone Beam Computed Tomography-Derived Adaptive Radiotherapy for Radical Treatment of Esophageal Cancer

    SciTech Connect

    Hawkins, Maria A.; Brooks, Corrinne; Hansen, Vibeke N.; Aitken, Alexandra; Tait, Diana M.

    2010-06-01

    Purpose: To investigate the potential for reduction in normal tissue irradiation by creating a patient specific planning target volume (PTV) using cone beam computed tomography (CBCT) imaging acquired in the first week of radiotherapy for patients receiving radical radiotherapy. Methods and materials: Patients receiving radical RT for carcinoma of the esophagus were investigated. The PTV is defined as CTV(tumor, nodes) plus esophagus outlined 3 to 5 cm cranio-caudally and a 1.5-cm circumferential margin is added (clinical plan). Prefraction CBCT are acquired on Days 1 to 4, then weekly. No correction for setup error made. The images are imported into the planning system. The tumor and esophagus for the length of the PTV are contoured on each CBCT and 5 mm margin is added. A composite volume (PTV1) is created using Week 1 composite CBCT volumes. The same process is repeated using CBCT Week 2 to 6 (PTV2). A new plan is created using PTV1 (adaptive plan). The coverage of the 95% isodose of PTV1 is evaluated on PTV2. Dose-volume histograms (DVH) for lungs, heart, and cord for two plans are compared. Results: A total of 139 CBCT for 14 cases were analyzed. For the adaptive plan the coverage of the 95% prescription isodose for PTV1 = 95.6% +- 4% and the PTV2 = 96.8% +- 4.1% (t test, 0.19). Lungs V20 (15.6 Gy vs. 10.2 Gy) and heart mean dose (26.9 Gy vs. 20.7 Gy) were significantly smaller for the adaptive plan. Conclusions: A reduced planning volume can be constructed within the first week of treatment using CBCT. A single plan modification can be performed within the second week of treatment with considerable reduction in organ at risk dose.

  18. Quality and accuracy of cone beam computed tomography gated by active breathing control

    SciTech Connect

    Thompson, Bria P.; Hugo, Geoffrey D.

    2008-12-15

    The purpose of this study was to evaluate the quality and accuracy of cone beam computed tomography (CBCT) gated by active breathing control (ABC), which may be useful for image guidance in the presence of respiration. Comparisons were made between conventional ABC-CBCT (stop and go), fast ABC-CBCT (a method to speed up the acquisition by slowing the gantry instead of stopping during free breathing), and free breathing respiration correlated CBCT. Image quality was assessed in phantom. Accuracy of reconstructed voxel intensity, uniformity, and root mean square error were evaluated. Registration accuracy (bony and soft tissue) was quantified with both an anthropomorphic and a quality assurance phantom. Gantry angle accuracy was measured with respect to gantry speed modulation. Conventional ABC-CBCT scan time ranged from 2.3 to 5.8 min. Fast ABC-CBCT scan time ranged from 1.4 to 1.8 min, and respiratory correlated CBCT scans took 2.1 min to complete. Voxel intensity value for ABC gated scans was accurate relative to a normal clinical scan with all projections. Uniformity and root mean square error performance degraded as the number of projections used in the reconstruction of the fast ABC-CBCT scans decreased (shortest breath hold, longest free breathing segment). Registration accuracy for small, large, and rotational corrections was within 1 mm and 1 degree sign . Gantry angle accuracy was within 1 degree sign for all scans. For high-contrast targets, performance for image-guidance purposes was similar for fast and conventional ABC-CBCT scans and respiration correlated CBCT.

  19. Evaluation of condyle defects using different reconstruction protocols of cone-beam computed tomography.

    PubMed

    Bastos, Luana Costa; Campos, Paulo Sérgio Flores; Ramos-Perez, Flávia Maria de Moraes; Pontual, Andrea dos Anjos; Almeida, Solange Maria

    2013-01-01

    This study was conducted to investigate how well cone-beam computed tomography (CBCT) can detect simulated cavitary defects in condyles, and to test the influence of the reconstruction protocols. Defects were created with spherical diamond burs (numbers 1013, 1016, 3017) in superior and/or posterior surfaces of twenty condyles. The condyles were scanned, and cross-sectional reconstructions were performed with nine different protocols, based on slice thickness (0.2, 0.6, 1.0 mm) and on the filters (original image, Sharpen Mild, S9) used. Two observers evaluated the defects, determining their presence and location. Statistical analysis was carried out using simple Kappa coefficient and McNemar's test to check inter- and intra-rater reliability. The chi-square test was used to compare the rater accuracy. Analysis of variance (Tukey's test) assessed the effect of the protocols used. Kappa values for inter- and intra-rater reliability demonstrate almost perfect agreement. The proportion of correct answers was significantly higher than that of errors for cavitary defects on both condyle surfaces (p < 0.01). Only in identifying the defects located on the posterior surface was it possible to observe the influence of the 1.0 mm protocol thickness and no filter, which showed a significantly lower value. Based on the results of the current study, the technique used was valid for identifying the existence of cavities in the condyle surface. However, the protocol of a 1.0 mm-thick slice and no filter proved to be the worst method for identifying the defects on the posterior surface. PMID:24346048

  20. Analysis of Prostate Bed Motion Using Daily Cone-Beam Computed Tomography During Postprostatectomy Radiotherapy

    SciTech Connect

    Ost, Piet; De Meerleer, Gert; De Gersem, Werner; Impens, Aline; De Neve, Wilfried

    2011-01-01

    Purpose: To report on the interfraction total positioning error of the postoperative prostate bed and to quantify its components (bony misalignment [BM]and prostate bed motion [PBM]) using daily kilovoltage cone-beam computed tomography (CBCT). The role of an adaptive radiotherapy schedule (ART) was investigated. Methods and Materials: A total of 547 daily CBCT images from 15 consecutive patients who had been treated with prostate bed radiotherapy were retrospectively analyzed. The positioning error was measured by rigid co-registration of the daily CBCT with pretreatment CT planning scan. The total positioning error was quantified by co-registration of the CBCT with the CT planning scan to match the anterior rectal wall. Automatic bony pelvis co-registration was performed to separate BM and PBM. The ART was determined by the average total positioning error from the first 5 CBCT images. Results: The systematic error for the total positioning error in the left-right, superoinferior, and anteroposterior direction was 2.69, 2.00, and 2.65 mm with a random error of 1.99, 1.49, and 2.25 mm, resulting in a planning target volume margin of 8, 6, and 8 mm, respectively. ART reduced the margin by 54%, 44%, and 40%, respectively. Systematic errors in the left-right, superoinferior, and anteroposterior direction for BM was 2.66, 1.83, and 2.60 mm and for PBM was 0.44, 0.92, and 2.50 mm with a random error of 1.88, 1.24, and 1.77 mm for BM and 0.99, 1.38, and 2.32 mm for PBM, respectively. Conclusion: Without treatment verifications, 6-8-mm planning target volume margins are required because of PBM and BM. The anteroposterior PBM was significant. An ART protocol can reduce these planning target volume margins.

  1. Study between anb angle and wits appraisal in cone beam computed tomography (cbct)

    PubMed Central

    Cibrián, Rosa; Gandia, Jose L.; Paredes, Vanessa

    2013-01-01

    Objectives: To analyse the ANB and Wits values and to study correlations between those two measurements and other measurements in diagnosing the anteroposterior maxilo-mandibular relationship with CBCT. Study Design: Ninety patients who had previously a CBCT (i-CAT®) as a diagnostic register were selected. A 3D cephalometry was designed using one software package, InVivo5®. This cephalometry included 3 planes of reference, 3 angle measurements and 1 linear measurement. The means and standard deviations of the mean of each measurement were assessed. After that, a Pearson´s correlation coefficient has been performed to analyse the significance of each relationship. Results: When classifying the sample according to the anteroposterior relationship, the values obtained of ANB (Class I: 53%; Class II: 37%; Class III: 10%) and Wits (Class I: 35%; Class II: 56%; Class III: 9%) did not coincide, except for the Class III group. However, of the patients classified differently (Class I and Class II patients) by ANB and Wits, a high percentage of individuals (n=22; 49%), had a mesofacial pattern with a mandibular plane angle within normal values. A correlation has been found between ANB and Wits (r=0,262), occlusal plane angle and ANB (r=0,426), and mandibular plane angle and Wits (r=0,242). No correlation was found between either Wits or ANB in relation with the age of the individuals. Conclusions: ANB and Wits must be included in 3D cephalometric analyses as both are necessary to undertake a more accurate diagnosis of the maxillo-mandibular relationship of the patients. Key words:Cone beam computed tomography, ANB, Wits, cephalometrics. PMID:23722136

  2. Poster — Thur Eve — 08: Rotational errors with on-board cone beam computed tomography

    SciTech Connect

    Ali, E. S. M.; Webb, R.; Nyiri, B.

    2014-08-15

    The focus of this study is on the Elekta XVI on-board cone beam computed tomography (CBCT) system. A rotational mismatch as large as 0.5° is observed between clockwise (CW) and counter-clockwise (CCW) CBCT scans. The error could affect non-isocentric treatments (e.g., lung SBRT and acoustic neuroma), as well as off-axis organs-at-risk. The error is caused by mislabeling of the projections with a lagging gantry angle, which is caused by the finite image acquisition time and delays in the imaging system. A 30 cm diameter cylindrical phantom with 5 mm diameter holes is used for the scanning. CW and CCW scans are acquired for five gantry speeds (360 to 120 deg./min.) on six linacs from three generations (MLCi, MLCi2, and Agility). Additional scans are acquired with different x-ray pulse widths for the same mAs. In the automated CBCT analysis (using ImageJ), the CW/CCW mismatch in a series of line profiles is identified and used to calculate the rotational error. Results are consistent among all linacs and indicate that the error varies linearly with gantry speed. The finite width of the x-ray pulses is a major but predictable contributor to the delay causing the error. For 40 ms pulses, the delay is 34 ± 1 ms. A simple solution applied in our clinic is adjusting the gantry angle offset to make the CCW one-minute scans correct. A more involved approach we are currently investigating includes adjustments of pulse width and mA, resulting in focal spot changes, with potential impact on image quality.

  3. Radiation Dose From Kilovoltage Cone Beam Computed Tomography in an Image-Guided Radiotherapy Procedure

    SciTech Connect

    Ding, George X. Coffey, Charles W.

    2009-02-01

    Purpose: Image-guided radiation therapy has emerged as the new paradigm in radiotherapy. This work is to provide detailed information concerning the additional imaging doses to patients' radiosensitive organs from a kilovoltage cone beam computed tomography (kV CBCT) scan procedure. Methods and Materials: The Vanderbilt-Monte-Carlo-Beam-Calibration (VMCBC; Vanderbilt University, Nashville, TN) algorithm was used to calculate radiation dose to organs resulting from a kV CBCT imaging guidance procedure. Eight patients, including 3 pediatric and 5 adult patients, were investigated. The CBCT scans in both full- and half-fan modes were studied. Results: For a head-and-neck scan in half-fan mode, dose-volume histogram analyses show mean doses of 7 and 8 cGy to the eyes, 5 and 6 cGy to the spinal cord, 5 and 6 cGy to the brain, and 18 and 23 cGy to the cervical vertebrae for an adult and a 29-month-old child, respectively. The dose from a scan in full-fan mode is 10-20% lower than that in half-fan mode. For an abdominal scan, mean doses are 3 and 7 cGy to prostate and 7 and 17 cGy to femoral heads for a large adult patient and a 31-month-old pediatric patient, respectively. Conclusions: Doses to radiosensitive organs can total 300 cGy accrued over an entire treatment course if kV CBCT scans are acquired daily. These findings provide needed data for clinicians to make informed decisions concerning additional imaging doses. The dose to bone is two to four times greater than dose to soft tissue for kV x-rays, which should be considered, especially for pediatric patients.

  4. Cone-beam computed tomography with a flat-panel imager: initial performance characterization.

    PubMed

    Jaffray, D A; Siewerdsen, J H

    2000-06-01

    The development and performance of a system for x-ray cone-beam computed tomography (CBCT) using an indirect-detection flat-panel imager (FPI) is presented. Developed as a bench-top prototype for initial investigation of FPI-based CBCT for bone and soft-tissue localization in radiotherapy, the system provides fully three-dimensional volumetric image data from projections acquired during a single rotation. The system employs a 512 x 512 active matrix of a-Si:H thin-film transistors and photodiodes in combination with a luminescent phosphor. Tomographic imaging performance is quantified in terms of response uniformity, response linearity, voxel noise, noise-power spectrum (NPS), and modulation transfer function (MTF), each in comparison to the performance measured on a conventional CT scanner. For the geometry employed and the objects considered, response is uniform to within 2% and linear within 1%. Voxel noise, at a level of approximately 20 HU, is comparable to the conventional CT scanner. NPS and MTF results highlight the frequency-dependent transfer characteristics, confirming that the CBCT system can provide high spatial resolution and does not suffer greatly from additive noise levels. For larger objects and/or low exposures, additive noise levels must be reduced to maintain high performance. Imaging studies of a low-contrast phantom and a small animal (a euthanized rat) qualitatively demonstrate excellent soft-tissue visibility and high spatial resolution. Image quality appears comparable or superior to that of the conventional scanner. These quantitative and qualitative results clearly demonstrate the potential of CBCT systems based upon flat-panel imagers. Advances in FPI technology (e.g., improved x-ray converters and enhanced electronics) are anticipated to allow high-performance FPI-based CBCT for medical imaging. General and specific requirements of kilovoltage CBCT systems are discussed, and the applicability of FPI-based CBCT systems to tomographic

  5. Automated patient setup and gating using cone beam computed tomography projections

    NASA Astrophysics Data System (ADS)

    Wan, Hanlin; Bertholet, Jenny; Ge, Jiajia; Poulsen, Per; Parikh, Parag

    2016-03-01

    In radiation therapy, fiducial markers are often implanted near tumors and used for patient positioning and respiratory gating purposes. These markers are then used to manually align the patients by matching the markers in the cone beam computed tomography (CBCT) reconstruction to those in the planning CT. This step is time-intensive and user-dependent, and often results in a suboptimal patient setup. We propose a fully automated, robust method based on dynamic programming (DP) for segmenting radiopaque fiducial markers in CBCT projection images, which are then used to automatically optimize the treatment couch position and/or gating window bounds. The mean of the absolute 2D segmentation error of our DP algorithm is 1.3+/- 1.0 mm for 87 markers on 39 patients. Intrafraction images were acquired every 3 s during treatment at two different institutions. For gated patients from Institution A (8 patients, 40 fractions), the DP algorithm increased the delivery accuracy (96+/- 6% versus 91+/- 11% , p  <  0.01) compared to the manual setup using kV fluoroscopy. For non-gated patients from Institution B (6 patients, 16 fractions), the DP algorithm performed similarly (1.5+/- 0.8 mm versus 1.6+/- 0.9 mm, p  =  0.48) compared to the manual setup matching the fiducial markers in the CBCT to the mean position. Our proposed automated patient setup algorithm only takes 1-2 s to run, requires no user intervention, and performs as well as or better than the current clinical setup.

  6. A Cone-Beam Computed Tomographic Study on Mandibular First Molars in a Chinese Subpopulation

    PubMed Central

    Ma, Yue; Han, Ting; Chen, Xinyu; Wan, Fang; Lu, Yating; Yan, Songhe; Wang, Yan

    2015-01-01

    The purpose of this study was to conduct a cone-beam computed tomographic (CBCT) investigation on the root and canal configuration of the mandibular first molars, especially the morphology of the disto-lingual (DL) root, in a Chinese subpopulation. A total of 910 CBCT images of the mandibular first molars were collected from 455 patients who underwent CBCT examinations as a preoperative assessment for implants or orthodontic treatment. The following information was analyzed and evaluated: tooth position, gender, root and root canal number per tooth, root canal type of the mesial root(s) and distal root(s), angle of the DL root canal curvature, distance between two distal canal orifices in the teeth with DL root, and angle of disto-buccal canal orifice–disto-lingual canal orifice–mesio-lingual canal orifice (DB-DL-ML). Most of the mandibular first molars (64.9%, n = 591) had two roots with three root canals, and most of the mesial root canals (87.7%, n = 798) were type VI. The prevalence of the DL root was 22.1% (n = 201). The right side had a higher prevalence of DL root than the left side (p<0.05). Additionally, the curvature of the DL root canal were greater in the bucco-lingual (BL) orientation (30.10°±14.02°) than in the mesio-distal (MD) orientation (14.03°± 8.56°) (p<0.05). Overall there was a high prevalence of DL root in the mandibular first molars, and most of the DL roots were curved in different degrees. This study provided detailed information about the root canal morphology of the mandibular first molars in a Chinese subpopulation. PMID:26241480

  7. Calculating nasoseptal flap dimensions: a cadaveric study using cone beam computed tomography.

    PubMed

    Ten Dam, Ellen; Korsten-Meijer, Astrid G W; Schepers, Rutger H; van der Meer, Wicher J; Gerrits, Peter O; van der Laan, Bernard F A M; Feijen, Robert A

    2015-09-01

    We hypothesize that three-dimensional imaging using cone beam computed tomography (CBCT) is suitable for calculating nasoseptal flap (NSF) dimensions. To evaluate our hypothesis, we compared CBCT NSF dimensions with anatomical dissections. The NSF reach and vascularity were studied. In an anatomical study (n = 10), CBCT NSF length and surface were calculated and compared with anatomical dissections. The NSF position was evaluated by placing the NSF from the anterior sphenoid sinus wall and from the sella along the skull base towards the frontal sinus. To visualize the NSF vascularity in CBCT, the external carotic arteries were perfused with colored Iomeron. Correlations between CBCT NSFs and anatomical dissections were strongly positive (r > 0.70). The CBCT NSF surface was 19.8 cm(2) [16.6-22.3] and the left and right CBCT NSF lengths were 78.3 mm [73.2-89.5] and 77.7 mm [72.2-88.4] respectively. Covering of the anterior skull base was possible by positioning the NSF anterior to the sphenoid sinus. If the NSF was positioned from the sella along the skull base towards the frontal sinus, the NSF reached partially into the anterior ethmoidal sinuses. CBCT is a valuable technique for calculating NSF dimensions. CBCT to demonstrate septum vascularity in cadavers proved to be less suitable. The NSF reach for covering the anterior skull base depends on positioning. This study encourages preoperative planning of a customized NSF, in an attempt to spare septal mucosa. In the concept of minimal invasive surgery, accompanied by providing customized care, this can benefit the patients' postoperative complaints. PMID:25359192

  8. Radiation Dose From Cone Beam Computed Tomography for Image-Guided Radiation Therapy

    SciTech Connect

    Kan, Monica W.K. Leung, Lucullus H.T.; Wong, Wicger; Lam, Nelson

    2008-01-01

    Purpose: To perform a comprehensive study on organ absorbed doses and effective doses from cone beam computed tomography (CBCT) for three different treatment sites. Methods and Materials: An extensive set of dosimetric measurements were performed using a widely used CBCT system, the On-Board Imager (OBI). Measurements were performed using a female anthropomorphic phantom with thermoluminescent dosimeters (TLD). The effective doses to the body and the absorbed doses to 26 organs were reported using two different technical settings, namely, the standard mode and the low-dose mode. The measurements were repeated for three different scan sites: head and neck, chest, and pelvis. Comparisons of patient doses as well as image quality were performed among the standard mode CBCT, low-dose mode CBCT, and fan beam CT. Results: The mean skin doses from standard mode CBCT to head and neck, chest and pelvis were 6.7, 6.4, and 5.4 cGy per scan, respectively. The effective doses to the body from standard mode CBCT for imaging of head and neck, chest, and pelvis were 10.3, 23.7, and 22.7 mSv per scan, respectively. Patient doses from low-dose mode CBCT were approximately one fifth of those from standard mode CBCT. Conclusions: Patient position verification by standard mode CBCT acquired by OBI on a daily basis could increase the secondary cancer risk by up to 2% to 4%. Therefore lower mAs settings for daily CBCT should be considered, especially when bony anatomy is the main interest.

  9. Quality Assessment of Frameless Fractionated Stereotactic Radiotherapy Using Cone Beam Computed Tomography

    SciTech Connect

    Peng, Lee-Cheng; Kahler, Darren; Samant, Sanjiv; Li, Jonathan; Amdur, Robert; Palta, Jatinder R.; Liu, Chihray

    2010-12-01

    Purpose: A quality assessment of intracranial stereotactic radiotherapy was performed using cone beam computed tomography (CBCT). Setup errors were analyzed for two groups of patients: (1) those who were positioned using a frameless SonArray (FSA) system and immobilized with a bite plate and thermoplastic (TP) mask (the bFSA group); and (2) those who were positioned by room laser and immobilized using a TP mask (the mLAS group). Methods and Materials: A quality assurance phantom was used to study the system differences between FSA and CBCT. The quality assessment was performed using an Elekta Synergy imager (XVI) (Elekta Oncology Systems, Norcross, GA) and an On-Board Imager (OBI) (Varian Medical Systems, Palo Alto, CA) for 25 patients. For the first three fractions, and weekly thereafter, the FSA system was used for patient positioning, after which CBCT was performed to obtain setup errors. Results: (1) Phantom tests: The mean differences in the isocenter displacements for the two systems was 1.2 {+-} 0.7 mm. No significant variances were seen between the XVI and OBI units (p{approx}0.208). (2)Patient tests: The mean of the displacements between FSA and CBCT were independent of the CBCT system used; mean setup errors for the bFSA group were smaller (1.2 mm) than those of the mLAS group (3.2 mm) (p < 0.005). For the mLAS patients, the 90th percentile and the maximum rotational displacements were 3{sup o} and 5{sup o}, respectively. A 4-mm drift in setup accuracy occurred over the treatment course for 1 bFSA patient. Conclusions: System differences of less than 1 mm between CBCT and FSA were seen. Error regression was observed for the bFSA patients, using CBCT (up to 4 mm) during the treatment course. For the mLAS group, daily CBCT imaging was needed to obtain acceptable setup accuracies.

  10. Performance characteristics of a novel megavoltage cone-beam-computed tomography device.

    PubMed

    Fast, M F; Koenig, T; Oelfke, U; Nill, S

    2012-02-01

    In this work, the image quality of a novel megavoltage cone-beam-computed tomography (CBCT) scanner is compared to three other image-guided radiation therapy devices by analysing images of different-sized quality assurance phantoms. The following devices are compared in terms of image uniformity, signal-to-noise ratio, contrast-to-noise ratio (CNR), electron density to HU conversion, presampling modulation transfer function (MTF(pre)) and combined spatial resolution and noise (Q-factor): (i) the Siemens Artiste kilovoltage (kV) (121 kV) CBCT device, (ii) the Artiste treatment beam line (TBL), 6 MV, (iii) the Tomotherapy (3.5 MV) fan-beam CT and (iv) Siemens' novel approach using a carbon target for a dedicated imaging beam line (IBL), 4.2 MV. Machine settings were selected to produce the same imaging dose for all devices. For a head phantom, IBL scans display CNR values 2.6 ± 0.3 times higher than for the TBL at the same dose level (for a CT-number range of -200 to -60 HU). kV CBCT, on the other hand, displays CNR values 7.9 ± 0.3 times higher than the IBL. There was no significant deviation in spatial resolution between IBL, TBL and Tomotherapy in terms of 50% and 10% MTF(pre). For kV CBCT, the MTF(pre) was significantly higher than those for other devices. In our Q-factor analysis, the IBL (14.6) scores higher than the TBL (7.9) and Tomotherapy (9.7) due to its lower noise level. The linearity of electron density to HU conversion is demonstrated for different-sized phantoms. Employing the IBL instead of the TBL significantly reduces the imaging dose by up to a factor of 5 at a constant image quality level, providing an immediate benefit for the patient. PMID:22251668

  11. Assessment of the Mandibular Incisive Canal by Panoramic Radiograph and Cone-Beam Computed Tomography

    PubMed Central

    Shimura, Elisabeth; Chilvarquer, Israel; Fenyo-Pereira, Marlene

    2014-01-01

    Objectives. The region between mental foramens is considered as a zone of choice for implants. However, complications may arise due to an extension anterior to the mental foramen that forms the mandible incisive canal [MIC]. Our goal is to evaluate identification of MIC by both panoramic radiograph [PAN] and cone-beam computed tomography [CBCT]. Methods. 150 cases with bilateral MIC were analyzed. Images of a radiolucent canal, within the trabecular bone, surrounded by a radiopaque cortical bone representing the canal walls, and extending to the anterior portion beyond the mental foramen, were considered by two independent radiologists as being images of MIC. PAN and CBCT of these cases were evaluated by 2 other radiologists at different times. Agreement between results of examination methods was assessed by the Kappa coefficient. The interexaminer and intramethod rates for detection of MIC were analyzed by the McNemar test. Gender, mandible side, examiner, and type of method were analyzed by the generalized estimating equations [GEE] model. Results. significant difference between examiners [PAN: P = 0.146; CBCT: P = 0.749] was not observed. Analysis by GEE model showed no significant difference between genders [P = 0.411] and examiners [P = 0.183]. However, significant difference was observed for identification in both mandible right side [P = 0.001], where the identification frequency was higher, and CBCT method [P < 0.001]. Conclusions. PAN was not shown to be a safe examination to identify MIC. CBCT should always be used in preoperative planning and to reduce the number of complications in implant surgeries. PMID:25332719

  12. The mandibular incisive canal and its anatomical relationships: A cone beam computed tomography study

    PubMed Central

    Pereira-Maciel, Patrícia; Oliveira-Sales, Marcelo-Augusto

    2015-01-01

    Background To avoid postoperative injuries in the interforaminal region, presence of the Mandibular Incisive Canal (MIC), its extension and canal positioning in relation to the cortical bone and alveolar process were investigated by cone beam computed tomography (CBCT). Material and Methods One hundred CBCT examinations obtained by means of the i-CAT CBCT imaging system were analyzed in multiple-plane views (axial, panoramic and cross-sectional) and three-dimensional representations were performed using iCAT CBCT software. The MIC was evaluated for its presence, measurement and proximity to the buccal and lingual plates, alveolar process and inferior border of the mandible. Results The MIC was visible in all (100%) CBCT images. The mean length of MIC was 9.8 ± 3.8 mm. The distances between the canal and buccal plate, as well as between the canal and lingual plate of the alveolar bone were 4.62 ± 1.41 mm and 6.25 ± 2.03 mm, respectively. The distances from the canal to the alveolar process, and to the inferior border of the mandible were 10.25 ± 2.27 mm and 7.06 ± 2.95 mm, respectively. Conclusions Due to the high prevalence of MIC, its variation in length and distance up to the cortical bone, suggested that preoperative radiographic evaluation of the MIC must be carried out case-by-case using CBCT, which could clearly show the three-dimensional structure and adjacent structure of the MIC. Key words:Diagnosis, anatomy, cross-sectional, tomography. PMID:26449433

  13. Cone-Beam Computed Tomography (CBCT) Versus CT in Lung Ablation Procedure: Which is Faster?

    SciTech Connect

    Cazzato, Roberto Luigi Battistuzzi, Jean-Benoit Catena, Vittorio; Grasso, Rosario Francesco Zobel, Bruno Beomonte; Schena, Emiliano; Buy, Xavier Palussiere, Jean

    2015-10-15

    AimTo compare cone-beam CT (CBCT) versus computed tomography (CT) guidance in terms of time needed to target and place the radiofrequency ablation (RFA) electrode on lung tumours.Materials and MethodsPatients at our institution who received CBCT- or CT-guided RFA for primary or metastatic lung tumours were retrospectively included. Time required to target and place the RFA electrode within the lesion was registered and compared across the two groups. Lesions were stratified into three groups according to their size (<10, 10–20, >20 mm). Occurrences of electrode repositioning, repositioning time, RFA complications, and local recurrence after RFA were also reported.ResultsForty tumours (22 under CT, 18 under CBCT guidance) were treated in 27 patients (19 male, 8 female, median age 67.25 ± 9.13 years). Thirty RFA sessions (16 under CBCT and 14 under CT guidance) were performed. Multivariable linear regression analysis showed that CBCT was faster than CT to target and place the electrode within the tumour independently from its size (β = −9.45, t = −3.09, p = 0.004). Electrode repositioning was required in 10/22 (45.4 %) tumours under CT guidance and 5/18 (27.8 %) tumours under CBCT guidance. Pneumothoraces occurred in 6/14 (42.8 %) sessions under CT guidance and in 6/16 (37.5 %) sessions under CBCT guidance. Two recurrences were noted for tumours receiving CBCT-guided RFA (2/17, 11.7 %) and three after CT-guided RFA (3/19, 15.8 %).ConclusionCBCT with live 3D needle guidance is a useful technique for percutaneous lung ablation. Despite lesion size, CBCT allows faster lung RFA than CT.

  14. Adaptive Radiotherapy for Prostate Cancer Using Kilovoltage Cone-Beam Computed Tomography: First Clinical Results

    SciTech Connect

    Nijkamp, Jasper; Pos, Floris J. Nuver, Tonnis T.; Jong, Rianne de; Remeijer, Peter; Sonke, Jan-Jakob; Lebesque, Joos V.

    2008-01-01

    Purpose: To evaluate the first clinical results of an off-line adaptive radiotherapy (ART) protocol for prostate cancer using kilovoltage cone-beam computed tomography (CBCT) in combination with a diet and mild laxatives. Methods and Materials: Twenty-three patients began treatment with a planning target volume (PTV) margin of 10 mm. The CBCT scans acquired during the first six fractions were used to generate an average prostate clinical target volume (AV-CTV), and average rectum (AV-Rect). Using these structures, a new treatment plan was generated with a 7-mm PTV margin. Weekly CBCT scans were used to monitor the CTV coverage. A diet and mild laxatives were introduced to improve image quality and reduce prostate motion. Results: Twenty patients were treated with conform ART protocol. For these patients, 91% of the CBCT scans could be used to calculate the AV-CTV and AV-Rect. In 96% of the follow-up CBCT scans, the CTV was located within the average PTV. In the remaining 4%, the prostate extended the PTV by a maximum of 1 mm. Systematic and random errors for organ motion were reduced by a factor of two compared with historical data without diet and laxatives. An average PTV reduction of 29% was achieved. The volume of the AV-Rect that received >65 Gy was reduced by 19%. The mean dose to the anal wall was reduced on average by 4.8 Gy. Conclusions: We safely reduced the high-dose region by 29%. The reduction in irradiated volume led to a significant reduction in the dose to the rectum. The diet and laxatives improved the image quality and tended to reduce prostate motion.

  15. Validity of ridge mapping and cone beam computed tomography in dental implant therapy

    PubMed Central

    Castro-Ruiz, Carmen Teresa; Noriega, Jorge; Guerrero, Maria Eugenia

    2015-01-01

    Aim: The purpose of this study was to compare the validity of alveolar ridge measurements obtained with ridge mapping (RM) technique against cone beam computed tomography (CBCT) measurements. Materials and Methods: Twenty partially edentulous patients were recruited for implant placement in the Clinic of San Martin de Porres University. For all the measurements, a vacuum-formed stent was fabricated for each subject. A buccal and lingual point was made in the stent to provide a reference of measurement for each implant site. RM measurements with the stent were obtained before and after surgical flap reflection. Two calibrated observers made the CBCT images measurements. T-test was used for the statistical analysis. Values <0.05 were considered statistically significant. Also, specificity and sensibility of CBCT and RM were compared. Intra-class correlation coefficient (ICC)_ was measure between CBCT measurements. Results: A total of 62 implants sites were evaluated. No statistical significant differences were obtained with CBCT and RM measurements (P = 0,207). Detecting proper buccal-lingual ridge, the sensitivity and specificity were 59% and 91% for RM while CBCT obtained 92% of sensitivity and 94% of specificity. Concordance was found “good” (ICC 0.82). Conclusion: Both methods provide valid measurements. Even though, we found diagnostic limitations in the RM, it demonstrated to be a useful method for its exactitude, low cost, the immediate result and no need of radiation. CBCT was recommended when the bone ridge width and height were in the less than ideal for conventional dental implant placement. PMID:26229269

  16. Evaluation of a cone beam computed tomography geometry for image guided small animal irradiation

    NASA Astrophysics Data System (ADS)

    Yang, Yidong; Armour, Michael; Kang-Hsin Wang, Ken; Gandhi, Nishant; Iordachita, Iulian; Siewerdsen, Jeffrey; Wong, John

    2015-07-01

    The conventional imaging geometry for small animal cone beam computed tomography (CBCT) is that a detector panel rotates around the head-to-tail axis of an imaged animal (‘tubular’ geometry). Another unusual but possible imaging geometry is that the detector panel rotates around the anterior-to-posterior axis of the animal (‘pancake’ geometry). The small animal radiation research platform developed at Johns Hopkins University employs the pancake geometry where a prone-positioned animal is rotated horizontally between an x-ray source and detector panel. This study is to assess the CBCT image quality in the pancake geometry and investigate potential methods for improvement. We compared CBCT images acquired in the pancake geometry with those acquired in the tubular geometry when the phantom/animal was placed upright simulating the conventional CBCT geometry. Results showed signal-to-noise and contrast-to-noise ratios in the pancake geometry were reduced in comparison to the tubular geometry at the same dose level. But the overall spatial resolution within the transverse plane of the imaged cylinder/animal was better in the pancake geometry. A modest exposure increase to two folds in the pancake geometry can improve image quality to a level close to the tubular geometry. Image quality can also be improved by inclining the animal, which reduces streak artifacts caused by bony structures. The major factor resulting in the inferior image quality in the pancake geometry is the elevated beam attenuation along the long axis of the phantom/animal and consequently increased scatter-to-primary ratio in that orientation. Not withstanding, the image quality in the pancake-geometry CBCT is adequate to support image guided animal positioning, while providing unique advantages of non-coplanar and multiple mice irradiation. This study also provides useful knowledge about the image quality in the two very different imaging geometries, i.e. pancake and tubular geometry

  17. Automatic Synthesis of Panoramic Radiographs from Dental Cone Beam Computed Tomography Data.

    PubMed

    Luo, Ting; Shi, Changrong; Zhao, Xing; Zhao, Yunsong; Xu, Jinqiu

    2016-01-01

    In this paper, we propose an automatic method of synthesizing panoramic radiographs from dental cone beam computed tomography (CBCT) data for directly observing the whole dentition without the superimposition of other structures. This method consists of three major steps. First, the dental arch curve is generated from the maximum intensity projection (MIP) of 3D CBCT data. Then, based on this curve, the long axial curves of the upper and lower teeth are extracted to create a 3D panoramic curved surface describing the whole dentition. Finally, the panoramic radiograph is synthesized by developing this 3D surface. Both open-bite shaped and closed-bite shaped dental CBCT datasets were applied in this study, and the resulting images were analyzed to evaluate the effectiveness of this method. With the proposed method, a single-slice panoramic radiograph can clearly and completely show the whole dentition without the blur and superimposition of other dental structures. Moreover, thickened panoramic radiographs can also be synthesized with increased slice thickness to show more features, such as the mandibular nerve canal. One feature of the proposed method is that it is automatically performed without human intervention. Another feature of the proposed method is that it requires thinner panoramic radiographs to show the whole dentition than those produced by other existing methods, which contributes to the clarity of the anatomical structures, including the enamel, dentine and pulp. In addition, this method can rapidly process common dental CBCT data. The speed and image quality of this method make it an attractive option for observing the whole dentition in a clinical setting. PMID:27300554

  18. Quality and accuracy of cone beam computed tomography gated by active breathing control

    PubMed Central

    Thompson, Bria P.; Hugo, Geoffrey D.

    2008-01-01

    The purpose of this study was to evaluate the quality and accuracy of cone beam computed tomography (CBCT) gated by active breathing control (ABC), which may be useful for image guidance in the presence of respiration. Comparisons were made between conventional ABC-CBCT (stop and go), fast ABC-CBCT (a method to speed up the acquisition by slowing the gantry instead of stopping during free breathing), and free breathing respiration correlated CBCT. Image quality was assessed in phantom. Accuracy of reconstructed voxel intensity, uniformity, and root mean square error were evaluated. Registration accuracy (bony and soft tissue) was quantified with both an anthropomorphic and a quality assurance phantom. Gantry angle accuracy was measured with respect to gantry speed modulation. Conventional ABC-CBCT scan time ranged from 2.3 to 5.8 min. Fast ABC-CBCT scan time ranged from 1.4 to 1.8 min, and respiratory correlated CBCT scans took 2.1 min to complete. Voxel intensity value for ABC gated scans was accurate relative to a normal clinical scan with all projections. Uniformity and root mean square error performance degraded as the number of projections used in the reconstruction of the fast ABC-CBCT scans decreased (shortest breath hold, longest free breathing segment). Registration accuracy for small, large, and rotational corrections was within 1 mm and 1°. Gantry angle accuracy was within 1° for all scans. For high-contrast targets, performance for image-guidance purposes was similar for fast and conventional ABC-CBCT scans and respiration correlated CBCT. PMID:19175117

  19. Accuracy of Cone Beam Computed Tomography for Detection of Bone Loss

    PubMed Central

    Goodarzi Pour, Daryoush; Soleimani Shayesteh, Yadollah

    2015-01-01

    Objectives: Bone assessment is essential for diagnosis, treatment planning and prediction of prognosis of periodontal diseases. However, two-dimensional radiographic techniques have multiple limitations, mainly addressed by the introduction of three-dimensional imaging techniques such as cone beam computed tomography (CBCT). This study aimed to assess the accuracy of CBCT for detection of marginal bone loss in patients receiving dental implants. Materials and Methods: A study of diagnostic test accuracy was designed and 38 teeth from candidates for dental implant treatment were selected. On CBCT scans, the amount of bone resorption in the buccal, lingual/palatal, mesial and distal surfaces was determined by measuring the distance from the cementoenamel junction to the alveolar crest (normal group: 0–1.5mm, mild bone loss: 1.6–3mm, moderate bone loss: 3.1–4.5mm and severe bone loss: >4.5mm). During the surgical phase, bone loss was measured at the same sites using a periodontal probe. The values were then compared by McNemar’s test. Results: In the buccal, lingual/palatal, mesial and distal surfaces, no significant difference was observed between the values obtained using CBCT and the surgical method. The correlation between CBCT and surgical method was mainly based on the estimation of the degree of bone resorption. CBCT was capable of showing various levels of resorption in all surfaces with high sensitivity, specificity, positive predictive value and negative predictive value compared to the surgical method. Conclusion: CBCT enables accurate measurement of bone loss comparable to surgical exploration and can be used for diagnosis of bone defects in periodontal diseases in clinical settings. PMID:26877741

  20. A system to track skin dose for neuro-interventional cone-beam computed tomography (CBCT)

    NASA Astrophysics Data System (ADS)

    Vijayan, Sarath; Xiong, Zhenyu; Rudin, Stephen; Bednarek, Daniel R.

    2016-03-01

    The skin-dose tracking system (DTS) provides a color-coded illustration of the cumulative skin-dose distribution on a closely-matching 3D graphic of the patient during fluoroscopic interventions in real-time for immediate feedback to the interventionist. The skin-dose tracking utility of DTS has been extended to include cone-beam computed tomography (CBCT) of neurointerventions. While the DTS was developed to track the entrance skin dose including backscatter, a significant part of the dose in CBCT is contributed by exit primary radiation and scatter due to the many overlapping projections during the rotational scan. The variation of backscatter inside and outside the collimated beam was measured with radiochromic film and a curve was fit to obtain a scatter spread function that could be applied in the DTS. Likewise, the exit dose distribution was measured with radiochromic film for a single projection and a correction factor was determined as a function of path length through the head. Both of these sources of skin dose are added for every projection in the CBCT scan to obtain a total dose mapping over the patient graphic. Results show the backscatter to follow a sigmoidal falloff near the edge of the beam, extending outside the beam as far as 8 cm. The exit dose measured for a cylindrical CTDI phantom was nearly 10 % of the entrance peak skin dose for the central ray. The dose mapping performed by the DTS for a CBCT scan was compared to that measured with radiochromic film and a CTDI-head phantom with good agreement.

  1. Automatic Synthesis of Panoramic Radiographs from Dental Cone Beam Computed Tomography Data

    PubMed Central

    Luo, Ting; Shi, Changrong; Zhao, Xing; Zhao, Yunsong; Xu, Jinqiu

    2016-01-01

    In this paper, we propose an automatic method of synthesizing panoramic radiographs from dental cone beam computed tomography (CBCT) data for directly observing the whole dentition without the superimposition of other structures. This method consists of three major steps. First, the dental arch curve is generated from the maximum intensity projection (MIP) of 3D CBCT data. Then, based on this curve, the long axial curves of the upper and lower teeth are extracted to create a 3D panoramic curved surface describing the whole dentition. Finally, the panoramic radiograph is synthesized by developing this 3D surface. Both open-bite shaped and closed-bite shaped dental CBCT datasets were applied in this study, and the resulting images were analyzed to evaluate the effectiveness of this method. With the proposed method, a single-slice panoramic radiograph can clearly and completely show the whole dentition without the blur and superimposition of other dental structures. Moreover, thickened panoramic radiographs can also be synthesized with increased slice thickness to show more features, such as the mandibular nerve canal. One feature of the proposed method is that it is automatically performed without human intervention. Another feature of the proposed method is that it requires thinner panoramic radiographs to show the whole dentition than those produced by other existing methods, which contributes to the clarity of the anatomical structures, including the enamel, dentine and pulp. In addition, this method can rapidly process common dental CBCT data. The speed and image quality of this method make it an attractive option for observing the whole dentition in a clinical setting. PMID:27300554

  2. Relationship of the Gonial Angle and Inferior Alveolar Canal Course Using Cone Beam Computed Tomography

    PubMed Central

    Anbiaee, Najmeh; Bagherpour, Ali

    2015-01-01

    Objectives: Accurate localization of the inferior alveolar canal (IAC) is extremely important in some dental treatments. Anatomical variation of the canal means that it can be difficult to locate. The purpose of this study was to assess the relationship of the gonial angle (GA) size and IAC position using cone beam computed tomography (CBCT). Materials and Methods: In this in vitro study, 61 dry adult human hemi-mandibles were used. The CBCT scans were taken of all samples and GA was measured on all CBCT scans. The samples were divided into two groups of low angle (≤125°) and high angle (>125°). The canal dimensions, length and course were evaluated. On the sagittal view, the IAC path was classified as type A, B or C. On the axial view, canal course was defined as A1 or A2 according to the mental foramen angle. Results: The average GA size was 121.8±7.05° at the right side and 123.8±6.32° at the left side. On the sagittal view, there was a significant correlation between the GA size and the canal course (P=0.04). In the high-angle group, type A was dominant; whereas in the low-angle group, type B was more common. On the axial view of IAC course, type A1 was more common (73.43%). Conclusion: The results showed that GA size was associated with IAC course. In cases with a larger GA, the canal runs in a more straightforward path, and at the same level as the mental foramen. PMID:27252759

  3. Evaluation of a cone beam computed tomography geometry for image guided small animal irradiation.

    PubMed

    Yang, Yidong; Armour, Michael; Wang, Ken Kang-Hsin; Gandhi, Nishant; Iordachita, Iulian; Siewerdsen, Jeffrey; Wong, John

    2015-07-01

    The conventional imaging geometry for small animal cone beam computed tomography (CBCT) is that a detector panel rotates around the head-to-tail axis of an imaged animal ('tubular' geometry). Another unusual but possible imaging geometry is that the detector panel rotates around the anterior-to-posterior axis of the animal ('pancake' geometry). The small animal radiation research platform developed at Johns Hopkins University employs the pancake geometry where a prone-positioned animal is rotated horizontally between an x-ray source and detector panel. This study is to assess the CBCT image quality in the pancake geometry and investigate potential methods for improvement. We compared CBCT images acquired in the pancake geometry with those acquired in the tubular geometry when the phantom/animal was placed upright simulating the conventional CBCT geometry. Results showed signal-to-noise and contrast-to-noise ratios in the pancake geometry were reduced in comparison to the tubular geometry at the same dose level. But the overall spatial resolution within the transverse plane of the imaged cylinder/animal was better in the pancake geometry. A modest exposure increase to two folds in the pancake geometry can improve image quality to a level close to the tubular geometry. Image quality can also be improved by inclining the animal, which reduces streak artifacts caused by bony structures. The major factor resulting in the inferior image quality in the pancake geometry is the elevated beam attenuation along the long axis of the phantom/animal and consequently increased scatter-to-primary ratio in that orientation. Not withstanding, the image quality in the pancake-geometry CBCT is adequate to support image guided animal positioning, while providing unique advantages of non-coplanar and multiple mice irradiation. This study also provides useful knowledge about the image quality in the two very different imaging geometries, i.e. pancake and tubular geometry, respectively

  4. Influence of intracanal post on apical periodontitis identified by cone-beam computed tomography.

    PubMed

    Estrela, Carlos; Bueno, Mike Reis; Porto, Olavo César Lyra; Rodrigues, Cleomar Donizeth; Pécora, Jesus Djalma

    2009-01-01

    The determination of the success of endodontic treatment has been often discussed based on outcome obtained by periapical radiography. The aim of this study was to verify the influence of intracanal post on apical periodontitis detected by cone-beam computed tomography (CBCT). A consecutive sample of 1020 images (periapical radiographs and CBCT scans) taken from 619 patients (245 men; mean age, 50.1 years) between February 2008 and September 2009 were used in this study. Presence and intracanal post length (short, medium and long) were associated with apical periodontitis (AP). Chi-square test was used for statistical analyses. Significance level was set at p<0.01. The kappa value was used to assess examiner variability. From a total of 591 intracanal posts, AP was observed in 15.06%, 18.78% and 7.95% using periapical radiographs, into the different lengths, short, medium and long, respectively (p=0.466). Considering the same posts length it was verified AP in 24.20%, 26.40% and 11.84% observed by CBCT scans, respectively (p=0.154). From a total of 1,020 teeth used in this study, AP was detected in 397 (38.92%) by periapical radiography and in 614 (60.19%) by CBCT scans (p<0.001). The distribution of intracanal posts in different dental groups showed higher prevalence in maxillary anterior teeth (54.79%). Intracanal posts lengths did not influenced AP. AP was detected more frequently when CBCT method was used. PMID:20126904

  5. Quantification of skeletal asymmetries in normal adolescents: cone-beam computed tomography analysis

    PubMed Central

    2014-01-01

    Background The detection and quantification of skeletal asymmetries is a fundamental component to diagnosis and treatment planning in orthodontics. The purpose of this study was to identify and quantify the characteristics of facial and dental asymmetries in a normal, adolescent population using 3D imaging. Methods Thirty consecutive Class I patients (mean age 14.32 years, SD 1.67) meeting the inclusion criteria were analyzed by three-dimensional cone-beam computed tomography (CBCT). Dental, maxillary, mandibular, and cranial base variables were measured with Dolphin 3D. CBCT analysis consisted of the localization of 34 anatomical landmarks. All reference points were digitized in 3D and analyzed using 67 skeletal and dental measurements. Student's t tests for paired samples were used with a significance level of p < 0.05. Results Minor right-left discrepancies were noted in all planes. The most anterior point of the glenoid fossa and most condylar points were positioned more superior and lateral on the right side, compared to the left side. Porion was also located more superiorly on the right side relative to the left side. The posterior nasal spine was found to be located to the right of the midsagittal plane. Slight dental midline discrepancies were found, and the dental arch lengths were slightly longer on the left side compared to the right. The height of the ramus, in both 3D and 2D, and the inclination of the ramus were greater on the right than that on the left side. Conclusions The findings of this study suggest minor asymmetries exist and are likely a common occurrence in the normal human craniofacial complex. Additionally, a natural compensatory mechanism may exist which controls the size and shape of specific tissues in order to maintain functional symmetry. PMID:24935152

  6. Accuracy of linear measurement using cone-beam computed tomography at different reconstruction angles

    PubMed Central

    Nikneshan, Sima; Aval, Shadi Hamidi; Bakhshalian, Neema; Shahab, Shahriyar; Mohammadpour, Mahdis

    2014-01-01

    Purpose This study was performed to evaluate the effect of changing the orientation of a reconstructed image on the accuracy of linear measurements using cone-beam computed tomography (CBCT). Materials and Methods Forty-two titanium pins were inserted in seven dry sheep mandibles. The length of these pins was measured using a digital caliper with readability of 0.01 mm. Mandibles were radiographed using a CBCT device. When the CBCT images were reconstructed, the orientation of slices was adjusted to parallel (i.e., 0°), +10°, +12°, -12°, and -10° with respect to the occlusal plane. The length of the pins was measured by three radiologists, and the accuracy of these measurements was reported using descriptive statistics and one-way analysis of variance (ANOVA); p<0.05 was considered statistically significant. Results The differences in radiographic measurements ranged from -0.64 to +0.06 at the orientation of -12°, -0.66 to -0.11 at -10°, -0.51 to +0.19 at 0°, -0.64 to +0.08 at +10°, and -0.64 to +0.1 at +12°. The mean absolute values of the errors were greater at negative orientations than at the parallel position or at positive orientations. The observers underestimated most of the variables by 0.5-0.1 mm (83.6%). In the second set of observations, the reproducibility at all orientations was greater than 0.9. Conclusion Changing the slice orientation in the range of -12° to +12° reduced the accuracy of linear measurements obtained using CBCT. However, the error value was smaller than 0.5 mm and was, therefore, clinically acceptable. PMID:25473632

  7. Assessment of vertical root fracture using cone-beam computed tomography

    PubMed Central

    Moudi, Ehsan; Haghanifar, Sina; Madani, Zahrasadat; Alhavaz, Abdolhamid; Bijani, Ali

    2014-01-01

    Purpose The aim of this study was to investigate the accuracy of cone-beam computed tomography (CBCT) in the diagnosis of vertical root fractures in a tooth with gutta-percha and prefabricated posts. Materials and Methods This study selected 96 extracted molar and premolar teeth of the mandible. These teeth were divided into six groups as follows: Groups A, B, and C consisted of teeth with vertical root fractures, and groups D, E, and F had teeth without vertical root fractures; groups A and D had teeth with gutta-percha and prefabricated posts; groups B and E had teeth with gutta-percha but without prefabricated posts, and groups C and F had teeth without gutta-percha or prefabricated posts. Then, the CBCT scans were obtained and examined by three oral and maxillofacial radiologists in order to determine the presence of vertical root fractures. The data were analyzed using IBM SPSS 20.0 (IBM Corp., Armonk, NY, USA). Results The kappa coefficient was 0.875±0.049. Groups A and D showed a sensitivity of 81% and a specificity of 100%; groups E and B, a sensitivity of 94% and a specificity of 100%; and groups C and F, a sensitivity of 88% and a specificity of 100%. Conclusion The CBCT scans revealed a high accuracy in the diagnosis of vertical root fractures; the accuracy did not decrease in the presence of gutta-percha. The presence of prefabricated posts also had little effect on the accuracy of the system, which was, of course, not statistically significant. PMID:24701457

  8. Evaluation of condylar positions in patients with temporomandibular disorders: A cone-beam computed tomographic study

    PubMed Central

    Imanimoghaddam, Mahrokh; Madani, Azam Sadat; Mahdavi, Pirooze; Bagherpour, Ali; Darijani, Mansoreh

    2016-01-01

    Purpose This study was performed to compare the condylar position in patients with temporomandibular joint disorders (TMDs) and a normal group by using cone-beam computed tomography (CBCT). Materials and Methods In the TMD group, 25 patients (5 men and 20 women) were randomly selected among the ones suffering from TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The control group consisted of 25 patients (8 men and 17 women) with normal temporomandibular joints (TMJs) who were referred to the radiology department in order to undergo CBCT scanning for implant treatment in the posterior maxilla. Linear measurements from the superior, anterior, and posterior joint spaces between the condyle and glenoid fossa were made through defined landmarks in the sagittal view. The inclination of articular eminence was also determined. Results The mean anterior joint space was 2.3 mm in the normal group and 2.8 mm in the TMD group, respectively. The results showed that there was a significant correlation between the superior and posterior joint spaces in both the normal and TMD groups, but it was only in the TMD group that the correlation coefficient among the dimensions of anterior and superior spaces was significant. There was a significant correlation between the inclination of articular eminence and the size of the superior and posterior spaces in the normal group. Conclusion The average dimension of the anterior joint space was different between the two groups. CBCT could be considered a useful diagnostic imaging modality for TMD patients. PMID:27358820

  9. Evaluation of the potential of automatic segmentation of the mandibular canal using cone-beam computed tomography.

    PubMed

    Gerlach, Nicolaas Lucius; Meijer, Gerrit Jacobus; Kroon, Dirk-Jan; Bronkhorst, Ewald Maria; Bergé, Stefaan Jozef; Maal, Thomas Jan Jaap

    2014-11-01

    We aimed to investigate the effectiveness of software for automatically tracing the mandibular canal on data from cone-beam computed tomography (CT). After the data had been collected from one dentate and one edentate fresh cadaver head, both a trained Active Shape Model (ASM) and an Active Appearance Model (AAM) were used to automatically segment the canals from the mandibular to the mental foramen. Semiautomatic segmentation was also evaluated by providing the models with manual annotations of the foramina. To find out if the tracings were in accordance with the actual anatomy, we compared the position of the automatic mandibular canal segmentations, as displayed on cross-sectional cone-beam CT views, with histological sections of exactly the same region. The significance of differences between results were analysed with the help of Fisher's exact test and Pearson's correlation coefficient. When tracings based on AAM and ASM were used, differences between cone-beam CT and histological measurements varied up to 3.45mm and 4.44mm, respectively. Manual marking of the mandibular and mental foramina did not improve the results, and there were no significant differences (p=0.097) among the methods. The accuracy of automatic segmentation of the mandibular canal by the AAM and ASM methods is inadequate for use in clinical practice. PMID:25156043

  10. Fast computation of statistical uncertainty for spatiotemporal distributions estimated directly from dynamic cone beam SPECT projections

    SciTech Connect

    Reutter, Bryan W.; Gullberg, Grant T.; Huesman, Ronald H.

    2001-04-09

    The estimation of time-activity curves and kinetic model parameters directly from projection data is potentially useful for clinical dynamic single photon emission computed tomography (SPECT) studies, particularly in those clinics that have only single-detector systems and thus are not able to perform rapid tomographic acquisitions. Because the radiopharmaceutical distribution changes while the SPECT gantry rotates, projections at different angles come from different tracer distributions. A dynamic image sequence reconstructed from the inconsistent projections acquired by a slowly rotating gantry can contain artifacts that lead to biases in kinetic parameters estimated from time-activity curves generated by overlaying regions of interest on the images. If cone beam collimators are used and the focal point of the collimators always remains in a particular transaxial plane, additional artifacts can arise in other planes reconstructed using insufficient projection samples [1]. If the projection samples truncate the patient's body, this can result in additional image artifacts. To overcome these sources of bias in conventional image based dynamic data analysis, we and others have been investigating the estimation of time-activity curves and kinetic model parameters directly from dynamic SPECT projection data by modeling the spatial and temporal distribution of the radiopharmaceutical throughout the projected field of view [2-8]. In our previous work we developed a computationally efficient method for fully four-dimensional (4-D) direct estimation of spatiotemporal distributions from dynamic SPECT projection data [5], which extended Formiconi's least squares algorithm for reconstructing temporally static distributions [9]. In addition, we studied the biases that result from modeling various orders temporal continuity and using various time samplings [5]. the present work, we address computational issues associated with evaluating the statistical uncertainty of

  11. On the computational implementation of forward and back-projection operations for cone-beam computed tomography.

    PubMed

    Karimi, Davood; Ward, Rabab

    2016-08-01

    Forward- and back-projection operations are the main computational burden in iterative image reconstruction in computed tomography. In addition, their implementation has to be accurate to ensure stable convergence to a high-quality image. This paper reviews and compares some of the variations in the implementation of these operations in cone-beam computed tomography. We compare four algorithms for computing the system matrix, including a distance-driven algorithm, an algorithm based on cubic basis functions, another based on spherically symmetric basis functions, and a voxel-driven algorithm. The focus of our study is on understanding how the choice of the implementation of the system matrix will influence the performance of iterative image reconstruction algorithms, including such factors as the noise strength and spatial resolution in the reconstructed image. Our experiments with simulated and real cone-beam data reveal the significance of the speed-accuracy trade-off in the implementation of the system matrix. Our results suggest that fast convergence of iterative image reconstruction methods requires accurate implementation of forward- and back-projection operations, involving a direct estimation of the convolution of the footprint of the voxel basis function with the surface of the detectors. The required accuracy decreases by increasing the resolution of the projection measurements beyond the resolution of the reconstructed image. Moreover, reconstruction of low-contrast objects needs more accurate implementation of these operations. Our results also show that, compared with regularized reconstruction methods, the behavior of iterative reconstruction algorithms that do not use a proper regularization is influenced more significantly by the implementation of the forward- and back-projection operations. PMID:26438389

  12. Comparison of the Diagnostic Image Quality of the Canine Maxillary Dentoalveolar Structures Obtained by Cone Beam Computed Tomography and 64-Multidetector Row Computed Tomography.

    PubMed

    Soukup, Jason W; Drees, Randi; Koenig, Lisa J; Snyder, Christopher J; Hetzel, Scott; Miles, Chanda R; Schwarz, Tobias

    2015-01-01

    The objective of this blinded study was to validate the use of cone beam computed tomography (C) for imaging of the canine maxillary dentoalveolar structures by comparing its diagnostic image quality with that of 64-multidetector row CT Sagittal slices of a tooth-bearing segment of the maxilla of a commercially purchased dog skull embedded in methylmethacrylate were obtained along a line parallel with the dental arch using a commercial histology diamond saw. The slice of tooth-bearing bone that best depicted the dentoalveolar structures was chosen and photographed. The maxillary segment was imaged with cone beam CT and 64-multidetector row CT. Four blinded evaluators compared the cone beam CT and 64-multidetector row CT images and image quality was scored as it related to the anatomy of dentoalveolar structures. Trabecular bone, enamel, dentin, pulp cavity, periodontal ligament space, and lamina dura were scored In addition, a score depicting the evaluators overall impression of the image was recorded. Images acquired with cone beam CT were found to be significantly superior in image quality to images acquired with 64-multidetector row CT overall, and in all scored categories. In our study setting cone beam CT was found to be a valid and clinically superior imaging modality for the canine maxillary dentoalveolar structures when compared to 64-multidetector row CT. PMID:26415384

  13. Trabecular bone structural parameters evaluated using dental cone-beam computed tomography: cellular synthetic bones

    PubMed Central

    2013-01-01

    Objective This study compared the adequacy of dental cone beam computed tomography (CBCT) and micro computed tomography (micro-CT) in evaluating the structural parameters of trabecular bones. Methods The cellular synthetic bones in 4 density groups (Groups 1–4: 0.12, 0.16, 0.20, and 0.32 g/cm3) were used in this study. Each group comprised 8 experimental specimens that were approximately 1 cm3. Dental CBCT and micro-CT scans were conducted on each specimen to obtain independent measurements of the following 4 trabecular bone structural parameters: bone volume fraction (BV/TV), specific bone surface (BS/BV), trabecular thickness (Tb.Th.), and trabecular separation (Tb.Sp.). Wilcoxon signed ranks tests were used to compare the measurement variations between the dental CBCT and micro-CT scans. A Spearman analysis was conducted to calculate the correlation coefficients (r) of the dental CBCT and micro-CT measurements. Results and Conclusion Of the 4 groups, the BV/TV and Tb.Th. measured using dental CBCT were larger compared with those measured using micro-CT. By contrast, the BS/BV measured using dental CBCT was significantly less compared with those measured using micro-CT. Furthermore, in the low-density groups (Groups 1 and 2), the Tb.Sp. measured using dental CBCT was smaller compared with those measured using micro-CT. However, the Tb.Sp. measured using dental CBCT was slightly larger in the high-density groups (Groups 3 and 4) than it was in the low density groups. The correlation coefficients between the BV/TV, BS/BV, Tb.Th., and Tb.Sp. values measured using dental CBCT and micro-CT were 0.9296 (p < .001), 0.8061 (p < .001), 0.9390 (p < .001), and 0.9583 (p < .001), respectively. Although the dental CBCT and micro-CT approaches exhibited high correlations, the absolute values of BV/TV, BS/BV, Tb.Th., Tb.Sp. differed significantly between these measurements. Additional studies must be conducted to evaluate using dental CBCT in clinical practice. PMID

  14. Image reconstruction in circular cone-beam computed tomography by constrained, total-variation minimization

    PubMed Central

    Sidky, Emil Y.; Pan, Xiaochuan

    2009-01-01

    An iterative algorithm, based on recent work in compressive sensing, is developed for volume image reconstruction from a circular cone-beam scan. The algorithm minimizes the total-variation (TV) of the image subject to the constraint that the estimated projection data is within a specified tolerance of the available data and that the values of the volume image are non-negative. The constraints are enforced by use of projection onto convex sets (POCS) and the TV objective is minimized by steepest descent with an adaptive step-size. The algorithm is referred to as adaptive-steepest-descent-POCS (ASD-POCS). It appears to be robust against cone-beam artifacts, and may be particularly useful when the angular range is limited or when the angular sampling rate is low. The ASD-POCS algorithm is tested with the Defrise disk and jaw computerized phantoms. Some comparisons are performed with the POCS and expectation-maximization (EM) algorithms. Although the algorithm is presented in the context of circular cone-beam image reconstruction, it can also be applied to scanning geometries involving other x-ray source trajectories. PMID:18701771

  15. Assessment of three dead detector correction methods for cone-beam computed tomography

    SciTech Connect

    Nelms, David W.; Shukla, Hemant I.; Nixon, Earl; Bayouth, John E.; Flynn, Ryan T.

    2009-10-15

    Purpose: Dead detectors due to manufacturing defects or radiation damage in the electronic portal imaging devices (EPIDs) used for cone-beam computed tomography (CBCT) can lead to image degradation and ring artifacts. In this work three dead detector correction methods were assessed using megavoltage CBCT (MVCBCT) as a test system, with the goals of assessing the relative effectiveness of the three methods and establishing the conditions for which they fail. Methods: MVCBCT projections acquired with four linacs at 8 and 60 MU (monitor units) were degraded with varying percentages (2%-95%) of randomly distributed dead single detectors (RDSs), randomly distributed dead detector clusters (RDCs) of 2 mm diameter, and nonrandomly distributed dead detector disks (NRDDs) of varying diameter (4-16 mm). Correction algorithms were bidirectional linear interpolation (BLI), quad-directional linear interpolation (QLI), and a Laplacian solution (LS) method. Correction method failure was defined to occur if ring artifacts were present in the reconstructed phantom images from any linac or if the modulation transfer function (MTF) for any linac dropped below baseline with a p value, calculated with the two sample t test, of less than 0.01. Results: All correction methods failed at the same or lower RDC/RDS percentages and NRDD diameters for the 60 MU as for the 8 MU cases. The LS method tended to outperform or match the BLI and QLI methods. If ring artifacts anywhere in the images were considered unacceptable, the LS method failed for 60 MU at >33% RDS, >2% RDC, and >4 mm NRDD. If ring artifacts within 4 mm longitudinally of the phantom section interfaces were considered acceptable, the LS method failed for 60 MU at >90% RDS, >80% RDC, and >4 mm NRDD. LS failed due to MTF drop for 60 MU at >50% RDS, >25% RDC, and >4 mm NRDD. Conclusions: The LS method is superior to the BLI and QLI methods, and correction algorithm effectiveness decreases as imaging dose increases. All correction

  16. Estimation of Rectal Dose Using Daily Megavoltage Cone-Beam Computed Tomography and Deformable Image Registration

    SciTech Connect

    Akino, Yuichi; Yoshioka, Yasuo; Fukuda, Shoichi; Maruoka, Shintaroh; Takahashi, Yutaka; Yagi, Masashi; Mizuno, Hirokazu; Isohashi, Fumiaki; Ogawa, Kazuhiko

    2013-11-01

    Purpose: The actual dose delivered to critical organs will differ from the simulated dose because of interfractional organ motion and deformation. Here, we developed a method to estimate the rectal dose in prostate intensity modulated radiation therapy with consideration to interfractional organ motion using daily megavoltage cone-beam computed tomography (MVCBCT). Methods and Materials: Under exemption status from our institutional review board, we retrospectively reviewed 231 series of MVCBCT of 8 patients with prostate cancer. On both planning CT (pCT) and MVCBCT images, the rectal contours were delineated and the CT value within the contours was replaced by the mean CT value within the pelvis, with the addition of 100 Hounsfield units. MVCBCT images were rigidly registered to pCT and then nonrigidly registered using B-Spline deformable image registration (DIR) with Velocity AI software. The concordance between the rectal contours on MVCBCT and pCT was evaluated using the Dice similarity coefficient (DSC). The dose distributions normalized for 1 fraction were also deformed and summed to estimate the actual total dose. Results: The DSC of all treatment fractions of 8 patients was improved from 0.75±0.04 (mean ±SD) to 0.90 ±0.02 by DIR. Six patients showed a decrease of the generalized equivalent uniform dose (gEUD) from total dose compared with treatment plans. Although the rectal volume of each treatment fraction did not show any correlation with the change in gEUD (R{sup 2}=0.18±0.13), the displacement of the center of gravity of rectal contours in the anterior-posterior (AP) direction showed an intermediate relationship (R{sup 2}=0.61±0.16). Conclusion: We developed a method for evaluation of rectal dose using DIR and MVCBCT images and showed the necessity of DIR for the evaluation of total dose. Displacement of the rectum in the AP direction showed a greater effect on the change in rectal dose compared with the rectal volume.

  17. Clinical Implementation of Intrafraction Cone Beam Computed Tomography Imaging During Lung Tumor Stereotactic Ablative Radiation Therapy

    SciTech Connect

    Li, Ruijiang; Han, Bin; Meng, Bowen; Maxim, Peter G.; Xing, Lei; Koong, Albert C.; Diehn, Maximilian; Loo, Billy W.

    2013-12-01

    Purpose: To develop and clinically evaluate a volumetric imaging technique for assessing intrafraction geometric and dosimetric accuracy of stereotactic ablative radiation therapy (SABR). Methods and Materials: Twenty patients received SABR for lung tumors using volumetric modulated arc therapy (VMAT). At the beginning of each fraction, pretreatment cone beam computed tomography (CBCT) was used to align the soft-tissue tumor position with that in the planning CT. Concurrent with dose delivery, we acquired fluoroscopic radiograph projections during VMAT using the Varian on-board imaging system. Those kilovolt projections acquired during millivolt beam-on were automatically extracted, and intrafraction CBCT images were reconstructed using the filtered backprojection technique. We determined the time-averaged target shift during VMAT by calculating the center of mass of the tumor target in the intrafraction CBCT relative to the planning CT. To estimate the dosimetric impact of the target shift during treatment, we recalculated the dose to the GTV after shifting the entire patient anatomy according to the time-averaged target shift determined earlier. Results: The mean target shift from intrafraction CBCT to planning CT was 1.6, 1.0, and 1.5 mm; the 95th percentile shift was 5.2, 3.1, 3.6 mm; and the maximum shift was 5.7, 3.6, and 4.9 mm along the anterior-posterior, left-right, and superior-inferior directions. Thus, the time-averaged intrafraction gross tumor volume (GTV) position was always within the planning target volume. We observed some degree of target blurring in the intrafraction CBCT, indicating imperfect breath-hold reproducibility or residual motion of the GTV during treatment. By our estimated dose recalculation, the GTV was consistently covered by the prescription dose (PD), that is, V100% above 0.97 for all patients, and minimum dose to GTV >100% PD for 18 patients and >95% PD for all patients. Conclusions: Intrafraction CBCT during VMAT can provide

  18. Impact of Immobilization on Intrafraction Motion for Spine Stereotactic Body Radiotherapy Using Cone Beam Computed Tomography

    SciTech Connect

    Li, Winnie; Sahgal, Arjun; Foote, Matthew; Millar, Barbara-Ann; Jaffray, David A.; Letourneau, Daniel

    2012-10-01

    Purpose: Spine stereotactic body radiotherapy (SBRT) involves tight planning margins and steep dose gradients to the surrounding organs at risk (OAR). This study aimed to assess intrafraction motion using cone beam computed tomography (CBCT) for spine SBRT patients treated using three immobilization devices. Methods and Materials: Setup accuracy using CBCT was retrospectively analyzed for 102 treated spinal metastases in 84 patients. Thoracic and lumbar spine patients were immobilized with either an evacuated cushion (EC, n = 24) or a semirigid vacuum body fixation (BF, n = 60). For cases treated at cervical/upper thoracic (thoracic [T]1-T3) vertebrae, a thermoplastic S-frame (SF) mask (n = 18) was used. Patient setup was corrected by using bony anatomy image registration and couch translations only (no rotation corrections) with shifts confirmed on verification CBCTs. Repeat imaging was performed mid- and post-treatment. Patient translational and rotational positioning data were recorded to calculate means, standard deviations (SD), and corresponding margins {+-} 2 SD for residual setup errors and intrafraction motion. Results: A total of 355 localizations, 333 verifications, and 248 mid- and 280 post-treatment CBCTs were analyzed. Residual translations and rotations after couch corrections (verification scans) were similar for all immobilization systems, with SDs of 0.6 to 0.9 mm in any direction and 0.9 Degree-Sign to 1.6 Degree-Sign , respectively. Margins to encompass residual setup errors after couch corrections were within 2 mm. Including intrafraction motion, as measured on post-treatment CBCTs, SDs for total setup error in the left-right, cranial-caudal, and anterior-posterior directions were 1.3, 1.2, and 1.0 mm for EC; 0.9, 0.7, and 0.9 mm for BF; and 1.3, 0.9, and 1.1 mm for SF, respectively. The calculated margins required to encompass total setup error increased to 3 mm for EC and SF and remained within 2 mm for BF. Conclusion: Following image

  19. Commissioning experience with cone-beam computed tomography for image-guided radiation therapy.

    PubMed

    Lehmann, Joerg; Perks, Julian; Semon, Sheldon; Harse, Rick; Purdy, James A

    2007-01-01

    This paper reports on the commissioning of an Elekta cone-beam computed tomography (CT) system at one of the first U.S. sites to install a "regular," off-the-shelf Elekta Synergy (Elekta, Stockholm, Sweden) accelerator system. We present the quality assurance (QA) procedure as a guide for other users. The commissioning had six elements: (1) system safety, (2) geometric accuracy (agreement of megavoltage and kilovoltage beam isocenters), (3) image quality, (4) registration and correction accuracy, (5) dose to patient and dosimetric stability, and (6) QA procedures. The system passed the safety tests, and agreement of the isocenters was found to be within 1 mm. Using a precisely moved skull phantom, the reconstruction and alignment algorithm was found to be accurate within 1 mm and 1 degree in each dimension. Of 12 measurement points spanning a 9x9x15-cm volume in a Rando phantom (The Phantom Laboratory, Salem, NY), the average agreement in the x, y, and z coordinates was 0.10 mm, -0.12 mm, and 0.22 mm [standard deviations (SDs): 0.21 mm, 0.55 mm, 0.21 mm; largest deviations: 0.6 mm, 1.0 mm, 0.5 mm] respectively. The larger deviation for the y component can be partly attributed to the CT slice thickness of 1 mm in that direction. Dose to the patient depends on the machine settings and patient geometry. To monitor dose consistency, air kerma (output) and half-value layer (beam quality) are measured for a typical clinical setting. Air kerma was 6.3 cGy (120 kVp, 40 mA, 40 ms per frame, 360-degree scan, S20 field of view); half value layer was 7.1 mm aluminum (120 kV, 40 mA). We suggest performing items 1, 2, and 3 monthly, and 4 and 5 annually. In addition, we devised a daily QA procedure to verify agreement of the megavoltage and kilovoltage isocenters using a simple phantom containing three small steel balls. The frequency of all checks will be reevaluated based on data collected during about 1 year. PMID:17712297

  20. Target-specific optimization of four-dimensional cone beam computed tomography

    SciTech Connect

    Ahmad, Moiz; Pan Tinsu

    2012-09-15

    Purpose: Under-sampling artifacts are a major problem in four-dimensional cone-beam computed tomography (4D-CBCT) and may compromise evaluation of target motion. Several studies have addressed scan parameter selection for minimizing under-sampling artifacts; however, the role of the target characteristics in scan parameter selection has not been investigated. In this work, the authors evaluated 4D-CBCT performance by assessing the accuracy of target motion measurements for various target sizes and motions. The results may serve as patient-specific guidelines for scan parameters selection in 4D-CBCT. Methods: The authors acquired 4D-CBCT scans of a moving phantom consisting of six water-filled sphere targets of sizes 10-37 mm, using various scan times ranging from 30 s to 3 min., setting the motion to 3-s and 6-s periods. The authors used automatic image registration to extract the target motion trajectories and evaluated these measurements for various target sizes and motions over various combinations of scan parameters including scan time, detector configuration, number of respiration phases, and reconstruction filters. Results: The most important object parameter to 4D-CBCT performance was the period of motion. Measurements for the 6-s motion were always systematically less accurate than measurements for the 3-s motion for 34 of 36 objects of various sizes and periods of motion. The 6-s motion required a greater scan time than the 3-s motion for equivalent measurement accuracy. The second most influential parameter was the target size. For the 3-s period of motion, objects larger than 13 mm were tracked with sub-millimeter accuracy with a 1-min scan time. For the 6-s period of motion, objects larger than 22-mm were tracked with sub-millimeter accuracy with a 1.5-min scan time. For all sizes and motions, temporal blurring was observed when the number of phases was fewer than 8. Offset detector configuration provided the same performance as centered detector except

  1. Clinical Implementation of Intrafraction Cone Beam Computed Tomography Imaging During Lung Tumor Stereotactic Ablative Radiation Therapy

    PubMed Central

    Li, Ruijiang; Han, Bin; Meng, Bowen; Maxim, Peter G.; Xing, Lei; Koong, Albert C.; Diehn, Maximilian; Loo, Billy W.

    2013-01-01

    Purpose To develop and clinically evaluate a volumetric imaging technique for assessing intrafraction geometric and dosimetric accuracy of stereotactic ablative radiation therapy (SABR). Methods and Materials Twenty patients received SABR for lung tumors using volumetric modulated arc therapy (VMAT). At the beginning of each fraction, pretreatment cone beam computed tomography (CBCT) was used to align the soft-tissue tumor position with that in the planning CT. Concurrent with dose delivery, we acquired fluoroscopic radiograph projections during VMAT using the Varian on-board imaging system. Those kilovolt projections acquired during megavolt beam-on were automatically extracted, and intrafraction CBCT images were reconstructed using the filtered backprojection technique. We determined the time-averaged target shift during VMAT by calculating the center of mass of the tumor target in the intrafraction CBCT relative to the planning CT. To estimate the dosimetric impact of the target shift during treatment, we recalculated the dose to the GTV after shifting the entire patient anatomy according to the time-averaged target shift determined earlier. Results The mean target shift from intrafraction CBCT to planning CT was 1.6, 1.0, and 1.5 mm; the 95th percentile shift was 5.2, 3.1, 3.6 mm; and the maximum shift was 5.7, 3.6, and 4.9 mm along the anterior-posterior, left-right, and superior-inferior directions. Thus, the time-averaged intrafraction gross tumor volume (GTV) position was always within the planning target volume. We observed some degree of target blurring in the intrafraction CBCT, indicating imperfect breath-hold reproducibility or residual motion of the GTV during treatment. By our estimated dose recalculation, the GTV was consistently covered by the prescription dose (PD), that is, V100% above 0.97 for all patients, and minimum dose to GTV >100% PD for 18 patients and >95% PD for all patients. Conclusions Intrafraction CBCT during VMAT can provide

  2. Assessment of buccal bone thickness of aesthetic maxillary region: a cone-beam computed tomography study

    PubMed Central

    Flores, Tania; Navarro, Pablo; Salamanca, Carlos; Beltrán, Víctor; Borie, Eduardo

    2015-01-01

    Purpose The aim of this study was to analyze the anatomical dimensions of the buccal bone walls of the aesthetic maxillary region for immediate implant placement, based upon cone-beam computed tomography (CBCT) scans in a sample of adult patients. Methods Two calibrated examiners analyzed a sample of 50 CBCT scans, performing morphometric analyses of both incisors and canines on the left and right sides. Subsequently, in the sagittal view, a line was traced through the major axis of the selected tooth. Then, a second line (E) was traced from the buccal to the palatal wall at the level of the observed bone ridges. The heights of the buccal and palatal bone ridges were determined at the major axis of the tooth. The buccal bone thickness was measured across five lines. The first was at the level of line E. The second was at the most apical point of the tooth, and the other three lines were equidistant between the apical and the cervical lines, and parallel to them. Statistical analysis was performed with a significance level of P≤0.05 for the bone thickness means and standard deviations per tooth and patient for the five lines at varying depths. Results The means of the buccal wall thicknesses in the central incisors, lateral incisors and canines were 1.14±0.65 mm, 0.95±0.67 mm and 1.15±0.68 mm, respectively. Additionally, only on the left side were significant differences in some measurements of buccal bone thickness observed according to age and gender. However, age and gender did not show significant differences in heights between the palatal and buccal plates. In a few cases, the buccal wall had a greater height than the palatal wall. Conclusions Less than 10% of sites showed more than a 2-mm thickness of the buccal bone wall, with the exception of the central incisor region, wherein 14.4% of cases were ≥2 mm. PMID:26550524

  3. Assessment of mandibular posterior regional landmarks using cone-beam computed tomography in dental implant surgery.

    PubMed

    de Souza, Lílian Azevedo; Souza Picorelli Assis, Neuza Maria; Ribeiro, Rosangela Almeida; Pires Carvalho, Antônio Carlos; Devito, Karina Lopes

    2016-05-01

    The aim of this study has been to evaluate and correlate the anatomical features of the posterior mandibular region (submandibular fossa depth, bone height and thickness, and mandibular canal corticalization) to improve accident prevention and allow safe planning in implantology. Four parasagittal sections of cone-beam computed tomography (CBCT) from 100 patients were bilaterally analyzed. Linear measurements of the submandibular fossa depth, bone height and thickness were performed. The submandibular fossa was also classified into non-influential undercuts and influential undercuts for implant placement. Mandibular canal corticalization was also evaluated and classified according to the visualization. Data on patient age and gender were also collected. Forty-one scans (41%) were from male patients, and 59 (59%) were from female patients. Patient age ranged between 18 and 84 years, with an average age of 51.37 years. The submandibular fossa depth and implant bone thickness had a significant effect on the variability of the sample (46.1% and 22.3%, respectively). The submandibular fossa depth was quite variable, and the highest values were observed in the posterior regions. In 18.27% of the cases, the presence of the fossa directly influenced implant placement, considering a bone height of 10mm (standard implant). A significant correlation was observed between fossa depth and bone thickness. Thus, greater attention should be paid to thick ridges; although thick ridges are favorable, they may be associated with deeper submandibular fossae. The mandibular canal was the most influential anatomical structure in the premolar region due to the reduced bone height in this region and the greater difficulty in viewing the canal, and the submandibular fossa was the most influential structure in the molar region due to lower bone height leading up to the fossa and the greater fossa depth in this region. Therefore, CBCT is an important tool for assessing the mandibular region

  4. Development of Kilovoltage X-ray Dosimetry Methods and Their Application to Cone Beam Computed Tomography

    NASA Astrophysics Data System (ADS)

    Lawless, Michael J.

    The increase in popularity of pre-treatment imaging procedures in radiation therapy, such as kilovoltage cone beam computed tomography (CBCT), has been accompanied by an increase in the dose delivered to the patient from these imaging procedures. The measurement of dose from CBCT scans is complicated, as currently available kilovoltage dosimetry protocols are based on air-kerma standards and radiation detectors exhibit large energy responses at the low photon energies used in the imaging procedures. This work aims to provide the tools and methodology needed to measure the dose from these scans more accurately and precisely. Through the use of a validated Monte Carlo (MC) model of the moderately filtered (M-series) x-ray beams at the University of Wisconsin Accredited Dosimetry Calibration Laboratory, dose-to-water rates were obtained in a water phantom for the M-series x-ray beams with tube potentials from 40-250 kVp. The resulting dose-to-water rates were consistent with previously established methods, but had significantly reduced uncertainties. While detectors are commonly used to measure dose in phantom, previous investigations of the energy response of common detectors in the kilovoltage energy range have been limited to in-air geometries. The newly determined dose-to-water rates were used to characterize the in-phantom energy and depth response of thermoluminescent dosimeters and ionization chambers. When compared to previous investigations of the in-air detector response, the impact of scatter and absorption of the photon beam by the water medium was found to have a significant impact on the response of certain detectors. The dose to water in the NIST-traceable M-series x-ray beams was transferred to clinical CBCT beams and the resulting doses agreed with other dose-to-water measurement techniques. The dose to water in the CBCT beams was used to characterize the energy and depth responses of a number of detectors. The energy response in the CBCT beams agreed

  5. Assessment of cone beam computed tomography techniques for imaging lung damage in mice in vivo

    NASA Astrophysics Data System (ADS)

    Cavanaugh, Dawn

    Lung damage is a common side effect of chemotherapeutic drugs such as bleomycin. This study used a bleomycin mouse model which simulates the lung damage observed in humans. Noninvasive, in vivo cone-beam computed tomography (CBCT) was used to visualize and quantify fibrotic and inflammatory damage over the entire lung volume of mice. Bleomycin was used to induce pulmonary damage in vivo and the results from two CBCT systems, a micro-CT and flat panel CT (fpCT), were compared to histologic measurements, the standard method of murine lung damage quantification. Twenty C57BL/6 mice were given either 3 U/kg of bleomycin or saline intratracheally. The mice were scanned at baseline, before the administration of bleomycin, and then 10, 14, and 21 days afterward. At each time point, a subset of mice was sacrificed for histologic analysis. The resulting CT images were used to assess lung volume. Percent lung damage (PLD) was calculated for each mouse on both the fpCT (PLDfpcT) and the micro-CT (PLDmuCT). Histologic PLD (PLDH) was calculated for each histologic section at each time point (day 10, n = 4; day 14, n = 4; day 21, n = 5; control group, n = 5). A linear regression was applied to the PLDfpCT vs. PLDH, PLDmuCT vs. PLDH and PLDfpCT vs. PLDmuCT distributions. This study did not demonstrate strong correlations between PLDCT and PLDH. The coefficient of determination, R, was 0.68 for PLDmuCT vs. PLDH and 0.75 for the PLD fpCT vs. PLDH. The experimental issues identified from this study were: (1) inconsistent inflation of the lungs from scan to scan, (2) variable distribution of damage (one histologic section not representative of overall lung damage), (3) control mice not scanned with each group of bleomycin mice, (4) two CT systems caused long anesthesia time for the mice, and (5) respiratory gating did not hold the volume of lung constant throughout the scan. Addressing these issues might allow for further improvement of the correlation between PLDCT and PLDH.

  6. Breath-Hold Target Localization With Simultaneous Kilovoltage/Megavoltage Cone-Beam Computed Tomography and Fast Reconstruction

    SciTech Connect

    Blessing, Manuel; Stsepankou, Dzmitry; Wertz, Hansjoerg; Arns, Anna; Lohr, Frank; Hesser, Juergen; Wenz, Frederik

    2010-11-15

    Purpose: Hypofractionated high-dose radiotherapy for small lung tumors has typically been based on stereotaxy. Cone-beam computed tomography and breath-hold techniques have provided a noninvasive basis for precise cranial and extracranial patient positioning. The cone-beam computed tomography acquisition time of 60 s, however, is beyond the breath-hold capacity of patients, resulting in respiratory motion artifacts. By combining megavoltage (MV) and kilovoltage (kV) photon sources (mounted perpendicularly on the linear accelerator) and accelerating the gantry rotation to the allowed limit, the data acquisition time could be reduced to 15 s. Methods and Materials: An Elekta Synergy 6-MV linear accelerator, with iViewGT as the MV- and XVI as the kV-imaging device, was used with a Catphan phantom and an anthropomorphic thorax phantom. Both image sources performed continuous image acquisition, passing an angle interval of 90{sup o} within 15 s. For reconstruction, filtered back projection on a graphics processor unit was used. It reconstructed 100 projections acquired to a 512 x 512 x 512 volume within 6 s. Results: The resolution in the Catphan phantom (CTP528 high-resolution module) was 3 lines/cm. The spatial accuracy was within 2-3 mm. The diameters of different tumor shapes in the thorax phantom were determined within an accuracy of 1.6 mm. The signal-to-noise ratio was 68% less than that with a 180{sup o}-kV scan. The dose generated to acquire the MV frames accumulated to 82.5 mGy, and the kV contribution was <6 mGy. Conclusion: The present results have shown that fast breath-hold, on-line volume imaging with a linear accelerator using simultaneous kV-MV cone-beam computed tomography is promising and can potentially be used for image-guided radiotherapy for lung cancer patients in the near future.

  7. Interfractional Position Variation of Pancreatic Tumors Quantified Using Intratumoral Fiducial Markers and Daily Cone Beam Computed Tomography

    SciTech Connect

    Horst, Astrid van der; Wognum, Silvia; Dávila Fajardo, Raquel; Jong, Rianne de; Hooft, Jeanin E. van; Fockens, Paul; Tienhoven, Geertjan van; Bel, Arjan

    2013-09-01

    Purpose: The aim of this study was to quantify interfractional pancreatic position variation using fiducial markers visible on daily cone beam computed tomography (CBCT) scans. In addition, we analyzed possible migration of the markers to investigate their suitability for tumor localization. Methods and Materials: For 13 pancreatic cancer patients with implanted Visicoil markers, CBCT scans were obtained before 17 to 25 fractions (300 CBCTs in total). Image registration with the reference CT was used to determine the displacement of the 2 to 3 markers relative to bony anatomy and to each other. We analyzed the distance between marker pairs as a function of time to identify marker registration error (SD of linear fit residuals) and possible marker migration. For each patient, we determined the mean displacement of markers relative to the reference CT (systematic position error) and the spread in displacements (random position error). From this, we calculated the group systematic error, Σ, and group random error, σ. Results: Marker pair distances showed slight trends with time (range, −0.14 to 0.14 mm/day), possibly due to tissue deformation, but no shifts that would indicate marker migration. The mean SD of the fit residuals was 0.8 mm. We found large interfractional position variations, with for 116 of 300 (39%) fractions a 3-dimensional vector displacement of >10 mm. The spread in displacement varied significantly (P<.01) between patients, from a vector range of 9.1 mm to one of 24.6 mm. For the patient group, Σ was 3.8, 6.6, and 3.5 mm; and σ was 3.6, 4.7 and 2.5 mm, in left–right, superior–inferior, and anterior–posterior directions, respectively. Conclusions: We found large systematic displacements of the fiducial markers relative to bony anatomy, in addition to wide distributions of displacement. These results for interfractional position variation confirm the potential benefit of using fiducial markers rather than bony anatomy for daily online

  8. Cone Beam Computed Tomography Assisted Endodontic Management of a Rare Case of Mandibular First Premolar with Three Roots.

    PubMed

    Balakasireddy, K; Kumar, K Pavan; John, Gijo; Gagan, C

    2015-06-01

    Understanding the morphological anatomy of the root and root canal systems of the teeth increases the success rate of endodontic therapy. Advanced diagnostic imaging techniques like cone beam computed tomography (CBCT) are an essential aid in understanding the anatomy of teeth especially in mandibular premolars. Most commonly mandibular first and second premolars have a single root and a single canal. However, multiple root and canals have also been reported. The present case report discusses endodontic management of a three rooted mandibular first premolar using CBCT. PMID:26124611

  9. Retreatment of a Maxillary Lateral Incisor With Two Separate Root Canals Confirmed With Cone Beam Computed Tomography

    PubMed Central

    Aydemir, Seda; Helvacioglu-Yigit, Dilek; Sinanoglu, Alper; Ozel, Emre

    2015-01-01

    The purpose of this report is to present a rare case of a maxillary lateral incisor exhibiting two separate root canals confirmed by cone-beam computed tomography (CBCT). A 65-year-old female patient with an esthetic complaint regarding her maxillary left lateral incisor was referred to our clinic. During a radiographical examination, an endodontically treated root canal and an extra root canal with an apical lesion were observed. The retreatment was performed. CBCT findings confirmed the root canal mophology of the maxillary left lateral with two distinct canals. We conclude that the CBCT imaging is an adjunctive tool for better assessment of complex root canal systems. PMID:26015823

  10. Cone-Beam Computed Tomography Study Of Crown Dilaceration With a Talon Cusp in an Unerupted Permanent Maxillary Tooth.

    PubMed

    Esmaeilzadeh, Mohammad; Donyavi, Zakiyeh; Shokri, Abbas

    2016-03-01

    This article describes a rare case of crown dilaceration with a talon cusp in an unerupted permanent maxillary central incisor. Our patient was a 7-year-old boy with a history of trauma to his primary maxillary teeth (#51 and 52), at 3 years of age complaining of failure of eruption of tooth #11. Periapical radiography showed incomplete formation of tooth root #11 and more superior position of tooth bud #11 relative to tooth bud #12. A cone-beam computed tomography was ordered, which revealed crown dilaceration with a talon cusp in tooth bud #11. The patient was scheduled for follow-up at 6 months. PMID:26854775

  11. Immediate Implant Placement in Anterior Aesthetic Region and Assessment using Cone-Beam Computed Tomography Scan Technology

    PubMed Central

    Joshi, Vaibhav; Gupta, Shalini

    2015-01-01

    The esthetics and functional integrity of the periodontal tissues may be compromised by the dental loss. Dental implants have become an additional tool in the armamentarium of treatment options to offer the patient for the replacement of a missing tooth or teeth. Diagnosis and treatment planning is the key factors in achieving the successful outcome after placing and restoring implants placed immediately after tooth extraction. The introduction of cone-beam computed tomography (CBCT) for the maxillofacial region provides opportunities for dental practitioners to request multiplanar imaging. This case report demonstrates the use of CBCT scan technology in immediate implant placement in the maxillary anterior teeth region. PMID:26668494

  12. Diagnosis of simulated condylar bone defects using panoramic radiography, spiral tomography and cone-beam computed tomography: A comparison study

    PubMed Central

    Salemi, Fatemeh; Shokri, Abbas; Baharvand, Maryam

    2015-01-01

    Objectives: Radiographic examination is one of the most important parts of the clinical assessment routine for temporomandibular disorders. The aim of this study was to compare the diagnostic accuracy of cone-beam computed tomography(CBCT) with panoramic radiography and spiral computed tomography for the detection of the simulated mandibular condyle bone lesions. Study Design: The sample consisted of 10 TMJs from 5 dried human skulls. Simulated erosive and osteophytic lesions were created in 3 different sizes using round diamond bur and bone chips, respectively. Panoramic radiography, spiral tomography and cone-beam computed tomography were used in defect detection. Data were statistically analyzed with the Mann-Whitney test. The reliability and degrees of agreement between two observers were also determined by the mean of Cohen’s Kappa analysis. Results: CBCT had a statistically significant superiority than other studied techniques in detection of both erosive and osteophytic lesions with different sizes. There were significant differences between tomography and panoramic in correct detection of both erosive and osteophytic lesions with 1mm and 1.5 mm in size. However, there were no significant differences between Tomography and Panoramic in correct detection of both erosive and osteophytic lesions with 0.5 mm in size. Conclusions: CBCT images provide a greater diagnostic accuracy than spiral tomography and panoramic radiography in the detection of condylar bone erosions and osteophytes. Key words:Bone defect, Condyle, CBCT, Panoramic, radiography. PMID:25810839

  13. A Monte Carlo investigation of cumulative dose measurements for cone beam computed tomography (CBCT) dosimetry

    NASA Astrophysics Data System (ADS)

    Abuhaimed, Abdullah; Martin, Colin J.; Sankaralingam, Marimuthu; Gentle, David J.

    2015-02-01

    Many studies have shown that the computed tomography dose index (CTDI100) which is considered as a main dose descriptor for CT dosimetry fails to provide a realistic reflection of the dose involved in cone beam computed tomography (CBCT) scans. Several practical approaches have been proposed to overcome drawbacks of the CTDI100. One of these is the cumulative dose concept. The purpose of this study was to investigate four different approaches based on the cumulative dose concept: the cumulative dose (1) f(0,150) and (2) f(0,∞) with a small ionization chamber 20 mm long, and the cumulative dose (3) f100(150) and (4) f100(∞) with a standard 100 mm pencil ionization chamber. The study also aimed to investigate the influence of using the 20 and 100 mm chambers and the standard and the infinitely long phantoms on cumulative dose measurements. Monte Carlo EGSnrc/BEAMnrc and EGSnrc/DOSXYZnrc codes were used to simulate a kV imaging system integrated with a TrueBeam linear accelerator and to calculate doses within cylindrical head and body PMMA phantoms with diameters of 16 cm and 32 cm, respectively, and lengths of 150, 600, 900 mm. f(0,150) and f100(150) approaches were studied within the standard PMMA phantoms (150 mm), while the other approaches f(0,∞) and f100(∞) were within infinitely long head (600 mm) and body (900 mm) phantoms. CTDI∞ values were used as a standard to compare the dose values for the approaches studied at the centre and periphery of the phantoms and for the weighted values. Four scanning protocols and beams of width 20-300 mm were used. It has been shown that the f(0,∞) approach gave the highest dose values which were comparable to CTDI∞ values for wide beams. The differences between the weighted dose values obtained with the 20 and 100 mm chambers were significant for the beam widths <120 mm, but these differences declined with increasing beam widths to be within 4%. The weighted dose values calculated within

  14. Imaging a moving lung tumor with megavoltage cone beam computed tomography

    SciTech Connect

    Gayou, Olivier Colonias, Athanasios

    2015-05-15

    Purpose: Respiratory motion may affect the accuracy of image guidance of radiation treatment of lung cancer. A cone beam computed tomography (CBCT) image spans several breathing cycles, resulting in a blurred object with a theoretical size equal to the sum of tumor size and breathing motion. However, several factors may affect this theoretical relationship. The objective of this study was to analyze the effect of tumor motion on megavoltage (MV)-CBCT images, by comparing target sizes on simulation and pretreatment images of a large cohort of lung cancer patients. Methods: Ninety-three MV-CBCT images from 17 patients were analyzed. Internal target volumes were contoured on each MV-CBCT dataset [internal target volume (ITV{sub CB})]. Their extent in each dimension was compared to that of two volumes contoured on simulation 4-dimensional computed tomography (4D-CT) images: the combination of the tumor contours of each phase of the 4D-CT (ITV{sub 4D}) and the volume contoured on the average CT calculated from the 4D-CT phases (ITV{sub ave}). Tumor size and breathing amplitude were assessed by contouring the tumor on each CBCT raw projection where it could be unambiguously identified. The effect of breathing amplitude on the quality of the MV-CBCT image reconstruction was analyzed. Results: The mean differences between the sizes of ITV{sub CB} and ITV{sub 4D} were −1.6 ± 3.3 mm (p < 0.001), −2.4 ± 3.1 mm (p < 0.001), and −7.2 ± 5.3 mm (p < 0.001) in the anterior/posterior (AP), left/right (LR), and superior/inferior (SI) directions, respectively, showing that MV-CBCT underestimates the full target size. The corresponding mean differences between ITV{sub CB} and ITV{sub ave} were 0.3 ± 2.6 mm (p = 0.307), 0.0 ± 2.4 mm (p = 0.86), and −4.0 ± 4.3 mm (p < 0.001), indicating that the average CT image is more representative of what is visible on MV-CBCT in the AP and LR directions. In the SI directions, differences between ITV{sub CB} and ITV{sub ave} could be

  15. The effects of field-of-view and patient size on CT numbers from cone-beam computed tomography

    NASA Astrophysics Data System (ADS)

    Seet, Katrina Y. T.; Barghi, Arvand; Yartsev, Slav; Van Dyk, Jake

    2009-10-01

    Cone-beam computed tomography (CBCT) is used for patient alignment before treatment and is ideal for use in adaptive radiotherapy to account for tumor shrinkage, organ deformation and weight loss. However, CBCT images are prone to artifacts such as streaking and cupping effects, reducing image quality and CT number accuracy. Our goal was to determine the optimum combination of cone-beam imaging options to increase the accuracy of image CT numbers. Several phantoms with and without inserts of known relative electron densities were imaged using the Varian on-board imaging system. It was found that CT numbers are most influenced by the selection of field-of-view and are dependent on object size and filter type. Image acquisition in half-fan mode consistently produced more accurate CT numbers, regardless of phantom size. Values measured using full-fan mode can differ by up to 7% from planning CT values. No differences were found between CT numbers of all phantom images with low and standard dose modes.

  16. Computer aided breast calcification auto-detection in cone beam breast CT

    NASA Astrophysics Data System (ADS)

    Zhang, Xiaohua; Ning, Ruola; Liu, Jiangkun

    2010-03-01

    In Cone Beam Breast CT (CBBCT), breast calcifications have higher intensities than the surrounding tissues. Without the superposition of breast structures, the three-dimensional distribution of the calcifications can be revealed. In this research, based on the fact that calcifications have higher contrast, a local thresholding and a histogram thresholding were used to select candidate calcification areas. Six features were extracted from each candidate calcification: average foreground CT number value, foreground CT number standard deviation, average background CT number value, background CT number standard deviation, foreground-background contrast, and average edge gradient. To reduce the false positive candidate calcifications, a feed-forward back propagation artificial neural network was designed. The artificial neural network was trained with the radiologists confirmed calcifications and used as classifier in the calcification auto-detection task. In the preliminary experiments, 90% of the calcifications in the testing data sets were detected correctly with an average of 10 false positives per data set.

  17. Estimation of computed tomography dose index in cone beam computed tomography: MOSFET measurements and Monte Carlo simulations.

    PubMed

    Kim, Sangroh; Yoshizumi, Terry; Toncheva, Greta; Yoo, Sua; Yin, Fang-Fang; Frush, Donald

    2010-05-01

    To address the lack of accurate dose estimation method in cone beam computed tomography (CBCT), we performed point dose metal oxide semiconductor field-effect transistor (MOSFET) measurements and Monte Carlo (MC) simulations. A Varian On-Board Imager (OBI) was employed to measure point doses in the polymethyl methacrylate (PMMA) CT phantoms with MOSFETs for standard and low dose modes. A MC model of the OBI x-ray tube was developed using BEAMnrc/EGSnrc MC system and validated by the half value layer, x-ray spectrum and lateral and depth dose profiles. We compared the weighted computed tomography dose index (CTDIw) between MOSFET measurements and MC simulations. The CTDIw was found to be 8.39 cGy for the head scan and 4.58 cGy for the body scan from the MOSFET measurements in standard dose mode, and 1.89 cGy for the head and 1.11 cGy for the body in low dose mode, respectively. The CTDIw from MC compared well to the MOSFET measurements within 5% differences. In conclusion, a MC model for Varian CBCT has been established and this approach may be easily extended from the CBCT geometry to multi-detector CT geometry. PMID:20386198

  18. Image calibration and registration in cone-beam computed tomogram for measuring the accuracy of computer-aided implant surgery

    NASA Astrophysics Data System (ADS)

    Lam, Walter Y. H.; Ngan, Henry Y. T.; Wat, Peter Y. P.; Luk, Henry W. K.; Goto, Tazuko K.; Pow, Edmond H. N.

    2015-02-01

    Medical radiography is the use of radiation to "see through" a human body without breaching its integrity (surface). With computed tomography (CT)/cone beam computed tomography (CBCT), three-dimensional (3D) imaging can be produced. These imagings not only facilitate disease diagnosis but also enable computer-aided surgical planning/navigation. In dentistry, the common method for transfer of the virtual surgical planning to the patient (reality) is the use of surgical stent either with a preloaded planning (static) like a channel or a real time surgical navigation (dynamic) after registration with fiducial markers (RF). This paper describes using the corner of a cube as a radiopaque fiducial marker on an acrylic (plastic) stent, this RF allows robust calibration and registration of Cartesian (x, y, z)- coordinates for linking up the patient (reality) and the imaging (virtuality) and hence the surgical planning can be transferred in either static or dynamic way. The accuracy of computer-aided implant surgery was measured with reference to coordinates. In our preliminary model surgery, a dental implant was planned virtually and placed with preloaded surgical guide. The deviation of the placed implant apex from the planning was x=+0.56mm [more right], y=- 0.05mm [deeper], z=-0.26mm [more lingual]) which was within clinically 2mm safety range. For comparison with the virtual planning, the physically placed implant was CT/CBCT scanned and errors may be introduced. The difference of the actual implant apex to the virtual apex was x=0.00mm, y=+0.21mm [shallower], z=-1.35mm [more lingual] and this should be brought in mind when interpret the results.

  19. Development and operation of a prototype cone-beam computed tomography system for X-ray medical imaging

    NASA Astrophysics Data System (ADS)

    Seo, Chang-Woo; Cha, Bo Kyung; Kim, Ryun Kyung; Kim, Cho-Rong; Yang, Keedong; Huh, Young; Jeon, Sungchae; Park, Justin C.; Song, Bongyong; Song, William Y.

    2014-01-01

    This paper describes the development of a prototype cone-beam computed tomography (CBCT) system for clinical use. The overall system design in terms of physical characteristics, geometric calibration methods, and three-dimensional image reconstruction algorithms are described. Our system consists of an X-ray source and a large-area flat-panel detector with the axial dimension large enough for most clinical applications when acquired in a full gantry rotation mode. Various elaborate methods are applied to measure, analyze and calibrate the system for imaging. The electromechanical and the radiographic subsystems through the synchronized control include: gantry rotation and speed, tube rotor, the high-frequency generator (kVp, mA, exposure time and repetition rate), and the reconstruction server (imaging acquisition and reconstruction). The operator can select between analytic and iterative reconstruction methods. Our prototype system contains the latest hardware and reconstruction algorithms and, thus, represents a step forward in CBCT technology.

  20. Cone Beam Computed Tomography Evaluation of Bone Remodeling Following the Osteotome Sinus Floor Elevation Technique for Future Site Development.

    PubMed

    Nakajima, Kazutoshi; Kusama, Yukio

    2016-01-01

    The effectiveness of the osteotome technique for sinus augmentation was evaluated using cone beam computed tomography (CBCT) analysis. Clinical results of two-stage sinus floor elevation using the osteotome technique performed on 15 patients at the Nakajima Dental Clinic between 2006 and 2013 were evaluated retrospectively. CBCT imaging revealed that the maxillary sinus floor was elevated by an average of 7.28 mm (SD 1.62) immediately following surgery, with a mean bone height of 9.55 mm (SD 1.43). In all cases, the osteotome technique provided sufficient bone height for implant placement. No pre- or postoperative complications (eg, mucosal perforation) were reported. The minimal surgical stress and morbidity further underscore the practicality of this approach for two-stage maxillary sinus floor augmentation. PMID:27333007

  1. Endodontic treatment of a maxillary first molar with seven root canals confirmed with cone beam computer tomography - case report.

    PubMed

    Martins, Jorge N R

    2014-06-01

    The most common configuration of the maxillary first molar is the presence of three roots and four root canals, although the presence of several other configurations have already been reported. The objective of this work is to present a rare anatomic configuration with seven root canals diagnosed during an endodontic therapy. Endodontic treatment was performed using a dental operating microscope. Exploring the grooves surrounding the main canals with ultrasonic troughing was able expose unexpected root canals. Instrumentation with files of smaller sizes and tapers was performed to prevent root physical weakness. The anatomic configuration was confirmed with a Cone Beam Computer Tomography image analysis which was able to clearly show the presence of seven root canals. An electronic database search was conducted to identify all the published similar cases and the best techniques to approach them are discussed. PMID:25121069

  2. Endodontic Treatment of a Maxillary First Molar with Seven Root Canals Confirmed with Cone Beam Computer Tomography – Case Report

    PubMed Central

    2014-01-01

    The most common configuration of the maxillary first molar is the presence of three roots and four root canals, although the presence of several other configurations have already been reported. The objective of this work is to present a rare anatomic configuration with seven root canals diagnosed during an endodontic therapy. Endodontic treatment was performed using a dental operating microscope. Exploring the grooves surrounding the main canals with ultrasonic troughing was able expose unexpected root canals. Instrumentation with files of smaller sizes and tapers was performed to prevent root physical weakness. The anatomic configuration was confirmed with a Cone Beam Computer Tomography image analysis which was able to clearly show the presence of seven root canals. An electronic database search was conducted to identify all the published similar cases and the best techniques to approach them are discussed. PMID:25121069

  3. Three-dimensional evaluation of the mandibular third molars’ development in unilateral crossbite patients: A cone beam computed tomography study

    PubMed Central

    Halicioglu, Koray; Celikoglu, Mevlut; Buyuk, Suleyman Kutalmis; Sekerci, Ahmet Ercan; Ucar, Faruk Izzet; Yavuz, Ibrahim

    2014-01-01

    Objectives: The aim was to investigate mandibular third molar (3M)'s maturation in the crossbite and normal sides by two- and three-dimensional analyses using cone beam computed tomography (CBCT). Materials and Methods: A retrospective study was performed using CBCT of 25 patients (16 females and 9 males; mean age: 16.8 ± 2.9 years) with unilateral posterior crossbite. The formation stages and the volume of the mandibular 3Ms were evaluated by means of CBCT data of the patients without knowing the crossbite side of the patients. Results: Statistically no significant differences were found in the development of the 3Ms between the crossbite and the control sides, whereas the volume of 3M was found to be less in the crossbite side than in the normal side (P = 0.021). Conclusions: A volume of 3M was found to be less in the crossbite side than in the normal side. PMID:25202221

  4. Clival lesion incidentally discovered on cone-beam computed tomography: A case report and review of the literature

    PubMed Central

    Tadinada, Aditya; Rengasamy, Kandasamy; Fellows, Douglas; Lurie, Alan G.

    2014-01-01

    An osteolytic lesion with a small central area of mineralization and sclerotic borders was discovered incidentally in the clivus on the cone-beam computed tomography (CBCT) of a 27-year-old male patient. This benign appearance indicated a primary differential diagnosis of non-aggressive lesions such as fibro-osseous lesions and arrested pneumatization. Further, on magnetic resonance imaging (MRI), the lesion showed a homogenously low T1 signal intensity with mild internal enhancement after post-gadolinium and a heterogeneous T2 signal intensity. These signal characteristics might be attributed to the fibrous tissues, chondroid matrix, calcific material, or cystic component of the lesion; thus, chondroblastoma and chondromyxoid fibroma were added to the differential diagnosis. Although this report was limited by the lack of final diagnosis and the patient lost to follow-up, the incidental skull base finding would be important for interpreting the entire volume of CBCT by a qualified oral and maxillofacial radiologist. PMID:24944968

  5. Comparison of conventional radiography with cone beam computed tomography for detection of vertical root fractures: an in vitro study.

    PubMed

    Varshosaz, Masoud; Tavakoli, Mohammad A; Mostafavi, Maryam; Baghban, Alireza A

    2010-12-01

    To assess the diagnostic accuracy of cone beam computed tomography (CBCT) in comparison with conventional radiography for vertical root fractures, 50 of 100 teeth were subjected to vertical root fracture (VRF) and then placed in dry mandibles. 3D scans were obtained for all teeth, and conventional radiographs were used as control images. All the images were assessed by 6 observers, who determined the presence of root fractures by using a 5-point confidence rating scale. The mean area under the curve (Az) for CBCT was 0.91, and that for conventional radiography was 0.64. The difference between the modalities was statistically significant (P = 0.003). On the basis of interclass coefficient, inter-observer agreement for CBCT was 0/750, and that for conventional radiography was 0/637. Thus CBCT was shown to be significantly better than conventional periapical radiography for diagnosis of vertical root fractures in vitro. PMID:21206162

  6. The role of cone beam computed tomography in the endodontic management of a mandibular first molar with three distal canals

    PubMed Central

    Kaushik, Aishvarya; Talwar, Sangeeta; Yadav, Seema; Chaudhary, Sarika; Nawal, Ruchika Roongta

    2014-01-01

    The presence of three root canals in the distal root of the mandibular first permanent molars is rare; based on in vitro studies its incidence is reported to be between 0.2% and 3%. With the advent of cone beam computed tomography (CBCT) as an adjunctive diagnostic aid, the determination of root canal anatomy in teeth with extra canals and complex canal configurations has become more precise. CBCT provides three dimensional visualization of the pulp canal space, allowing the clinician in determining the spatial relationships of the root canals with each other at various cross sectional levels along the length of the root. The present report discusses the endodontic management of a mandibular first permanent molar with three canals in the distal root, employing CBCT as an adjunctive diagnostic aid to conventional radiography. PMID:25540667

  7. Accuracy of linear measurement in the Galileos cone beam computed tomography under simulated clinical conditions

    PubMed Central

    Ganguly, R; Ruprecht, A; Vincent, S; Hellstein, J; Timmons, S; Qian, F

    2011-01-01

    Objectives The aim of this study was to determine the geometric accuracy of cone beam CT (CBCT)-based linear measurements of bone height obtained with the Galileos CBCT (Sirona Dental Systems Inc., Bensheim, Hessen, Germany) in the presence of soft tissues. Methods Six embalmed cadaver heads were imaged with the Galileos CBCT unit subsequent to placement of radiopaque fiduciary markers over the buccal and lingual cortical plates. Electronic linear measurements of bone height were obtained using the Sirona software. Physical measurements were obtained with digital calipers at the same location. This distance was compared on all six specimens bilaterally to determine accuracy of the image measurements. Results The findings showed no statistically significant difference between the imaging and physical measurements (P > 0.05) as determined by a paired sample t-test. The intraclass correlation was used to measure the intrarater reliability of repeated measures and there was no statistically significant difference between measurements performed at the same location (P > 0.05). Conclusions The Galileos CBCT image-based linear measurement between anatomical structures within the mandible in the presence of soft tissues is sufficiently accurate for clinical use. PMID:21697155

  8. Deriving Hounsfield units using grey levels in cone beam computed tomography

    PubMed Central

    Mah, P; Reeves, T E; McDavid, W D

    2010-01-01

    Objectives An in vitro study was performed to investigate the relationship between grey levels in dental cone beam CT (CBCT) and Hounsfield units (HU) in CBCT scanners. Methods A phantom containing 8 different materials of known composition and density was imaged with 11 different dental CBCT scanners and 2 medical CT scanners. The phantom was scanned under three conditions: phantom alone and phantom in a small and large water container. The reconstructed data were exported as Digital Imaging and Communications in Medicine (DICOM) and analysed with On Demand 3D® by Cybermed, Seoul, Korea. The relationship between grey levels and linear attenuation coefficients was investigated. Results It was demonstrated that a linear relationship between the grey levels and the attenuation coefficients of each of the materials exists at some “effective” energy. From the linear regression equation of the reference materials, attenuation coefficients were obtained for each of the materials and CT numbers in HU were derived using the standard equation. Conclusions HU can be derived from the grey levels in dental CBCT scanners using linear attenuation coefficients as an intermediate step. PMID:20729181

  9. The current status of cone beam computed tomography imaging in orthodontics

    PubMed Central

    Kapila, S; Conley, R S; Harrell, W E

    2011-01-01

    Cone beam CT (CBCT) has become an increasingly important source of three dimensional (3D) volumetric data in clinical orthodontics since its introduction into dentistry in 1998. The purpose of this manuscript is to highlight the current understanding of, and evidence for, the clinical use of CBCT in orthodontics, and to review the findings to answer clinically relevant questions. Currently available information from studies using CBCT can be organized into five broad categories: 1, the assessment of CBCT technology; 2, its use in craniofacial morphometric analyses; 3, incidental and missed findings; 4, analysis of treatment outcomes; and 5, efficacy of CBCT in diagnosis and treatment planning. The findings in these topical areas are summarized, followed by current indications and protocols for the use of CBCT in specific cases. Despite the increasing popularity of CBCT in orthodontics, and its advantages over routine radiography in specific cases, the effects of information derived from these images in altering diagnosis and treatment decisions has not been demonstrated in several types of cases. It has therefore been recommended that CBCT be used in select cases in which conventional radiography cannot supply satisfactory diagnostic information; these include cleft palate patients, assessment of unerupted tooth position, supernumerary teeth, identification of root resorption and for planning orthognathic surgery. The need to image other types of cases should be made on a case-by-case basis following an assessment of benefits vs risks of scanning in these situations. PMID:21159912

  10. Effect of object location on the density measurement in cone-beam computed tomography versus multislice computed tomography

    PubMed Central

    Eskandarloo, Amir; Abdinian, Mehrdad; Salemi, Fatemeh; Hashemzadeh, Zahra; Safaei, Mehran

    2012-01-01

    Background: Bone density measurement in a radiographic view is a valuable method for evaluating the density of bone quality before performing some dental procedures such as, dental implant placements. It seems that Cone-Beam Computed Tomography (CBCT) can be used as a diagnostic tool for evaluating the density of the bone, prior to any treatment, as the reported radiation dose in this method is minimal. The aim of this study is to investigate the effect of object location on the density measurement in CBCT versus Multislice computed tomography (CT). Materials and Methods: In an experimental study, three samples with similar dimensions, but different compositions, different densities (Polyethylene, Polyamide, Polyvinyl Chloride), and three bone pieces of different parts of the mandibular bone were imaged in three different positions by CBCT and Multislice CT sets. The average density value was computed for each sample in each position. Then the data obtained from each CBCT was converted to a Hounsfield unit and evaluated using a single variable T analysis. A P value <0.05 was considered to be significant. Results: The density in a Multislice CT is stable in the form of a Hounsfield Number, but this density is variable in the images acquired through CBCT, and the change in the position results in significant changes in the density. In this study, a statistically significant difference (P value = 0.000) has been observed for the position of the sample and its density in CBCT in comparison to Multislice CT. Conclusions: Density values in CBCT are not real because they are affected by the position of the object in the machine. PMID:23814567

  11. Analysis of prostate bed motion using an endorectal balloon and cone beam computed tomography during postprostatectomy radiotherapy

    PubMed Central

    Joo, Ji Hyeon; Kim, Yeon Joo; Kim, Young Seok; Cho, Young Pil; Lee, Ho Yeon; Jeong, Chang Young; Kwak, Jungwon; Cho, Byung Chul

    2016-01-01

    Background The authors conducted this prospective study to analyze the amount of interfractional prostate bed motion (PBM) and quantify its components with the use of an endorectal balloon (ERB). Methods A total of 1,348 cone beam computed tomography images from 46 patients who underwent postprostatectomy radiotherapy were analyzed. For the pilot image, electronic portal imaging, guided by skin marks was performed to ensure proper positioning and inflation of the ERB. Then, for bone matching, manual or automatic registration of the planning and each cone beam computed tomography was performed, based on the bony anatomy of the pelvis. Shifts (bony misalignment [BM]) in three directions were recorded at each treatment session. For prostate bed matching, manual matching was conducted based on the anterior rectal wall and the shift (PBM) was recorded. Total setup error was defined as the shift from the skin mark to the prostate bed matching, based on anterior rectal wall stretched by the ERB. PBM was defined as the difference between the total setup error and BM. Results Systematic errors for the total setup error were 1.0, 1.3, and 1.0 mm in the right–left, anterior–posterior, and superior–inferior directions, with random errors of 1.9, 2.4, and 1.9 mm, respectively. Systematic errors were 1.6, 1.6, and 0.3 mm for BM and 0.8, 1.1, and 0.9 mm for PBM, with random errors of 2.4, 2.5, and 1.1 mm for BM and 1.8, 2.2, and 1.9 mm for PBM. Conclusion The BM was the main component of the total setup error, suggesting that interfractional PBM was well controlled by the ERB device. Planning target volume margins of <5 mm were needed to include 95% of the interfractional variations when using an ERB. PMID:27307750

  12. Detailed Anatomical Analysis of the Sphenoid Sinus and Sphenoid Sinus Ostium by Cone-Beam Computed Tomography.

    PubMed

    Yilmaz, Nesibe; Kose, Evren; Dedeoglu, Numan; Colak, Cemil; Ozbag, Davut; Durak, Mehmet Akif

    2016-09-01

    The aim of this study is the evaluation of the anatomical structures of sphenoid sinus ostium used as a reference point for transsphenoidal surgery by cone beam computed tomography. The authors' study was performed using the cone-beam computed tomography images of 16 to 82-year old 200 (112 female, 88 male) patients (Newton 5G, Verona, Italy). Septum deviation of sphenoid sinus and the distance between 2 ostia were evaluated by coronal and axial sections, respectively. Pneumatization degree of sphenoid sinus, diameter of sphenoid sinus ostium, and distance lower edge of superior turbinate to sphenoid sinus ostium were measured by using sagittal sections. The sellar type was the most common pneumatization type of sphenoid sinus in authors' study. While the C-type septum deviation was observed as the most common, T-type deviation was the least type. Sphenoid sinus ostium was bilaterally in 71.5% of individuals, and it was not found in 10% of individuals included in the study. A significant decrease was determined in diameter of the left sphenoid sinus ostium with aging. The distances between 2 sphenoid sinus ostia were 7.30 ± 2.77 mm for women and 6.09 ± 2.58 mm for men, respectively. No statistical differences were found in women and men in terms of distances between the lower edge of the right and left superior turbinate and sphenoid sinus ostium on their sides. Consequently, making detailed preoperative radiological evaluation of anatomic variations of sphenoid sinus and sphenoid sinus ostium is important in terms of guiding the surgeon in the process of a successful transsphenoidal surgery. PMID:27428910

  13. Effect of Time Lapse on the Diagnostic Accuracy of Cone Beam Computed Tomography for Detection of Vertical Root Fractures.

    PubMed

    Eskandarloo, Amir; Asl, Amin Mahdavi; Jalalzadeh, Mohsen; Tayari, Maryam; Hosseinipanah, Mohammad; Fardmal, Javad; Shokri, Abbas

    2016-01-01

    Accurate and early diagnosis of vertical root fractures (VRFs) is imperative to prevent extensive bone loss and unnecessary endodontic and prosthodontic treatments. The aim of this study was to assess the effect of time lapse on the diagnostic accuracy of cone beam computed tomography (CBCT) for VRFs in endodontically treated dog's teeth. Forty-eight incisors and premolars of three adult male dogs underwent root canal therapy. The teeth were assigned to two groups: VRFs were artificially induced in the first group (n=24) while the teeth in the second group remained intact (n=24). The CBCT scans were obtained by NewTom 3G unit immediately after inducing VRFs and after one, two, three, four, eight, 12 and 16 weeks. Three oral and maxillofacial radiologists blinded to the date of radiographs assessed the presence/absence of VRFs on CBCT scans. The sensitivity, specificity and accuracy values were calculated and data were analyzed using SPSS v.16 software and ANOVA. The total accuracy of detection of VRFs immediately after surgery, one, two, three, four, eight, 12 and 16 weeks was 67.3%, 68.7%, 66.6%, 64.6%, 64.5%, 69.4%, 68.7%, 68% respectively. The effect of time lapse on detection of VRFs was not significant (p>0.05). Overall sensitivity, specificity and accuracy of CBCT for detection of VRFs were 74.3%, 62.2%, 67.2% respectively. Cone beam computed tomography is a valuable tool for detection of VRFs. Time lapse (four months) had no effect on detection of VRFs on CBCT scans. PMID:27007339

  14. Positioning accuracy of cone-beam computed tomography in combination with a HexaPOD robot treatment table

    SciTech Connect

    Meyer, Juergen . E-mail: juergen.meyer@canterbury.ac.nz; Wilbert, Juergen; Baier, Kurt; Guckenberger, Matthias; Richter, Anne; Sauer, Otto; Flentje, Michael

    2007-03-15

    Purpose: To scrutinize the positioning accuracy and reproducibility of a commercial hexapod robot treatment table (HRTT) in combination with a commercial cone-beam computed tomography system for image-guided radiotherapy (IGRT). Methods and Materials: The mechanical stability of the X-ray volume imaging (XVI) system was tested in terms of reproducibility and with a focus on the moveable parts, i.e., the influence of kV panel and the source arm on the reproducibility and accuracy of both bone and gray value registration using a head-and-neck phantom. In consecutive measurements the accuracy of the HRTT for translational, rotational, and a combination of translational and rotational corrections was investigated. The operational range of the HRTT was also determined and analyzed. Results: The system performance of the XVI system alone was very stable with mean translational and rotational errors of below 0.2 mm and below 0.2{sup o}, respectively. The mean positioning accuracy of the HRTT in combination with the XVI system summarized over all measurements was below 0.3 mm and below 0.3{sup o} for translational and rotational corrections, respectively. The gray value match was more accurate than the bone match. Conclusion: The XVI image acquisition and registration procedure were highly reproducible. Both translational and rotational positioning errors can be corrected very precisely with the HRTT. The HRTT is therefore well suited to complement cone-beam computed tomography to take full advantage of position correction in six degrees of freedom for IGRT. The combination of XVI and the HRTT has the potential to improve the accuracy of high-precision treatments.

  15. Detection of root perforations using conventional and digital intraoral radiography, multidetector computed tomography and cone beam computed tomography

    PubMed Central

    Eskandarloo, Amir; Noruzi-Gangachin, Maruf; Khajeh, Samira

    2015-01-01

    Objectives This study aimed to compare the accuracy of conventional intraoral (CI) radiography, photostimulable phosphor (PSP) radiography, cone beam computed tomography (CBCT) and multidetector computed tomography (MDCT) for detection of strip and root perforations in endodontically treated teeth. Materials and Methods Mesial and distal roots of 72 recently extracted molar were endodontically prepared. Perforations were created in 0.2, 0.3, or 0.4 mm diameter around the furcation of 48 roots (strip perforation) and at the external surface of 48 roots (root perforation); 48 roots were not perforated (control group). After root obturation, intraoral radiography, CBCT and MDCT were taken. Discontinuity in the root structure was interpreted as perforation. Two observers examined the images. Data were analyzed using Stata software and Chi-square test. Results The sensitivity and specificity of CI, PSP, CBCT and MDCT in detection of strip perforations were 81.25% and 93.75%, 85.42% and 91.67%, 97.92% and 85.42%, and 72.92% and 87.50%, respectively. For diagnosis of root perforation, the sensitivity and specificity were 87.50% and 93.75%, 89.58% and 91.67%, 97.92% and 85.42%, and 81.25% and 87.50%, respectively. For detection of strip perforation, the difference between CBCT and all other methods including CI, PSP and MDCT was significant (p < 0.05). For detection of root perforation, only the difference between CBCT and MDCT was significant, and for all the other methods no statistically significant difference was observed. Conclusions If it is not possible to diagnose the root perforations by periapical radiographs, CBCT is the best radiographic technique while MDCT is not recommended. PMID:25671214

  16. Contemporary management of horizontal root fractures to the permanent dentition: diagnosis--radiologic assessment to include cone-beam computed tomography.

    PubMed

    May, Jeremy J; Cohenca, Nestor; Peters, Ove A

    2013-01-01

    Historically, obtaining several periapical radiographs has been recommended to diagnose horizontal root fractures. Assessing the 3-dimensional orientation of a fracture is correlated to treatment and outcome. However, conventional radiography yields only limited information for accurate diagnosis. Cone-beam computed tomography (CBCT) is a relatively new and useful technology, which provides an auxiliary imaging modality to supplement conventional radiography for evaluating horizontal root fractures. Despite the increasing application of this technology as well as a growing body of evidence supporting its value in diagnosing horizontal root fractures, there are no specific guidelines for its use. This article aimed to provide such preliminary guidelines for cases of suspected horizontal root fracture as a result of trauma. From a database search it was concluded that CBCT is most useful in cases in which conventional radiography yields inconclusive results or shows a fracture in the middle third of a root. In such cases CBCT may rule out false negatives, ie, a suspected root fracture not visualized with conventional radiography. For a root fracture in the middle third, CBCT may rule out or confirm an oblique course of fracture involving the cervical third in the labiolingual dimension. Although there are considerable advantages when CBCT is included in the assessment of horizontal root fracture and its possible sequelae, more experimental and clinical studies are warranted to determine the exact impact on outcomes. PMID:23635979

  17. Contemporary management of horizontal root fractures to the permanent dentition: diagnosis--radiologic assessment to include cone-beam computed tomography.

    PubMed

    May, Jeremy J; Cohenca, Nestor; Peters, Ove A

    2013-03-01

    Historically, obtaining several periapical radiographs has been recommended to diagnose horizontal root fractures. Assessing the 3-dimensional orientation of a fracture is correlated to treatment and outcome. However, conventional radiography yields only limited information for accurate diagnosis. Cone-beam computed tomography (CBCT) is a relatively new and useful technology, which provides an auxiliary imaging modality to supplement conventional radiography for evaluating horizontal root fractures. Despite the increasing application of this technology as well as a growing body of evidence supporting its value in diagnosing horizontal root fractures, there are no specific guidelines for its use. This article aimed to provide such preliminary guidelines for cases of suspected horizontal root fracture as a result of trauma. From a database search it was concluded that CBCT is most useful in cases in which conventional radiography yields inconclusive results or shows a fracture in the middle third of a root. In such cases CBCT may rule out false negatives, ie, a suspected root fracture not visualized with conventional radiography. For a root fracture in the middle third, CBCT may rule out or confirm an oblique course of fracture involving the cervical third in the labiolingual dimension. Although there are considerable advantages when CBCT is included in the assessment of horizontal root fracture and its possible sequelae, more experimental and clinical studies are warranted to determine the exact impact on outcomes. PMID:23439041

  18. [Endodontics in motion: new concepts, materials and techniques 2. The use of cone-beam computed tomography in endodontic diagnosis and treatment planning].

    PubMed

    Özok, A R; Metska, M E

    2015-09-01

    Systems for cone-beam computed tomography make a high-quality 3D reconstruction of dentomaxillofacial structures possible, without exposing the patient to excessive doses of radiation. Due to its 3D nature cone-beam computed tomography is superior to conventional dental radiographic imaging methods for many aspects of endodontic diagnosis and treatment planning. There are multiple indications for the use of cone-beam computed tomography scans in endodontics, including detection of periapical lesions or root fractures and the exploration of the root canal anatomy and its deviations. Depending on conditions, a judicious decision will always have to be made with regard to the radiographic technique to be applied. Primary in that respect must be the means by which the most accurate diagnostic image can be achieved with the lowest possible dose of radiation. Making a cone-beam computed tomography scan is justified only when the required diagnostic information cannot be achieved adequately using lower dose conventional dental radiographic imaging techniques. PMID:26397106

  19. Stray light in cone beam optical computed tomography: I. Measurement and reduction strategies with planar diffuse source.

    PubMed

    Granton, Patrick V; Dekker, Kurtis H; Battista, Jerry J; Jordan, Kevin J

    2016-04-01

    Optical cone-beam computed tomographic (CBCT) scanning of 3D radiochromic dosimeters may provide a practical method for 3D dose verification in radiation therapy. However, in cone-beam geometry stray light contaminates the projection images, degrading the accuracy of reconstructed linear attenuation coefficients. Stray light was measured using a beam pass aperture array (BPA) and structured illumination methods. The stray-to-primary ray ratio (SPR) along the central axis was found to be 0.24 for a 5% gelatin hydrogel, representative of radiochromic hydrogels. The scanner was modified by moving the spectral filter from the detector to the source, changing the light's spatial fluence pattern and lowering the acceptance angle by extending distance between the source and object. These modifications reduced the SPR significantly from 0.24 to 0.06. The accuracy of the reconstructed linear attenuation coefficients for uniform carbon black liquids was compared to independent spectrometer measurements. Reducing the stray light increased the range of accurate transmission readings. In order to evaluate scanner performance for the more challenging application to small field dosimetry, a carbon black finger gel phantom was prepared. Reconstructions of the phantom from CBCT and fan-beam CT scans were compared. The modified source resulted in improved agreement. Subtraction of residual stray light, measured with BPA or structured illumination from each projection further improved agreement. Structured illumination was superior to BPA for measuring stray light for the smaller 1.2 and 0.5 cm diameter phantom fingers. At the costs of doubling the scanner size and tripling the number of scans, CBCT reconstructions of low-scattering hydrogel dosimeters agreed with those of fan-beam CT scans. PMID:26988028

  20. Stray light in cone beam optical computed tomography: I. Measurement and reduction strategies with planar diffuse source

    NASA Astrophysics Data System (ADS)

    Granton, Patrick V.; Dekker, Kurtis H.; Battista, Jerry J.; Jordan, Kevin J.

    2016-04-01

    Optical cone-beam computed tomographic (CBCT) scanning of 3D radiochromic dosimeters may provide a practical method for 3D dose verification in radiation therapy. However, in cone-beam geometry stray light contaminates the projection images, degrading the accuracy of reconstructed linear attenuation coefficients. Stray light was measured using a beam pass aperture array (BPA) and structured illumination methods. The stray-to-primary ray ratio (SPR) along the central axis was found to be 0.24 for a 5% gelatin hydrogel, representative of radiochromic hydrogels. The scanner was modified by moving the spectral filter from the detector to the source, changing the light’s spatial fluence pattern and lowering the acceptance angle by extending distance between the source and object. These modifications reduced the SPR significantly from 0.24 to 0.06. The accuracy of the reconstructed linear attenuation coefficients for uniform carbon black liquids was compared to independent spectrometer measurements. Reducing the stray light increased the range of accurate transmission readings. In order to evaluate scanner performance for the more challenging application to small field dosimetry, a carbon black finger gel phantom was prepared. Reconstructions of the phantom from CBCT and fan-beam CT scans were compared. The modified source resulted in improved agreement. Subtraction of residual stray light, measured with BPA or structured illumination from each projection further improved agreement. Structured illumination was superior to BPA for measuring stray light for the smaller 1.2 and 0.5 cm diameter phantom fingers. At the costs of doubling the scanner size and tripling the number of scans, CBCT reconstructions of low-scattering hydrogel dosimeters agreed with those of fan-beam CT scans.

  1. Characteristics of kilovoltage x-ray beams used for cone-beam computed tomography in radiation therapy

    NASA Astrophysics Data System (ADS)

    Ding, George X.; Duggan, Dennis M.; Coffey, Charles W.

    2007-03-01

    The purpose of this investigation is to characterize the beams produced by a kilovoltage (kV) imager integrated into a linear accelerator (Varian on-board imager integrated into the Trilogy accelerator) for acquiring high resolution volumetric cone-beam computed tomography (CBCT) images of the patient on the treatment table. The x-ray tube is capable of generating photon spectra with kVp values between 40 and 125 kV. The Monte Carlo simulations were used to study the characteristics of kV beams and the properties of imaged target scatters. The Monte Carlo results were benchmarked against measurements, and excellent agreements were obtained. We also studied the effect of including the electron impact ionization (EII), and the simulation showed that the characteristic radiation is increased significantly in the energy spectra when EII is included. Although only slight beam hardening is observed in the spectra of all photons after passing through the phantom target, there is a significant difference in the spectra and angular distributions between scattered and primary photons. The results also show that the photon fluence distributions are significantly altered by adding bow tie filters. The results indicate that a combination of large cone-beam field size and large imaged target significantly increases scatter-to-primary ratios for photons that reach the detector panel. For phantoms 10 cm, 20 cm and 30 cm thick of water placed at the isocentre, the scatter-to-primary ratios are 0.94, 3.0 and 7.6 respectively for an open 125 kVp CBCT beam. The Monte Carlo simulations show that the increase of the scatter is proportional to the increase of the imaged volume, and this also applies to scatter-to-primary ratios. This study shows both the magnitude and the characteristics of scattered x-rays. The knowledge obtained from this investigation may be useful in the future design of the image detector to improve the image quality.

  2. Cone-Beam Computed Tomography: Imaging Dose during CBCT Scan Acquisition and Accuracy of CBCT Based Dose Calculations

    NASA Astrophysics Data System (ADS)

    Giles, David Matthew

    Cone beam computed tomography (CBCT) is a recent development in radiotherapy for use in image guidance. Image guided radiotherapy using CBCT allows visualization of soft tissue targets and critical structures prior to treatment. Dose escalation is made possible by accurately localizing the target volume while reducing normal tissue toxicity. The kilovoltage x-rays of the cone beam imaging system contribute additional dose to the patient. In this study a 2D reference radiochromic film dosimetry method employing GAFCHROMIC(TM) model XR-QA film is used to measure point skin doses and dose profiles from the Elekta XVI CBCT system integrated onto the Synergy linac. The soft tissue contrast of the daily CBCT images makes adaptive radiotherapy possible in the clinic. In order to track dose to the patient or utilize on-line replanning for adaptive radiotherapy the CBCT images must be used to calculate dose. A Hounsfield unit calibration method for scatter correction is investigated for heterogeneity corrected dose calculation in CBCT images. Three Hounsfield unit to density calibration tables are used for each of four cases including patients and an anthropomorphic phantom, and the calculated dose from each is compared to results from the clinical standard fan beam CT. The dose from the scan acquisition is reported and the effect of scan geometry and total output of the x-ray tube on dose magnitude and distribution is shown. The ability to calculate dose with CBCT is shown to improve with the use of patient specific density tables for scatter correction, and for high beam energies the calculated dose agreement is within 1%.

  3. Prostate Localization on Daily Cone-Beam Computed Tomography Images: Accuracy Assessment of Similarity Metrics

    SciTech Connect

    Kim, Jinkoo; Hammoud, Rabih; Pradhan, Deepak; Zhong Hualiang; Jin, Ryan Y.; Movsas, Benjamin; Chetty, Indrin J.

    2010-07-15

    Purpose: To evaluate different similarity metrics (SM) using natural calcifications and observation-based measures to determine the most accurate prostate and seminal vesicle localization on daily cone-beam CT (CBCT) images. Methods and Materials: CBCT images of 29 patients were retrospectively analyzed; 14 patients with prostate calcifications (calcification data set) and 15 patients without calcifications (no-calcification data set). Three groups of test registrations were performed. Test 1: 70 CT/CBCT pairs from calcification dataset were registered using 17 SMs (6,580 registrations) and compared using the calcification mismatch error as an endpoint. Test 2: Using the four best SMs from Test 1, 75 CT/CBCT pairs in the no-calcification data set were registered (300 registrations). Accuracy of contour overlays was ranked visually. Test 3: For the best SM from Tests 1 and 2, accuracy was estimated using 356 CT/CBCT registrations. Additionally, target expansion margins were investigated for generating registration regions of interest. Results: Test 1-Incremental sign correlation (ISC), gradient correlation (GC), gradient difference (GD), and normalized cross correlation (NCC) showed the smallest errors ({mu} {+-} {sigma}: 1.6 {+-} 0.9 {approx} 2.9 {+-} 2.1 mm). Test 2-Two of the three reviewers ranked GC higher. Test 3-Using GC, 96% of registrations showed <3-mm error when calcifications were filtered. Errors were left/right: 0.1 {+-} 0.5mm, anterior/posterior: 0.8 {+-} 1.0mm, and superior/inferior: 0.5 {+-} 1.1 mm. The existence of calcifications increased the success rate to 97%. Expansion margins of 4-10 mm were equally successful. Conclusion: Gradient-based SMs were most accurate. Estimated error was found to be <3 mm (1.1 mm SD) in 96% of the registrations. Results suggest that the contour expansion margin should be no less than 4 mm.

  4. A suggested technique for the application of the cone beam computed tomography periapical index

    PubMed Central

    Esposito, S; Cardaropoli, M; Cotti, E

    2011-01-01

    Objectives Cone beam CT (CBCT) produces undistorted three-dimensional (3D) images of the maxillofacial region with a radiation dosage lower than conventional CT. The periapical index score (PAI) is commonly used to follow up the lesions in the bone using periapical radiographs. Recently, a new PAI based on CBCT was introduced (CBCT-PAI). The aim of this technical report is to present a modified reproducible method to assess the CBCT-PAI. Methods CBCT was used to evaluate a periapical bone lesion observed in the area of tooth number 13 before treatment and 2 years after treatment. The modified CBCT-PAI was applied to both the examinations to measure the lesion. The dimensional analysis of the lesion was performed in each plane, assessing three fixed and reproducible dimensions: mesiodistal (M-D), buccolingual (B-L) and coronoapical (C-A). The images were evaluated by three mutually independent examiners. Data were collected and reported in a chart. The results were compared with each other and with the PAI score from the periapical radiographs. Results The three observers reported the same measurements of the lesion for each plane. The CBCT-PAI follow-up showed a reduction of the size of the lesion (5D vs 4D) but also an increase in the erosion of the buccal cortical plate. The comparison of CBCT-PAI with classic PAI showed the first method to be more precise. Conclusions This technical report shows how the CBCT-PAI can be applied to the CBCT exam of a periapical lesion in a reproducible way. PMID:22065800

  5. Characterization of Scattered X-Ray Photons in Dental Cone-Beam Computed Tomography

    PubMed Central

    Yang, Ching-Ching

    2016-01-01

    Purpose Scatter is a very important artifact causing factor in dental cone-beam CT (CBCT), which has a major influence on the detectability of details within images. This work aimed to improve the image quality of dental CBCT through scatter correction. Methods Scatter was estimated in the projection domain from the low frequency component of the difference between the raw CBCT projection and the projection obtained by extrapolating the model fitted to the raw projections acquired with 2 different sizes of axial field-of-view (FOV). The function for curve fitting was optimized by using Monte Carlo simulation. To validate the proposed method, an anthropomorphic phantom and a water-filled cylindrical phantom with rod inserts simulating different tissue materials were scanned using 120 kVp, 5 mA and 9-second scanning time covering an axial FOV of 4 cm and 13 cm. The detectability of the CT image was evaluated by calculating the contrast-to-noise ratio (CNR). Results Beam hardening and cupping artifacts were observed in CBCT images without scatter correction, especially in those acquired with 13 cm FOV. These artifacts were reduced in CBCT images corrected by the proposed method, demonstrating its efficacy on scatter correction. After scatter correction, the image quality of CBCT was improved in terms of target detectability which was quantified as the CNR for rod inserts in the cylindrical phantom. Conclusions Hopefully the calculations performed in this work can provide a route to reach a high level of diagnostic image quality for CBCT imaging used in oral and maxillofacial structures whilst ensuring patient dose as low as reasonably achievable, which may ultimately make CBCT scan a reliable and safe tool in clinical practice. PMID:26950435

  6. Fractal dimension evaluation of cone beam computed tomography in patients with bisphosphonate-associated osteonecrosis

    PubMed Central

    Torres, SR; Chen, CSK; Leroux, BG; Lee, PP; Hollender, LG; Schubert, MM

    2011-01-01

    Objectives The aim of this study was to (1) evaluate the fractal dimension (FD) in regions of the mandible on cone beam CT (CBCT) images of patients with bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) and (2) to select the most suitable region of interest (ROI) for further study on detection of bone alterations associated with bisphosphonates. Methods CBCT images of patients with BP-ONJ were included with matched controls. Values of FD were compared between groups. Selected ROIs were: ROI-1 — below the mandibular foramen; ROI-2 — above the mandibular foramen; ROI-3 — anterior to the mental foramen; ROI-4 — above the mandibular canal. The area of bone exposure was included as ROI-5. The results were analysed using generalized estimating equations and conditional logistic regression. Results There were 36 patients (67% female) with a mean age of 60.7 years. The mean FDs were: ROI-1 — 1.678 for controls and 1.673 for patients (P = 0.81); ROI-2 — 1.657 for controls and 1.653 for patients (P = 0.78); ROI-3 — 1.661 for controls and 1.684 for patients (P = 0.17); and ROI-4 — 1.670 for controls and 1.698 for patients (P = 0.03). The value of the FD in the area of exposed bone was the highest (1.729). The odds of being a BP-ONJ patient vs being a control was six times as high for individuals with a higher FD score at ROI-4, although the confidence interval was quite wide owing to the small sample size. Conclusion In this preliminary study, BP-ONJ patients had higher FD values than controls at regions close to the alveolar process. The results suggest that FD is a promising tool for detection of bone alterations associated with BP-ONJ. PMID:22065799

  7. Accuracy assessment of the axial images obtained from cone beam computed tomography

    PubMed Central

    Panzarella, FK; Junqueira, JLC; Oliveira, LB; de Araújo, NS; Costa, C

    2011-01-01

    Objective The aim of this study was to evaluate accuracy of linear measurements assessed from axial tomograms and the influence of the use of different protocols in two cone beam CT (CBCT) units. Methods A cylinder object consisting of Nylon® (Day Brazil, Sao Paulo, Brazil) with radiopaque markers was radiographically examined applying different protocols from NewTom 3GTM (Quantitative Radiology s.r.l, Verona, Veneto, Italy) and i-CATTM (Imaging Sciences International, Hatfield, PA) units. Horizontal (A–B) and vertical (C–D) distances were assessed from axial tomograms and measured using a digital calliper that provided the gold standard for actual values. Results There were differences when considering acquisition protocols to each CBCT unit. Concerning all analysed protocols from i-CATTM and Newtom 3GTM, both A–B and C–D distances presented underestimated values. Measurements of the axial images obtained from NewTom 3GTM (6 inch 0.16 mm and 9 inch 0.25 mm) were similar to the ones obtained from i-CATTM (13 cm 20 s 0.3 mm, 13 cm 20 s 0.4 mm and 13 cm 40 s 0.25 mm). Conclusion The use of different protocols from CBCT machines influences linear measurements assessed from axial images. Linear distances were underestimated in both equipments. Our findings suggest that the best protocol for the i-CATTM is 13 cm 20 s 0.3 mm and for the NewTom 3GTM, the use of 6 inch or 9 inch is recommended. PMID:21831977

  8. Patient dose from kilovoltage cone beam computed tomography imaging in radiation therapy

    SciTech Connect

    Islam, Mohammad K.; Purdie, Thomas G.; Norrlinger, Bernhard D.; Alasti, Hamideh; Moseley, Douglas J.; Sharpe, Michael B.; Siewerdsen, Jeffrey H.; Jaffray, David A.

    2006-06-15

    Kilovoltage cone-beam computerized tomography (kV-CBCT) systems integrated into the gantry of linear accelerators can be used to acquire high-resolution volumetric images of the patient in the treatment position. Using on-line software and hardware, patient position can be determined accurately with a high degree of precision and, subsequently, set-up parameters can be adjusted to deliver the intended treatment. While the patient dose due to a single volumetric imaging acquisition is small compared to the therapy dose, repeated and daily image guidance procedures can lead to substantial dose to normal tissue. The dosimetric properties of a clinical CBCT system have been studied on an Elekta linear accelerator (Synergy[reg] RP, XVI system) and additional measurements performed on a laboratory system with identical geometry. Dose measurements were performed with an ion chamber and MOSFET detectors at the center, periphery, and surface of 30 and 16-cm-diam cylindrical shaped water phantoms, as a function of x-ray energy and longitudinal field-of-view (FOV) settings of 5,10,15, and 26 cm. The measurements were performed for full 360 deg.CBCT acquisition as well as for half-rotation scans for 120 kVp beams using the 30-cm-diam phantom. The dose at the center and surface of the body phantom were determined to be 1.6 and 2.3 cGy for a typical imaging protocol, using full rotation scan, with a technique setting of 120 kVp and 660 mAs. The results of our measurements have been presented in terms of a dose conversion factor f{sub CBCT}, expressed in cGy/R. These factors depend on beam quality and phantom size as well as on scan geometry and can be utilized to estimate dose for any arbitrary mAs setting and reference exposure rate of the x-ray tube at standard distance. The results demonstrate the opportunity to manipulate the scanning parameters to reduce the dose to the patient by employing lower energy (kVp) beams, smaller FOV, or by using half-rotation scan.

  9. Megavoltage cone beam computed tomography: Commissioning and evaluation of patient dose

    PubMed Central

    Abou-elenein, Hassan S.; Attalla, Ehab M.; Ammar, H.; Eldesoky, Ismail; Farouk, Mohamed; Zaghloul, Mohamed S.

    2011-01-01

    The improvement in conformal radiotherapy techniques enables us to achieve steep dose gradients around the target which allows the delivery of higher doses to a tumor volume while maintaining the sparing of surrounding normal tissue. One of the reasons for this improvement was the implementation of intensity-modulated radio therapy (IMRT) by using linear accelerators fitted with multi-leaf collimator (MLC), Tomo therapy and Rapid arc. In this situation, verification of patient set-up and evaluation of internal organ motion just prior to radiation delivery become important. To this end, several volumetric image-guided techniques have been developed for patient localization, such as Siemens OPTIVUE/MVCB and MVision megavoltage cone beam CT (MV-CBCT) system. Quality assurance for MV-CBCT is important to insure that the performance of the Electronic portal image device (EPID) and MV-CBCT is suitable for the required treatment accuracy. In this work, the commissioning and clinical implementation of the OPTIVUE/MVCB system was presented. The geometry and gain calibration procedures for the system were described. The image quality characteristics of the OPTIVUE/MVCB system were measured and assessed qualitatively and quantitatively, including the image noise and uniformity, low-contrast resolution, and spatial resolution. The image reconstruction and registration software were evaluated. Dose at isocenter from CBCT and the EPID were evaluated using ionization chamber and thermo-luminescent dosimeters; then compared with that calculated by the treatment planning system (TPS- XiO 4.4). The results showed that there are no offsets greater than 1 mm in the flat panel alignment in the lateral and longitudinal direction over 18 months of the study. The image quality tests showed that the image noise and uniformity were within the acceptable range, and that a 2 cm large object with 1% electron density contrast can be detected with the OPTIVUE/MVCB system with 5 monitor units (MU

  10. Cone beam computed tomography imaging as a primary diagnostic tool for computer-guided surgery and CAD-CAM interim removable and fixed dental prostheses.

    PubMed

    Charette, Jyme R; Goldberg, Jack; Harris, Bryan T; Morton, Dean; Llop, Daniel R; Lin, Wei-Shao

    2016-08-01

    This article describes a digital workflow using cone beam computed tomography imaging as the primary diagnostic tool in the virtual planning of the computer-guided surgery and fabrication of a maxillary interim complete removable dental prosthesis and mandibular interim implant-supported complete fixed dental prosthesis with computer-aided design and computer-aided manufacturing technology. Diagnostic impressions (conventional or digital) and casts are unnecessary in this proposed digital workflow, providing clinicians with an alternative treatment in the indicated clinical scenario. PMID:27086108

  11. Assessment of residual error in liver position using kV cone-beam computed tomography for liver cancer high-precision radiation therapy

    SciTech Connect

    Hawkins, Maria A.; Brock, Kristy K.; Eccles, Cynthia; Moseley, Douglas; Jaffray, David; Dawson, Laura A. . E-mail: laura.dawson@rmp.uhn.on.ca

    2006-10-01

    Purpose: To evaluate the residual error in liver position using breath-hold kilovoltage (kV) cone-beam computed tomography (CT) following on-line orthogonal megavoltage (MV) image-guided breath-hold liver cancer conformal radiotherapy. Methods and Materials: Thirteen patients with liver cancer treated with 6-fraction breath-hold conformal radiotherapy were investigated. Before each fraction, orthogonal MV images were obtained during exhale breath-hold, with repositioning for offsets >3 mm, using the diaphragm for cranio-caudal (CC) alignment and vertebral bodies for medial-lateral (ML) and anterior posterior (AP) alignment. After repositioning, repeat orthogonal MV images, orthogonal kV fluoroscopic movies, and kV cone-beam CTs were obtained in exhale breath-hold. The cone-beam CT livers were registered to the planning CT liver to obtain the residual setup error in liver position. Results: After repositioning, 78 orthogonal MV image pairs, 61 orthogonal kV image pairs, and 72 kV cone-beam CT scans were obtained. Population random setup errors ({sigma}) in liver position were 2.7 mm (CC), 2.3 mm (ML), and 3.0 mm (AP), and systematic errors ({sigma}) were 1.1 mm, 1.9 mm, and 1.3 mm in the superior, medial, and posterior directions. Liver offsets >5 mm were observed in 33% of cases; offsets >10 mm and liver deformation >5 mm were observed in a minority of patients. Conclusions: Liver position after radiation therapy guided with MV orthogonal imaging was within 5 mm of planned position in the majority of patients. kV cone-beam CT image guidance should improve accuracy with reduced dose compared with orthogonal MV image guidance for liver cancer radiation therapy.

  12. Diagnostic accuracy of cone beam computed tomography compared with intraoral radiography for the detection of noncavitated occlusal carious lesions.

    PubMed

    Krzyżostaniak, Joanna; Surdacka, Anna; Kulczyk, Tomasz; Dyszkiewicz-Konwińska, Marta; Owecka, Magdalena

    2014-01-01

    The aim of this study was to evaluate the accuracy of cone beam computed tomography (CBCT) in the detection of noncavitated occlusal caries lesions and to compare this accuracy with that observed with conventional radiographs. 135 human teeth, 67 premolars and 68 molars with macroscopically intact occlusal surfaces, were examined by two independent observers using the CBCT system: NewTom 3G (Quantitative Radiology) and intraoral conventional film (Kodak Insight). The true lesion diagnosis was established by histological examination. The detection methods were compared by means of sensitivity, specificity, predictive values and accuracy. To assess intra- and interobserver agreement, weighted kappa coefficients were computed. Analyses were performed separately for caries reaching into dentin and for all noncavitated lesions. For the detection of occlusal lesions extending into dentin, sensitivity values were lower for film (0.45) when compared with CBCT (0.51), but the differences were not statistically significant (p > 0.19). For all occlusal lesions sensitivity values were 0.32 and 0.22, respectively, for CBCT and film. The specificity scores were high for both modalities. Interobserver agreement amounted to 0.93 for the CBCT system and to 0.87 for film. It was concluded that the use of the 9-inch field of view NewTom CBCT unit for the diagnosis of noncavitated occlusal caries cannot be recommended. PMID:24852420

  13. Osteogenesis effect of guided bone regeneration combined with alveolar cleft grafting: assessment by cone beam computed tomography.

    PubMed

    Xiao, W-L; Zhang, D-Z; Chen, X-J; Yuan, C; Xue, L-F

    2016-06-01

    Cone beam computed tomography (CBCT) allows for a significantly lower radiation dose than conventional computed tomography (CT) scans and provides accurate images of the alveolar cleft area. The osteogenic effect of guided bone regeneration (GBR) vs. conventional alveolar bone grafting alone for alveolar cleft defects was evaluated in this study. Sixty alveolar cleft patients were divided randomly into two groups. One group underwent GBR using acellular dermal matrix film combined with alveolar bone grafting using iliac crest bone grafts (GBR group), while the other group underwent alveolar bone grafting only (non-GBR group). CBCT images were obtained at 1 week and at 3 months following the procedure. Using Simplant 11.04 software, the bone resorption rate was calculated and compared between the two groups. The bone resorption rate from 1 week to 3 months following bone grafting without the GBR technique was 36.50±5.04%, whereas the bone resorption rate using the GBR technique was 31.69±5.50% (P=0.017). The application of autogenous iliac bone combined with the GBR technique for alveolar bone grafting of alveolar cleft patients can reduce bone resorption and result in better osteogenesis. PMID:26876144

  14. Development and implementation of a low-cost phantom for quality control in cone beam computed tomography.

    PubMed

    Batista, W O; Navarro, M V T; Maia, A F

    2013-12-01

    A phantom for quality control in cone beam computed tomography (CBCT) scanners was designed and constructed, and a methodology for testing was developed. The phantom had a polymethyl methacrylate structure filled with water and plastic objects that allowed the assessment of parameters related to quality control. The phantom allowed the evaluation of essential parameters in CBCT as well as the evaluation of linear and angular dimensions. The plastics used in the phantom were chosen so that their density and linear attenuation coefficient were similar to those of human facial structures. Three types of CBCT equipment, with two different technological concepts, were evaluated. The results of the assessment of the accuracy of linear and angular dimensions agreed with the existing standards. However, other parameters such as computed tomography number accuracy, uniformity and high-contrast detail did not meet the tolerances established in current regulations or the manufacturer's specifications. The results demonstrate the importance of establishing specific protocols and phantoms, which meet the specificities of CBCT. The practicality of implementation, the quality control test results for the proposed phantom and the consistency of the results using different equipment demonstrate its adequacy. PMID:23838096

  15. High resolution cone beam X-ray computed tomography of 3D-microstructures of cast Al-alloys

    SciTech Connect

    Kastner, Johann; Harrer, Bernhard; Degischer, H. Peter

    2011-01-15

    X-ray computed tomography (XCT) has become a very important method for non-destructive 3D-characterisation of materials. XCT systems with cone beam geometry, micro- or nano-focus tubes and matrix detectors are increasingly used in research and non-destructive testing. Spatial resolutions down to 1 {mu}m can be reached with such XCT-systems for heterogeneities in metals with high absorption contrast. High resolution cone beam XCT is applied to five different Al-alloys: AlMg5Si7, AlCu4Mg1, AlZn6Mg2Cu2, AlZn8Mg2Cu2 and AlSi12Ni1. Up to four different types of inhomogeneities are segmented in one alloy using voxel sizes between (0.4 {mu}m){sup 3} and (2.3 {mu}m){sup 3}. Target metallography and elemental analysis by energy dispersive X-ray analysis are used to identify the inhomogeneities. The possibilities and restrictions of XCT applied to Al-alloys are discussed. AlMg5Si7 XCT-data with a voxel size of (0.4 {mu}m){sup 3} show inhomogeneities with brighter grey-values than the Al-matrix identified as elongated Fe-aluminides, and those with lower grey-values identified as pores and Mg{sub 2}Si-particles with a 'Chinese script-like' structure. Higher-absorbing interdendritic Al-Al{sub 2}Cu-eutectic regions appear brighter than the Al-dendrites in the CT-data of AlCu4Mg1 with (1.1 {mu}m){sup 3}/voxel, whereas pores > 4 {mu}m appear darker than the Al-matrix. The size and the 3D-structure of the {alpha}-Al dendrite arms with a diameter of 50-100 {mu}m are determined in samples from chill cast billets of AlCu4Mg1 and AlZn6Mg2Cu2 alloys. The irregular interdendritic regions containing eutectic segregations with Cu- and Zn-rich phases are > 5 {mu}m wide. Equally absorbing primary equi-axed Al{sub 3}(Sc, Zr) particles > 5 {mu}m are distinguished in the centres of the dendrites by the level of sphericity values. The distribution of Ni- and Fe-aluminides in a squeeze cast AlSi12Ni1-alloy is imaged with (0.4 {mu}m){sup 3}/voxel, but the Si-phase cannot be segmented.

  16. Incidental occurrence of an unusually large mastoid foramen on cone-beam computed tomography and review of the literature.

    PubMed

    Syed, Ali Z; Sin, Cleo; Rios, Raquel; Mupparapu, Mel

    2016-03-01

    The incidental finding of an enlarged mastoid foramen on the right posterior mastoid region of temporal bone is reported, together with a discussion of its clinical significance. A 67-year-old female underwent the pre-implant assessment of a maxillary left edentulous region. A cone-beam computed tomographic (CBCT) image was acquired and referred for consultation. Axial CBCT slices revealed a unilateral, well-defined, noncorticated, low-attenuation, transosseous defect posterior to the mastoid air cells in the right temporal bone. The borders of the osseous defect were smooth and continuous. No other radiographic signs suggestive of erosion or sclerosis were noted in the vicinity. The density within the defect was homogenous and consistent with a foramen and/or soft tissue. The patient's history and physical examination revealed no significant medical issues, and she was referred to a neuroradiologist for a second opinion. The diagnosis of an enlarged mastoid foramen was made and the patient was reassured. PMID:27051638

  17. Incidental occurrence of an unusually large mastoid foramen on cone-beam computed tomography and review of the literature

    PubMed Central

    Syed, Ali Z.; Sin, Cleo; Rios, Raquel

    2016-01-01

    The incidental finding of an enlarged mastoid foramen on the right posterior mastoid region of temporal bone is reported, together with a discussion of its clinical significance. A 67-year-old female underwent the pre-implant assessment of a maxillary left edentulous region. A cone-beam computed tomographic (CBCT) image was acquired and referred for consultation. Axial CBCT slices revealed a unilateral, well-defined, noncorticated, low-attenuation, transosseous defect posterior to the mastoid air cells in the right temporal bone. The borders of the osseous defect were smooth and continuous. No other radiographic signs suggestive of erosion or sclerosis were noted in the vicinity. The density within the defect was homogenous and consistent with a foramen and/or soft tissue. The patient's history and physical examination revealed no significant medical issues, and she was referred to a neuroradiologist for a second opinion. The diagnosis of an enlarged mastoid foramen was made and the patient was reassured. PMID:27051638

  18. Comparative Evaluation of the Artefacts Index of Dental Materials on Two-Dimensional Cone-beam Computed Tomography.

    PubMed

    Yuan, Fusong; Chen, Litong; Wang, Xiaofei; Wang, Yong; Lyu, Peijun; Sun, Yuchun

    2016-01-01

    The aim of the study was to propose the artefact index on cone-beam computed tomography (CBCT) images of clinical prosthodontics materials, and to compare the effect of the artefacts on CBCT image clarity of normal oral tissues. Seven spheres of different materials were secured on the centre of a resin baseboard, respectively, and four human molars in vitro were placed at 10 mm front, back, left and right of the sphere. The board was scanned using CBCT with the same setting. 10 tomographic images from each of the seven data sets with clear artefacts was selected. The grayscale measuring tool of Photoshop software was used to measure the grayscale (G0) within the boundary of tomographic image and the grayscales of the streaky artefacts that were 1 mm and 20 mm outside the circular boundary (G1 and G2). The arc length, L1, of the circular boundary with artefacts was measured; the circumference, L2, was calculated. The artefact index, A, was determined as (G1/G0) × 0.5 + (G2/G1) × 0.4 + (L2/L1) × 0.1. The artefact index A can comprehensively represent the effect of artefacts on CBCT image clarity for oral tissue. PMID:27185627

  19. Accuracy of Cone Beam Computed Tomography in Diagnosis and Treatment Planning of Periodontal Bone Defects: A Case Report

    PubMed Central

    Songa, Vajra Madhuri; Jampani, Narendra Dev; Babu, Venkateshwara; Buggapati, Lahari

    2014-01-01

    Diagnosis of periodontitis depend mostly on traditional two-dimensional (2-D) radiographic assessment. Regardless of efforts in improving reliability, present methods of detecting bone level changes over time or determining three-dimensional (3-D) architecture of osseous defects are lacking. To improve the diagnostic potential, an imaging modality which would give an undistorted 3-D vision of a tooth and surrounding structures is imperative. Cone beam computed tomography (CBCT) generates 3D volumetric images which provide axial, coronal and sagittal multi-planar reconstructed images without magnification and renders image guidance throughout the treatment phase. The purpose of this case report was to introduce the clinical application of a newly developed, CBCT system for detecting alveolar bone loss in 21-year-old male patient with periodontitis. To evaluate the bone defect we took an intraoral radiograph and performed CBCT scanning on mandibular left first molar tooth and compared their images. CBCT images of mandibular left first molar showed the extension of furcation involvement, its distal root is devoid of supporting bone and it has only lingual cortical plate which were not shown precisely by the conventional intraoral radiograph. So we consider that the use of latest adjuncts like CBCT is successful in diagnosing periodontal defects. PMID:25654049

  20. Effect of Metal Artifacts on Detection of Vertical Root Fractures Using Two Cone Beam Computed Tomography Systems

    PubMed Central

    Safi, Yaser; Aghdasi, Mohammad Mehdi; Ezoddini-Ardakani, Fatemeh; Beiraghi, Samira; Vasegh, Zahra

    2015-01-01

    Introduction: Vertical root fracture (VRF) is common in endodontically treated teeth. Conventional and digital radiographies have limitations for detection of VRFs. Cone-beam computed tomography (CBCT) offers greater detection accuracy of VRFs in comparison with conventional radiography. This study compared the effects of metal artifacts on detection of VRFs by using two CBCT systems. Methods and Materials: Eighty extracted premolars were selected and sectioned at the level of the cemento enamel junction (CEJ). After preparation, root canals were filled with gutta-percha. Subsequently, two thirds of the root fillings were removed for post space preparation and a custom-made post was cemented into each canal. The teeth were randomly divided into two groups (n=40). In the test group, root fracture was created with Instron universal testing machine. The control teeth remained intact. CBCT scans of all teeth were obtained with either New Tom VGI or Soredex Scanora 3D. Three observers analyzed the images for detection of VRF. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for VRF detection and percentage of probable cases were calculated for each imaging system and compared using non-parametric tests considering the non-normal distribution of data. The inter-observer reproducibility was calculated using the weighted kappa coefficient. Results: There were no statistically significant differences in sensitivity, specificity, PPV and NPV between the two CBCT systems. Conclusion: The effect of metal artifacts on VRF detection was not significantly different between the two CBCT systems. PMID:26213543

  1. Auto-masked 2D/3D image registration and its validation with clinical cone-beam computed tomography

    NASA Astrophysics Data System (ADS)

    Steininger, P.; Neuner, M.; Weichenberger, H.; Sharp, G. C.; Winey, B.; Kametriser, G.; Sedlmayer, F.; Deutschmann, H.

    2012-07-01

    Image-guided alignment procedures in radiotherapy aim at minimizing discrepancies between the planned and the real patient setup. For that purpose, we developed a 2D/3D approach which rigidly registers a computed tomography (CT) with two x-rays by maximizing the agreement in pixel intensity between the x-rays and the corresponding reconstructed radiographs from the CT. Moreover, the algorithm selects regions of interest (masks) in the x-rays based on 3D segmentations from the pre-planning stage. For validation, orthogonal x-ray pairs from different viewing directions of 80 pelvic cone-beam CT (CBCT) raw data sets were used. The 2D/3D results were compared to corresponding standard 3D/3D CBCT-to-CT alignments. Outcome over 8400 2D/3D experiments showed that parametric errors in root mean square were <0.18° (rotations) and <0.73 mm (translations), respectively, using rank correlation as intensity metric. This corresponds to a mean target registration error, related to the voxels of the lesser pelvis, of <2 mm in 94.1% of the cases. From the results we conclude that 2D/3D registration based on sequentially acquired orthogonal x-rays of the pelvis is a viable alternative to CBCT-based approaches if rigid alignment on bony anatomy is sufficient, no volumetric intra-interventional data set is required and the expected error range fits the individual treatment prescription.

  2. Alveolar bone thickness around maxillary central incisors of different inclination assessed with cone-beam computed tomography

    PubMed Central

    Liu, Fang; Sun, Hong-jing; Lv, Pin; Cao, Yu-ming; Yu, Mo; Yue, Yang

    2015-01-01

    Objective To assess the labial and lingual alveolar bone thickness in adults with maxillary central incisors of different inclination by cone-beam computed tomography (CBCT). Methods Ninety maxillary central incisors from 45 patients were divided into three groups based on the maxillary central incisors to palatal plane angle; lingual-inclined, normal, and labial-inclined. Reformatted CBCT images were used to measure the labial and lingual alveolar bone thickness (ABT) at intervals corresponding to every 1/10 of the root length. The sum of labial ABT and lingual ABT at the level of the root apex was used to calculate the total ABT (TABT). The number of teeth exhibiting alveolar fenestration and dehiscence in each group was also tallied. One-way analysis of variance and Tukey's honestly significant difference test were applied for statistical analysis. Results The labial ABT and TABT values at the root apex in the lingual-inclined group were significantly lower than in the other groups (p < 0.05). Lingual and labial ABT values were very low at the cervical level in the lingual-inclined and normal groups. There was a higher prevalence of alveolar fenestration in the lingual-inclined group. Conclusions Lingual-inclined maxillary central incisors have less bone support at the level of the root apex and a greater frequency of alveolar bone defects than normal maxillary central incisors. The bone plate at the marginal level is also very thin. PMID:26445719

  3. Low-dose megavoltage cone-beam computed tomography for lung tumors using a high-efficiency image receptor

    SciTech Connect

    Sillanpaa, Jussi; Chang Jenghwa; Mageras, Gikas; Yorke, Ellen; Arruda, Fernando De; Rosenzweig, Kenneth E.; Munro, Peter; Seppi, Edward; Pavkovich, John; Amols, Howard

    2006-09-15

    We report on the capabilities of a low-dose megavoltage cone-beam computed tomography (MV CBCT) system. The high-efficiency image receptor consists of a photodiode array coupled to a scintillator composed of individual CsI crystals. The CBCT system uses the 6 MV beam from a linear accelerator. A synchronization circuit allows us to limit the exposure to one beam pulse [0.028 monitor units (MU)] per projection image. 150-500 images (4.2-13.9 MU total) are collected during a one-minute scan and reconstructed using a filtered backprojection algorithm. Anthropomorphic and contrast phantoms are imaged and the contrast-to-noise ratio of the reconstruction is studied as a function of the number of projections and the error in the projection angles. The detector dose response is linear (R{sup 2} value 0.9989). A 2% electron density difference is discernible using 460 projection images and a total exposure of 13 MU (corresponding to a maximum absorbed dose of about 12 cGy in a patient). We present first patient images acquired with this system. Tumors in lung are clearly visible and skeletal anatomy is observed in sufficient detail to allow reproducible registration with the planning kV CT images. The MV CBCT system is shown to be capable of obtaining good quality three-dimensional reconstructions at relatively low dose and to be clinically usable for improving the accuracy of radiotherapy patient positioning.

  4. Correlation between hyoid bone position and airway dimensions in Chinese adolescents by cone beam computed tomography analysis.

    PubMed

    Jiang, Y-Y

    2016-07-01

    This study aimed to investigate the correlation between upper airway dimensions and hyoid bone position in Chinese adolescents based on cone beam computed tomography (CBCT) images. CBCT images from a total of 254 study subjects were included. The upper airway and hyoid bone parameters were measured by Materialism's interactive medical image control system (MIMICS) v.16.01 (Materialise, Leuven, Belgium). The airway dimensions were evaluated in terms of volume, cross-sectional area (CSA), mean CSA, length, anteroposterior dimension of the cross-section (AP), lateral dimension of the cross-section (LAT), and LAT/AP ratio. The hyoid bone position was evaluated using eight linear parameters and two angular parameters. Facial characteristics were evaluated using three linear parameters and three angular parameters. Most hyoid bone position parameters (especially the distance between the hyoid bone and hard palate) were significantly associated with most airway dimension parameters. Significant correlations were also observed between the different facial characteristic parameters and hyoid bone position parameters. Most airway dimension parameters showed significant correlations with linear facial parameters, but they displayed significant correlations with only a few angular facial parameters. These findings provide an understanding of the static relationship between the hyoid bone position and airway dimensions, which may serve as a reference for surgeons before orthodontic or orthognathic surgery. PMID:26949129

  5. Evaluation of digital dental models obtained from dental cone-beam computed tomography scan of alginate impressions

    PubMed Central

    Jiang, Tingting; Lee, Sang-Mi; Hou, Yanan; Chang, Xin

    2016-01-01

    Objective To investigate the dimensional accuracy of digital dental models obtained from the dental cone-beam computed tomography (CBCT) scan of alginate impressions according to the time elapse when the impressions are stored under ambient conditions. Methods Alginate impressions were obtained from 20 adults using 3 different alginate materials, 2 traditional alginate materials (Alginoplast and Cavex Impressional) and 1 extended-pour alginate material (Cavex ColorChange). The impressions were stored under ambient conditions, and scanned by CBCT immediately after the impressions were taken, and then at 1 hour intervals for 6 hours. After reconstructing three-dimensional digital dental models, the models were measured and the data were analyzed to determine dimensional changes according to the elapsed time. The changes within the measurement error were regarded as clinically acceptable in this study. Results All measurements showed a decreasing tendency with an increase in the elapsed time after the impressions. Although the extended-pour alginate exhibited a less decreasing tendency than the other 2 materials, there were no statistically significant differences between the materials. Changes above the measurement error occurred between the time points of 3 and 4 hours after the impressions. Conclusions The results of this study indicate that digital dental models can be obtained simply from a CBCT scan of alginate impressions without sending them to a remote laboratory. However, when the impressions are not stored under special conditions, they should be scanned immediately, or at least within 2 to 3 hours after the impressions are taken. PMID:27226958

  6. Radiation dose reduction in cone-beam computed tomography of extremities: evaluation of a novel radiation shield.

    PubMed

    Matikka, H; Virén, T

    2014-06-01

    Cone-beam computed tomography (CBCT) is a relatively new technique for imaging of extremities. It provides high-resolution images with lower effective dose compared to conventional CT. However following the ALARA principle, CBCT-imaging protocols and practices must also be optimised to minimize the dose absorbed by the patient as well as personnel. The aim of this study is to evaluate the effect of a novel scanner-attached radiation shield on the dose absorbed by the patient and on the amount of scattered radiation around the scanner.An orthopedic CBCT scanner was applied for comparing the doses with and without the shield during an elbow and a knee scan. A homogeneous 8 cm PMMA phantom with either an anthropomorphic Alderson phantom or a 16 cm PMMA phantom simulated the tissues of a patient. Measurements were made for several scan parameters using calibrated dose meters.The results show that the radiation shield significantly decreased the doses measured on the patient during CBCT scans of the elbow and the knee. The usage of the shield decreased the absorbed doses by up to 95.5%. Also scattered radiation around the gantry decreased notably. The use of the shield is highly recommended, especially for pediatric patients. PMID:24894593

  7. Open Sinus Lift Surgery and the Importance of Preoperative Cone-Beam Computed Tomography Scan: A Review

    PubMed Central

    Rahpeyma, Amin; Khajehahmadi, Saeedeh

    2015-01-01

    Open sinus lift surgery is a form of pre-prosthetic surgery for increasing the quality and quantity of bone in the posterior region of the maxilla. Pre-operative assessment of the maxillary sinus is essential for the success of this surgery. PubMed search was carried out in English language literature for open sinus lift surgery and cone-beam computed tomography (CBCT). The results focused on anatomic variants, vascular anatomy, complications, osteotomy/ostectomy window dimensions and thickness of the Schneiderian Membrane. 59 articles were included in this review. Features other than the height and the width of the residual alveolar ridge that should be evaluated in preoperative CBCT scan include the thickness of the lateral maxillary sinus wall, the presence of the alveolar antral artery and its diameter, the maxillary sinus floor width and angulation, irregularity of sinus floor, intimate relation of Schneiderian membrane with the roots of the adjacent teeth, sinus septum, and the quality of subantral bone. Other conditions that occasionally may be observed in special situations are also explained. More than ten parameters should be checked in evaluating CBCT images of paranasal sinuses other than the width and the length of the residual ridge in the posterior region of the maxilla. Each of them may have a significant impact on the results of the open sinus lift surgery. PMID:26435632

  8. The impact of reorienting cone-beam computed tomographic images in varied head positions on the coordinates of anatomical landmarks

    PubMed Central

    Kim, Jae Hun; Hwang, Jae Joon; Lee, Jung-Hee

    2016-01-01

    Purpose The aim of this study was to compare the coordinates of anatomical landmarks on cone-beam computed tomographic (CBCT) images in varied head positions before and after reorientation using image analysis software. Materials and Methods CBCT images were taken in a normal position and four varied head positions using a dry skull marked with 3 points where gutta percha was fixed. In each of the five radiographic images, reference points were set, 20 anatomical landmarks were identified, and each set of coordinates was calculated. Coordinates in the images from the normally positioned head were compared with those in the images obtained from varied head positions using statistical methods. Post-reorientation coordinates calculated using a three-dimensional image analysis program were also compared to the reference coordinates. Results In the original images, statistically significant differences were found between coordinates in the normal-position and varied-position images. However, post-reorientation, no statistically significant differences were found between coordinates in the normal-position and varied-position images. Conclusion The changes in head position impacted the coordinates of the anatomical landmarks in three-dimensional images. However, reorientation using image analysis software allowed accurate superimposition onto the reference positions. PMID:27358821

  9. Comparison of Cone-Beam Computed Tomography and Periapical Radiography in Predicting Treatment Decision for Periapical Lesions: A Clinical Study

    PubMed Central

    Balasundaram, Ashok; Shah, Punit; Hoen, Michael M.; Wheater, Michelle A.; Bringas, Josef S.; Gartner, Arnold; Geist, James R.

    2012-01-01

    Objectives. To compare the ability of endodontists to determine the size of apical pathological lesions and select the most appropriate choice of treatment based on lesions' projected image characteristics using 2 D and 3 D images. Study Design. Twenty-four subjects were selected. Radiographic examination of symptomatic study teeth with an intraoral periapical radiograph revealed periapical lesions equal to or greater than 3 mm in the greatest diameter. Cone-beam Computed tomography (CBCT) images were made of the involved teeth after the intraoral periapical radiograph confirmed the size of lesion to be equal to greater than 3 mm. Six observers (endodontists) viewed both the periapical and CBCT images. Upon viewing each of the images from the two imaging modalities, observers (1) measured lesion size and (2) made decisions on treatment based on each radiograph. Chi-square test was used to look for differences in the choice of treatment among observers. Results. No significant difference was noted in the treatment plan selected by observers using the two modalities (χ2(3) = .036, P > 0.05). Conclusion. Lesion size and choice of treatment of periapical lesions based on CBCT radiographs do not change significantly from those made on the basis of 2 D radiographs. PMID:23056050

  10. Segmentation of large periapical lesions toward dental computer-aided diagnosis in cone-beam CT scans

    NASA Astrophysics Data System (ADS)

    Rysavy, Steven; Flores, Arturo; Enciso, Reyes; Okada, Kazunori

    2008-03-01

    This paper presents an experimental study for assessing the applicability of general-purpose 3D segmentation algorithms for analyzing dental periapical lesions in cone-beam computed tomography (CBCT) scans. In the field of Endodontics, clinical studies have been unable to determine if a periapical granuloma can heal with non-surgical methods. Addressing this issue, Simon et al. recently proposed a diagnostic technique which non-invasively classifies target lesions using CBCT. Manual segmentation exploited in their study, however, is too time consuming and unreliable for real world adoption. On the other hand, many technically advanced algorithms have been proposed to address segmentation problems in various biomedical and non-biomedical contexts, but they have not yet been applied to the field of dentistry. Presented in this paper is a novel application of such segmentation algorithms to the clinically-significant dental problem. This study evaluates three state-of-the-art graph-based algorithms: a normalized cut algorithm based on a generalized eigen-value problem, a graph cut algorithm implementing energy minimization techniques, and a random walks algorithm derived from discrete electrical potential theory. In this paper, we extend the original 2D formulation of the above algorithms to segment 3D images directly and apply the resulting algorithms to the dental CBCT images. We experimentally evaluate quality of the segmentation results for 3D CBCT images, as well as their 2D cross sections. The benefits and pitfalls of each algorithm are highlighted.

  11. Evaluating positional accuracy using megavoltage cone-beam computed tomography for IMRT with head-and-neck cancer

    PubMed Central

    Motegi, Kana; Kohno, Ryosuke; Ueda, Takashi; Shibuya, Toshiyuki; Ariji, Takaki; Kawashima, Mitsuhiko; Akimoto, Tetsuo

    2014-01-01

    Accurate dose delivery is essential for the success of intensity-modulated radiation therapy (IMRT) for patients with head-and-neck (HN) cancer. Reproducibility of IMRT dose delivery to HN regions can be critically influenced by treatment-related changes in body contours. Moreover, some set-up margins may not be adaptable to positional uncertainties of HN structures at every treatment. To obtain evidence for appropriate set-up margins in various head and neck areas, we prospectively evaluated positional deviation (δ values) of four bony landmarks (i.e. the clivus and occipital protuberance for the head region, and the mental protuberance and C5 for the neck region) using megavoltage cone-beam computed tomography during a treatment course. Over 800 δ values were analyzed in each translational direction. Positional uncertainties for HN cancer patients undergoing IMRT were evaluated relative to the body mass index. Low positional accuracy was observed for the neck region compared with the head region. For the head region, most of the δ was distributed within ±5 mm, and use of the current set-up margin was appropriate. However, the δ values for the neck region were within ±8 mm. Especially for overweight patients, a few millimeters needed to be added to give an adequate set-up margin. For accurate dose delivery to targets and to avoid excess exposure to normal tissues, we recommend that the positional verification process be performed before every treatment. PMID:24449713

  12. Idiosyncratic Presentation of Cemento-Osseous Dysplasia – An in Depth Analysis Using Cone Beam Computed Tomography

    PubMed Central

    Pachigolla, Ramaswamy; Govada, Vanya Mahitha; Alapati, Satish; Balla, Smitha

    2016-01-01

    Bone dysplasias comprise of a condition where the normal bone is replaced with fibrous tissue. Periapical Cemento-Osseous Dysplasia (PCOD) is a benign fibro-osseous condition where bone tissue is supplanted with fibrous tissue and cementum-like material. This condition affects mostly mandibular anterior region and rarely occurs in the maxilla. PCOD is seen above 30 years of age and has slight female predilection. Generally the teeth related to such lesions appear to be vital and are usually asymptomatic. These lesions are mostly seen during routine radiographic examination whose presentation may vary from complete radiolucency to dense radiopacity. The advent of Cone Beam Computed Tomography (CBCT) has brought a massive change in the field of dentistry which has become an important tool for diagnosis. Hence we hereby present an unusual case of cemento-osseous dysplasia in an unfamiliar location with an atypical presentation. The shape of the pathology was completely idiosyncratic and different from an orthodox lesion of COD, as the lesion was observed to grow out of the palatal surface with a prominent palatal expansion. This case highlights the importance of CBCT in radiographic diagnosis and in evaluating the characteristics of such lesion, which present with high diagnostic dilemma. PMID:27437374

  13. Three-dimensional prediction of the human eyeball and canthi for craniofacial reconstruction using cone-beam computed tomography.

    PubMed

    Kim, Sang-Rok; Lee, Kyung-Min; Cho, Jin-Hyoung; Hwang, Hyeon-Shik

    2016-04-01

    An anatomical relationship between the hard and soft tissues of the face is mandatory for facial reconstruction. The purpose of this study was to investigate the positions of the eyeball and canthi three-dimensionally from the relationships between the facial hard and soft tissues using cone-beam computed tomography (CBCT). CBCT scan data of 100 living subjects were used to obtain the measurements of facial hard and soft tissues. Stepwise multiple regression analyses were carried out using the hard tissue measurements in the orbit, nasal bone, nasal cavity and maxillary canine to predict the most probable positions of the eyeball and canthi within the orbit. Orbital width, orbital height, and orbital depth were strong predictors of the eyeball and canthi position. Intercanine width was also a predictor of the mediolateral position of the eyeball. Statistically significant regression models for the positions of the eyeball and canthi could be derived from the measurements of orbit and maxillary canine. These results suggest that CBCT data can be useful in predicting the positions of the eyeball and canthi three-dimensionally. PMID:26921985

  14. Evaluation of Cone Beam Computed Tomography (CBCT) System: Comparison with Intraoral Periapical Radiography in Proximal Caries Detection

    PubMed Central

    Valizadeh, Solmaz; Tavakkoli, Mohammad Amin; Karimi Vasigh, Homaoun; Azizi, Zeynab; Zarrabian, Tara

    2012-01-01

    Background and aims With the introduction of Cone Beam Computed Tomography (CBCT) in dentistry, a question has been raised whether the technique significantly increases the diagnostic accuracy in comparison with other techniques or not. Therefore, the present study was undertaken to assess the accuracy of CBCT modality in detecting proximal carious lesions as compared to conventional periapical radiographs. Materials and methods This diagnostic study was carried out on 84 human extracted molars and premolars. The teeth were mounted and divided in 28 blocks of 3 teeth. Periapical and CBCT images of teeth were obtained. Five observers scored the images for the detection of proximal carious lesions using a 2-point scale (caries, present; caries, absent). The gold standard was determined by histopathologic sections. Sensitivity, specificity, PPV, NPV and receiver operating charac-teristics (ROC) curves were traced for observers in both systems. The results were analyzed by paired t-test. Results The area under the ROC curve, sensitivity, specificity, accuracy, positive and negative predictive values of CBCT images were 0.568, 0.835, 0.637, 0.714, 0.598 and 0.856, respectively. These parameters were 0.432, 0.837, 0.722, 0.77, 0.687 and 0.858 for the periapical conventional technique, respectively. Conclusion The CBCT images did not enhance detection of proximal caries in comparison with periapical images. PMID:22991626

  15. The use of a dynamic real-time jaw tracking device and cone beam computed tomography simulation

    PubMed Central

    He, Shushu; Kau, Chung How; Liao, Lina; Kinderknecht, Keith; Ow, Andrew; Saleh, Tayem Abou

    2016-01-01

    Background: The aim was to introduce and preliminarily evaluate a new software application, SICAT Function, which can directly combine and merge three-dimensional cone beam computed tomography (CBCT) and electronic SICAT jaw motion tracking (JMT) data. Methods: A detailed description of the methods and dynamic clinical simulation of mandibular movements of a patient are demonstrated. Functional jaw movements on 3 days were recorded by JMT tracking system. The simulation was performed by merging CBCT and JMT data in the software SICAT Function suite. The condylar position simulated by SICAT Function suite was compared with real condyle position showed by a CBCT of the patient. Results: The incisor ranges of functional movements were displayed by JMT tracking system. The visualization of patient-specific mandibular movement including the translation of the condyles was displayed after data merge. The recordings of mandibular movements of the patient were similar on 3 different days. The condylar position simulated by SICAT was coincident with real condyle position by CBCT data with the same amount of mouth opening. Conclusions: The SICAT Function software is a system capable of measuring and visualizing patient-specific jaw movement relative to the patient-specific anatomy of the jaw. Further studies are needed to validate its accuracy and its potential for future use. PMID:27563619

  16. Comparative Evaluation of the Artefacts Index of Dental Materials on Two-Dimensional Cone-beam Computed Tomography

    PubMed Central

    Yuan, Fusong; Chen, Litong; Wang, Xiaofei; Wang, Yong; Lyu, Peijun; Sun, Yuchun

    2016-01-01

    The aim of the study was to propose the artefact index on cone-beam computed tomography (CBCT) images of clinical prosthodontics materials, and to compare the effect of the artefacts on CBCT image clarity of normal oral tissues. Seven spheres of different materials were secured on the centre of a resin baseboard, respectively, and four human molars in vitro were placed at 10 mm front, back, left and right of the sphere. The board was scanned using CBCT with the same setting. 10 tomographic images from each of the seven data sets with clear artefacts was selected. The grayscale measuring tool of Photoshop software was used to measure the grayscale (G0) within the boundary of tomographic image and the grayscales of the streaky artefacts that were 1 mm and 20 mm outside the circular boundary (G1 and G2). The arc length, L1, of the circular boundary with artefacts was measured; the circumference, L2, was calculated. The artefact index, A, was determined as (G1/G0) × 0.5 + (G2/G1) × 0.4 + (L2/L1) × 0.1. The artefact index A can comprehensively represent the effect of artefacts on CBCT image clarity for oral tissue. PMID:27185627

  17. Cone-Beam Computed Tomography Assessment of Root Canal Transportation by Neoniti and Reciproc Single-File Systems

    PubMed Central

    Moazzami, Fariborz; Khojastepour, Leila; Nabavizadeh, Mohammadreza; Seied Habashi, Mina

    2016-01-01

    Introduction: The aim of this in vitro study was to compare the canal transportation of two single-file engine-driven systems, Neoniti and Reciproc, using cone-beam computed tomography (CBCT). Methods and Materials: Forty-five non-calcified roots with mature apices and apical curvature of 15-30 degrees were selected from extracted human maxillary molars for this study. Samples were randomly divided into two groups (n=20) and a control group (n=5) and canal preparation with either system was performed according to manufacturers' instructions. Pre- and post-instrumentation CBCT images were captured and the amount of canal transportation within the files was calculated at levels of 3, 4, and 5 mm from the apex. The independent sample t-test was used to analyze the statistical significance between the two groups. The level of significance was defined at 0.05. Results: Reciproc created more canal transportation compared to Neoniti in both mesiodistal and buccolingual directions. The difference between the two systems was statistically significant in all evaluated distances from the apex (P<0.001). During this study fracture of one file (25/0.08) in the Neoniti group occurred. Conclusion: Neoniti and Reciproc systems have significant difference in terms of creating canal transportation. Reciproc created more canal transportation in buccolingual and mesiodistal dimensions. PMID:27141215

  18. Analysis of the greater palatine foramen in a Lebanese population using cone-beam computed tomography technology

    PubMed Central

    Aoun, Georges; Nasseh, Ibrahim; Sokhn, Sayde; Saadeh, Maria

    2015-01-01

    Objective: The aim of this study was to describe the diameter and the position of the greater palatine foramen (GPF) in relation to adjacent anatomical landmarks in the maxilla in a Lebanese population using cone-beam computed tomography (CBCT) technology. Materials and Methods: CBCT images of 58 Lebanese adult patients were included in this study and a total of 116 GPF were evaluated bilaterally. The diameter of the GPF and its position relative to the maxillary molars, and distances to the midline maxillary suture and to the anterior nasal spine were analyzed. Results: Of all foramina assessed, 41.38% were located opposite to the third molar, 29.31% were distal to it, 27.59% were between the second and the third, and only 1.72% were opposite to the second. The average diameter was 5.633 mm on the right and 5.723 mm on the left, and the average distances to midline maxillary suture and anterior nasal spine were 16.228 mm and 48.294 mm on the right and 14.907 mm and 48.122 mm on the left, respectively. Conclusion: Within the limits of this study, we conclude that in Lebanese patients, the GPF location is variable, very rarely opposite to the second molar, and more closely related to the third, but may present mesial or distal to it in one-fourth of patients. PMID:26942122

  19. Are all soft tissue calcifications detected by cone-beam computed tomography in the submandibular region sialoliths?

    PubMed

    Çağlayan, Fatma; Sümbüllü, Muhammed Akif; Miloğlu, Özkan; Akgül, Hayati Murat

    2014-08-01

    Heterotrophic soft tissue calcification occurs with the deposit of calcium salts in soft tissue rather than bone. The aim of this report is to describe cone-beam computed tomographic (CBCT) and ultrasonographic (US) findings of 2 cases of soft tissue calcifications that were initially diagnosed as submandibular or parotid sialolithiasis. Multiple soft tissue calcifications were evaluated by panoramic radiography, CBCT imaging, and US imaging in a 50-year-old male patient and a 30-year-old male patient. Calcifications were detected in the soft tissue of the submandibular area at axial, coronal, and multiplanar reformatted examinations and were prediagnosed as sialolithiasis. US examination was conducted to determine the complete relation between the soft tissues and the calcifications. In conclusion, high-resolution dental volumetric tomography with a low radiation dose is the optimal diagnostic tool to analyze the skeletal structure of the maxillofacial region in 3 dimensions. However, it is not sufficient to examine the soft tissues. US imaging is a useful diagnostic tool to evaluate the relation between the soft tissues and the calcifications in the submandibular area. PMID:25037186

  20. Auto-masked 2D/3D image registration and its validation with clinical cone-beam computed tomography.

    PubMed

    Steininger, P; Neuner, M; Weichenberger, H; Sharp, G C; Winey, B; Kametriser, G; Sedlmayer, F; Deutschmann, H

    2012-07-01

    Image-guided alignment procedures in radiotherapy aim at minimizing discrepancies between the planned and the real patient setup. For that purpose, we developed a 2D/3D approach which rigidly registers a computed tomography (CT) with two x-rays by maximizing the agreement in pixel intensity between the x-rays and the corresponding reconstructed radiographs from the CT. Moreover, the algorithm selects regions of interest (masks) in the x-rays based on 3D segmentations from the pre-planning stage. For validation, orthogonal x-ray pairs from different viewing directions of 80 pelvic cone-beam CT (CBCT) raw data sets were used. The 2D/3D results were compared to corresponding standard 3D/3D CBCT-to-CT alignments. Outcome over 8400 2D/3D experiments showed that parametric errors in root mean square were <0.18° (rotations) and <0.73 mm (translations), respectively, using rank correlation as intensity metric. This corresponds to a mean target registration error, related to the voxels of the lesser pelvis, of <2 mm in 94.1% of the cases. From the results we conclude that 2D/3D registration based on sequentially acquired orthogonal x-rays of the pelvis is a viable alternative to CBCT-based approaches if rigid alignment on bony anatomy is sufficient, no volumetric intra-interventional data set is required and the expected error range fits the individual treatment prescription. PMID:22705709

  1. Analysis of C-shaped canal systems in mandibular second molars using surgical operating microscope and cone beam computed tomography: A clinical approach

    PubMed Central

    Chhabra, Sanjay; Yadav, Seema; Talwar, Sangeeta

    2014-01-01

    Aims: The study was aimed to acquire better understanding of C-shaped canal systems in mandibular second molar teeth through a clinical approach using sophisticated techniques such as surgical operating microscope and cone beam computed tomography (CBCT). Materials and Methods: A total of 42 extracted mandibular second molar teeth with fused roots and longitudinal grooves were collected randomly from native Indian population. Pulp chamber floors of all specimens were examined under surgical operating microscope and classified into four types (Min's method). Subsequently, samples were subjected to CBCT scan after insertion of K-files size #10 or 15 into each canal orifice and evaluated using the cross-sectional and 3-dimensional images in consultation with dental radiologist so as to obtain more accurate results. Minimum distance between the external root surface on the groove and initial file placed in the canal was also measured at different levels and statistically analyzed. Results: Out of 42 teeth, maximum number of samples (15) belonged to Type-II category. A total of 100 files were inserted in 86 orifices of various types of specimens. Evaluation of the CBCT scan images of the teeth revealed that a total of 21 canals were missing completely or partially at different levels. The mean values for the minimum thickness were highest at coronal followed by middle and apical third levels in all the categories. Lowest values were obtained for teeth with Type-III category at all three levels. Conclusions: The present study revealed anatomical variations of C-shaped canal system in mandibular second molars. The prognosis of such complex canal anatomies can be improved by simultaneous employment of modern techniques such as surgical operating microscope and CBCT. PMID:24944447

  2. Reciprocating vs Rotary Instrumentation in Pediatric Endodontics: Cone Beam Computed Tomographic Analysis of Deciduous Root Canals using Two Single-file Systems

    PubMed Central

    Prabhakar, Attiguppe R; Yavagal, Chandrashekar; Naik, Saraswathi V

    2016-01-01

    ABSTRACT Background: Primary root canals are considered to be most challenging due to their complex anatomy. "Wave one" and "one shape" are single-file systems with reciprocating and rotary motion respectively. The aim of this study was to evaluate and compare dentin thickness, centering ability, canal transportation, and instrumentation time of wave one and one shape files in primary root canals using a cone beam computed tomographic (CBCT) analysis. Study design: This is an experimental, in vitro study comparing the two groups. Materials and methods: A total of 24 extracted human primary teeth with minimum 7 mm root length were included in the study. Cone beam computed tomographic images were taken before and after the instrumentation for each group. Dentin thickness, centering ability, canal transportation, and instrumentation times were evaluated for each group. Results: A significant difference was found in instrumentation time and canal transportation measures between the two groups. Wave one showed less canal transportation as compared with one shape, and the mean instrumentation time of wave one was significantly less than one shape. Conclusion: Reciprocating single-file systems was found to be faster with much less procedural errors and can hence be recommended for shaping the root canals of primary teeth. How to cite this article: Prabhakar AR, Yavagal C, Dixit K, Naik SV. Reciprocating vs Rotary Instrumentation in Pediatric Endodontics: Cone Beam Computed Tomographic Analysis of Deciduous Root Canals using Two Single-File Systems. Int J Clin Pediatr Dent 2016;9(1):45-49. PMID:27274155

  3. A comparative evaluation of root canal area increase using three different nickel-titanium rotary systems: An ex vivo cone-beam computed tomographic analysis

    PubMed Central

    Deka, Adrija; Bhuyan, A.C.; Bhuyan, Darpana

    2015-01-01

    Background and Objectives: The present study was undertaken to compare and evaluate the area increase of root canals with ProTaper, iRaCe and Revo-S systems using cone beam computed tomography for analysis. Materials and Methodology: Forty five extracted human mandibular premolars having single canal and straight root were collected. Teeth were randomly assigned to three groups (n=15). Samples were decoronized by maintaining root length at 14 mm. Pre-instrumentation cone beam computed tomography scan was done after stabilizing the samples on wax blocks. The working length was determined at 1 mm short from the apical foramen by using a ISO 15 K-file tip protruding at apical foramen. Preparation was carried out according to the manufacturer's instructions. Finally, canals were instrumented upto 30/.06 apically for each group. After each instrumentation, root canals were irrigated with 2ml of 3% sodium hypochlorite solution followed by 2 ml of 17% EDTA solution. Final irrigation was done with 5ml of saline. Post instrumentation cone beam computed tomography scans of all samples in the 3 groups were acquired. Results: Mean percentage of area increase in different thirds of the canal was highest for ProTaper followed by i-RaCe and Revo-s system which was statistically significant. Interpretation and Conclusion: Root canal area increase was highest for ProTaper followed by i-Race and Revo-S systems. PMID:25684917

  4. Cardiac cone-beam CT

    SciTech Connect

    Manzke, Robert . E-mail: robert.manzke@philips.com

    2005-10-15

    This doctoral thesis addresses imaging of the heart with retrospectively gated helical cone-beam computed tomography (CT). A thorough review of the CT reconstruction literature is presented in combination with a historic overview of cardiac CT imaging and a brief introduction to other cardiac imaging modalities. The thesis includes a comprehensive chapter about the theory of CT reconstruction, familiarizing the reader with the problem of cone-beam reconstruction. The anatomic and dynamic properties of the heart are outlined and techniques to derive the gating information are reviewed. With the extended cardiac reconstruction (ECR) framework, a new approach is presented for the heart-rate-adaptive gated helical cardiac cone-beam CT reconstruction. Reconstruction assessment criteria such as the temporal resolution, the homogeneity in terms of the cardiac phase, and the smoothness at cycle-to-cycle transitions are developed. Several reconstruction optimization approaches are described: An approach for the heart-rate-adaptive optimization of the temporal resolution is presented. Streak artifacts at cycle-to-cycle transitions can be minimized by using an improved cardiac weighting scheme. The optimal quiescent cardiac phase for the reconstruction can be determined automatically with the motion map technique. Results for all optimization procedures applied to ECR are presented and discussed based on patient and phantom data. The ECR algorithm is analyzed for larger detector arrays of future cone-beam systems throughout an extensive simulation study based on a four-dimensional cardiac CT phantom. The results of the scientific work are summarized and an outlook proposing future directions is given. The presented thesis is available for public download at www.cardiac-ct.net.

  5. Ultrafast and scalable cone-beam CT reconstruction using MapReduce in a cloud computing environment

    PubMed Central

    Meng, Bowen; Pratx, Guillem; Xing, Lei

    2011-01-01

    Purpose: Four-dimensional CT (4DCT) and cone beam CT (CBCT) are widely used in radiation therapy for accurate tumor target definition and localization. However, high-resolution and dynamic image reconstruction is computationally demanding because of the large amount of data processed. Efficient use of these imaging techniques in the clinic requires high-performance computing. The purpose of this work is to develop a novel ultrafast, scalable and reliable image reconstruction technique for 4D CBCT/CT using a parallel computing framework called MapReduce. We show the utility of MapReduce for solving large-scale medical physics problems in a cloud computing environment. Methods: In this work, we accelerated the Feldcamp–Davis–Kress (FDK) algorithm by porting it to Hadoop, an open-source MapReduce implementation. Gated phases from a 4DCT scans were reconstructed independently. Following the MapReduce formalism, Map functions were used to filter and backproject subsets of projections, and Reduce function to aggregate those partial backprojection into the whole volume. MapReduce automatically parallelized the reconstruction process on a large cluster of computer nodes. As a validation, reconstruction of a digital phantom and an acquired CatPhan 600 phantom was performed on a commercial cloud computing environment using the proposed 4D CBCT/CT reconstruction algorithm. Results: Speedup of reconstruction time is found to be roughly linear with the number of nodes employed. For instance, greater than 10 times speedup was achieved using 200 nodes for all cases, compared to the same code executed on a single machine. Without modifying the code, faster reconstruction is readily achievable by allocating more nodes in the cloud computing environment. Root mean square error between the images obtained using MapReduce and a single-threaded reference implementation was on the order of 10−7. Our study also proved that cloud computing with MapReduce is fault tolerant: the

  6. Human dental age estimation by calculation of pulp-tooth volume ratios yielded on clinically acquired cone beam computed tomography images of monoradicular teeth.

    PubMed

    Star, Hazha; Thevissen, Patrick; Jacobs, Reinhilde; Fieuws, Steffen; Solheim, Tore; Willems, Guy

    2011-01-01

    Secondary dentine is responsible for a decrease in the volume of the dental pulp cavity with aging. The aim of this study is to evaluate a human dental age estimation method based on the ratio between the volume of the pulp and the volume of its corresponding tooth, calculated on clinically taken cone beam computed tomography (CBCT) images from monoradicular teeth. On the 3D images of 111 clinically obtained CBCT images (Scanora(®) 3D dental cone beam unit) of 57 female and 54 male patients ranging in age between 10 and 65 years, the pulp-tooth volume ratio of 64 incisors, 32 canines, and 15 premolars was calculated with Simplant(®) Pro software. A linear regression model was fit with age as dependent variable and ratio as predictor, allowing for interactions of specific gender or tooth type. The obtained pulp-tooth volume ratios were the strongest related to age on incisors. PMID:21182523

  7. Validation of a technique for integration of a digital dental model into stereophotogrammetric images of the face using cone-beam computed tomographic data.

    PubMed

    Codari, Marina; Pucciarelli, Valentina; Tommasi, Davide G; Sforza, Chiarella

    2016-06-01

    We wanted to find and validate a new way to visualise patients' faces and their dental arches non-invasively. The stereophotogrammetric images of the faces and the digitised dental casts of seven healthy subjects were analysed. Point-based and surface-based recording techniques matched the facial image with those of the mandibular and maxillary dental arches in their relative positions. The cone-beam computed tomographic (CT) images of the same subjects were analysed retrospectively. Twenty-eight dentofacial distances were obtained on cone-beam CT images and on the recorded facial and dental surfaces. The median (IQR) distances of more than 96% of the measurements did not differ significantly. PMID:26852270

  8. Organ doses can be estimated from the computed tomography (CT) dose index for cone-beam CT on radiotherapy equipment.

    PubMed

    Martin, Colin J; Abuhaimed, Abdullah; Sankaralingam, Marimuthu; Metwaly, Mohamed; Gentle, David J

    2016-06-01

    Cone beam computed tomography (CBCT) systems are fitted to radiotherapy linear accelerators and used for patient positioning prior to treatment by image guided radiotherapy (IGRT). Radiotherapists' and radiographers' knowledge of doses to organs from CBCT imaging is limited. The weighted CT dose index for a reference beam of width 20 mm (CTDIw,ref) is displayed on Varian CBCT imaging equipment known as an On-Board Imager (OBI) linked to the Truebeam linear accelerator. This has the potential to provide an indication of organ doses. This knowledge would be helpful for guidance of radiotherapy clinicians preparing treatments. Monte Carlo simulations of imaging protocols for head, thorax and pelvic scans have been performed using EGSnrc/BEAMnrc, EGSnrc/DOSXYZnrc, and ICRP reference computational male and female phantoms to derive the mean absorbed doses to organs and tissues, which have been compared with values for the CTDIw,ref displayed on the CBCT scanner console. Substantial variations in dose were observed between male and female phantoms. Nevertheless, the CTDIw,ref gave doses within  ±21% for the stomach and liver in thorax scans and 2  ×  CTDIw,ref can be used as a measure of doses to breast, lung and oesophagus. The CTDIw,ref could provide indications of doses to the brain for head scans, and the colon for pelvic scans. It is proposed that knowledge of the link between CTDIw for CBCT should be promoted and included in the training of radiotherapy staff. PMID:26975735

  9. Evaluation of the setup margins for cone beam computed tomography-guided cranial radiosurgery: A phantom study.

    PubMed

    Calvo Ortega, Juan Francisco; Wunderink, Wouter; Delgado, David; Moragues, Sandra; Pozo, Miquel; Casals, Joan

    2016-01-01

    The aim of this study is to evaluate the setup margins from the clinical target volume (CTV) to planning target volume (PTV) for cranial stereotactic radiosurgery (SRS) treatments guided by cone beam computed tomography (CBCT). We designed an end-to-end (E2E) test using a skull phantom with an embedded 6mm tungsten ball (target). A noncoplanar plan was computed (E2E plan) to irradiate the target. The CBCT-guided positioning of the skull phantom on the linac was performed. Megavoltage portal images were acquired after 15 independent deliveries of the E2E plan. The displacement 2-dimensional (2D) vector between the centers of the square field and the ball target on each portal image was used to quantify the isocenter accuracy. Geometrical margins on each patient׳s direction (left-right or LR, anterior-posterior or AP, superior-inferior or SI) were calculated. Dosimetric validation of the margins was performed in 5 real SRS cases: 3-dimesional (3D) isocenter deviations were mimicked, and changes in CTV dose coverage and organs-at-risk (OARs) dosage were analyzed. The CTV-PTV margins of 1.1mm in LR direction, and 0.7mm in AP and SI directions were derived from the E2E tests. The dosimetric analysis revealed that a 1-mm uniform margin was sufficient to ensure the CTV dose coverage, without compromising the OAR dose tolerances. The effect of isocenter uncertainty has been estimated to be 1mm in our CBCT-guided SRS approach. PMID:26994824

  10. Cone-Beam Computed Tomography (CBCT) Hepatic Arteriography in Chemoembolization for Hepatocellular Carcinoma: Performance Depicting Tumors and Tumor Feeders

    SciTech Connect

    Lee, In Joon; Chung, Jin Wook Yin, Yong Hu; Kim, Hyo-Cheol; Kim, Young Il; Jae, Hwan Jun; Park, Jae Hyung

    2015-10-15

    PurposeThis study was designed to analyze retrospectively the performance of cone-beam computed tomography (CBCT) hepatic arteriography in depicting tumors and their feeders and to investigate the related determining factors in chemoembolization for hepatocellular carcinoma (HCC).MethodsEighty-six patients with 142 tumors satisfying the imaging diagnosis criteria of HCC were included in this study. The performance of CBCT hepatic arteriography for chemoembolization per tumor and per patient was evaluated using maximum intensity projection images alone (MIP analysis) or MIP combined with multiplanar reformation images (MIP + MPR analysis) regarding the following three aspects: tumor depiction, confidence of tumor feeder detection, and trackability of tumor feeders. Tumor size, tumor enhancement, tumor location, number of feeders, diaphragmatic motion, portal vein enhancement, and hepatic artery to parenchyma enhancement ratio were regarded as potential determining factors.ResultsTumors were depicted in 125 (88.0 %) and 142 tumors (100 %) on MIP and MIP + MPR analysis, respectively. Imaging performances on MIP and MIP + MPR analysis were good enough to perform subsegmental chemoembolization without additional angiographic investigation in 88 (62.0 %) and 128 tumors (90.1 %) on per-tumor basis and in 43 (50 %) and 73 (84.9 %) on per-patient basis, respectively. Significant determining factors for performance in MIP + MPR analysis on per tumor basis were tumor size (p = 0.030), tumor enhancement (0.005), tumor location (p = 0.001), and diaphragmatic motion (p < 0.001).ConclusionsCBCT hepatic arteriography provided sufficient information for subsegmental chemoembolization by depicting tumors and their feeders in the vast majority of patients. Combined analysis of MIP and MPR images was essential to enhance the performance of CBCT hepatic arteriography.

  11. Accuracy of Image Guidance Using Free-Breathing Cone-Beam Computed Tomography for Stereotactic Lung Radiotherapy

    PubMed Central

    Kamomae, Takeshi; Monzen, Hajime; Nakayama, Shinichi; Mizote, Rika; Oonishi, Yuuichi; Kaneshige, Soichiro; Sakamoto, Takashi

    2015-01-01

    Movement of the target object during cone-beam computed tomography (CBCT) leads to motion blurring artifacts. The accuracy of manual image matching in image-guided radiotherapy depends on the image quality. We aimed to assess the accuracy of target position localization using free-breathing CBCT during stereotactic lung radiotherapy. The Vero4DRT linear accelerator device was used for the examinations. Reference point discrepancies between the MV X-ray beam and the CBCT system were calculated using a phantom device with a centrally mounted steel ball. The precision of manual image matching between the CBCT and the averaged intensity (AI) images restructured from four-dimensional CT (4DCT) was estimated with a respiratory motion phantom, as determined in evaluations by five independent operators. Reference point discrepancies between the MV X-ray beam and the CBCT image-guidance systems, categorized as left-right (LR), anterior-posterior (AP), and superior-inferior (SI), were 0.33 ± 0.09, 0.16 ± 0.07, and 0.05 ± 0.04 mm, respectively. The LR, AP, and SI values for residual errors from manual image matching were -0.03 ± 0.22, 0.07 ± 0.25, and -0.79 ± 0.68 mm, respectively. The accuracy of target position localization using the Vero4DRT system in our center was 1.07 ± 1.23 mm (2 SD). This study experimentally demonstrated the sufficient level of geometric accuracy using the free-breathing CBCT and the image-guidance system mounted on the Vero4DRT. However, the inter-observer variation and systematic localization error of image matching substantially affected the overall geometric accuracy. Therefore, when using the free-breathing CBCT images, careful consideration of image matching is especially important. PMID:25954809

  12. Comparison of cone-beam computed tomography cephalometric measurements using a midsagittal projection and conventional two-dimensional cephalometric measurements

    PubMed Central

    Jung, Pil-Kyo; Lee, Gung-Chol

    2015-01-01

    Objective This study investigated whether it is possible to use a two-dimensional (2D) standard in three-dimensional (3D) analysis, by comparing the angles and lengths measured from a midsagittal projection in 3D cone-beam computed tomography (CBCT) with those measured by 2D lateral cephalometric radiography (LCR). Methods Fifty patients who underwent both LCR and CBCT were selected as subjects. CBCT was reoriented in 3 different methods and the measuring-points were projected onto the midsagittal plane. Twelve angle values and 8 length values were measured on both LCR and CBCT and compared. Results Repeated measures analysis of the variance revealed statistically significant differences in 7 angular and 5 linear measurements among LCR and 3 types of CBCT (p < 0.05). Of these 12 measurements, multiple comparisons showed that 6 measurements (ANB, AB to FH, IMPA, FMA, Co-Gn, Go-Me) were not significantly different in pairwise comparisons. LCR was significantly different from 3 types of CBCT in 3 angular (SN to FH, interincisal angle, FMIA) and 2 linear (S-Go, Co-ANS) measurements. The CBCT method was similar for all measurements, except for 1 linear measurement, i.e., S-N. However, the disparity between the mean values for all parameters was within the range of clinical measurement error. Conclusions 3D-CBCT analysis, using midsagittal projection, is a useful method in which the 2D-LCR normative values can be used. Although the measurements changed with reorientation, these changes were not clinically significant. PMID:26629474

  13. TH-E-17A-05: Optimizing Four Dimensional Cone Beam Computed Tomography Projection Allocation to Respiratory Bins

    SciTech Connect

    OBrien, R; Shieh, C; Kipritidis, J; Keall, P

    2014-06-15

    Purpose: Four dimensional cone beam computed tomography (4DCBCT) is an emerging image guidance strategy but it can suffer from poor image quality. To avoid repeating scans it is beneficial to make the best use of the imaging data obtained. For conventional 4DCBCT the location and size of respiratory bins is fixed and projections are allocated to the respiratory bin within which it falls. Strictly adhering to this rule is unnecessary and can compromise image quality. In this study we optimize the size and location of respiratory bins and allow projections to be sourced from adjacent phases of the respiratory cycle. Methods: A mathematical optimization framework using mixed integer quadratic programming has been developed that determines when to source projections from adjacent respiratory bins and optimizes the size and location of the bins. The method, which we will call projection sharing, runs in under 2 seconds of CPU time. Five 4DCBCT datasets of stage III-IV lung cancer patients were used to test the algorithm. The standard deviation of the angular separation between projections (SD-A) and the standard deviation in the volume of the reconstructed fiducial gold coil (SD-V) were used as proxies to measure streaking artefacts and motion blur respectively. Results: The SD-A using displacement binning and projection sharing was 30%–50% smaller than conventional phase based binning and 59%–76% smaller than conventional displacement binning indicating more uniformly spaced projections and fewer streaking artefacts. The SD-V was 20–90% smaller when using projection sharing than using conventional phase based binning suggesting more uniform marker segmentation and less motion blur. Conclusion: Image quality was visibly and significantly improved with projection sharing. Projection sharing does not require any modifications to existing hardware and offers a more robust replacement to phase based binning, or, an option if phase based reconstruction is not of a

  14. Feasibility Study of Needle Placement in Percutaneous Vertebroplasty: Cone-Beam Computed Tomography Guidance Versus Conventional Fluoroscopy

    SciTech Connect

    Braak, Sicco J.; Zuurmond, Kirsten Aerts, Hans C. J.; Leersum, Marc van Overtoom, Timotheus T. Th. Heesewijk, Johannes P. M. van Strijen, Marco J. L. van

    2013-08-01

    ObjectiveTo investigate the accuracy, procedure time, fluoroscopy time, and dose area product (DAP) of needle placement during percutaneous vertebroplasty (PVP) using cone-beam computed tomography (CBCT) guidance versus fluoroscopy.Materials and MethodsOn 4 spine phantoms with 11 vertebrae (Th7-L5), 4 interventional radiologists (2 experienced with CBCT guidance and two inexperienced) punctured all vertebrae in a bipedicular fashion. Each side was randomization to either CBCT guidance or fluoroscopy. CBCT guidance is a sophisticated needle guidance technique using CBCT, navigation software, and real-time fluoroscopy. The placement of the needle had to be to a specific target point. After the procedure, CBCT was performed to determine the accuracy, procedure time, fluoroscopy time, and DAP. Analysis of the difference between methods and experience level was performed.ResultsMean accuracy using CBCT guidance (2.61 mm) was significantly better compared with fluoroscopy (5.86 mm) (p < 0.0001). Procedure time was in favor of fluoroscopy (7.39 vs. 10.13 min; p = 0.001). Fluoroscopy time during CBCT guidance was lower, but this difference is not significant (71.3 vs. 95.8 s; p = 0.056). DAP values for CBCT guidance and fluoroscopy were 514 and 174 mGy cm{sup 2}, respectively (p < 0.0001). There was a significant difference in favor of experienced CBCT guidance users regarding accuracy for both methods, procedure time of CBCT guidance, and added DAP values for fluoroscopy.ConclusionCBCT guidance allows users to perform PVP more accurately at the cost of higher patient dose and longer procedure time. Because procedural complications (e.g., cement leakage) are related to the accuracy of the needle placement, improvements in accuracy are clinically relevant. Training in CBCT guidance is essential to achieve greater accuracy and decrease procedure time/dose values.

  15. Prevalence and patterns of palatine and adenoid tonsilloliths in cone-beam computed tomography images of an Iranian population

    PubMed Central

    Kajan, Zahra Dalili; Sigaroudi, Ali Khalighi; Mohebbi, Majedeh

    2016-01-01

    Background: Tonsilloliths are calcified concretions that develop in tonsillar crypts. They are usually small and asymptomatic, so they are found accidentally during routine dental radiogrphy procedure. Large tonsilloliths can occur with clinical signs and symptoms. The purpose of this study was to evaluate the prevalence and patterns of palatine and adenoid tonsilloliths in cone-beam computed tomography (CBCT) images. Materials and Methods: In this cross-sectional study, 0.5-mm axial and coronal slices of 134 CBCT images were evaluated to determine the presence of palatine and adenoid calcifications. Their patterns such as being unilateral or bilateral as well as single or multiple and their largest linear sizes were reported. Results: Fifty-four (40.3%) patients with palatine tonsilloliths and 17 (12.7%) with adenoid calcifications were found. Thirty (55.6%) palatine tonsilloliths were unilateral, 19 (35.2%) were detected in the left tonsils. Approximately, 54 cases of 78 palatine calcifications were multiple. Seventeen patients had adenoid calcifications that 41.1% of them were unilateral. Fourteen adenoid calcifications were single. The mean ages of patients with palatine tonsilloliths and adenoid calcifications were 45.59 years and 46.53 years, respectively. The range of linear measurements of palatine tonsil calcifications was 0.9–4.2 mm (2.47-mm mean size) while adenoid calcifications ranged from 0.5 to 2.2 mm (0.95-mm mean size). The level of statistical significant difference was <0.05. Conclusion: Gender did not affect total prevalence, the pattern of tonsilar calcifications and their linear sizes. The prevalence of tonsilloliths increased with aging, but this variable did not have an effect on their linear size.

  16. Phantom and Clinical Study of Differences in Cone Beam Computed Tomographic Registration When Aligned to Maximum and Average Intensity Projection

    SciTech Connect

    Shirai, Kiyonori; Nishiyama, Kinji; Katsuda, Toshizo; Teshima, Teruki; Ueda, Yoshihiro; Miyazaki, Masayoshi; Tsujii, Katsutomo

    2014-01-01

    Purpose: To determine whether maximum or average intensity projection (MIP or AIP, respectively) reconstructed from 4-dimensional computed tomography (4DCT) is preferred for alignment to cone beam CT (CBCT) images in lung stereotactic body radiation therapy. Methods and Materials: Stationary CT and 4DCT images were acquired with a target phantom at the center of motion and moving along the superior–inferior (SI) direction, respectively. Motion profiles were asymmetrical waveforms with amplitudes of 10, 15, and 20 mm and a 4-second cycle. Stationary CBCT and dynamic CBCT images were acquired in the same manner as stationary CT and 4DCT images. Stationary CBCT was aligned to stationary CT, and the couch position was used as the baseline. Dynamic CBCT was aligned to the MIP and AIP of corresponding amplitudes. Registration error was defined as the SI deviation of the couch position from the baseline. In 16 patients with isolated lung lesions, free-breathing CBCT (FBCBCT) was registered to AIP and MIP (64 sessions in total), and the difference in couch shifts was calculated. Results: In the phantom study, registration errors were within 0.1 mm for AIP and 1.5 to 1.8 mm toward the inferior direction for MIP. In the patient study, the difference in the couch shifts (mean, range) was insignificant in the right-left (0.0 mm, ≤1.0 mm) and anterior–posterior (0.0 mm, ≤2.1 mm) directions. In the SI direction, however, the couch position significantly shifted in the inferior direction after MIP registration compared with after AIP registration (mean, −0.6 mm; ranging 1.7 mm to the superior side and 3.5 mm to the inferior side, P=.02). Conclusions: AIP is recommended as the reference image for registration to FBCBCT when target alignment is performed in the presence of asymmetrical respiratory motion, whereas MIP causes systematic target positioning error.

  17. Comparison of Kilovoltage Cone-Beam Computed Tomography With Megavoltage Projection Pairs for Paraspinal Radiosurgery Patient Alignment and Position Verification

    SciTech Connect

    Kriminski, Sergey A. Lovelock, D. Michael; Seshan, Venkatraman E.; Ali, Imad; Munro, Peter; Amols, Howard I.; Fuks, Zvi; Bilsky, Mark; Yamada, Yoshiya

    2008-08-01

    Purpose: Implanted gold markers and megavoltage (MV) portal imaging are commonly used for setup verification of paraspinal tumors treated with high-dose, single-fraction radiotherapy. We investigated whether the use of kilovoltage cone-beam computed tomography (CBCT) imaging eliminates the need for marker implantation. Methods and Materials: Patients with paraspinal disease who were eligible for single-fraction stereotactic body radiotherapy were accrued to an institutional review board-approved protocol. Each of 16 patients underwent implantation of fiducial markers near the target. The markers were visible on the MV images. Three MV image pairs were acquired for each patient (initial, verification, and final) and were registered to the reference images. Every MV pair was complemented by a CBCT scan. CBCT image registration was performed automatically by maximizing the mutual information using a region of interest that excluded the markers. The corrections, as determined from the MV images, were compared with these from CBCT and were used for actual patient setup. Results: The mean and standard deviation of the absolute values of the differences between the CBCT and MV corrections were 1.0 {+-} 0.7, 1.0 {+-} 0.6, and 1.0 {+-} 0.8 mm for the left-right, anteroposterior, and superoinferior directions, respectively. The absolute differences between the corresponding pre- and post-treatment kilovoltage CBCT image registration were 0.6 {+-} 0.5, 0.6 {+-} 0.5, and 1.0 {+-} 0.8 mm. Conclusion: The setup corrections found using CBCT without the use of implanted markers were consistent with the marker registration on MV projections. CBCT has additional advantages, including better positioning precision and robust automatic three-dimensional registration, as well as eliminating the need for invasive marker implantation. We have adopted CBCT for the setup of all single-fraction paraspinal patients. Our data have also demonstrated that target displacements during treatment

  18. Panoramic radiography and cone-beam computed tomography findings in preoperative examination of impacted mandibular third molars

    PubMed Central

    2014-01-01

    Background Preoperative radiographic examination of impacted mandibular third molars (IMTM) is essential to prevent inferior alveolar nerve injury during extraction. The purpose of this study was to evaluate the correlation between cone-beam computed tomography (CBCT) and digital panoramic radiography (DPR) findings in preoperative examination of IMTM. Methods This retrospective study included 298 teeth in 191 individuals. The relationship between the inferior alveolar canal (IAC) and the IMTM (buccal, lingual, interradicular or inferior), the position of the IMTM with respect to the IAC (contact, no contact), the morphologic shape of the mandible in the IMTM region (round, lingual extended, lingual concave), the type of IMTM (vertical, horizontal or angular) and the number of roots of the IMTM were evaluated on CBCT images. DPR images were evaluated for the number of roots of the IMTM and for the most common radiographic findings indicating a relationship between the IAC and the IMTM (darkening of the roots, diversion of the IAC, narrowing of the IAC and interruption of the white line). Data were statistically analyzed with Cramer V coefficient, Kappa statistic, chi-square and Fisher’s exact test. Results There was a significant difference in number of roots detected on DPR versus CBCT images. There was a significant association between the type of IMTM and the morphologic shape of the mandible on CBCT images. Darkening of the roots and interruption of the white line on DPR images were significantly associated with the presence of contact between the IMTM and the IAC on CBCT images. Conclusions Panoramic radiography is inadequate, whereas CBCT is useful to detect multiple roots of IMTM. When darkening of the roots and interruption of the white line are observed on panoramic images, there is increased likelihood of contact between the IMTM and the IAC. CBCT is required in these cases. PMID:24928108

  19. The incidence and configuration of the bifid mandibular canal in Koreans by using cone-beam computed tomography

    PubMed Central

    Kang, Ju-Han; Lee, Kook-Sun; Oh, Min-Gyu; Choi, Hwa-Young; Lee, Sae-Rom; Oh, Song-Hee; Choi, Yoon-Joo; Kim, Gyu-Tae; Hwang, Eui-Hwan

    2014-01-01

    Purpose This study was performed to investigate the incidence and configuration of the bifid mandibular canal in a Korean population by using cone-beam computed tomography (CBCT) imaging. Materials and Methods CBCT images of 1933 patients (884 male and 1049 female) were evaluated using PSR-9000N and Alphard-Vega 3030 Dental CT units (Asahi Roentgen Ind. Co., Ltd, Kyoto, Japan). Image analysis was performed by using OnDemand3D software (CyberMed Inc., Seoul, Korea). The bifid mandibular canal was identified and classified into four types, namely, the forward canal, buccolingual canal, dental canal, and retromolar canal. Statistical analysis was performed by using the chi-squared test and one-way analysis of variance (ANOVA). Results Bifid mandibular canals were observed in 198 (10.2%) of 1933 patients. The most frequently observed type of bifid mandibular canal was the retromolar canal (n=104, rate: 52.5%) without any significant difference among the incidence of each age and gender. The mean diameter of the accessory canal was 1.27 mm (range: 0.27-3.29 mm) without any significant difference among the mean diameter of each type of the bifid mandibular canal. The mean length of the bifid mandibular canals was 14.97mm(range: 2.17-38.8 mm) with only a significant difference between the dental canal and the other types. Conclusion The bifid mandibular canal is not uncommon in Koreans and has a prevalence of 10.2% as indicated in the present study. It is suggested that a CBCT examination be recommended for detecting a bifid canal. PMID:24701459

  20. Topographic analysis of the mandibular symphysis in a normal occlusion population using cone-beam computed tomography

    PubMed Central

    LEE, JI-EUN; LEE, YOON-JIN; JIN, SEONG-HO; KIM, YOONJI; KOOK, YOON-AH; KO, YOUNGKYUNG; PARK, JUN-BEOM

    2015-01-01

    At present, the relationship between the morphological characteristics of the sympheseal region and occlusion has not been well documented. The aim of the present study was to investigate the following, using cone-beam computed tomography (CBCT): Interforaminal distance, the anterior loop, labial bone thickness at the tooth apex, cortical bone thickness, and the basal bone height from the apex of the tooth to the base of the mandible. Three-dimensional CBCT was performed on 20 normal occlusion subjects (9 males and 11 females; mean age=21.9±3.0 years); the mean interforaminal distance was 53.1±3.6 mm, with 85% of the participants demonstrating a mental foramen located below the second premolars on both sides. The mean anterior loop was 1.9±0.8 mm, the mean horizontal distance value was 4.5±1.3 mm, and the mean cortical bone thickness value was 2.3±0.5 mm. An increasing tendency for cortical bone thickness was seen from the central incisor to the second premolar. The mean vertical distance value was 20.3±3.1 mm. Decreasing tendency of vertical distance was seen from the central incisor to the second premolar. Furthermore, the width (mental foramina of both sides and their anterior loops), height (teeth apices and the inferior border of the mandible), depth (cortical bone thickness of the symphysis), and safety margins for vital anatomical structures (anterior loop, tooth apex, and inferior border of mandible) should be taken into account prior to symphyseal block-bone harvesting. The results of the present study suggested that a pre-operative evaluation with CBCT may be useful for diagnosis and treatment planning, and for minimizing complications during block-bone graft. PMID:26668608

  1. 5D respiratory motion model based image reconstruction algorithm for 4D cone-beam computed tomography

    NASA Astrophysics Data System (ADS)

    Liu, Jiulong; Zhang, Xue; Zhang, Xiaoqun; Zhao, Hongkai; Gao, Yu; Thomas, David; Low, Daniel A.; Gao, Hao

    2015-11-01

    4D cone-beam computed tomography (4DCBCT) reconstructs a temporal sequence of CBCT images for the purpose of motion management or 4D treatment in radiotherapy. However the image reconstruction often involves the binning of projection data to each temporal phase, and therefore suffers from deteriorated image quality due to inaccurate or uneven binning in phase, e.g., under the non-periodic breathing. A 5D model has been developed as an accurate model of (periodic and non-periodic) respiratory motion. That is, given the measurements of breathing amplitude and its time derivative, the 5D model parametrizes the respiratory motion by three time-independent variables, i.e., one reference image and two vector fields. In this work we aim to develop a new 4DCBCT reconstruction method based on 5D model. Instead of reconstructing a temporal sequence of images after the projection binning, the new method reconstructs time-independent reference image and vector fields with no requirement of binning. The image reconstruction is formulated as a optimization problem with total-variation regularization on both reference image and vector fields, and the problem is solved by the proximal alternating minimization algorithm, during which the split Bregman method is used to reconstruct the reference image, and the Chambolle's duality-based algorithm is used to reconstruct the vector fields. The convergence analysis of the proposed algorithm is provided for this nonconvex problem. Validated by the simulation studies, the new method has significantly improved image reconstruction accuracy due to no binning and reduced number of unknowns via the use of the 5D model.

  2. Breast Patient Setup Error Assessment: Comparison of Electronic Portal Image Devices and Cone-Beam Computed Tomography Matching Results

    SciTech Connect

    Topolnjak, Rajko; Sonke, Jan-Jakob; Nijkamp, Jasper; Rasch, Coen; Minkema, Danny; Remeijer, Peter; Vliet-Vroegindeweij, Corine van

    2010-11-15

    Purpose: To quantify the differences in setup errors measured with the cone-beam computed tomography (CBCT) and electronic portal image devices (EPID) in breast cancer patients. Methods and Materials: Repeat CBCT scan were acquired for routine offline setup verification in 20 breast cancer patients. During the CBCT imaging fractions, EPID images of the treatment beams were recorded. Registrations of the bony anatomy for CBCT to planning CT and EPID to digitally reconstructed-radiographs (DRRs) were compared. In addition, similar measurements of an anthropomorphic thorax phantom were acquired. Bland-Altman and linear regression analysis were performed for clinical and phantom registrations. Systematic and random setup errors were quantified for CBCT and EPID-driven correction protocols in the EPID coordinate system (U, V), with V parallel to the cranial-caudal axis and U perpendicular to V and the central beam axis. Results: Bland-Altman analysis of clinical EPID and CBCT registrations yielded 4 to 6-mm limits of agreement, indicating that both methods were not compatible. The EPID-based setup errors were smaller than the CBCT-based setup errors. Phantom measurements showed that CBCT accurately measures setup error whereas EPID underestimates setup errors in the cranial-caudal direction. In the clinical measurements, the residual bony anatomy setup errors after offline CBCT-based corrections were {Sigma}{sub U} = 1.4 mm, {Sigma}{sub V} = 1.7 mm, and {sigma}{sub U} = 2.6 mm, {sigma}{sub V} = 3.1 mm. Residual setup errors of EPID driven corrections corrected for underestimation were estimated at {Sigma}{sub U} = 2.2mm, {Sigma}{sub V} = 3.3 mm, and {sigma}{sub U} = 2.9 mm, {sigma}{sub V} = 2.9 mm. Conclusion: EPID registration underestimated the actual bony anatomy setup error in breast cancer patients by 20% to 50%. Using CBCT decreased setup uncertainties significantly.

  3. Assessment of the anterior loop of the mandibular canal: A study using cone-beam computed tomography

    PubMed Central

    do Nascimento, Eduarda Helena Leandro; dos Anjos Pontual, Maria Luiza; dos Anjos Pontual, Andréa; da Cruz Perez, Danyel Elias; Figueiroa, José Natal; Frazão, Marco Antônio Gomes

    2016-01-01

    Purpose Sufficient area in the interforaminal region is required for dental implant placement, and the anterior loop of the mandibular canal is located within the limits of this area. The aim of this study was to evaluate the prevalence and extent of the anterior loop in a Brazilian sample population using cone-beam computed tomography (CBCT). Materials and Methods CBCT images from 250 patients (500 hemimandibles) obtained for various clinical indications were randomly selected and evaluated to determine the presence and length of the anterior loop. The length of the anterior loop was then compared based on gender, age, and the side of the mandible. The data were analyzed using the Pearson chi-square test and linear regression analysis. Results An anterior loop was identified in 41.6% of the cases, and its length ranged from 0.25 mm to 4.00 mm (mean, 1.1±0.8 mm). The loop had a greater mean length and was significantly more prevalent in males (p=0.014). No significant differences were found between the right and left sides regarding length (p=0.696) or prevalence (p=0.650). Conclusion In this study, a high prevalence of the anterior loop of the mandibular canal was found, and although its length varied greatly, in most cases it was less than 1 mm long. Although this is a prevalent anatomical variation, safety limits for the placement of implants in this region cannot be established before an accurate evaluation using imaging techniques in order to identify and preserve the neurovascular bundles. PMID:27358813

  4. Incidental Findings on Cone Beam Computed Tomography and Reasons for Referral by Dental Practitioners in Indore City (M.P)

    PubMed Central

    Nagarajappa, Sandesh; Dasar, Prahlad L; Warhekar, Ashish M; Parihar, Ajay; Phulambrikar, Tushar; Airen, Bhuvnesh; Jain, Deepika

    2015-01-01

    Introduction: Cone beam computed tomography is a new diagnostic innovation to dental imaging. Despite the use of CBCT in oral and maxillofacial imaging, reports on its use either by individual practitioners or referral patterns to CBCT centers is lacking. Hence, a study was conducted to determine incidental findings on CBCT and reasons for referral by dental practitioners in Indore city. Materials and Methods: A retrospective analysis of 795 records that were referred for CBCT imaging at Institutional and Oracal CBCT Centre, Indore was undertaken. Referrals from both within and outside institution, as well as from private practitioners were considered. The reason for CBCT referral, provision diagnosis, final diagnosis and any incidental diagnosis were recorded. Results: This retrospective chart audit revealed that 56.7 % were male and 43.3% were females. Greatest source of patients was referred by oral surgeons (21.9%) followed by oral and maxillofacial radiologist (14.2%) and prosthodontist (9.3%). The most common reason for referral was for implant analysis (24.2%) and the most common incidental finding diagnosed by CBCT was oral malignancies. Conclusion: In Institutional set-up, CBCT referrals were mostly for the reason of planning implant placement followed by trauma whereas private practitioners used CBCT mostly for implant placement followed by impaction. CBCT was being utilized more by Oral surgeons in private sector whereas it in an Institutional setup majority of referrals from Department of Oral Diagnosis and Radiology. Findings that were most commonly diagnosed incidentally on CBCT were Orofacial malignancies followed maxillary sinus pathologies. PMID:25859519

  5. A local shift-variant Fourier model and experimental validation of circular cone-beam computed tomography artifacts.

    PubMed

    Bartolac, Steven; Clackdoyle, Roll; Noo, Frederic; Siewerdsen, Jeff; Moseley, Douglas; Jaffray, David

    2009-02-01

    Large field of view cone-beam computed tomography (CBCT) is being achieved using circular source and detector trajectories. These circular trajectories are known to collect insufficient data for accurate image reconstruction. Although various descriptions of the missing information exist, the manifestation of this lack of data in reconstructed images is generally nonintuitive. One model predicts that the missing information corresponds to a shift-variant cone of missing frequency components. This description implies that artifacts depend on the imaging geometry, as well as the frequency content of the imaged object. In particular, objects with a large proportion of energy distributed over frequency bands that coincide with the missing cone will be most compromised. These predictions were experimentally verified by imaging small, localized objects (acrylic spheres, stacked disks) at varying positions in the object space and observing the frequency spectrums of the reconstructions. Measurements of the internal angle of the missing cone agreed well with theory, indicating a right circular cone for points on the rotation axis, and an oblique, circular cone elsewhere. In the former case, the largest internal angle with respect to the vertical axis corresponds to the (half) cone angle of the CBCT system (typically approximately 5 degrees - 7.5 degrees in IGRT). Object recovery was also found to be strongly dependent on the distribution of the object's frequency spectrum relative to the missing cone, as expected. The observed artifacts were also reproducible via removal of local frequency components, further supporting the theoretical model. Larger objects with differing internal structures (cellular polyurethane, solid acrylic) were also imaged and interpreted with respect to the previous results. Finally, small animal data obtained using a clinical CBCT scanner were observed for evidence of the missing cone. This study provides insight into the influence of incomplete

  6. A local shift-variant Fourier model and experimental validation of circular cone-beam computed tomography artifacts

    PubMed Central

    Bartolac, Steven; Clackdoyle, Rolf; Noo, Frederic; Siewerdsen, Jeff; Moseley, Douglas; Jaffray, David

    2009-01-01

    Large field of view cone-beam computed tomography (CBCT) is being achieved using circular source and detector trajectories. These circular trajectories are known to collect insufficient data for accurate image reconstruction. Although various descriptions of the missing information exist, the manifestation of this lack of data in reconstructed images is generally nonintuitive. One model predicts that the missing information corresponds to a shift-variant cone of missing frequency components. This description implies that artifacts depend on the imaging geometry, as well as the frequency content of the imaged object. In particular, objects with a large proportion of energy distributed over frequency bands that coincide with the missing cone will be most compromised. These predictions were experimentally verified by imaging small, localized objects (acrylic spheres, stacked disks) at varying positions in the object space and observing the frequency spectrums of the reconstructions. Measurements of the internal angle of the missing cone agreed well with theory, indicating a right circular cone for points on the rotation axis, and an oblique, circular cone elsewhere. In the former case, the largest internal angle with respect to the vertical axis corresponds to the (half) cone angle of the CBCT system (typically ∼5°–7.5° in IGRT). Object recovery was also found to be strongly dependent on the distribution of the object’s frequency spectrum relative to the missing cone, as expected. The observed artifacts were also reproducible via removal of local frequency components, further supporting the theoretical model. Larger objects with differing internal structures (cellular polyurethane, solid acrylic) were also imaged and interpreted with respect to the previous results. Finally, small animal data obtained using a clinical CBCT scanner were observed for evidence of the missing cone. This study provides insight into the influence of incomplete data collection on the

  7. Scatter kernel estimation with an edge-spread function method for cone-beam computed tomography imaging

    NASA Astrophysics Data System (ADS)

    Li, Heng; Mohan, Radhe; Zhu, X. Ronald

    2008-12-01

    The clinical applications of kilovoltage x-ray cone-beam computed tomography (CBCT) have been compromised by the limited quality of CBCT images, which typically is due to a substantial scatter component in the projection data. In this paper, we describe an experimental method of deriving the scatter kernel of a CBCT imaging system. The estimated scatter kernel can be used to remove the scatter component from the CBCT projection images, thus improving the quality of the reconstructed image. The scattered radiation was approximated as depth-dependent, pencil-beam kernels, which were derived using an edge-spread function (ESF) method. The ESF geometry was achieved with a half-beam block created by a 3 mm thick lead sheet placed on a stack of slab solid-water phantoms. Measurements for ten water-equivalent thicknesses (WET) ranging from 0 cm to 41 cm were taken with (half-blocked) and without (unblocked) the lead sheet, and corresponding pencil-beam scatter kernels or point-spread functions (PSFs) were then derived without assuming any empirical trial function. The derived scatter kernels were verified with phantom studies. Scatter correction was then incorporated into the reconstruction process to improve image quality. For a 32 cm diameter cylinder phantom, the flatness of the reconstructed image was improved from 22% to 5%. When the method was applied to CBCT images for patients undergoing image-guided therapy of the pelvis and lung, the variation in selected regions of interest (ROIs) was reduced from >300 HU to <100 HU. We conclude that the scatter reduction technique utilizing the scatter kernel effectively suppresses the artifact caused by scatter in CBCT.

  8. Proximity of the mandibular molar root apex from the buccal bone surface: a cone-beam computed tomographic study

    PubMed Central

    Kim, Dokyung; Jin, Myoung-Uk

    2016-01-01

    Objectives The purpose of this study was to evaluate the proximity of the mandibular molar apex to the buccal bone surface in order to provide anatomic information for apical surgery. Materials and Methods Cone-beam computed tomography (CBCT) images of 127 mandibular first molars and 153 mandibular second molars were analyzed from 160 patients' records. The distance was measured from the buccal bone surface to the root apex and the apical 3.0 mm on the cross-sectional view of CBCT. Results The second molar apex and apical 3 mm were located significantly deeper relative to the buccal bone surface compared with the first molar (p < 0.01). For the mandibular second molars, the distance from the buccal bone surface to the root apex was significantly shorter in patients over 70 years of age (p < 0.05). Furthermore, this distance was significantly shorter when the first molar was missing compared to nonmissing cases (p < 0.05). For the mandibular first molars, the distance to the distal root apex of one distal-rooted tooth was significantly greater than the distance to the disto-buccal root apex (p < 0.01). In mandibular second molar, the distance to the apex of C-shaped roots was significantly greater than the distance to the mesial root apex of non-C-shaped roots (p < 0.01). Conclusions For apical surgery in mandibular molars, the distance from the buccal bone surface to the apex and apical 3 mm is significantly affected by the location, patient age, an adjacent missing anterior tooth, and root configuration. PMID:27508159

  9. Accuracy of Cone-Beam Computed Tomography in Determining the Root Canal Morphology of Mandibular First Molars

    PubMed Central

    Mokhtari, Hadi; Niknami, Mahdi; Mokhtari Zonouzi, Hamid Reza; Sohrabi, Aydin; Ghasemi, Negin; Akbari Golzar, Amir

    2016-01-01

    Introduction: The aim of the present in vitro study was to compare the accuracy of cone-beam computed tomography (CBCT) in determining root canal morphology of mandibular first molars in comparison with staining and clearing technique. Methods and Materials: CBCT images were taken from 96 extracted human mandibular first molars and the teeth were then evaluated based on Vertucci’s classification to determine the root canal morphology. Afterwards, access cavities were prepared and India ink was injected into the canals with an insulin syringe. The teeth were demineralized with 5% nitric acid. Finally, the cleared teeth were evaluated under a magnifying glass at 5× magnification to determine the root canal morphology. Data were analyzed using the SPSS software. The Fisher’s exact test assessed the differences between the mesial and distal canals and the Cohen’s kappa test was used to assess the level of agreement between the methods. Statistical significance was defined at 0.05. Results: The Kappa coefficient for agreement between the two methods evaluating canal types was 0.346 (95% CI: 0.247-0.445), which is considered a fair level of agreement based on classification of Koch and Landis. The agreement between CBCT and Vertucci’s classification was 52.6% (95% CI: 45.54-59.66%), with a significantly higher agreement rate in the mesial canals (28.1%) compared to the distal canals (77.1%) (P<0.001). Conclusion: Under the limitations of this study, clearing technique was more accurate than CBCT in providing accurate picture of the root canal anatomy of mandibular first molars. PMID:27141216

  10. SU-D-12A-07: Optimization of a Moving Blocker System for Cone-Beam Computed Tomography Scatter Correction

    SciTech Connect

    Ouyang, L; Yan, H; Jia, X; Jiang, S; Wang, J; Zhang, H

    2014-06-01

    Purpose: A moving blocker based strategy has shown promising results for scatter correction in cone-beam computed tomography (CBCT). Different parameters of the system design affect its performance in scatter estimation and image reconstruction accuracy. The goal of this work is to optimize the geometric design of the moving block system. Methods: In the moving blocker system, a blocker consisting of lead strips is inserted between the x-ray source and imaging object and moving back and forth along rotation axis during CBCT acquisition. CT image of an anthropomorphic pelvic phantom was used in the simulation study. Scatter signal was simulated by Monte Carlo calculation with various combinations of the lead strip width and the gap between neighboring lead strips, ranging from 4 mm to 80 mm (projected at the detector plane). Scatter signal in the unblocked region was estimated by cubic B-spline interpolation from the blocked region. Scatter estimation accuracy was quantified as relative root mean squared error by comparing the interpolated scatter to the Monte Carlo simulated scatter. CBCT was reconstructed by total variation minimization from the unblocked region, under various combinations of the lead strip width and gap. Reconstruction accuracy in each condition is quantified by CT number error as comparing to a CBCT reconstructed from unblocked full projection data. Results: Scatter estimation error varied from 0.5% to 2.6% as the lead strip width and the gap varied from 4mm to 80mm. CT number error in the reconstructed CBCT images varied from 12 to 44. Highest reconstruction accuracy is achieved when the blocker lead strip width is 8 mm and the gap is 48 mm. Conclusions: Accurate scatter estimation can be achieved in large range of combinations of lead strip width and gap. However, image reconstruction accuracy is greatly affected by the geometry design of the blocker.

  11. Cone-beam computed tomography analysis of the vestibular surgical pathway to the palatine root of the maxillary first molar

    PubMed Central

    Kalender, Atakan; Aksoy, Umut; Basmaci, Fatma; Orhan, Kaan; Orhan, Ayse Isil

    2013-01-01

    Objective: The aim of this study was to evaluate the anatomical distance between apices of the palatine root of the maxillary first molars to the buccal bone plate to identify the vestibular surgical pathway in a Turkish adult population using cone-beam computed tomography (CBCT) images. Methods: CBCT scans of 107 (48 male and 59 female) patients were retrospectively analyzed. The overall mean age was 38.6 years. The distance between the vestibular cortex and vestibular side of the palatine root was measured for 192 maxillary first molars both on axial images parallel to the palatal plane and on reformatted cross-sectional images. A Pearson’s chi square test and Mann-Whitney U-test were performed to evaluate differences among age, localization, and measurements. Differences were considered statistically significant at P<.05. Results: The mean distance between the buccal cortex and the buccal side of the palatine root of the superior first molar in both male and female patients was 10.13 and 9.70 mm, respectively. The incidence of interposition of the lateral recess of the maxillary sinus between the roots was 42.2% and 49% in men and women, respectively. Statistically significant sex-related differences were found in the vestibular surgical pathway (P<.05). Conclusions: For precise planning of endodontic surgery, it is crucial to determine the exact dimensions and location of the periapical lesion, as well as its relationship with the roots and other neighboring anatomical structures. CBCT can be a powerful tool for the evaluation of surgical cases in three dimensions with less ionizing radiation and better avoidance of complications during surgery. PMID:23408714

  12. A comparative study of cone-beam computed tomography and digital periapical radiography in detecting mandibular molars root perforations

    PubMed Central

    Haghanifar, Sina; Moudi, Ehsan; Mesgarani, Abbas; Bijani, Ali

    2014-01-01

    Purpose The aim of this in vitro study was to determine the sensitivity and specificity of cone-beam computed tomography (CBCT) and digital periapical radiography in the detection of mesial root perforations of mandibular molars. Materials and Methods In this in vitro study, 48 mandibular molars were divided into 4 groups. First, the mesial canals of all the 48 teeth were endodontically prepared. In 2 groups (24 teeth each), the roots were axially perforated in the mesiolingual canal 1-3 mm below the furcation region, penetrating the root surface ("root perforation"). Then, in one of these 2 groups, the mesial canals were filled with gutta-percha and AH26 sealer. Mesial canals in one of the other 2 groups without perforation (control groups) were filled with the same materials. The CBCT and periapical radiographs with 3 different angulations were evaluated by 2 oral and maxillofacial radiologists. The specificity and sensitivity of the two methods were calculated, and P<0.05 was considered significant. Results The sensitivity and specificity of CBCT scans in the detection of obturated root canal perforations were 79% and 96%, respectively, and in the case of three-angled periapical radiographs, they were 92% and 100%, respectively. In non-obturated root canals, the sensitivity and specificity of CBCT scans in perforation detection were 92% and 100%, respectively, and for three-angled periapical radiographs, they were 50% and 96%, respectively. Conclusion For perforation detection in filled-root canals, periapical radiography with three different horizontal angulations would be trustworthy, but it is recommended that CBCT be used for perforation detection before obturating root canals. PMID:24944960

  13. Diagnostic Value of Cone-Beam Computed Tomography and Periapical Radiography In Detection of Vertical Root Fracture

    PubMed Central

    Ezzodini Ardakani, Fatemeh; Razavi, Seyed Hossein; Tabrizizadeh, Mehdi

    2015-01-01

    Introduction: Vertical root fracture (VRF) is the longitudinal fracture of the root in endodontically treated teeth. Considering the limitations of two-dimensional radiographic images in detection of VRF and introduction of cone-beam computed tomography (CBCT), this study was designed to find the sensitivity, specificity and accuracy of CBCT and periapical (PA) radiography in detection of VRFs. Methods and Materials: This was a cross-sectional in vitro study on 80 extracted human single canal teeth including 40 maxillary and 40 mandibular teeth. After standardized endodontic treatment of the roots, VRF was induced in half of the teeth in each group, and other half were left without fracture. Teeth were inserted in dry maxillary and mandibular alveoli. PA radiographs and CBCT images were taken from the specimens. Data were analyzed with SPSS software. The McNemar test was used to evaluate the sensitivity, specificity and accuracy of images, and kappa coefficient was used to assess the degree of agreement between the observers. The level of significance was set at 0.05. Results: Sensitivity and specificity values of CBCT were 97.5% and 95%, respectively. However, for PA radiography the sensitivity and specificity were 67.5% and 92.5%, in order of appearance. Accuracy of CBCT (96.25%) and PA radiography (80%) in both jaws were significantly different (P=0.022). Two methods were not significantly different when testing specificity (P=0.298). Conclusion: This study showed that the sensitivity and accuracy of CBCT in detection of vertical root fracture are higher than periapical radiography. CBCT can be recommended to be used in detection of vertical root fractures. PMID:25834597

  14. [Evaluation on Ability to Detect the Intracranial Hematoma with Different Density Using C-Arm Cone-beam Computed Tomography Based on Animal Model].

    PubMed

    Zhou, Mi; Zeng, Yongming; Yu, Renqiang; Zhou, Yang; Xu, Rui; Sun, Jingkun; Gao, Zhimei

    2016-02-01

    This study aims to evaluate the ability of C-arm cone-beam CT to detect intracranial hematomas in canine models. Twenty one healthy canines were divided into seven groups and each group had three animals. Autologous blood and contrast agent (3 mL) were slowly injected into the left/right frontal lobes of each animal. Canines in the first group, the control group, were only injected with autologous blood without contrast agent. Each animal in all the 7 groups was scanned with C-arm cone-beam CT and multislice computed tomography (MSCT) after 5 minutes. The attenuation values and their standard deviations of the hematoma and uniformed brain tissues were measured to calculate the image noise, signal to noise ratio (SNR) and contrast to noise ratio (CNR). A scale with scores 1-3 was used to rate the quality of the reconstructed image of different hematoma as a subjective evaluation, and all the experimental data were processed with statistical treatment. The results revealed that when the density of hematoma was less than 65 HU, hematomata were not very clear on C-arm CT images, and when the density of hematoma was more than 65 HU, hematomata showed clearly on both C-arm CT and MSCT images and the scores of them were close. The coherence between the two physicians was very reliable. The same results were obtained with C-arm cone-beam CT and MSCT grades in measuring SD value, SNR, and CNR. The reasonable choice of density detection range of intracranial hematoma with C-arm cone-beam CT could be effectively applied to monitoring the intracranial hemorrhage during interventional diagnosis and treatment. PMID:27382751

  15. The influence of antiscatter grids on soft-tissue detectability in cone-beam computed tomography with flat-panel detectors

    SciTech Connect

    Siewerdsen, J.H.; Moseley, D.J.; Bakhtiar, B.; Richard, S.; Jaffray, D.A.

    2004-12-01

    The influence of antiscatter x-ray grids on image quality in cone-beam computed tomography (CT) is evaluated through broad experimental investigation for various anatomical sites (head and body), scatter conditions (scatter-to-primary ratio (SPR) ranging from {approx}10% to 150%), patient dose, and spatial resolution in three-dimensional reconstructions. Studies involved linear grids in combination with a flat-panel imager on a system for kilovoltage cone-beam CT imaging and guidance of radiation therapy. Grids were found to be effective in reducing x-ray scatter 'cupping' artifacts, with heavier grids providing increased image uniformity. The system was highly robust against ring artifacts that might arise in CT reconstructions as a result of gridline shadows in the projection data. The influence of grids on soft-tissue detectability was evaluated quantitatively in terms of absolute contrast, voxel noise, and contrast-to-noise ratio (CNR) in cone-beam CT reconstructions of 16 cm 'head' and 32 cm 'body' cylindrical phantoms. Imaging performance was investigated qualitatively in observer preference tests based on patient images (pelvis, abdomen, and head-and-neck sites) acquired with and without antiscatter grids. The results suggest that although grids reduce scatter artifacts and improve subject contrast, there is little strong motivation for the use of grids in cone-beam CT in terms of CNR and overall image quality under most circumstances. The results highlight the tradeoffs in contrast and noise imparted by grids, showing improved image quality with grids only under specific conditions of high x-ray scatter (SPR>100%), high imaging dose (D{sub center}>2 cGy), and low spatial resolution (voxel size {>=}1 mm)

  16. Analysis of the effect of cone-beam geometry and test object configuration on the measurement accuracy of a computed tomography scanner used for dimensional measurement

    NASA Astrophysics Data System (ADS)

    Kumar, Jagadeesha; Attridge, Alex; Wood, P. K. C.; Williams, Mark A.

    2011-03-01

    Industrial x-ray computed tomography (CT) scanners are used for non-contact dimensional measurement of small, fragile components and difficult-to-access internal features of castings and mouldings. However, the accuracy and repeatability of measurements are influenced by factors such as cone-beam system geometry, test object configuration, x-ray power, material and size of test object, detector characteristics and data analysis methods. An attempt is made in this work to understand the measurement errors of a CT scanner over the complete scan volume, taking into account only the errors in system geometry and the object configuration within the scanner. A cone-beam simulation model is developed with the radiographic image projection and reconstruction steps. A known amount of errors in geometrical parameters were introduced in the model to understand the effect of geometry of the cone-beam CT system on measurement accuracy for different positions, orientations and sizes of the test object. Simulation analysis shows that the geometrical parameters have a significant influence on the dimensional measurement at specific configurations of the test object. Finally, the importance of system alignment and estimation of correct parameters for accurate CT measurements is outlined based on the analysis.

  17. Empirical cupping correction: A first-order raw data precorrection for cone-beam computed tomography

    SciTech Connect

    Kachelriess, Marc; Sourbelle, Katia; Kalender, Willi A.

    2006-05-15

    We propose an empirical cupping correction (ECC) algorithm to correct for CT cupping artifacts that are induced by nonlinearities in the projection data. The method is raw data based, empirical, and requires neither knowledge of the x-ray spectrum nor of the attenuation coefficients. It aims at linearizing the attenuation data using a precorrection function of polynomial form. The coefficients of the polynomial are determined once using a calibration scan of a homogeneous phantom. Computing the coefficients is done in image domain by fitting a series of basis images to a template image. The template image is obtained directly from the uncorrected phantom image and no assumptions on the phantom size or of its positioning are made. Raw data are precorrected by passing them through the once-determined polynomial. As an example we demonstrate how ECC can be used to perform water precorrection for an in vivo micro-CT scanner (TomoScope 30 s, VAMP GmbH, Erlangen, Germany). For this particular case, practical considerations regarding the definition of the template image are given. ECC strives to remove the cupping artifacts and to obtain well-calibrated CT values. Although ECC is a first-order correction and cannot compete with iterative higher-order beam hardening or scatter correction algorithms, our in vivo mouse images show a significant reduction of bone-induced artifacts as well. A combination of ECC with analytical techniques yielding a hybrid cupping correction method is possible and allows for channel-dependent correction functions.

  18. Four-dimensional volume-of-interest reconstruction for cone-beam computed tomography-guided radiation therapy

    SciTech Connect

    Ahmad, Moiz; Balter, Peter; Pan, Tinsu

    2011-10-15

    Purpose: Data sufficiency are a major problem in four-dimensional cone-beam computed tomography (4D-CBCT) on linear accelerator-integrated scanners for image-guided radiotherapy. Scan times must be in the range of 4-6 min to avoid undersampling artifacts. Various image reconstruction algorithms have been proposed to accommodate undersampled data acquisitions, but these algorithms are computationally expensive, may require long reconstruction times, and may require algorithm parameters to be optimized. The authors present a novel reconstruction method, 4D volume-of-interest (4D-VOI) reconstruction which suppresses undersampling artifacts and resolves lung tumor motion for undersampled 1-min scans. The 4D-VOI reconstruction is much less computationally expensive than other 4D-CBCT algorithms. Methods: The 4D-VOI method uses respiration-correlated projection data to reconstruct a four-dimensional (4D) image inside a VOI containing the moving tumor, and uncorrelated projection data to reconstruct a three-dimensional (3D) image outside the VOI. Anatomical motion is resolved inside the VOI and blurred outside the VOI. The authors acquired a 1-min. scan of an anthropomorphic chest phantom containing a moving water-filled sphere. The authors also used previously acquired 1-min scans for two lung cancer patients who had received CBCT-guided radiation therapy. The same raw data were used to test and compare the 4D-VOI reconstruction with the standard 4D reconstruction and the McKinnon-Bates (MB) reconstruction algorithms. Results: Both the 4D-VOI and the MB reconstructions suppress nearly all the streak artifacts compared with the standard 4D reconstruction, but the 4D-VOI has 3-8 times greater contrast-to-noise ratio than the MB reconstruction. In the dynamic chest phantom study, the 4D-VOI and the standard 4D reconstructions both resolved a moving sphere with an 18 mm displacement. The 4D-VOI reconstruction shows a motion blur of only 3 mm, whereas the MB reconstruction

  19. Evaluation of radiation dose to organs during kilovoltage cone-beam computed tomography using Monte Carlo simulation.

    PubMed

    Son, Kihong; Cho, Seungryong; Kim, Jin Sung; Han, Youngyih; Ju, Sang Gyu; Choi, Doo Ho

    2014-01-01

    Image-guided techniques for radiation therapy have improved the precision of radiation delivery by sparing normal tissues. Cone-beam computed tomography (CBCT) has emerged as a key technique for patient positioning and target localization in radiotherapy. Here, we investigated the imaging radiation dose delivered to radiosensitive organs of a patient during CBCT scan. The 4D extended cardiac-torso (XCAT) phantom and Geant4 Application for Tomographic Emission (GATE) Monte Carlo (MC) simulation tool were used for the study. A computed tomography dose index (CTDI) standard polymethyl methacrylate (PMMA) phantom was used to validate the MC-based dosimetric evaluation. We implemented an MC model of a clinical on-board imager integrated with the Trilogy accelerator. The MC model's accuracy was validated by comparing its weighted CTDI (CTDIw) values with those of previous studies, which revealed good agreement. We calculated the absorbed doses of various human organs at different treatment sites such as the head-and-neck, chest, abdomen, and pelvis regions, in both standard CBCT scan mode (125 kVp, 80 mA, and 25 ms) and low-dose scan mode (125 kVp, 40 mA, and 10 ms). In the former mode, the average absorbed doses of the organs in the head and neck and chest regions ranged 4.09-8.28 cGy, whereas those of the organs in the abdomen and pelvis regions were 4.30-7.48 cGy. In the latter mode, the absorbed doses of the organs in the head and neck and chest regions ranged 1.61-1.89 cGy, whereas those of the organs in the abdomen and pelvis region ranged between 0.79-1.85 cGy. The reduction in the radiation dose in the low-dose mode compared to the standard mode was about 20%, which is in good agreement with previous reports. We opine that the findings of this study would significantly facilitate decisions regarding the administration of extra imaging doses to radiosensitive organs. PMID:24710444

  20. A quality assurance framework for the fully automated and objective evaluation of image quality in cone-beam computed tomography

    SciTech Connect

    Steiding, Christian; Kolditz, Daniel; Kalender, Willi A.

    2014-03-15

    Purpose: Thousands of cone-beam computed tomography (CBCT) scanners for vascular, maxillofacial, neurological, and body imaging are in clinical use today, but there is no consensus on uniform acceptance and constancy testing for image quality (IQ) and dose yet. The authors developed a quality assurance (QA) framework for fully automated and time-efficient performance evaluation of these systems. In addition, the dependence of objective Fourier-based IQ metrics on direction and position in 3D volumes was investigated for CBCT. Methods: The authors designed a dedicated QA phantom 10 cm in length consisting of five compartments, each with a diameter of 10 cm, and an optional extension ring 16 cm in diameter. A homogeneous section of water-equivalent material allows measuring CT value accuracy, image noise and uniformity, and multidimensional global and local noise power spectra (NPS). For the quantitative determination of 3D high-contrast spatial resolution, the modulation transfer function (MTF) of centrally and peripherally positioned aluminum spheres was computed from edge profiles. Additional in-plane and axial resolution patterns were used to assess resolution qualitatively. The characterization of low-contrast detectability as well as CT value linearity and artifact behavior was tested by utilizing sections with soft-tissue-equivalent and metallic inserts. For an automated QA procedure, a phantom detection algorithm was implemented. All tests used in the dedicated QA program were initially verified in simulation studies and experimentally confirmed on a clinical dental CBCT system. Results: The automated IQ evaluation of volume data sets of the dental CBCT system was achieved with the proposed phantom requiring only one scan for the determination of all desired parameters. Typically, less than 5 min were needed for phantom set-up, scanning, and data analysis. Quantitative evaluation of system performance over time by comparison to previous examinations was also

  1. Personalized Assessment of kV Cone Beam Computed Tomography Doses in Image-guided Radiotherapy of Pediatric Cancer Patients

    SciTech Connect

    Zhang Yibao; Yan Yulong; Nath, Ravinder; Bao Shanglian; Deng Jun

    2012-08-01

    Purpose: To develop a quantitative method for the estimation of kV cone beam computed tomography (kVCBCT) doses in pediatric patients undergoing image-guided radiotherapy. Methods and Materials: Forty-two children were retrospectively analyzed in subgroups of different scanned regions: one group in the head-and-neck and the other group in the pelvis. Critical structures in planning CT images were delineated on an Eclipse treatment planning system before being converted into CT phantoms for Monte Carlo simulations. A benchmarked EGS4 Monte Carlo code was used to calculate three-dimensional dose distributions of kVCBCT scans with full-fan high-quality head or half-fan pelvis protocols predefined by the manufacturer. Based on planning CT images and structures exported in DICOM RT format, occipital-frontal circumferences (OFC) were calculated for head-and-neck patients using DICOMan software. Similarly, hip circumferences (HIP) were acquired for the pelvic group. Correlations between mean organ doses and age, weight, OFC, and HIP values were analyzed with SigmaPlot software suite, where regression performances were analyzed with relative dose differences (RDD) and coefficients of determination (R{sup 2}). Results: kVCBCT-contributed mean doses to all critical structures decreased monotonically with studied parameters, with a steeper decrease in the pelvis than in the head. Empirical functions have been developed for a dose estimation of the major organs at risk in the head and pelvis, respectively. If evaluated with physical parameters other than age, a mean RDD of up to 7.9% was observed for all the structures in our population of 42 patients. Conclusions: kVCBCT doses are highly correlated with patient size. According to this study, weight can be used as a primary index for dose assessment in both head and pelvis scans, while OFC and HIP may serve as secondary indices for dose estimation in corresponding regions. With the proposed empirical functions, it is possible

  2. Prospective Study of Cone-Beam Computed Tomography Image-Guided Radiotherapy for Prone Accelerated Partial Breast Irradiation

    SciTech Connect

    Jozsef, Gabor; DeWyngaert, J. Keith; Becker, Stewart J.; Lymberis, Stella; Formenti, Silvia C.

    2011-10-01

    Purpose: To report setup variations during prone accelerated partial breast irradiation (APBI). Methods: New York University (NYU) 07-582 is an institutional review board-approved protocol of cone-beam computed tomography (CBCT) to deliver image-guided ABPI in the prone position. Eligible are postmenopausal women with pT1 breast cancer excised with negative margins and no nodal involvement. A total dose of 30 Gy in five daily fractions of 6 Gy are delivered to the planning target volume (the tumor cavity with 1.5-cm margin) by image-guided radiotherapy. Patients are set up prone, on a dedicated mattress, used for both simulation and treatment. After positioning with skin marks and lasers, CBCTs are performed and the images are registered to the planning CT. The resulting shifts (setup corrections) are recorded in the three principal directions and applied. Portal images are taken for verification. If they differ from the planning digital reconstructed radiographs, the patient is reset, and a new CBCT is taken. Results: 70 consecutive patients have undergone a total of 343 CBCTs: 7 patients had four of five planned CBCTs performed. Seven CBCTs (2%) required to be repeated because of misalignment in the comparison between portal and digital reconstructed radiograph image after the first CBCT. The mean shifts and standard deviations in the anterior-posterior (AP), superior-inferior (SI), and medial-lateral (ML) directions were -0.19 (0.54), -0.02 (0.33), and -0.02 (0.43) cm, respectively. The average root mean squares of the daily shifts were 0.50 (0.28), 0.29 (0.17), and 0.38 (0.20). A conservative margin formula resulted in a recommended margin of 1.26, 0.73, 0.96 cm in the AP, SI, and ML directions. Conclusion: CBCTs confirmed that the NYU prone APBI setup and treatment technique are reproducible, with interfraction variation comparable to those reported for supine setup. The currently applied margin (1.5 cm) adequately compensates for the setup variation detected.

  3. Dosimetric Evaluation Between Megavoltage Cone-Beam Computed Tomography and Body Mass Index for Intracranial, Thoracic, and Pelvic Localization

    SciTech Connect

    VanAntwerp, April E.; Raymond, Sarah M.; Addington, Mark C.; Gajdos, Stephen; Vassil, Andrew; Xia, Ping

    2011-10-01

    The aim of this study was to evaluate radiation dose for organs at risk (OAR) within the cranium, thorax, and pelvis from megavoltage cone-beam computed tomography (MV-CBCT). Using a clinical treatment planning system, CBCT doses were calculated from 60 patient datasets using 27.4 x 27.4 cm{sup 2} field size and 200{sup o} arc length. The body mass indices (BMIs) for these patients range from 17.2-48.4 kg/m{sup 2}. A total of 60 CBCT plans were created and calculated with heterogeneity corrections, with monitor units (MU) that varied from 8, 4, and 2 MU per plan. The isocenters of these plans were placed at defined anatomical structures. The maximum dose, dose to the isocenter, and mean dose to the selected critical organs were analyzed. The study found that maximum and isocenter doses were weakly associated with BMI, but linearly associated with the total MU. Average maximum/isocenter doses in the cranium were 10.0 ({+-} 0.18)/7.0 ({+-} 0.08) cGy, 5.0 ({+-} 0.09)/3.5 ({+-} 0.05) cGy, and 2.5 ({+-} .04)/1.8 ({+-} 0.05) cGy for 8, 4, and 2 MU, respectively. Similar trends but slightly larger maximum/isocenter doses were found in the thoracic and pelvic regions. For the cranial region, the average mean doses with a total of 8 MU to the eye, lens, and brain were 9.7 ({+-} 0.12) cGy, 9.1 ({+-} 0.16) cGy, and 7.2 ({+-} 0.10) cGy, respectively. For the thoracic region, the average mean doses to the lung, heart, and spinal cord were 6.6 ({+-} 0.05) cGy, 6.9 ({+-} 1.2) cGy, and 4.7 ({+-} 0.8) cGy, respectively. For the pelvic region, the average mean dose to the femoral heads was 6.4 ({+-} 1.1) cGy. The MV-CBCT doses were linearly associated with the total MU but weakly dependent on patients' BMIs. Daily MV-CBCT has a cumulative effect on the total body dose and critical organs, which should be carefully considered for clinical impacts.

  4. Volumetric Measurement of Root Resorption following Molar Mini-Screw Implant Intrusion Using Cone Beam Computed Tomography

    PubMed Central

    Li, Wen; Chen, Fei; Zhang, Feng; Ding, Wanghui; Ye, Qingsong; Shi, Jiejun; Fu, Baiping

    2013-01-01

    Objective Molar intrusion by mini-screw implantation can cause different degrees of root resorption. However, most methods (2-D and 3-D) used for evaluating root resorption have focused on the root length without considering 3-D resorption. The purpose of this study was to volumetrically evaluate root resorption using cone beam computed tomography(CBCT) after mini-screw implant intrusion. Materials and Methods 1. The volumes of 32 teeth were measured using CBCT and laser scanning to verify the accuracy of CBCT. 2. Twelve overerupted molars from adult patients were investigated in this study. After mini-screw implants were inserted into the buccal and palatal alveolar bones, 150 g of force was applied to the mini-screw implants on each side to intrude the molars. CBCT images of all patients were taken immediately prior to intrusion and after intrusion. The volumes of the roots were calculated using the Mimics software program. The differences between the pre-intrusion and post-intrusion root volumes were statistically evaluated with a paired-samples t-test. In addition, the losses of the roots were statistically compared with each other using one-way analysis of variance at the P<0.05 level. Results No statistically significant volume differences were observed between the physical (laser scanning) and CBCT measurements (P>0.05). The overerupted molars were significantly intruded (P<0.05), and the average intrusion was 3.30±1.60 mm. The differences between the pre-intrusion and post-intrusion root volumes were statistically significant for all of the roots investigated (P<0.05). The roots were sorted by volume loss in descending order as follows: mesiobuccal, palatal, and distobuccal. Statistical significance was achieved among the three roots. The average total resorption for each tooth was 58.39±1.54 mm3. Conclusion Volume measurement using CBCT was able to effectively evaluate root resorption caused by mini-screw intrusion. The highest volume loss was observed

  5. Patient-Specific Three-Dimensional Concomitant Dose From Cone Beam Computed Tomography Exposure in Image-Guided Radiotherapy

    SciTech Connect

    Spezi, Emiliano; Downes, Patrick; Jarvis, Richard; Radu, Emil; Staffurth, John

    2012-05-01

    Purpose: The purpose of the present study was to quantify the concomitant dose received by patients undergoing cone beam computed tomography (CBCT) scanning in different clinical scenarios as a part of image-guided radiotherapy (IGRT) procedures. Methods and Materials: We calculated the three-dimensional concomitant dose received as a result of CBCT scans in 6 patients representing different clinical scenarios: two pelvis, two head and neck, and two chest. We assessed the effect that a daily on-line IGRT strategy would have on the patient dose distribution, assuming 40 CBCT scans throughout the treatment course. The additional dose to the planning target volume margin region was also estimated. Results: In the pelvis, a single CBCT scan delivered a mean dose to the femoral heads of 2-6 cGy and the rectum of 1-2 cGy. An additional dose to the planning target volume was within 1-3 cGy. In the chest, the mean dose to the planning target volume varied from 2.5 to 5 cGy. The lung and spinal cord planning organ at risk volume received {<=}4 cGy and {<=}5 cGy, respectively. In the head and neck, a single CBCT scan delivered a mean dose of 0.3 cGy, with bony structures receiving 0.5-0.8 cGy. The femoral heads received an additional dose of 1.5-2.5 Gy. A reduction of 20-30% in the mean dose to the organs at risk was achieved using bowtie filtration. In the head and neck, the dose to the eyes and brainstem was eliminated by decreasing the craniocaudal field size. Conclusions: The additional dose from on-line IGRT procedures can be clinically relevant. The organ dose can be significantly reduced with the use of appropriate patient-specific settings. The concomitant dose from CBCT should be accounted for and the acquisition settings optimized for optimal IGRT strategies on a patient basis.

  6. Motion-map constrained image reconstruction (MCIR): Application to four-dimensional cone-beam computed tomography

    SciTech Connect

    Park, Justin C.; Kim, Jin Sung; Park, Sung Ho; Liu, Zhaowei; Song, Bongyong; Song, William Y.

    2013-12-15

    Purpose: Utilization of respiratory correlated four-dimensional cone-beam computed tomography (4DCBCT) has enabled verification of internal target motion and volume immediately prior to treatment. However, with current standard CBCT scan, 4DCBCT poses challenge for reconstruction due to the fact that multiple phase binning leads to insufficient number of projection data to reconstruct and thus cause streaking artifacts. The purpose of this study is to develop a novel 4DCBCT reconstruction algorithm framework called motion-map constrained image reconstruction (MCIR), that allows reconstruction of high quality and high phase resolution 4DCBCT images with no more than the imaging dose as well as projections used in a standard free breathing 3DCBCT (FB-3DCBCT) scan.Methods: The unknown 4DCBCT volume at each phase was mathematically modeled as a combination of FB-3DCBCT and phase-specific update vector which has an associated motion-map matrix. The motion-map matrix, which is the key innovation of the MCIR algorithm, was defined as the matrix that distinguishes voxels that are moving from stationary ones. This 4DCBCT model was then reconstructed with compressed sensing (CS) reconstruction framework such that the voxels with high motion would be aggressively updated by the phase-wise sorted projections and the voxels with less motion would be minimally updated to preserve the FB-3DCBCT. To evaluate the performance of our proposed MCIR algorithm, we evaluated both numerical phantoms and a lung cancer patient. The results were then compared with the (1) clinical FB-3DCBCT reconstructed using the FDK, (2) 4DCBCT reconstructed using the FDK, and (3) 4DCBCT reconstructed using the well-known prior image constrained compressed sensing (PICCS).Results: Examination of the MCIR algorithm showed that high phase-resolved 4DCBCT with sets of up to 20 phases using a typical FB-3DCBCT scan could be reconstructed without compromising the image quality. Moreover, in comparison with

  7. ANATOMO-MORPHOLOGICAL FEUTURES OF THE ROOT CANAL SYSTEM IN GEORGIAN POPULATION - CONE-BEAM COMPUTED TOMOGRAPHY STUDY.

    PubMed

    Beshkenadze, E; Chipashvili, N

    2015-10-01

    Incomplete and superficial knowledge of morphological types and anatomical variations of the root canal system will become the reason leading to the failure of endodontic treatment. cone-beam computed tomography (CBCT) - it is a technologically more sophisticated, interesting, reliable, non-invasive imaging technique with high degree of visualization, considered as a particularly important and useful tool to study complexity and variability of canal system. 2753 teeth of 228 patients have been studied by CT. Ages of the patients varied within 25-55 years. Among them 122 men and 106 women. Maxillary teeth - 1394 and mandibular - 1359, respectively. The aim of our study was investigation and evaluation of: tooth length, number of roots and canals, type of configuration, root canal curvature and degree of curvature in Georgian population. The results of the study revealed interesting data and anatomical characteristics, those replicating the racial signs and differs from the data recorded by the other researchers, became evident. In studying of dental form variations were interested anatomists (description and comparison) anthropologists, biologists, palaeontologists and stomatologists. The field of human dental anatomy has not been completely explored so, the modern human teeth still remain a matter of continual curiosity and research. The knowledge of anatomical characteristics of dental root canals will help clinicians to optimize the algorithm of endodontic treatment. Thus, statistic data are not the universal criterias, however, basing on these indicators anthropometrical data of roots and canals vary according to the geographic zones and nationalities. The study of variations in tooth form has interested anatomists (description and comparison), anthropologists, biologists, palaeontologists and dentists. The field of human dental anatomy has not been completely explored and the dentition of modern man still remains a matter of continual curiosity and research

  8. Priori mask guided image reconstruction (p-MGIR) for ultra-low dose cone-beam computed tomography

    NASA Astrophysics Data System (ADS)

    Park, Justin C.; Zhang, Hao; Chen, Yunmei; Fan, Qiyong; Kahler, Darren L.; Liu, Chihray; Lu, Bo

    2015-11-01

    Recently, the compressed sensing (CS) based iterative reconstruction method has received attention because of its ability to reconstruct cone beam computed tomography (CBCT) images with good quality using sparsely sampled or noisy projections, thus enabling dose reduction. However, some challenges remain. In particular, there is always a tradeoff between image resolution and noise/streak artifact reduction based on the amount of regularization weighting that is applied uniformly across the CBCT volume. The purpose of this study is to develop a novel low-dose CBCT reconstruction algorithm framework called priori mask guided image reconstruction (p-MGIR) that allows reconstruction of high-quality low-dose CBCT images while preserving the image resolution. In p-MGIR, the unknown CBCT volume was mathematically modeled as a combination of two regions: (1) where anatomical structures are complex, and (2) where intensities are relatively uniform. The priori mask, which is the key concept of the p-MGIR algorithm, was defined as the matrix that distinguishes between the two separate CBCT regions where the resolution needs to be preserved and where streak or noise needs to be suppressed. We then alternately updated each part of image by solving two sub-minimization problems iteratively, where one minimization was focused on preserving the edge information of the first part while the other concentrated on the removal of noise/artifacts from the latter part. To evaluate the performance of the p-MGIR algorithm, a numerical head-and-neck phantom, a Catphan 600 physical phantom, and a clinical head-and-neck cancer case were used for analysis. The results were compared with the standard Feldkamp-Davis-Kress as well as conventional CS-based algorithms. Examination of the p-MGIR algorithm showed that high-quality low-dose CBCT images can be reconstructed without compromising the image resolution. For both phantom and the patient cases, the p-MGIR is able to achieve a clinically

  9. Evaluation of the effect of patient dose from cone beam computed tomography on prostate IMRT using Monte Carlo simulation

    SciTech Connect

    Chow, James C. L.; Leung, Michael K. K.; Islam, Mohammad K.; Norrlinger, Bernhard D.; Jaffray, David A.

    2008-01-15

    The aim of this study is to evaluate the impact of the patient dose due to the kilovoltage cone beam computed tomography (kV-CBCT) in a prostate intensity-modulated radiation therapy (IMRT). The dose distributions for the five prostate IMRTs were calculated using the Pinnacle3 treatment planning system. To calculate the patient dose from CBCT, phase-space beams of a CBCT head based on the ELEKTA x-ray volume imaging system were generated using the Monte Carlo BEAMnrc code for 100, 120, 130, and 140 kVp energies. An in-house graphical user interface called DOSCTP (DOSXYZnrc-based) developed using MATLAB was used to calculate the dose distributions due to a 360 deg. photon arc from the CBCT beam with the same patient CT image sets as used in Pinnacle3. The two calculated dose distributions were added together by setting the CBCT doses equal to 1%, 1.5%, 2%, and 2.5% of the prescription dose of the prostate IMRT. The prostate plan and the summed dose distributions were then processed in the CERR platform to determine the dose-volume histograms (DVHs) of the regions of interest. Moreover, dose profiles along the x- and y-axes crossing the isocenter with and without addition of the CBCT dose were determined. It was found that the added doses due to CBCT are most significant at the femur heads. Higher doses were found at the bones for a relatively low energy CBCT beam such as 100 kVp. Apart from the bones, the CBCT dose was observed to be most concentrated on the anterior and posterior side of the patient anatomy. Analysis of the DVHs for the prostate and other critical tissues showed that they vary only slightly with the added CBCT dose at different beam energies. On the other hand, the changes of the DVHs for the femur heads due to the CBCT dose and beam energy were more significant than those of rectal and bladder wall. By analyzing the vertical and horizontal dose profiles crossing the femur heads and isocenter, with and without the CBCT dose equal to 2% of the

  10. Absorbed dose measurements for kV-cone beam computed tomography in image-guided radiation therapy.

    PubMed

    Hioki, Kazunari; Araki, Fujio; Ohno, Takeshi; Nakaguchi, Yuji; Tomiyama, Yuuki

    2014-12-01

    In this study, we develope a novel method to directly evaluate an absorbed dose-to-water for kilovoltage-cone beam computed tomography (kV-CBCT) in image-guided radiation therapy (IGRT). Absorbed doses for the kV-CBCT systems of the Varian On-Board Imager (OBI) and the Elekta X-ray Volumetric Imager (XVI) were measured by a Farmer ionization chamber with a (60)Co calibration factor. The chamber measurements were performed at the center and four peripheral points in body-type (30 cm diameter and 51 cm length) and head-type (16 cm diameter and 33 cm length) cylindrical water phantoms. The measured ionization was converted to the absorbed dose-to-water by using a (60)Co calibration factor and a Monte Carlo (MC)-calculated beam quality conversion factor, kQ, for (60)Co to kV-CBCT. The irradiation for OBI and XVI was performed with pelvis and head modes for the body- and the head-type phantoms, respectively. In addition, the dose distributions in the phantom for both kV-CBCT systems were calculated with MC method and were compared with measured values. The MC-calculated doses were calibrated at the center in the water phantom and compared with measured doses at four peripheral points. The measured absorbed doses at the center in the body-type phantom were 1.96 cGy for OBI and 0.83 cGy for XVI. The peripheral doses were 2.36-2.90 cGy for OBI and 0.83-1.06 cGy for XVI. The doses for XVI were lower up to approximately one-third of those for OBI. Similarly, the measured doses at the center in the head-type phantom were 0.48 cGy for OBI and 0.21 cGy for XVI. The peripheral doses were 0.26-0.66 cGy for OBI and 0.16-0.30 cGy for XVI. The calculated peripheral doses agreed within 3% in the pelvis mode and within 4% in the head mode with measured doses for both kV-CBCT systems. In addition, the absorbed dose determined in this study was approximately 4% lower than that in TG-61 but the absorbed dose by both methods was in agreement within their combined uncertainty. This method

  11. IMRT planning and delivery incorporating daily dose from mega-voltage cone-beam computed tomography imaging

    SciTech Connect

    Miften, Moyed; Gayou, Olivier; Reitz, Bodo; Fuhrer, Russell; Leicher, Brian; Parda, David S.

    2007-10-15

    The technology of online mega-voltage cone-beam (CB) computed tomography (MV-CBCT) imaging is currently used in many institutions to generate a 3D anatomical dataset of a patient in treatment position. It utilizes an accelerator therapy beam, delivered with 200 deg. gantry rotation, and captured by an electronic portal imager to account for organ motion and setup variations. Although the patient dose exposure from a single volumetric MV-CBCT imaging procedure is comparable to that from standard double-exposure orthogonal portal images, daily image localization procedures can result in a significant dose increase to healthy tissue. A technique to incorporate the daily dose, from a MV-CBCT imaging procedure, in the IMRT treatment planning optimization process was developed. A composite IMRT plan incorporating the total dose from the CB was optimized with the objective of ensuring uniform target coverage while sparing the surrounding normal tissue. One head and neck cancer patient and four prostate cancer patients were planned and treated using this technique. Dosimetric results from the prostate IMRT plans optimized with or without CB showed similar target coverage and comparable sparing of bladder and rectum volumes. Average mean doses were higher by 1.6{+-}1.0 Gy for the bladder and comparable for the rectum (-0.3{+-}1.4 Gy). In addition, an average mean dose increase of 1.9{+-}0.8 Gy in the femoral heads and 1.7{+-}0.6 Gy in irradiated tissue was observed. However, the V{sub 65} and V{sub 70} values for bladder and rectum were lower by 2.3{+-}1.5% and 2.4{+-}2.1% indicating better volume sparing at high doses with the optimized plans incorporating CB. For the head and neck case, identical target coverage was achieved, while a comparable sparing of the brain stem, optic chiasm, and optic nerves was observed. The technique of optimized planning incorporating doses from daily online MV-CBCT procedures provides an alternative method for imaging IMRT patients. It

  12. Dental Cone-Beam Scans: Important Anatomic Views for the Contemporary Implant Surgeon.

    PubMed

    Greenstein, Gary; Carpentieri, Joseph R; Cavallaro, John

    2015-01-01

    Intraoral cone-beam computed tomography (CBCT), otherwise known as volume imaging CT scan, provides 3-dimensional images of mandibular and maxillary structures. These images offer highly accurate and valuable diagnostic information to facilitate treatment planning for implant cases. This article serves as a primer on how to read and interpret CBCT cross sectional views. It identifies anatomic structures of interest and discusses their clinical relevance. PMID:26625166

  13. Image-Guided Radiotherapy (IGRT) for Prostate Cancer Comparing kV Imaging of Fiducial Markers With Cone Beam Computed Tomography (CBCT)

    SciTech Connect

    Barney, Brandon M.; Lee, R. Jeffrey; Handrahan, Diana; Welsh, Keith T.; Cook, J. Taylor; Sause, William T.

    2011-05-01

    Purpose: To present our single-institution experience with image-guided radiotherapy comparing fiducial markers and cone-beam computed tomography (CBCT) for daily localization of prostate cancer. Methods and Materials: From April 2007 to October 2008, 36 patients with prostate cancer received intensity-modulated radiotherapy with daily localization by use of implanted fiducials. Orthogonal kilovoltage (kV) portal imaging preceded all 1244 treatments. Cone-beam computed tomography images were also obtained before 286 treatments (23%). Shifts in the anterior-posterior (AP), superior-inferior (SI), and left-right (LR) dimensions were made from kV fiducial imaging. Cone-beam computed tomography shifts based on soft tissues were recorded. Shifts were compared by use of Bland-Altman limits of agreement. Mean and standard deviation of absolute differences were also compared. A difference of 5 mm or less was acceptable. Subsets including start date, body mass index, and prostate size were analyzed. Results: Of 286 treatments, 81 (28%) resulted in a greater than 5.0-mm difference in one or more dimensions. Mean differences in the AP, SI, and LR dimensions were 3.4 {+-} 2.6 mm, 3.1 {+-} 2.7 mm, and 1.3 {+-} 1.6 mm, respectively. Most deviations occurred in the posterior (fiducials, 78%; CBCT, 59%), superior (79%, 61%), and left (57%, 63%) directions. Bland-Altman 95% confidence intervals were -4.0 to 9.3 mm for AP, -9.0 to 5.3 mm for SI, and -4.1 to 3.9 mm for LR. The percentages of shift agreements within {+-}5 mm were 72.4% for AP, 72.7% for SI, and 97.2% for LR. Correlation between imaging techniques was not altered by time, body mass index, or prostate size. Conclusions: Cone-beam computed tomography and kV fiducial imaging are similar; however, more than one-fourth of CBCT and kV shifts differed enough to affect target coverage. This was even more pronounced with smaller margins (3 mm). Fiducial imaging requires less daily physician input, is less time-consuming, and is

  14. [Use of cone-beam computed tomography to detect atypical vertical root fracture occurring at first left mandibular incisor:report of one case].

    PubMed

    Zhang, Ge-chang

    2013-12-01

    The use of cone-beam computed tomography (CBCT) in stomatology was a hot spot in recent years, both to CT researchers and dentists. Vertical root fracture was the fracture occurring in root which didn't spread to the crown. This paper showed how to use CBCT to diagnose a vertical root fracture occurring in incisor correctly. Compared with conventional periapical film, CBCT was more accurate in diagnosing root fracture and had higher clinical application value.Supported by Science and Technology Program of Shandong University (J12LK57). PMID:24469143

  15. Adaptive-Predictive Organ Localization Using Cone-Beam Computed Tomography for Improved Accuracy in External Beam Radiotherapy for Bladder Cancer

    SciTech Connect

    Lalondrelle, Susan; Huddart, Robert; Warren-Oseni, Karole; Hansen, Vibeke Nordmark; McNair, Helen; Thomas, Karen; Dearnaley, David; Horwich, Alan; Khoo, Vincent

    2011-03-01

    Purpose: To examine patterns of bladder wall motion during high-dose hypofractionated bladder radiotherapy and to validate a novel adaptive planning method, A-POLO, to prevent subsequent geographic miss. Methods and Materials: Patterns of individual bladder filling were obtained with repeat computed tomography planning scans at 0, 15, and 30 minutes after voiding. A series of patient-specific plans corresponding to these time-displacement points was created. Pretreatment cone-beam computed tomography was performed before each fraction and assessed retrospectively for adaptive intervention. In fractions that would have required intervention, the most appropriate plan was chosen from the patient's 'library,' and the resulting target coverage was reassessed with repeat cone-beam computed tomography. Results: A large variation in patterns of bladder filling and interfraction displacement was seen. During radiotherapy, predominant translations occurred cranially (maximum 2.5 cm) and anteriorly (maximum 1.75 cm). No apparent explanation was found for this variation using pretreatment patient factors. A need for adaptive planning was demonstrated by 51% of fractions, and 73% of fractions would have been delivered correctly using A-POLO. The adaptive strategy improved target coverage and was able to account for intrafraction motion also. Conclusions: Bladder volume variation will result in geographic miss in a high proportion of delivered bladder radiotherapy treatments. The A-POLO strategy can be used to correct for this and can be implemented from the first fraction of radiotherapy; thus, it is particularly suited to hypofractionated bladder radiotherapy regimens.

  16. Small animal imaging using a flat panel detector-based cone beam computed tomography (FPD-CBCT) imaging system

    NASA Astrophysics Data System (ADS)

    Conover, David L.; Ning, Ruola; Yu, Yong; Lu, Xianghua; Wood, Ronald W.; Reeder, Jay E.; Johnson, Aimee M.

    2005-04-01

    Flat panel detector-based cone beam CT (FPD-CBCT) imaging system prototypes have been constructed based on modified clinical CT scanners (a modified GE 8800 CT system and a modified GE HighSpeed Advantage (HSA) spiral CT system) each with a Varian PaxScan 2520 imager. The functions of the electromechanical and radiographic subsystems of the CT system were controlled through specially made hardware, software and data acquisition modules to perform animal cone beam CT studies. Small animal (mouse) imaging studies were performed to demonstrate the feasibility of an optimized CBCT imaging system to have the capability to perform longitudinal studies to monitor the progression of cancerous tumors or the efficacy of treatments. Radiographic parameters were optimized for fast (~10 second) scans of live mice to produce good reconstructed image quality with dose levels low enough to avoid any detectable radiation treatment to the animals. Specifically, organs in the pelvic region were clearly imaged and contrast studies showed the feasibility to visualize small vasculature and space-filling bladder tumors. In addition, prostate and mammary tumors were monitored in volume growth studies.

  17. Common-mask guided image reconstruction (c-MGIR) for enhanced 4D cone-beam computed tomography

    NASA Astrophysics Data System (ADS)

    Park, Justin C.; Zhang, Hao; Chen, Yunmei; Fan, Qiyong; Li, Jonathan G.; Liu, Chihray; Lu, Bo

    2015-12-01

    Compared to 3D cone beam computed tomography (3D CBCT), the image quality of commercially available four-dimensional (4D) CBCT is severely impaired due to the insufficient amount of projection data available for each phase. Since the traditional Feldkamp-Davis-Kress (FDK)-based algorithm is infeasible for reconstructing high quality 4D CBCT images with limited projections, investigators had developed several compress-sensing (CS) based algorithms to improve image quality. The aim of this study is to develop a novel algorithm which can provide better image quality than the FDK and other CS based algorithms with limited projections. We named this algorithm ‘the common mask guided image reconstruction’ (c-MGIR). In c-MGIR, the unknown CBCT volume is mathematically modeled as a combination of phase-specific motion vectors and phase-independent static vectors. The common-mask matrix, which is the key concept behind the c-MGIR algorithm, separates the common static part across all phase images from the possible moving part in each phase image. The moving part and the static part of the volumes were then alternatively updated by solving two sub-minimization problems iteratively. As the novel mathematical transformation allows the static volume and moving volumes to be updated (during each iteration) with global projections and ‘well’ solved static volume respectively, the algorithm was able to reduce the noise and under-sampling artifact (an issue faced by other algorithms) to the maximum extent. To evaluate the performance of our proposed c-MGIR, we utilized imaging data from both numerical phantoms and a lung cancer patient. The qualities of the images reconstructed with c-MGIR were compared with (1) standard FDK algorithm, (2) conventional total variation (CTV) based algorithm, (3) prior image constrained compressed sensing (PICCS) algorithm, and (4) motion-map constrained image reconstruction (MCIR) algorithm, respectively. To improve the efficiency of the

  18. Accuracy Assessment of Three-dimensional Surface Reconstructions of In vivo Teeth from Cone-beam Computed Tomography

    PubMed Central

    Sang, Yan-Hui; Hu, Hong-Cheng; Lu, Song-He; Wu, Yu-Wei; Li, Wei-Ran; Tang, Zhi-Hui

    2016-01-01

    Background: The accuracy of three-dimensional (3D) reconstructions from cone-beam computed tomography (CBCT) has been particularly important in dentistry, which will affect the effectiveness of diagnosis, treatment plan, and outcome in clinical practice. The aims of this study were to assess the linear, volumetric, and geometric accuracy of 3D reconstructions from CBCT and to investigate the influence of voxel size and CBCT system on the reconstructions results. Methods: Fifty teeth from 18 orthodontic patients were assigned to three groups as NewTom VG 0.15 mm group (NewTom VG; voxel size: 0.15 mm; n = 17), NewTom VG 0.30 mm group (NewTom VG; voxel size: 0.30 mm; n = 16), and VATECH DCTPRO 0.30 mm group (VATECH DCTPRO; voxel size: 0.30 mm; n = 17). The 3D reconstruction models of the teeth were segmented from CBCT data manually using Mimics 18.0 (Materialise Dental, Leuven, Belgium), and the extracted teeth were scanned by 3Shape optical scanner (3Shape A/S, Denmark). Linear and volumetric deviations were separately assessed by comparing the length and volume of the 3D reconstruction model with physical measurement by paired t-test. Geometric deviations were assessed by the root mean square value of the imposed 3D reconstruction and optical models by one-sample t-test. To assess the influence of voxel size and CBCT system on 3D reconstruction, analysis of variance (ANOVA) was used (α = 0.05). Results: The linear, volumetric, and geometric deviations were −0.03 ± 0.48 mm, −5.4 ± 2.8%, and 0.117 ± 0.018 mm for NewTom VG 0.15 mm group; −0.45 ± 0.42 mm, −4.5 ± 3.4%, and 0.116 ± 0.014 mm for NewTom VG 0.30 mm group; and −0.93 ± 0.40 mm, −4.8 ± 5.1%, and 0.194 ± 0.117 mm for VATECH DCTPRO 0.30 mm group, respectively. There were statistically significant differences between groups in terms of linear measurement (P < 0.001), but no significant difference in terms of volumetric measurement (P = 0.774). No statistically significant difference were

  19. Absorbed dose measurements for kV-cone beam computed tomography in image-guided radiation therapy

    NASA Astrophysics Data System (ADS)

    Hioki, Kazunari; Araki, Fujio; Ohno, Takeshi; Nakaguchi, Yuji; Tomiyama, Yuuki

    2014-12-01

    In this study, we develope a novel method to directly evaluate an absorbed dose-to-water for kilovoltage-cone beam computed tomography (kV-CBCT) in image-guided radiation therapy (IGRT). Absorbed doses for the kV-CBCT systems of the Varian On-Board Imager (OBI) and the Elekta X-ray Volumetric Imager (XVI) were measured by a Farmer ionization chamber with a 60Co calibration factor. The chamber measurements were performed at the center and four peripheral points in body-type (30 cm diameter and 51 cm length) and head-type (16 cm diameter and 33 cm length) cylindrical water phantoms. The measured ionization was converted to the absorbed dose-to-water by using a 60Co calibration factor and a Monte Carlo (MC)-calculated beam quality conversion factor, kQ, for 60Co to kV-CBCT. The irradiation for OBI and XVI was performed with pelvis and head modes for the body- and the head-type phantoms, respectively. In addition, the dose distributions in the phantom for both kV-CBCT systems were calculated with MC method and were compared with measured values. The MC-calculated doses were calibrated at the center in the water phantom and compared with measured doses at four peripheral points. The measured absorbed doses at the center in the body-type phantom were 1.96 cGy for OBI and 0.83 cGy for XVI. The peripheral doses were 2.36-2.90 cGy for OBI and 0.83-1.06 cGy for XVI. The doses for XVI were lower up to approximately one-third of those for OBI. Similarly, the measured doses at the center in the head-type phantom were 0.48 cGy for OBI and 0.21 cGy for XVI. The peripheral doses were 0.26-0.66 cGy for OBI and 0.16-0.30 cGy for XVI. The calculated peripheral doses agreed within 3% in the pelvis mode and within 4% in the head mode with measured doses for both kV-CBCT systems. In addition, the absorbed dose determined in this study was approximately 4% lower than that in TG-61 but the absorbed dose by both methods was in agreement within their combined

  20. Comparison of the effects of TripleGates and Gates-Glidden burs on cervical dentin thickness and root canal area by using cone beam computed tomography

    PubMed Central

    SOUSA, Kássio; ANDRADE-JUNIOR, Carlos Vieira; da SILVA, Juliana Melo; DUARTE, Marco Antonio Hungaro; DE-DEUS, Gustavo; da SILVA, Emmanuel João Nogueira Leal

    2015-01-01

    The search for new instruments to promote an appropriate cervical preparation has led to the development of new rotary instruments such as TripleGates. However, to the best of the authors' knowledge, there is no study evaluating TripleGates effect on the “risk zone” of mandibular molars. Objectives : The aim of this study was to evaluate the effects of a crown-down sequence of Gates-Glidden and TripleGates burs on the remaining cervical dentin thickness and the total amount of dentin removed from the root canals during the instrumentation by using cone beam computed tomography. The number of separated instruments was also evaluated. Material and Methods : Mesial roots of 40 mandibular first molars were divided into 2 equal groups: crown-down sequence of Gates-Glidden (#3, #2, #1) and TripleGates burs. Cervical dentin thickness and canal area were measured before and after instrumentation by using cone beam computed tomography and image analysis software. Student’s t-test was used to determine significant differences at p<0.05. Results : No significant differences (p>0.05) were observed between the instruments, regarding the root canal area and dentin wall thickness. Conclusion : Both tested instruments used for cervical preparation were safe to be used in the mesial root canal of mandibular molars. PMID:26018308

  1. Comparative Evaluation of Three Different Obturating Techniques Lateral Compaction, Thermafil and Calamus for Filling Area and Voids Using Cone Beam Computed Tomography: An Invitro study

    PubMed Central

    Dhingra, Anil; Panwar, Nidhi R

    2015-01-01

    Introduction The success of root canal treatment depends upon the proper sealing of root canal system. Improper apical seal leads to the microleakage which can be prevented by proper obturation technique. Aim To compare the quality of three different root canal obturation techniques: lateral compaction, Thermafil and Calamus by using cone beam computed tomography. Materials and Methods A total of 30 central incisors were selected. Biomechanical preparation was done by Reciproc file no 25. Teeth were divided into 3 groups of 10 teeth each according to the obturation technique i.e. Calamus, Thermafil and lateral compaction. Cone beam computed tomography was used to measure filling area and voids at coronal, middle and apical third of the root canal after obturation by different techniques. Data was statistically analysed by One-Way Anova and multiple comparison of Tukey HSD tests. Result The maximum amount of obturating material was observed in Calamus group followed by Thermafil and lateral compaction. Minimum voids were seen in obturation by Calamus technique. Conclusion Within the limitations of this study, it can be concluded that Calamus may be a good obturation technique. PMID:26436038

  2. Cone beam computed tomography evaluation and endodontic management of permanent mandibular second molar with four roots: A rare case report and literature review

    PubMed Central

    Rajasekhara, Subhashini; Sharath Chandra, SM; Parthasarathy, Late Bharath

    2014-01-01

    The morphological variation in the number of roots and root canals, especially in multi-rooted teeth is a constant challenge for diagnosis and successful endodontic therapy. Knowledge of the most common anatomic characteristics and their possible variations is fundamental. Although, endodontic management of four-rooted mandibular first molars have been observed on a few occasions in the literature, to the best of our knowledge four-rooted mandibular second molars having two mesial and two distal roots have not been reported. This paper highlights endodontic management of mandibular second molar with four roots (two mesial and two distal) with one canal in each root and its cone beam computed tomography (CBCT) evaluation which was primarily done for post treatment assessment for diagnosing post-endodontic complications, at the same time confirmed our radiographic diagnosis of this variation. This also helped us portraying the anatomy of this rare variation. PMID:25125856

  3. Central odontogenic fibroma (simple type) in a four-year-old boy: atypical cone-beam computed tomographic appearance with periosteal reaction

    PubMed Central

    Anbiaee, Najme; Sanaei, Alireza

    2015-01-01

    Central odontogenic fibroma (COF) is a rare benign tumor that accounts for 0.1% of all odontogenic tumors. A case of COF (simple type) of the mandible in a four-year-old boy is described in this report. The patient showed asymptomatic swelling in the right inferior border of the lower jaw for one week. A panoramic radiograph showed a poorly-defined destructive unilocular radiolucent area. Cone-beam computed tomography showed expansion and perforation of the adjacent cortical bone plates. A periosteal reaction with the Codman triangle pattern was clearly visible in the buccal cortex. Since the tumor had destroyed a considerable amount of bone, surgical resection was performed. No recurrence was noted. PMID:26125006

  4. Palatal bone thickness measured by palatal index method using cone-beam computed tomography in nonorthodontic patients for placement of mini-implants

    PubMed Central

    Manjula, W. S.; Murali, R. V.; Kumar, S. Kishore; Tajir, Faizal; Mahalakshmi, K.

    2015-01-01

    Introduction: The purpose of this study was to compare the bone thickness of the palatal areas in different palatal index (PI) groups Materials and Methods: Cone-beam computed tomography scans of 10 subjects were selected with ameanage group of 18 years. The measurements of palatal bone thickness were made at 36 sites using CareStream 3D Imaging software. The PIwas measured using Korkhaus ratio (palatal height/palatal width). One-way analysis of variance was used to analyze intergroup differences, as well as the PI difference. Results: Bone thickness was higher in the anterior region than in the middle and posterior regions P <0.001. Furthermore, significant differences were found among the midline, medial, and lateralareas of the palate. Conclusions: These findings might be helpful for clinicians to enhance the successful useof temporary anchorage devices in the palate. PMID:26015685

  5. Comparison of 64-Detector-Multislice and Cone Beam Computed Tomographies in the Evaluation of Linear Measurements in the Alveolar Ridge.

    PubMed

    Pena de Andrade, Juliana Gracinda; Valerio, Claudia Scigliano; de Oliveira Monteiro, Marco Antônio; de Carvalho Machado, Vinícius; Manzi, Flávio Ricardo

    2016-01-01

    This study compared the accuracy of linear measurements of the alveolar ridge in images obtained using 64-detector-multislice computed tomography (CT) and cone beam CT (CBCT). Eight sites were selected corresponding to the regions of molars, premolars, canines, and incisors in six dry human jaws. After the completion of multislice CT and CBCT, the jaws were sectioned into specific regions. Results showed there was no statistically significant difference between the measurements obtained from the CT images and those obtained from dry jaws (actual measurements) for all the evaluated sites (molars, premolars, and anterior teeth). There was also no statistically significant difference between the measurements obtained by the two CT methods. PMID:26929949

  6. Non-invasive endodontic management of fused mandibular second molar and a paramolar, using cone beam computed tomography as an adjunctive diagnostic aid: A case report

    PubMed Central

    Ghogre, Priyanka; Gurav, Sandeep

    2014-01-01

    Tooth fusion is a developmental anomaly characterized by the union between the dentin and/or enamel of at least two separately developing teeth. Fusion is a rare occurrence, with overall prevalence to be approximately 0.5% in deciduous teeth and 0.1% in permanent dentition. The significance of this particular case was that the unilateral fusion occurred in a permanent mandibular second molar with a paramolar and successful endodontic management was done. The rarity with which this entity appears, along with its complex characteristics, often makes it difficult to treat. In this case, a new advanced three-dimensional imaging Cone Beam Computed Tomography (CBCT) was used as an adjunctive diagnostic aid to differentiate between fusion occurred before or after root formation and help to reach the correct diagnosis. PMID:25298654

  7. A unique functional craniofacial suture that may normally never ossify: A cone-beam computed tomography-based report of two cases.

    PubMed

    Poorsattar Bejeh Mir, Karim; Poorsattar Bejeh Mir, Arash; Bejeh Mir, Morvarid Poorsattar; Haghanifar, Sina

    2016-01-01

    The premise of complete ossification of midpalatal suture in early adulthood still has its popularity, though conflicting data are emerging in the literature. A 49-year-old male and a 54-year-old female Iranian patient, both dentulous, were referred to a Maxillofacial Radiology Center to be evaluated for implant insertion. In cone-beam computed tomography (CBCT) evaluation, an in-ossified suture was found in anterior two-third of midpalatal region of both individuals. The application of clinical vignettes from CBCT findings for maxillofacial orthodontic and orthopedic purposes is of value. Existing cases of successful nonsurgical rapid palatal expansion of maxilla in adults could surrogate this dogma about timing for ossification of midpalatal suture which is considered as a purely chronologic-related phenomenon and transmitted masticatory forces may be one possible cause (functional hypothesis). PMID:27134455

  8. Accelerating an Ordered-Subset Low-Dose X-Ray Cone Beam Computed Tomography Image Reconstruction with a Power Factor and Total Variation Minimization

    PubMed Central

    Huang, Hsuan-Ming; Hsiao, Ing-Tsung

    2016-01-01

    In recent years, there has been increased interest in low-dose X-ray cone beam computed tomography (CBCT) in many fields, including dentistry, guided radiotherapy and small animal imaging. Despite reducing the radiation dose, low-dose CBCT has not gained widespread acceptance in routine clinical practice. In addition to performing more evaluation studies, developing a fast and high-quality reconstruction algorithm is required. In this work, we propose an iterative reconstruction method that accelerates ordered-subsets (OS) reconstruction using a power factor. Furthermore, we combine it with the total-variation (TV) minimization method. Both simulation and phantom studies were conducted to evaluate the performance of the proposed method. Results show that the proposed method can accelerate conventional OS methods, greatly increase the convergence speed in early iterations. Moreover, applying the TV minimization to the power acceleration scheme can further improve the image quality while preserving the fast convergence rate. PMID:27073853

  9. Some current legal issues that may affect oral and maxillofacial radiology. Part 2: digital monitors and cone-beam computed tomography.

    PubMed

    Macdonald-Jankowski, David S; Orpe, Elaine C

    2007-01-01

    In this second of 2 papers about technological developments in dental radiology, we discuss the legal impact of using digital monitors and cone-beam computed tomography (CBCT) on dental practice. Although some technical developments such as charge-coupled devices and photostimulatable phosphors are commonly used in the dental profession, some, such as greyscale monitors, are better known in medicine as standards of care for primary diagnosis. This complex subject has been overviewed. The recent emergence of CBCT, which is changing current approaches to imaging for preimplant planning, has provoked a number of legal dilemmas, such as an accompanying responsibility for reading and interpreting large fields of view that include extragnathic areas that are ordinarily outside the dentist"s purview. PMID:17672955

  10. The combination of digital surface scanners and cone beam computed tomography technology for guided implant surgery using 3Shape implant studio software: a case history report.

    PubMed

    Lanis, Alejandro; Álvarez Del Canto, Orlando

    2015-01-01

    The incorporation of virtual engineering into dentistry and the digitization of information are providing new perspectives and innovative alternatives for dental treatment modalities. The use of digital surface scanners with surgical planning software allows for the combination of the radiographic, prosthetic, surgical, and laboratory fields under a common virtual scenario, permitting complete digital treatment planning. In this article, the authors present a clinical case in which a guided implant surgery was performed based on a complete digital surgical plan combining the information from a cone beam computed tomography scan and the virtual simulation obtained from the 3Shape TRIOS intraoral surface scanner. The information was imported to and combined in the 3Shape Implant Studio software for guided implant surgery planning. A surgical guide was obtained by a 3D printer, and the surgical procedure was done using the Biohorizons Guided Surgery Kit and its protocol. PMID:25822304

  11. Cone-Beam Computed Tomography-Guided Management of C-Shaped Type III Dens Invaginatus With Peri-invagination Periodontitis in a Maxillary Canine: A Case Report.

    PubMed

    Mittal, Priya; Jadhav, Ganesh R; Syed, Shibli; Bhujbal, Nikita D

    2016-06-01

    Dens invaginatus (DI) is a developmental anomaly seen infrequently in maxillary canines. This article describes cone-beam computed tomography-guided nonsurgical management of type III (subtype B) DI in a permanent maxillary canine associated with a sinus tract and peri-invagination periodontitis in a 17-year-old female. After gaining access to the root canal, thorough chemo-mechanical preparation was performed and usage of intracanal medicament of calcium hydroxide was prescribed for 3 weeks, during which the sinus tract healed completely. Obturation was completed by a technique of down-packing master-cone gutta-percha, followed by backfilling with thermoplasticized gutta-percha. At 12-months follow-up, the patient was asymptomatic with complete resolution of the sinus tract and radiographic evidence of healing of periapical pathology. PMID:27525733

  12. Retrospective study of root canal configurations of maxillary third molars in Central India population using cone beam computed tomography Part- I

    PubMed Central

    Rawtiya, Manjusha; Somasundaram, Pavithra; Wadhwani, Shefali; Munuga, Swapna; Agarwal, Manish; Sethi, Priyank

    2016-01-01

    Objective: The aim of this study was to investigate the root and canal morphology of maxillary third molars in Central India population using cone-beam computed tomography (CBCT) analysis. Materials and Methods: CBCT images of 116 maxillary third molars were observed, and data regarding the number of roots, the number of canals, and Vertucci's Classification in each root was statistically evaluated. Results: Majority of Maxillary third molars had three roots (55.2%) and three canals (37.9%). Most MB root (43.8%), DB root (87.5%), and palatal root (100%) of maxillary third molars had Vertucci Type I. Mesiobuccal root of three-rooted maxillary third molars had Vertucci Type I (43.8%) and Type IV (40.6%) configuration. Overall prevalence of C-shaped canals in maxillary third molars was 3.4%. Conclusion: There was a high prevalence of three-rooted maxillary molars with three canals. PMID:27011747

  13. Accuracy of Cone-beam Computed Tomography and Periapical Radiography in Endodontically Treated Teeth Evaluation: A Five-Year Retrospective Study

    PubMed Central

    Saidi, Anastasia; Naaman, Alfred; Zogheib, Carla

    2015-01-01

    Background: This study aimed to evaluate the accuracy of two imaging methods in detecting the apical pathology in endodontically treated teeth. Material and Methods: A clinical examination from a sample of 156 teeth of patients treated by students of masters in endodontics at the Care Center of the Faculty of Dentistry at St. Joseph University, Beirut was done after 5 years of follow-up. Periradicular digital radiographs and a cone-beam computed tomography (CBCT)scans were taken and analyzed statistically using both the Exact Fisher tests and McNemar tests. Results: The prevalence of lesions was significantly higher with CBCT (34.8%), whereas for digital radiography (13.8%). The CBCT was revealed more precise to identify periapical lesions. As for the clinical success, the rate was 82.5%. Conclusion: Within the limitations of the present study, CBCT was more reliable in detecting periapical lesions compared with digital periapical radiographs. PMID:25878472

  14. Endodontic and Esthetic Management of a Dilacerated Maxillary Central Incisor Having Two Root Canals Using Cone Beam Computed Tomography as a Diagnostic Aid

    PubMed Central

    Sharma, Sarang; Grover, Shibani; Sharma, Vivek; Srivastava, Dhirendra; Mittal, Meenu

    2014-01-01

    Traumatic injuries to the primary dentition are quite common. When primary teeth are subjected to trauma, force transmission and/or invasion of the underlying tooth germs lying in close proximity can result in a variety of disturbances in the permanent successors. Few of these disturbances include hypoplasia, dilaceration, or alteration in the eruption sequence and pattern. Dilaceration is defined as an angulation or sharp bend or curve in the linear relationship of the crown of a tooth to its root. A rare case of maxillary left central incisor having crown dilaceration and Vertucci's type II canal configuration with symptomatic periapical periodontitis is reported. Cone beam computed tomography was used for better understanding of the anomaly and complicated root canal morphology. The tooth was successfully managed by nonsurgical root canal therapy and restoration with resin composite to restore esthetics. PMID:24955260

  15. Three-dimensional cone-beam computed tomography based comparison of condylar position and morphology according to the vertical skeletal pattern

    PubMed Central

    Park, In-Young; Kim, Ji-Hyun

    2015-01-01

    Objective To compare condylar position and morphology among different vertical skeletal patterns. Methods Diagnostic cone-beam computed tomography images of 60 adult patients (120 temporomandibular joints) who visited the orthodontic clinic of Hallym University Sacred Heart Hospital were reviewed. The subjects were divided into three equal groups according to the mandibular plane angle: hypodivergent, normodivergent, and hyperdivergent groups. Morphology of the condyle and mandibular fossa and condylar position were compared among the groups. Results The hypodivergent and hyperdivergent groups showed significant differences in superior joint spaces, antero-posterior condyle width, medio-lateral condyle width, condyle head angle, and condylar shapes. Conclusions Condylar position and morphology vary according to vertical facial morphology. This relationship should be considered for predicting and establishing a proper treatment plan for temporomandibular diseases during orthodontic treatment. PMID:25798412

  16. Efficient TpV minimization for circular, cone-beam computed tomography reconstruction via non-convex optimization.

    PubMed

    Cai, Ailong; Wang, Linyuan; Yan, Bin; Li, Lei; Zhang, Hanming; Hu, Guoen

    2015-10-01

    An efficient iterative algorithm, based on recent work in non-convex optimization and generalized p-shrinkage mappings, is proposed for volume image reconstruction from circular cone-beam scans. Conventional total variation regularization makes use of L1 norm of gradient magnitude images (GMI). However, this paper utilizes a generalized penalty function, induced by p-shrinkage, of GMI which is proven to be a better measurement of its sparsity. The reconstruction model is formed using generalized total p-variation (TpV) minimization, which differs with the state of the art methods, with the constraint that the estimated projection data is within a specified tolerance of the available data and that the values of the volume image are non-negative. Theoretically, the proximal mapping for penalty functions induced by p-shrinkage has an exact and closed-form expression; thus, the constrained optimization can be stably and efficiently solved by the alternating direction minimization (ADM) scheme. Each sub-problem decoupled by variable splitting is minimized by explicit and easy-to-implement formulas developed by ADM. The proposed algorithm is efficiently implemented using a graphics processing unit and is referred to as "TpV-ADM." This method is robust and accurate even for very few view reconstruction datasets. Verifications and comparisons performed using various datasets (including ideal, noisy, and real projections) illustrate that the proposed method is effective and promising. PMID:26233922

  17. Verification of In-Treatment Tumor Position Using Kilovoltage Cone-Beam Computed Tomography: A Preliminary Study

    SciTech Connect

    Nakagawa, Keiichi Yamashita, Hideomi; Shiraishi, Kenshiro; Igaki, Hiroshi; Terahara, Atsuro; Nakamura, Naoki; Ohtomo, Kuni; Saegusa, Shigeki R.T.T.; Shiraki, Takashi R.T.T.; Oritate, Takashi R.T.T.; Yoda, Kiyoshi

    2007-11-15

    Three-dimensional tumor position during rotational dose delivery was evaluated by acquiring in-treatment kilovoltage (kV) cone-beam CT (CBCT) to ensure treatment quality. The CBCT projection data of a phantom were acquired during rotational megavoltage (MV) dose delivery up to 6 Gy to evaluate image quality under MV beam irradiation. A lung tumor patient was treated with a total dose of 48 Gy in four fractions, each fraction including seven coplanar and noncoplanar beams, as well as a full-angle rotational beam. Tumor registration was performed between a planning CT image and a CBCT image immediately after patient setup. The patient couch was adjusted according to the registration results, and then the registration was repeated three times: immediately before treatment, during treatment, and immediately after treatment. The phantom image quality of the kV CBCT was not visually degraded up to the rotational MV dose of 6 Gy. Tumor position during rotational dose delivery was verified for the first time using kV CBCT.

  18. SU-C-207-05: A Comparative Study of Noise-Reduction Algorithms for Low-Dose Cone-Beam Computed Tomography

    SciTech Connect

    Mukherjee, S; Yao, W

    2015-06-15

    Purpose: To study different noise-reduction algorithms and to improve the image quality of low dose cone beam CT for patient positioning in radiation therapy. Methods: In low-dose cone-beam CT, the reconstructed image is contaminated with excessive quantum noise. In this study, three well-developed noise reduction algorithms namely, a) penalized weighted least square (PWLS) method, b) split-Bregman total variation (TV) method, and c) compressed sensing (CS) method were studied and applied to the images of a computer–simulated “Shepp-Logan” phantom and a physical CATPHAN phantom. Up to 20% additive Gaussian noise was added to the Shepp-Logan phantom. The CATPHAN phantom was scanned by a Varian OBI system with 100 kVp, 4 ms and 20 mA. For comparing the performance of these algorithms, peak signal-to-noise ratio (PSNR) of the denoised images was computed. Results: The algorithms were shown to have the potential in reducing the noise level for low-dose CBCT images. For Shepp-Logan phantom, an improvement of PSNR of 2 dB, 3.1 dB and 4 dB was observed using PWLS, TV and CS respectively, while for CATPHAN, the improvement was 1.2 dB, 1.8 dB and 2.1 dB, respectively. Conclusion: Penalized weighted least square, total variation and compressed sensing methods were studied and compared for reducing the noise on a simulated phantom and a physical phantom scanned by low-dose CBCT. The techniques have shown promising results for noise reduction in terms of PSNR improvement. However, reducing the noise without compromising the smoothness and resolution of the image needs more extensive research.

  19. Diagnostic accuracy of cone beam computed tomography and conventional multislice spiral tomography in sheep mandibular condyle fractures

    PubMed Central

    Sirin, Y; Guven, K; Horasan, S; Sencan, S

    2010-01-01

    Objectives The aim of this study was to compare diagnostic accuracy of cone beam CT (CBCT) and multislice CT in artificially created fractures of the sheep mandibular condyle. Methods 63 full-thickness sheep heads were used in this study. Two surgeons created the fractures, which were either displaced or non-displaced. CBCT images were acquired by the NewTom 3G® CBCT scanner (NIM, Verona, Italy) and CT imaging was performed using the Toshiba Aquillon® multislice CT scanner (Toshiba Medical Systems, Otawara, Japan). Two-dimensional (2D) cross-sectional images and three-dimensional (3D) reconstructions were evaluated by two observers who were asked to determine the presence or absence of fracture and displacement, the type of fracture, anatomical localization and type of displacement. The naked-eye inspection during surgery served as the gold standard. Inter- and intra-observer agreements were calculated with weighted kappa statistics. The receiver operating characteristics (ROC) curve analyses were used to compare statistically the area under the curve (AUC) of both imaging modalities. Results Kappa coefficients of intra- and interobserver agreement scores varied between 0.56 – 0.98, which were classified as moderate and excellent, respectively. There was no statistically significant difference between the imaging modalities, which were both sensitive and specific for the diagnosis of sheep condylar fractures. Conclusions This study confirms that CBCT is similar to CT in the diagnosis of different types of experimentally created sheep condylar fractures and can provide a cost- and dose-effective diagnostic option. PMID:20729182

  20. Lipiodol: A Potential Direct Surrogate for Cone-Beam Computed Tomography Image Guidance in Radiotherapy of Liver Tumor

    SciTech Connect

    Yue Jinbo; Sun Xindong; Cai Jing; Yin Fangfang; Yin Yong; Zhu Jian; Lu Jie; Liu Tonghai; Yu Jinming; Shi Xuetao; Song Jinlong

    2012-02-01

    Purpose: To investigate the feasibility of using lipiodol as a direct surrogate for target localization using cone-beam CT (CBCT) image guidance in radiotherapy (RT) of patients with unresectable liver tumors after transarterial chemoembolization. Methods and Materials: Forty-six patients with an unresectable solitary liver tumor were enrolled for RT using active breathing control (ABC) and CBCT image guidance after transarterial chemoembolization. Each patient had pre- and posttreatment CBCT in the first 10 fractions of treatment. Lipiodol retention was evaluated using daily CBCT scans, and volume of lipiodol retention in the liver was calculated and compared between planning CT and post-RT CT. Influence of lipiodol on dosimetry was evaluated by measuring doses using an ion chamber with and without the presence of lipiodol. Margin analysis was performed on the basis of both inter- and intrafractional target localization errors. Results: Twenty-eight patients successfully completed the study. The shape and size of lipiodol retention did not vary substantially during the course of treatment. The mean Dice similarity coefficient for the lipiodol volume in pretreatment CT and that in posttreatment CT was 0.836 (range, 0.817-0.885). The maximum change (ratio of the lipiodol volume in pretreatment CT to that in posttreatment CT) was 1.045. The mean dose changes with the presence of <10 mL lipiodol were -1.44% and 0.13% for 6 MV and 15 MV, respectively. With ABC and online CBCT image guidance, clinical target volume-planning target volume margins were determined to be 2.5 mm in the mediolateral direction, 2.9 mm in the anteroposterior direction, and 4.0 mm in the craniocaudal direction. Conclusions: Lipiodol could be used as a direct surrogate for CBCT image guidance to improve the localization accuracy for RT of liver tumors. Combination of ABC and CBCT image guidance with lipiodol can potentially reduce the clinical target volume-planning target volume margin.

  1. Assessing the prevalence of paranasal sinuses anatomical variants in patients with sinusitis using Cone Beam Computer Tomography

    PubMed Central

    ROMAN, RALUCA ANCUTA; HEDEŞIU, MIHAELA; GERSAK, MIRELA; FIDAN, FLOAREA; BĂCIUŢ, GRIGORE; BĂCIUŢ, MIHAELA

    2016-01-01

    Background and aims To asses, by using the Cone Beam CT (CBCT) reformatted images, the presence of anatomical variants of the sinonasal cavities and to determine the correlation of these variations with the onset of maxillary sinus inflammations. Method The study is a retrospective one and consists of the investigation of 130 patients with CBCT imaging, patients that were referred to the Maxillo-Facial Clinic, Radiology Department of the Iuliu Hatieganu University of Medicine and Pharmacy in Cluj-Napoca, for clinical symptoms of sinusitis within a period of 24 months. The images were analyzed for the presence of different anatomical variations and sinus inflammation. The CBCT images were obtained using a NewTom 3G scanner and the data acquired were statistically analyzed using Chi-square test, Odds ratio data and confidence intervals, with a determined p<0.05 considered to be statistically significant. Results The anatomical variants were detected both in the inflammation and control group. From the spectrum of variations concha bullosa, deviation of uncinate process and asymmetrical ethmoid roof presented significant association with sinusitis. The deviated position of the uncinate process appeared in more than 50% of patients in the positive group [OR=2.55] compared with a third of the control group. Concha bullosa was observed in 31% cases, 23% in the control group and 34% in the positive group [OR=1.73]. Haller cells showed a small difference between groups [OR=1.14] whereas the ethmoid roof asymmetry was evidently more prevalent in the inflammation group. Conclusion The anatomical variants of the paranasal sinuses are not incidental, being found in a large number of patients and may be a predisposing factor in the onset and recurrence of sinuses inflammation. The CBCT technique, due to the finest multiplanar reconstruction, permits a very good pre-therapeutic assessment of these predisposing conditions.

  2. A comparative study of the effective radiation doses from cone beam computed tomography and plain radiography for sialography

    PubMed Central

    Jadu, F; Yaffe, MJ; Lam, EWN

    2010-01-01

    Objectives As a first step in developing a protocol for multidimensional sialography using cone beam CT (CBCT), the objective of this study was to compare the effective radiation doses from sialography of the parotid and submandibular glands using plain radiography and CBCT. Methods The effective doses were calculated from dose measurements made at 25 selected locations in the head and neck of a radiation analogue dosimeter (RANDO) phantom, using International Commission on Radiological Protection 2007 tissue weighting factors. Results The effective dose (E) changed in relationship to changes in CBCT field of view (FOV), peak kilovoltage (kVp) and milliamperage (mA). Specifically, E decreased from a maximum of 932 μSv (30 cm FOV, 120 kVp, 15 mA) to 60 μSv (15 cm FOV, 80 kVp, 10 mA) for a parotid gland study and to 148 μSv (15 cm FOV, 80 kVp, 10 mA) for a submandibular study. The collective series of plain radiographs made during sialography of the parotid and submandibular glands yielded effective doses of 65 μSv and 156 μSv, respectively. The plain parotid gland series included one panoramic, two anterior–posterior skull and four lateral skull radiographs, whereas the submandibular gland series included one panoramic, one standard mandibular occlusal and four lateral skull radiographs. Conclusion The effective doses from CBCT examinations centred on the parotid and submandibular glands were similar to those calculated for plain radiograph sialography when a 15 cm FOV was chosen in combination with exposure conditions of 80 kVp and 10 mA. PMID:20587648

  3. Image Registration of Cone-Beam Computer Tomography and Preprocedural Computer Tomography Aids in Localization of Adrenal Veins and Decreasing Radiation Dose in Adrenal Vein Sampling

    SciTech Connect

    Busser, Wendy M. H. Arntz, Mark J.; Jenniskens, Sjoerd F. M.; Deinum, Jaap; Hoogeveen, Yvonne L.; Lange, Frank de; Schultze Kool, Leo J.

    2015-08-15

    PurposeWe assessed whether image registration of cone-beam computed tomography (CT) (CBCT) and contrast-enhanced CT (CE-CT) images indicating the locations of the adrenal veins can aid in increasing the success rate of first-attempts adrenal vein sampling (AVS) and therefore decreasing patient radiation dose.Materials and Methods CBCT scans were acquired in the interventional suite (Philips Allura Xper FD20) and rigidly registered to the vertebra in previously acquired CE-CT. Adrenal vein locations were marked on the CT image and superimposed with live fluoroscopy and digital-subtraction angiography (DSA) to guide the AVS. Seventeen first attempts at AVS were performed with image registration and retrospectively compared with 15 first attempts without image registration performed earlier by the same 2 interventional radiologists. First-attempt AVS was considered successful when both adrenal vein samples showed representative cortisol levels. Sampling time, dose-area product (DAP), number of DSA runs, fluoroscopy time, and skin dose were recorded.ResultsWithout image registration, the first attempt at sampling was successful in 8 of 15 procedures indicating a success rate of 53.3 %. This increased to 76.5 % (13 of 17) by adding CBCT and CE-CT image registration to AVS procedures (p = 0.266). DAP values (p = 0.001) and DSA runs (p = 0.026) decreased significantly by adding image registration guidance. Sampling and fluoroscopy times and skin dose showed no significant changes.ConclusionGuidance based on registration of CBCT and previously acquired diagnostic CE-CT can aid in enhancing localization of the adrenal veins thereby increasing the success rate of first-attempt AVS with a significant decrease in the number of used DSA runs and, consequently, radiation dose required.

  4. Comparison of cone beam artifacts reduction: two pass algorithm vs TV-based CS algorithm

    NASA Astrophysics Data System (ADS)

    Choi, Shinkook; Baek, Jongduk

    2015-03-01

    In a cone beam computed tomography (CBCT), the severity of the cone beam artifacts is increased as the cone angle increases. To reduce the cone beam artifacts, several modified FDK algorithms and compressed sensing based iterative algorithms have been proposed. In this paper, we used two pass algorithm and Gradient-Projection-Barzilai-Borwein (GPBB) algorithm to reduce the cone beam artifacts, and compared their performance using structural similarity (SSIM) index. In two pass algorithm, it is assumed that the cone beam artifacts are mainly caused by extreme-density(ED) objects, and therefore the algorithm reproduces the cone beam artifacts(i.e., error image) produced by ED objects, and then subtract it from the original image. GPBB algorithm is a compressed sensing based iterative algorithm which minimizes an energy function for calculating the gradient projection with the step size determined by the Barzilai- Borwein formulation, therefore it can estimate missing data caused by the cone beam artifacts. To evaluate the performance of two algorithms, we used testing objects consisting of 7 ellipsoids separated along the z direction and cone beam artifacts were generated using 30 degree cone angle. Even though the FDK algorithm produced severe cone beam artifacts with a large cone angle, two pass algorithm reduced the cone beam artifacts with small residual errors caused by inaccuracy of ED objects. In contrast, GPBB algorithm completely removed the cone beam artifacts and restored the original shape of the objects.

  5. Assessment of CT numbers in limited and medium field-of-view scans taken using Accuitomo 170 and Veraviewepocs 3De cone-beam computed tomography scanners

    PubMed Central

    Oliveira, Matheus L.; Tosoni, Guilherme M.; Lindsey, David H.; Mendoza, Kristopher; Tetradis, Sotirios

    2014-01-01

    Purpose To assess the influence of anatomic location on the relationship between computed tomography (CT) number and X-ray attenuation in limited and medium field-of-view (FOV) scans. Materials and Methods Tubes containing solutions with different concentrations of K2HPO4 were placed in the tooth sockets of a human head phantom. Cone-beam computed tomography (CBCT) scans were acquired, and CT numbers of the K2HPO4 solutions were measured. The relationship between CT number and K2HPO4 concentration was examined by linear regression analyses. Then, the variation in CT number according to anatomic location was examined. Results The relationship between K2HPO4 concentration and CT number was strongly linear. The slopes of the linear regressions for the limited FOVs were almost 2-fold lower than those for the medium FOVs. The absolute CT number differed between imaging protocols and anatomic locations. Conclusion There is a strong linear relationship between X-ray attenuation and CT number. The specific imaging protocol and anatomic location of the object strongly influence this relationship. PMID:25473635

  6. SU-E-I-05: A Correction Algorithm for Kilovoltage Cone-Beam Computed Tomography Dose Calculations in Cervical Cancer Patients

    SciTech Connect

    Zhang, J; Zhang, W; Lu, J

    2015-06-15

    Purpose: To investigate the accuracy and feasibility of dose calculations using kilovoltage cone beam computed tomography in cervical cancer radiotherapy using a correction algorithm. Methods: The Hounsfield units (HU) and electron density (HU-density) curve was obtained for both planning CT (pCT) and kilovoltage cone beam CT (CBCT) using a CIRS-062 calibration phantom. The pCT and kV-CBCT images have different HU values, and if the HU-density curve of CBCT was directly used to calculate dose in CBCT images may have a deviation on dose distribution. It is necessary to normalize the different HU values between pCT and CBCT. A HU correction algorithm was used for CBCT images (cCBCT). Fifteen intensity-modulated radiation therapy (IMRT) plans of cervical cancer were chosen, and the plans were transferred to the pCT and cCBCT data sets without any changes for dose calculations. Phantom and patient studies were carried out. The dose differences and dose distributions were compared between cCBCT plan and pCT plan. Results: The HU number of CBCT was measured by several times, and the maximum change was less than 2%. To compare with pCT, the CBCT and cCBCT has a discrepancy, the dose differences in CBCT and cCBCT images were 2.48%±0.65% (range: 1.3%∼3.8%) and 0.48%±0.21% (range: 0.1%∼0.82%) for phantom study, respectively. For dose calculation in patient images, the dose differences were 2.25%±0.43% (range: 1.4%∼3.4%) and 0.63%±0.35% (range: 0.13%∼0.97%), respectively. And for the dose distributions, the passing rate of cCBCT was higher than the CBCTs. Conclusion: The CBCT image for dose calculation is feasible in cervical cancer radiotherapy, and the correction algorithm offers acceptable accuracy. It will become a useful tool for adaptive radiation therapy.

  7. Different setup errors assessed by weekly cone-beam computed tomography on different registration in nasopharyngeal carcinoma treated with intensity-modulated radiation therapy

    PubMed Central

    Su, Jiqing; Chen, Wen; Yang, Huiyun; Hong, Jidong; Zhang, Zijian; Yang, Guangzheng; Li, Li; Wei, Rui

    2015-01-01

    The study aimed to investigate the difference of setup errors on different registration in the treatment of nasopharyngeal carcinoma based on weekly cone-beam computed tomography (CBCT). Thirty nasopharyngeal cancer patients scheduled to undergo intensity-modulated radiotherapy (IMRT) were prospectively enrolled in the study. Each patient had a weekly CBCT before radiation therapy. In the entire study, 201 CBCT scans were obtained. The scans were registered to the planning CT to determine the difference of setup errors on different registration sites. Different registration sites were represented by bony landmarks. Nasal septum and pterygoid process represent head, cervical vertebrae 1–3 represent upper neck, and cervical vertebrae 4–6 represent lower neck. Patient positioning errors were recorded in the right–left (RL), superior–inferior (SI), and anterior–posterior (AP) directions over the course of radiotherapy. Planning target volume margins were calculated from the systematic and random errors. In this study, we can make a conclusion that there are setup errors in RL, SI, and AP directions of nasopharyngeal carcinoma patients undergoing IMRT. In addition, the head and neck setup error has the difference, with statistical significance, while patient setup error of neck is greater than that of head during the course of radiotherapy. In our institution, we recommend a planning target volume margin of 3.0 mm in RL direction, 1.3 mm in SI direction, and 2.6 mm in AP direction for nasopharyngeal cancer patients undergoing IMRT with weekly CBCT scans. PMID:26396530

  8. Prevalence of Cervical Enamel Projection and Its Impact on Furcation Involvement in Mandibular Molars: A Cone-Beam Computed Tomography Study in Koreans.

    PubMed

    Lim, Hyun-Chang; Jeon, Seok-Kyun; Cha, Jae-Kook; Lee, Jung-Seok; Choi, Seong-Ho; Jung, Ui-Won

    2016-03-01

    This study evaluated the prevalence of cervical enamel projections (CEPs) in mandibular molars, and analyzed the correlation between CEPs and furcation involvement (FI) based on cone-beam computed tomography (CBCT) data in a Korean population. CBCT images obtained from March 2012 to August 2012 were analyzed. CEPs and FI on the buccal and lingual surface were classified in three-dimensionally reconstructed images and cross-sectional views, and the correlation between these two parameters was analyzed. In total, 982 teeth in 425 patients were analyzed. The overall prevalence rate of CEPs was 76% (71% and 27% on the buccal and lingual surfaces, respectively). Grade I CEPs were the most common, followed by CEPs of grades II and III. There was a statistically significant, but negligible correlation between the CEP grade and the degree of FI on the buccal and lingual surfaces. Within the limitations of this cross-sectional study, a high prevalence of CEPs were found in a Korean population, but the role of CEPs in provoking FI appeared not to be decisive. PMID:26663760

  9. Differences in the mandibular premolar positions in Angle Class I subjects with different vertical facial types: A cone-beam computed tomography study

    PubMed Central

    Duan, Jun; Deng, Feng; Li, Wan-Shan; Li, Xue-Lei; Zheng, Lei-Lei; Li, Gui-Yuan

    2015-01-01

    Objective To compare the positions of the mandibular premolars in Angle Class I subjects according to vertical facial type. The results will provide a theoretical basis for predicting effective tooth movement in orthodontic treatment. Methods Cephalometric parameters were determined using cone-beam computed tomography in 120 Angle Class I subjects. Subjects were categorized as short, normal, and long face types according to the Frankfort mandibular angle. Parameters indicating the position of the mandibular right premolars and the mandible were also measured. Results The angle between the mandibular first premolar axis and buccal cortex, the distance between the root apex and buccal cortex, angle of vestibularization, arc of vestibularization, and root apex maximum movable distance were significantly greater in the short face type than in the long and norm face types. The angle between the mandibular second premolar axis and buccal cortex, the distance from root apex to buccal cortex, and the arc of vestibularization were significantly greater in the short face type than in the normal face type. Conclusions There are significant differences in the mandibular premolar positions in Class I subjects according to vertical facial type. PMID:26258064

  10. Evaluation of upper airways after bimaxillary orthognathic surgery in patients with skeletal Class III pattern using cone-beam computed tomography

    PubMed Central

    Azevêdo, Marília Spínola; Machado, Andre Wilson; Barbosa, Inêssa da Silva; Esteves, Lucas Senhorinho; Rocha, Vanessa Álvares Castro; Bittencourt, Marcos Alan Vieira

    2016-01-01

    Introduction: It has been suggested that mandibular setback surgery, combined or not with maxillary advancement as a treatment alternative for patients with mandibular prognathism, can induce changes in upper airway space (UAS). Therefore, this study aimed to assess the response of the upper airway in the oropharynx region of patients with Class III skeletal pattern that underwent bimaxillary orthognathic surgery (maxillary advancement and mandibular setback) combined with mentoplasty. Material and Methods: The sample comprised 26 cone-beam computed tomography (CBCT) scans of 13 patients. The examination was taken before and after surgery. UAS volume, sagittal area, length and minimal axial area with its width, depth and location, were measured with the aid of Dolphin ImagingTMsoftware version 11.5 Premium. Data were statistically treated by applying Shapiro-Wilk test and Student's paired t-test, considering as statistically significant the results of which p-value was lower than 0.05. Results: No statistically significant differences were found in any measurements evaluated. Conclusions: No significant changes were observed in the oropharynx after bimaxillary orthognathic surgery and mentoplasty. PMID:27007759

  11. Dental image replacement on cone beam computed tomography with three-dimensional optical scanning of a dental cast, occlusal bite, or bite tray impression.

    PubMed

    Kang, S-H; Lee, J-W; Lim, S-H; Kim, Y-H; Kim, M-K

    2014-10-01

    The goal of the present study was to compare the accuracy of dental image replacement on a cone beam computed tomography (CBCT) image using digital image data from three-dimensional (3D) optical scanning of a dental cast, occlusal bite, and bite tray impression. A Bracket Typodont dental model was used. CBCT of the dental model was performed and the data were converted to stereolithography (STL) format. Three experimental materials, a dental cast, occlusal bite, and bite tray impression, were optically scanned in 3D. STL files converted from the CBCT of the Typodont model and the 3D optical-scanned STL files of the study materials were image-registered. The error range of each methodology was measured and compared with a 3D optical scan of the Typodont. For the three materials, the smallest error observed was 0.099±0.114mm (mean error±standard deviation) for registering the 3D optical scan image of the dental cast onto the CBCT dental image. Although producing a dental cast can be laborious, the study results indicate that it is the preferred method. In addition, an occlusal bite is recommended when bite impression materials are used. PMID:25015906

  12. A Rare Case of Type III Dens Invaginatus in a Mandibular Second Premolar and Its Nonsurgical Endodontic Management by Using Cone-beam Computed Tomography: A Case Report.

    PubMed

    Agrawal, Pritesh Kisanlal; Wankhade, Jyoti; Warhadpande, Manjusha

    2016-04-01

    Invaginated teeth present technical difficulties in clinical management because of their abnormal anatomic configuration. Endodontic clinical management of type III dens invaginatus can be greatly enhanced by newer techniques and materials such as cone-beam computed tomography (CBCT), mineral trioxide aggregate, and platelet-rich fibrin. This case report presents a 13-year-old male patient with type III dens invaginatus (DI) in left mandibular second premolar with history of recurrent swelling. Pulp testing revealed no response with the tooth. Dens invaginatus type III with an immature apex and periapical lesion was seen on radiograph. The case was diagnosed as Oehlers type III DI with pulp necrosis and chronic apical abscess. The treatment was planned and performed by using CBCT imaging. CBCT was performed to see the canal anatomy and to know the size of periapical lesion. Root canal treatment was completed in 2 visits. Calcium hydroxide dressing was placed in the first visit. In the second visit MTA was used for apexification in the main canal, and warm vertical compaction technique with gutta-percha was used in the invaginated canal. At the 2-year reevaluation, the patient was asymptomatic, and his tooth had remained functional since the treatment was completed. Radiographic assessment of the tooth showed significant osseous healing of the preoperative lesion. Three-dimensional imaging is a valuable tool for endodontic management of teeth with complex internal anatomy. PMID:26874642

  13. 3D Segmentation of Maxilla in Cone-beam Computed Tomography Imaging Using Base Invariant Wavelet Active Shape Model on Customized Two-manifold Topology

    PubMed Central

    Chang, Yu-Bing; Xia, James J.; Yuan, Peng; Kuo, Tai-Hong; Xiong, Zixiang; Gateno, Jaime; Zhou, Xiaobo

    2013-01-01

    Recent advances in cone-beam computed tomography (CBCT) have rapidly enabled widepsread applications of dentomaxillofacial imaging and orthodontic practices in the past decades due to its low radiation dose, high spatial resolution, and accessibility. However, low contrast resolution in CBCT image has become its major limitation in building skull models. Intensive hand-segmentation is usually required to reconstruct the skull models. One of the regions affected by this limitation the most is the thin bone images. This paper presents a novel segmentation approach based on wavelet density model (WDM) for a particular interest in the outer surface of anterior wall of maxilla. Nineteen CBCT datasets are used to conduct two experiments. This mode-based segmentation approach is validated and compared with three different segmentation approaches. The results show that the performance of this model-based segmentation approach is better than those of the other approaches. It can achieve 0.25 ± 0.2mm of surface error from ground truth of bone surface. PMID:23694914

  14. Analysis of vector models in quantification of artifacts produced by standard prosthetic inlays in Cone-Beam Computed Tomography (CBCT)--a preliminary study.

    PubMed

    Różyło-Kalinowska, Ingrid; Miechowicz, Sławomir; Sarna-Boś, Katarzyna; Borowicz, Janusz; Kalinowski, Paweł

    2014-01-01

    Cone-beam computed tomography (CBCT) is a relatively new, but highly efficient imaging method applied first in dentistry in 1998. However, the quality of the obtained slices depends among other things on artifacts generated by dental restorations as well as orthodontic and prosthetic appliances. The aim of the study was to quantify the artifacts produced by standard prosthetic inlays in CBCT images. The material consisted of 17 standard prosthetic inlays mounted in dental roots embedded in resin. The samples were examined by means of a large field of view CBCT unit, Galileos (Sirona, Germany), at 85 kV and 14 mAs. The analysis was performed using Able 3DDoctor software for data in the CT raster space as well as by means of Materialise Magics software for generated vector models (STL). The masks generated in the raster space included the area of the inlays together with image artifacts. The region of interest (ROI) of the raster space is a set of voxels from a selected range of Hounsfield units (109-3071). Ceramic inlay with zirconium dioxide (Cera Post) as well as epoxy resin inlay including silica fibers enriched with zirconium (Easy Post) produced the most intense artifacts. The smallest image distortions were created by titanium inlays, both passive (Harald Nordin) and active (Flexi Flange). Inlays containing zirconium generated the strongest artifacts, thus leading to the greatest distortions in the CBCT images. Carbon fiber inlay did not considerably affect the image quality. PMID:25404623

  15. Three-dimensional finite element analysis of unilateral mastication in malocclusion cases using cone-beam computed tomography and a motion capture system

    PubMed Central

    2016-01-01

    Purpose Stress distribution and mandible distortion during lateral movements are known to be closely linked to bruxism, dental implant placement, and temporomandibular joint disorder. The present study was performed to determine stress distribution and distortion patterns of the mandible during lateral movements in Class I, II, and III relationships. Methods Five Korean volunteers (one normal, two Class II, and two Class III occlusion cases) were selected. Finite element (FE) modeling was performed using information from cone-beam computed tomographic (CBCT) scans of the subjects’ skulls, scanned images of dental casts, and incisor movement captured by an optical motion-capture system. Results In the Class I and II cases, maximum stress load occurred at the condyle of the balancing side, but, in the Class III cases, the maximum stress was loaded on the condyle of the working side. Maximum distortion was observed on the menton at the midline in every case, regardless of loading force. The distortion was greatest in Class III cases and smallest in Class II cases. Conclusions The stress distribution along and accompanying distortion of a mandible seems to be affected by the anteroposterior position of the mandible. Additionally, 3-D modeling of the craniofacial skeleton using CBCT and an optical laser scanner and reproduction of mandibular movement by way of the optical motion-capture technique used in this study are reliable techniques for investigating the masticatory system. PMID:27127690

  16. Effect of titanium and stainless steel posts in detection of vertical root fractures using NewTom VG cone beam computed tomography system

    PubMed Central

    Mohammadpour, Mahdis; Bakhshalian, Neema; Shahab, Shahriar; Sadeghi, Shaya; Ataee, Mona

    2014-01-01

    Purpose Vertical root fracture (VRF) is a common complication in endodontically treated teeth. Considering the poor prognosis of VRF, a reliable and valid detection method is necessary. Cone beam computed tomography (CBCT) has been reported to be a reliable tool for the detection of VRF; however, the presence of metallic intracanal posts can decrease the diagnostic values of CBCT systems. This study evaluated and compared the effects of intracanal stainless steel or titanium posts on the sensitivity, specificity, and accuracy of VRF detection using a NewTom VG CBCT system. Materials and Methods Eighty extracted single-rooted teeth were selected and sectioned at the cemento-enamel junction. The roots were divided into two groups of 40. Root fracture was induced in the test group by using an Instron machine, while the control group was kept intact. Roots were randomly embedded in acrylic blocks and radiographed with the NewTom VG, both with titanium and stainless steel posts and also without posts. Sensitivity, specificity, and accuracy values were calculated as compared to the gold standard. Results The sensitivity, specificity, and accuracy of VRF diagnosis were significantly lower in teeth with stainless steel and titanium posts than in those without posts. Interobserver agreement was the highest in teeth without posts, followed by stainless steel posts, and then titanium posts. Conclusion Intracanal posts significantly decreased the VRF diagnostic values of CBCT. The stainless steel posts decreased the diagnostic values more than the titanium posts. PMID:24944957

  17. The effect of metal artifacts on the identification of vertical root fractures using different fields of view in cone-beam computed tomography

    PubMed Central

    Moudi, Ehsan; Haghanifar, Sina; Madani, Zahrasadat; Bijani, Ali

    2015-01-01

    Purpose The aim of this study was to investigate the effects of metal artifacts on the accurate diagnosis of root fractures using cone-beam computed tomography (CBCT) images with large and small/limited fields of view (FOVs). Materials and Methods Forty extracted molar and premolar teeth were collected. Access canals were made in all teeth using a rotary system. In half of the teeth, fractures were created by the application of mild pressure with a hammer. The teeth were then randomly put into a wax rim on an acryl base designed in the shape of a mandible. CBCT scans were obtained using a Newtom 5G system with FOVs of 18 cm×16 cm and 6 cm×6 cm. A metal pin was then placed into each tooth, and CBCT imaging was again performed using the same fields of view. All scans were evaluated by two oral and maxillofacial radiologists. The specificity, sensitivity, positive predictive value, negative predictive value, and likelihood ratios (positive and negative) were calculated. Results The maximum levels of sensitivity and specificity (100% and 100%, respectively) were observed in smallvolume CBCT scans of teeth without pins. The highest negative predictive value was found in the small-volume group without pins, whereas the positive predictive value was 100% in all groups except the large-volume group with pins. Conclusion The specificity of CBCT decreased with the presence of a pin in the large-volume group, but not in the small-volume group. PMID:26389056

  18. Cone-beam computed tomography study of the root and canal morphology of mandibular permanent anterior teeth in a Chongqing population

    PubMed Central

    Zhengyan, Yang; Keke, Lu; Fei, Wang; Yueheng, Li; Zhi, Zhou

    2016-01-01

    Objective To investigate the root and canal morphology of permanent mandibular anterior teeth in a Chongqing population using cone-beam computed tomography (CBCT). Methods CBCT images of 1,725 patients in a Chongqing population were selected, and a total of 9,646 mandibular anterior teeth were analyzed. The number of root canals and the canal configurations were investigated. Results In total, 0.3% (11/3,257) of lateral incisors and 0.8% (26/3,014) of canines had double roots, and 3.8% (127/3,375) of central incisors, 10.6% (345/3,257) of lateral incisors, and 4.2% (127/3,014) of canines had multi-root canals. The difference in the incidence of multi-canals in lateral incisors between female and male was statistically significant. The frequency of multi-canals in the different age groups was 5.0% for central incisors for ages 21–30 years, 14.7% for lateral incisors for ages 41–50 years, and 8.1% for canines for ages 41–50 years. Conclusion With the limitations of the current study, we found that a high percentage of mandibular anterior teeth had multiple canals in the studied Chinese Chongqing population. The current data may provide clinicians practicing in Chongqing with a more thorough understanding of root canal morphology. PMID:26730198

  19. Cone-beam computed tomography based evaluation of rotational patterns of dentofacial structures in skeletal Class III deformity with mandibular asymmetry

    PubMed Central

    Ryu, Hyeong-Seok; An, Ki-Yong

    2015-01-01

    Objective The purpose of this study was to assess rotational patterns of dentofacial structures according to different vertical skeletal patterns by cone-beam computed tomography (CBCT) and analyze their influence on menton deviation in skeletal Class III deformity with mandibular asymmetry. Methods The control group consisted of 30 young adults (15 men, 15 women) without any severe skeletal deformity. The asymmetry group included 55 adults (28 men, 27 women) with skeletal Class III deformity and at least 3-mm menton deviation from the midsagittal plane; it was divided into the hyperdivergent and hypodivergent subgroups using a mandibular plane angle cutoff of 35°. Fourteen rotational variables of the dental arches and mandible were measured and compared among the groups. Correlations between menton deviation and the other variables were evaluated. Results The asymmetry group showed significantly larger measurements of roll and yaw in the mandible than the control group. The hypodivergent subgroup showed significant differences in maxillary posterior measurements of yaw (p < 0.01) and maxillary anterior shift (p < 0.05) compared with the hyperdivergent subgroup. All the mandibular measurements had significant correlations with menton deviation (p < 0.01). Most measurements of roll were positively correlated with one another (p < 0.01). Measurements of yaw and roll in the posterior regions were also positively correlated (p < 0.05). Conclusions Menton deviation in skeletal Class III deformity with mandibular asymmetry is influenced by rotation of mandibular posterior dentofacial structures. The rotational patterns vary slightly according to the vertical skeletal pattern. PMID:26258061

  20. A unique case of Turner syndrome accompanying prolactinoma and unexpected elongated styloid process: Clinical and cone-beam computed tomographic features

    PubMed Central

    Tatli, Ufuk; Yazicioglu, Iffet; Evlice, Ahmet; Oztunc, Haluk

    2013-01-01

    Turner syndrome (TS) is one of the most common chromosomal abnormalities, with an estimated frequency among female live births of 1/2,000-3,000. The syndrome is characterized by the partial or complete absence of one X chromosome (45,X karyotype). We reported a unique case of a 40-year-old woman with TS accompanying unexpected elongated styloid process specific to Eagle syndrome (ES) and followed up-prolactinoma. The present article is the first report to define the cone-beam computed tomographic (CBCT) features of TS accompanying ES. Patients with TS carry various risks that make treatment more complicated; thus advanced imaging techniques for proper treatment and follow-up are extremely important. In the light of CBCT examination, craniofacial abnormalities specific to TS and accompanying syndromes such as the crowding of teeth especially in the maxillary anterior region caused by maxillary narrowness, micrognatic maxilla and mandible, relative mandibular retrusion, malocclusion, open-bite, and an elongated styloid process (length of 32.7 mm) on the right side were illustrated in detail. PMID:23807938

  1. A Three-Dimensional Study of Variations in Root Canal Morphology Using Cone-Beam Computed Tomography of Mandibular Premolars in a South Indian Population

    PubMed Central

    Hegde, Mithra N; Tahiliani, Divya; Shetty, Heeresh; Bhat, Ganesh T; Shetty, Shishir

    2014-01-01

    Background: Conventional radiographic techniques being two dimensional, has its restrictions and is confined to limited diagnostic value. However, the incorporation of Cone Beam Computed Tomography (CBCT) gives a three dimensional insight to the tooth morphology and leads to better evaluation and treatment management. Aim: The aim of this study was to evaluate and assess the root canal morphology of mandibular pre-molars in South Indian Population using CBCT radiographic technique. Materials and Methods: One thousand and eighty six and 814 fully erupted mandibular first and second premolars respectively were scanned using CBCT to evaluate the canal morphology according to Vertucci and Gulabiwala’s classification. Results: The most common configuration in mandibular first and second premolars was Vertucci’s Type I(83.81% and 93.48% respectively) followed by Type V (11.97% and 3.5% respectively). Conclusion: South Indian population presented Type IV ertucci’s canal morphology as the most common in mandibular first and second pre-molars followed by Type V. CBCT scanning poses a greater advantage in assessing the complexity of root canal morphology and planning an appropriate endodontic treatment for the same. PMID:25302261

  2. Cone Beam Computed Tomographic Analyses of the Position and Course of the Mandibular Canal: Relevance to the Sagittal Split Ramus Osteotomy

    PubMed Central

    Sekerci, Ahmet Ercan; Sahman, Halil

    2014-01-01

    Purpose. The aim of this study was to document the position and course of the mandibular canal through the region of the mandibular angle and body in dental patients, using cone beam computed tomographic imaging. Methods. The position and course of the mandibular canal from the region of the third molar to the first molar were measured at five specific locations in the same plane: at three different positions just between the first and second molars; between the second and third molars; and just distal to the third molar. Results. The study sample was composed of 500 hemimandibles from 250 dental patients with a mean age of 26.32. Significant differences were found between genders, distances, and positions. B decreased significantly from the anterior positions to the posterior positions in both females and males. The mean values of S and CB increased significantly from the posterior positions to the anterior positions in both females and males. Conclusion. Because the sagittal split ramus osteotomy is a technically difficult procedure, we hope that the findings of the present study will help the surgeon in choosing the safest surgical technique for the treatment of mandibular deformities. PMID:24719896

  3. Availability of Software-Based Correction of Mandibular Plane for the Vertical Measurement of the Mandible in Cone Beam Computed Tomography

    PubMed Central

    Han, Sang-Sun; Lee, Kwang-Min; Kim, Kee-Deog

    2015-01-01

    Objectives. To investigate the availability of correction of mandibular plane using software for vertical measurements in cone beam computed tomography (CBCT) according to the sites of the mandible. Methods. CBCT scans of six dry mandibles were performed at 0-, 5-, 10-, 15-, and 20-degree angles relative to CBCT scanning table. Using the imaging software, mandibular planes of the different angles were corrected to that of 0-degree angle on the CBCT images. Before and after correction of the mandibular planes, the distance from the mandibular canal to the alveolar crest was measured at M1, M2, and M3 areas of the mandible and vertical measurements were statistically compared with those of 0-angle location using the paired t-test. Results. Prior to correction, the vertical measurements increased as the angle increased. The greatest differences of measurements were observed in M3 areas (P < 0.05). After correction, a strong correlation was found in measurements between the 0-degree angle and the other angles in all sites of the mandible (P > 0.05). Conclusions. The vertical measurements of CBCT were significantly influenced by mandibular positioning. When CBCT scans are performed at angles other than 0-degree angle, software-based correction of the mandibular plane can be a reliable tool for the accurate vertical measurements in CBCT. PMID:26579540

  4. Comparison of Cone Beam Computed Tomography, Orthopantomography with Direct Ridge Mapping for Pre-Surgical Planning to Place Implants in Cadaveric Mandibles: An Ex-Vivo Study

    PubMed Central

    Amarnath, G S; Kumar, Ullash; Hilal, Mohammed; Muddugangadhar, B C; Anshuraj, Kopal; Shruthi, C S

    2015-01-01

    Background: Implant treatment is today a common and most widely accepted prosthetic therapy worldwide. The quality and quantity of the bone available at the anticipated implant site is of prime importance. Accurate measurement of alveolar bone and adjacent anatomic structures are of paramount importance in implant insertion. Proper pre-surgical assessment requires precise radiographic visualization of anatomic structures and pathologic conditions. However, the concern for radiation exposure has also grown. Materials and Methods: A total of 15 partially or completely edentulous human cadaveric mandibles were used which were further subdivided into three further groups for cone-beam computed tomography (CBCT), orthopantomography (OPG), and direct measurements (DM). Mandibles were prepared for each sample and subjected to radiographs according to the respective techniques, and radiographic measurements were done using the appropriate software. The cadaveric mandibles were then sectioned, and the actual measurements were done using a digital vernier caliper. Results: Analysis of variance test revealed that there was no significant difference among the three different measurements techniques. Conclusion: A sizable portion of the CBCT measurements with respect to width showed slight overestimation when compared to DMs. There were no statistically significant differences found between CBCT, OPG, and DM when height was taken into consideration. PMID:26225103

  5. Assessment of anterior-posterior jaw relationships in Korean adults using the nasion true vertical plane in cone-beam computed tomography images

    PubMed Central

    Park, Youngju; Cho, Youngserk; Mah, James

    2016-01-01

    Objective The aims of this study were to investigate a simple method for assessing anterior-posterior jaw relationships via cone-beam computed tomography (CBCT) images taken in the natural head position (NHP) relative to the nasion true vertical plane (NTVP), and measure normative data in Korean adults with normal profiles. Methods Subjects were selected from patients presenting for third molar extraction and evaluated as having normal profiles by three examiners. The CBCT images of 80 subjects (39 males, 41 females) were taken in the NHP according to Solow and Tallgren's method. Linear measurements of the A-point, B-point, and Pog were calculated relative to the NTVP. Student's t-test was used to assess sexual differences in these measurements. Results The mean linear measurements of the A-point, B-point, and Pog relative to the NTVP were 0.18 mm (standard deviation [SD], 4.77 mm), −4.00 mm (SD, 6.62 mm), and −2.49 mm (SD, 7.14 mm) respectively in Korean males, and 1.48 mm (SD, 4.21 mm), −4.07 mm (SD, 6.70 mm) and −2.91 mm (SD, 7.25 mm) in Korean females respectively. There were no statistically significant differences between Korean males and females (p < 0.05). Conclusions Three-dimensional CBCT analysis using the NTVP is a simple and reliable method for assessing anterior-posterior skeletal relationships. PMID:27226962

  6. A moving blocker-based strategy for simultaneous megavoltage and kilovoltage scatter correction in cone-beam computed tomography image acquired during volumetric modulated arc therapy

    PubMed Central

    Ouyang, Luo; Lee, Huichen Pam; Wang, Jing

    2015-01-01

    Purpose To evaluate a moving blocker-based approach in estimating and correcting megavoltage (MV) and kilovoltage (kV) scatter contamination in kV cone-beam computed tomography (CBCT) acquired during volumetric modulated arc therapy (VMAT). Methods and materials During the concurrent CBCT/VMAT acquisition, a physical attenuator (i.e., "blocker") consisting of equally spaced lead strips was mounted and moved constantly between the CBCT source and patient. Both kV and MV scatter signals were estimated from the blocked region of the imaging panel, and interpolated into the unblocked region. A scatter corrected CBCT was then reconstructed from the unblocked projections after scatter subtraction using an iterative image reconstruction algorithm based on constraint optimization. Experimental studies were performed on a Catphan® phantom and an anthropomorphic pelvis phantom to demonstrate the feasibility of using a moving blocker for kV-MV scatter correction. Results Scatter induced cupping artifacts were substantially reduced in the moving blocker corrected CBCT images. Quantitatively, the root mean square error of Hounsfield unites (HU) in seven density inserts of the Catphan phantom was reduced from 395 to 40. Conclusions The proposed moving blocker strategy greatly improves the image quality of CBCT acquired with concurrent VMAT by reducing the kV-MV scatter induced HU inaccuracy and cupping artifacts. PMID:26026484

  7. Cone-Beam Computed Tomography Comparison of Canal Transportation after Preparation with BioRaCe and Mtwo Rotary Instruments and Hand K-Flexofiles

    PubMed Central

    Mokhtari, Hadi; Niknami, Mahdi; Sohrabi, Aydin; Habibivand, Ehsan; Mokhtari Zonouzi, Hamid Reza; Rahimi, Saeed; Zand, Vahid

    2014-01-01

    Introduction: The aim of this in vitro study was to evaluate the transportation of mesiobuccal canals of mandibular first molars prepared with either BioRaCe or Mtwo rotary instruments or hand K-Flexofile, by means of cone-beam computed tomography (CBCT). Methods and Materials: Forty-five mandibular molars were selected and randomly divided into three groups (n=15). Mesiobuccal roots of these teeth were prepared by BioRaCe, Mtwo, or hand K-Flexofile. Transportation was measured by pre- and post-operative CBCT images. Two-way ANOVA analysis was applied to detect any differences between the groups followed by the post hoc Tukey’s tests. The level of significance was set at 0.05. Results: The non-parametric Friedman test was used to compare the behavior of each file at 3-, 6- and 9-mm levels. There were no significant differences between different levels in Mtwo group (P=0.15); however, the differences in K-Flexofile and BioRaCe groups were significant (P>0.05). The post hoc Tukey’s test revealed significant differences between BioRaCe and K-Flexofile and also between Mtwo and K-Flexofile, both in the 3-mm depths (P<0.05). Conclusion: Under the limitations of the present study, BioRaCe and Mtwo rotary instruments are considered suitable for canal preparation to greater apical sizes provided that the recommended sequences are observed. PMID:25031590

  8. Cone-Beam Computed Tomography as a Diagnostic Method for Determination of Gingival Thickness and Distance between Gingival Margin and Bone Crest

    PubMed Central

    Borges, Germana Jayme; Ruiz, Luis Fernando Naldi; de Alencar, Ana Helena Gonçalves; Porto, Olavo César Lyra; Estrela, Carlos

    2015-01-01

    The objective of the present study was to assess cone-beam computed tomography (CBCT) as a diagnostic method for determination of gingival thickness (GT) and distance between gingival margin and vestibular (GMBC-V) and interproximal bone crests (GMBC-I). GT and GMBC-V were measured in 348 teeth and GMBC-I was measured in 377 tooth regions of 29 patients with gummy smile. GT was assessed using transgingival probing (TP), ultrasound (US), and CBCT, whereas GMBC-V and GMBC-I were assessed by transsurgical clinical evaluation (TCE) and CBCT. Statistical analyses used independent t-test, Pearson's correlation coefficient, and simple linear regression. Difference was observed for GT: between TP, CBCT, and US considering all teeth; between TP and CBCT and between TP and US in incisors and canines; between TP and US in premolars and first molars. TP presented the highest means for GT. Positive correlation and linear regression were observed between TP and CBCT, TP and US, and CBCT and US. Difference was observed for GMBC-V and GMBC-I using TCE and CBCT, considering all teeth. Correlation and linear regression results were significant for GMBC-V and GMBC-I in incisors, canines, and premolars. CBCT is an effective diagnostic method to visualize and measure GT, GMBC-V, and GMBC-I. PMID:25918737

  9. Volumetric stability of autogenous bone graft with mandibular body bone: cone-beam computed tomography and three-dimensional reconstruction analysis

    PubMed Central

    Lee, Hyeong-Geun

    2015-01-01

    Objectives The purpose of this study was to estimate the volumetric change of augmented autobone harvested from mandibular body cortical bone, using cone-beam computed tomography (CBCT) and three-dimensional reconstruction. In addition, the clinical success of dental implants placed 4 to 6 months after bone grafting was also evaluated. Materials and Methods Ninety-five patients (48 men and 47 women) aged 19 to 72 years were included in this study. A total of 128 graft sites were evaluated. The graft sites were divided into three parts: anterior and both posterior regions of one jaw. All patients included in the study were scheduled for an onlay graft and implantation using a two-stage procedure. The dental implants were inserted 4 to 6 months after the bone graft. Volumetric stability was evaluated by serial CBCT images. Results No major complications were observed for the donor sites. A total of 128 block bones were used to augment severely resorbed alveolar bone. Only 1 of the 128 bone grafts was resorbed by more than half, and that was due to infection. In total, the average amount of residual grafted bone after resorption at the recipient sites was 74.6%±8.4%. Conclusion Volumetric stability of mandibular body autogenous block grafts is predictable. The procedure is satisfactory for patients who want dental implants regardless of atrophic alveolar bone. PMID:26568924

  10. The anterior maxilla as a potential source of bone grafts: a morphometric cone beam computed tomography analysis of different anatomical areas.

    PubMed

    Bernades Mayordomo, R; Guijarro Martínez, R; Hernández Alfaro, F

    2016-08-01

    The aim of this research was to use cone beam computed tomography (CBCT) to analyze the volume, density, and morphology of the bone available in the anterior region of the maxilla, in order to investigate its potential as a source of bone grafts. Three independent zones were evaluated: the palatine process of the maxilla (PPM), anterior nasal spine (ANS), and subnasal bone (SN). The latter was analyzed bilaterally (SNR, SNL). One hundred CBCT scans were evaluated. The morphometric analysis comprised volumetric and subsequent automatic density calculations, as well as linear measurements. Potential correlations among these parameters, including demographic characteristics, were investigated. The study comprised 52 women and 48 men (mean age 49.6±14.5 years). The calculated bone volume averaged 2.41±0.72cm(3) for PPM, 0.46±0.16cm(3) for ANS, 0.58±0.2cm(3) for SNR, and 0.57±0.21cm(3) for SNL. The anterior region of the maxilla can provide a considerable amount of bone volume from different anatomical zones and should be regarded as a potential donor site for the regeneration of maxillary atrophic bones. Further investigation is required before these findings can be applied in the routine clinical setting. PMID:26993106

  11. Initial Report on the Use of In-Office Cone Beam Computed Tomography for Early Diagnosis of Osteomyelitis in Diabetic Patients.

    PubMed

    Shih, Chia-Ding; Bazarov, Irina; Harrington, Tara; Vartivarian, Mher; Reyzelman, Alexander M

    2016-03-01

    Osteomyelitis is one of the most feared sequelae of diabetic foot ulceration, which often leads to lower-extremity amputation and disability. Early diagnosis of osteomyelitis increases the likelihood of successful treatment and may limit the amount of bone resected, preserving ambulatory function. Although a variety of techniques exist for imaging the diabetic foot, standard radiography is still the only in-office imaging modality used today. However, radiographs lack sensitivity and specificity, making it difficult to diagnose bone infection at its early stages. In this report, we describe our initial experience with a cone beam computed tomography (CBCT)-based device, which may serve as an accurate and readily available tool for early diagnosis of osteomyelitis in a patient with diabetes. Two patients with infected diabetic foot ulcers were evaluated for osteomyelitis using radiography and CBCT. Positive imaging findings were confirmed by bone biopsy. In both patients, CBCT captured early osteolytic changes that were not apparent on radiographs, leading to early surgical intervention and successful treatment. The CBCT was helpful in facilitating detection and early clinical intervention for osteomyelitis in two diabetic patients with foot ulcers. These results are encouraging and warrant future evaluation. PMID:27031549

  12. Bone dimensions in the posterior mandible: a retrospective radiographic study using cone beam computed tomography. Part 1--analysis of dentate sites.

    PubMed

    Braut, Vedrana; Bornstein, Michael M; Lauber, Roland; Buser, Daniel

    2012-04-01

    This retrospective radiographic study analyzed the dimensions of the alveolar bone in the posterior dentate mandible based on cone beam computed tomography (CBCT) images. A total of 56 CBCT images met the inclusion criteria, resulting in a sample size of 122 cross sections showing posterior mandibular teeth (premolars and molars). The thickness of the buccal and lingual bone walls was measured at two locations: 4 mm apical to the cementoenamel junction (measurement point 1, MP1) and at the middle of the root (measurement point 2, MP2). Further, alveolar bone width was assessed at the level of the most coronal buccal bone detectable (alveolar bone width 1, BW1) and at the superior border of the mandibular canal (alveolar bone width 2, BW2). The vertical distance between the two as well as the presence of a lingual undercut were also analyzed. There was a steady increase in buccal bone wall thickness from the first premolar to the second molar at both MP1 and MP2. BW1 at the level of the premolars was significantly thinner than that for molars. Alveolar bone height was constant for all teeth examined. For the selection of an appropriate postextraction treatment approach, analysis of the alveolar bone dimensions at the tooth to be extracted by means of CBCT can offer valuable information concerning bone volume and morphology at the future implant site. PMID:22292147

  13. Accuracy of Bolton analysis measured in laser scanned digital models compared with plaster models (gold standard) and cone-beam computer tomography images

    PubMed Central

    Kim, Jooseong

    2016-01-01

    Objective The aim of this study was to compare the accuracy of Bolton analysis obtained from digital models scanned with the Ortho Insight three-dimensional (3D) laser scanner system to those obtained from cone-beam computed tomography (CBCT) images and traditional plaster models. Methods CBCT scans and plaster models were obtained from 50 patients. Plaster models were scanned using the Ortho Insight 3D laser scanner; Bolton ratios were calculated with its software. CBCT scans were imported and analyzed using AVIZO software. Plaster models were measured with a digital caliper. Data were analyzed with descriptive statistics and the intraclass correlation coefficient (ICC). Results Anterior and overall Bolton ratios obtained by the three different modalities exhibited excellent agreement (> 0.970). The mean differences between the scanned digital models and physical models and between the CBCT images and scanned digital models for overall Bolton ratios were 0.41 ± 0.305% and 0.45 ± 0.456%, respectively; for anterior Bolton ratios, 0.59 ± 0.520% and 1.01 ± 0.780%, respectively. ICC results showed that intraexaminer error reliability was generally excellent (> 0.858 for all three diagnostic modalities), with < 1.45% discrepancy in the Bolton analysis. Conclusions Laser scanned digital models are highly accurate compared to physical models and CBCT scans for assessing the spatial relationships of dental arches for orthodontic diagnosis. PMID:26877978

  14. Working Length Determination Using Cone-Beam Computed Tomography, Periapical Radiography and Electronic Apex Locator in Teeth with Apical Periodontitis: A Clinical Study

    PubMed Central

    de Morais, André Luiz Gomide; de Alencar, Ana Helena Gonçalves; Estrela, Cyntia Rodrigues de Araújo; Decurcio, Daniel Almeida; Estrela, Carlos

    2016-01-01

    Introduction: The purpose of this clinical study was to compare the accuracy of working length (WL) determination using cone-beam computed tomography (CBCT), conventional periapical radiographies and electronic apex locator. Methods and Materials: This study was conducted during root canal treatment of 19 patients with a total of 30 single-rooted teeth diagnosed with apical periodontitis. After taking the initial parallel periapical radiographies, the initial file was advanced into the canal until the WL was detected by the apex locator. Subsequently, the WL was measured and WL radiographies were taken with the file set in the canal. Afterwards, CBCT images were acquired. These three measurements were tabulated and compared and the data were analyzed using the Friedman test. The level of significance was set at 0.05. Results: The mean values for WL determination by electronic apex locator, periapical radiograph and CBCT images were 22.25, 22.43 and 22.65, respectively which was not statistically significant (P>0.05). Conclusion: Working length determination using CBCT images was precise when compared to radiographic method and electronic apex locator. PMID:27471524

  15. Prevalence of bony septa, antral pathology, and dimensions of the maxillary sinus from a sinus augmentation perspective: A retrospective cone-beam computed tomography study

    PubMed Central

    Jalali, Elnaz; Al-Salman, Wesam; Jambhekar, Shantanu; Katechia, Bina; Almas, Khalid

    2016-01-01

    Purpose Sinus elevation procedures have become a routine and reliable way to gain bone volume in the edentulous maxilla for dental implant placement. Presence of bony septations and pathology in the maxillary sinus often cause complications leading to graft or implant failure or both. The aim of this study was to retrospectively evaluate the prevalence of pathology, direction of the septa, and sinus width measured at 2 mm, 5 mm, and 10 mm from the sinus floor in maxillary sinuses using cone-beam computed tomography (CBCT). Materials and Methods Seventy-two sinuses from 36 random preoperative CBCT scans referred for implant therapy were retrospectively evaluated for the number, prevalence, and direction of bony septations and presence of pathology. Width of the sinus was also measured at 2 mm, 5 mm, and 10 mm from the sinus floor to account for the amount of bone available for implant placement. Results Maxillary sinus septa were found in 59.7%. Presence of a single septum was noted in 20 sinuses (27.7%), followed by two septa in 17 sinuses. The most common direction of the septum was the transverse direction. Retention pseudocyst and mucosal thickening were the most commonly seen abnormality/pathology. Conclusion Based on the high prevalence of septa and sinus pathology in this sample, a preoperative CBCT scan might be helpful in minimizing complications during sinus augmentation procedures for dental implant therapy. PMID:27358818

  16. Comparison of periapical radiography with cone beam computed tomography in the diagnosis of vertical root fractures in teeth with metallic post

    PubMed Central

    Takeshita, Wilton Mitsunari; Iwaki, Lilian Cristina Vessoni; da Silva, Mariliani Chicarelli; Sabio, Sergio; Albino, Paulo Ricardo Febrairo

    2014-01-01

    Aim: To compare the diagnostic accuracy of conventional periapical radiography and cone beam computed tomography (CBCT) in detecting vertical root fracture (VRF) in tooth with metallic post (MP). Materials and Methods: Twenty endodontically-treated teeth received MPs, artificial fractures were created in 10 teeth, and they were all examined with tomography and radiography. The sample consisted of periapical radiography with post and without post, and tomography with post and without post; each group with five fractured and five non-fractured teeth. The images were evaluated by three dental/maxillofacial radiologists and statistical validations were carried out using receiver operating characteristic (ROC) analysis. Results: Sensitivity and specificity of the area under the ROC (Az) of tomography with post (Az = 0.953) and without post (Az = 0.956) were significantly higher than those of periapical radiography with post (Az = 0.753) and without post (Az = 0.778). Conclusion: CBCT was more accurate than conventional periapical radiography in detecting VRF. PMID:24944444

  17. Characterization of mandibular molar root and canal morphology using cone beam computed tomography and its variability in Belgian and Chilean population samples

    PubMed Central

    Jacobs, Reinhilde; Lambrechts, Paul; Brizuela, Claudia; Cabrera, Carolina; Concha, Guillermo; Pedemonte, María Eugenia

    2015-01-01

    Purpose This study used cone-beam computed tomography (CBCT) to characterize mandibular molar root and canal morphology and its variability in Belgian and Chilean population samples. Materials and Methods We analyzed the CBCT images of 515 mandibular molars (257 from Belgium and 258 from Chile). Molars meeting the inclusion criteria were analyzed to determine (1) the number of roots; (2) the root canal configuration; (3) the presence of a curved canal in the cross-sectional image of the distal root in the mandibular first molar and (4) the presence of a C-shaped canal in the second mandibular molar. A descriptive analysis was performed. The association between national origin and the presence of a curved or C-shaped canal was evaluated using the chi-squared test. Results The most common configurations in the mesial root of both molars were type V and type III. In the distal root, type I canal configuration was the most common. Curvature in the cross-sectional image was found in 25% of the distal canals of the mandibular first molars in the Belgian population, compared to 11% in the Chilean population. The prevalence of C-shaped canals was 10% or less in both populations. Conclusion In cases of unclear or complex root and canal morphology in the mandibular molars, CBCT imaging might assist endodontic specialists in making an accurate diagnosis and in treatment planning. PMID:26125004

  18. Comparative evaluation of soft and hard tissue dimensions in the anterior maxilla using radiovisiography and cone beam computed tomography: A pilot study

    PubMed Central

    Mallikarjun, Savita; Babu, Harsha Mysore; Das, Sreedevi; Neelakanti, Abhilash; Dawra, Charu; Shinde, Sachin Vaijnathrao

    2016-01-01

    Aims: To assess and compare the thickness of gingiva in the anterior maxilla using radiovisiography (RVG) and cone beam computed tomography (CBCT) and its correlation with the thickness of underlying alveolar bone. Settings and Design: This cross-sectional study included 10 male subjects in the age group of 20–45 years. Materials and Methods: After analyzing the width of keratinized gingiva of the maxillary right central incisor, the radiographic assessment was done using a modified technique for RVG and CBCT, to measure the thickness of both the labial gingiva and labial plate of alveolar bone at 4 predetermined locations along the length of the root in each case. Statistical Analysis Used: Statistical analysis was performed using Student's t-test and Pearson's correlation test, with the help of statistical software (SPSS V13). Results: No statistically significant differences were obtained in the measurement made using RVG and CBCT. The results of the present study also failed to reveal any significant correlation between the width of gingiva and the alveolar bone in the maxillary anterior region. Conclusions: Within the limitations of this study, it can be concluded that both CBCT and RVG can be used as valuable tools in the assessment of the soft and hard tissue dimensions. PMID:27143830

  19. Predetermination of root canal lengths in molar teeth: A comparison between radiovisiography and two-dimensional and three-dimensional measurements using cone-beam computed tomography

    PubMed Central

    Dhingra, Annil; Dayal, Charu; Singh, Amteshwar; Bhardwaj, Neetika

    2015-01-01

    Introduction: Obtaining a correct working length is critical to the success of endodontic therapy. The aim of this clinical study was to compare the effect of working length determination using radiovisiography (RVG) and two-dimensional (2D) and three-dimensional (3D) measurements using cone-beam computed tomography (CBCT). Materials and Methods: Thirty mandibular teeth were taken and three groups of 10 each were made. Teeth with previous endodontic treatments, metal restorations, resorptions, incomplete apex formations, and multiple visible foramina were excluded. The root canal length was determined using RVG, CBCT measurement method 2D, and CBCT measurement method 3D. The difference between CBCT measurements, RVG, and the actual canal length were compared to evaluate the accuracy of each method. Results: No significant statistically difference was seen with 3D measurements and actual measurements. Measurements with RVG were better than CBCT 2D. Conclusion: Under experimental conditions, CBCT 3D measurements are accurate than RVG and CBCT 2D in the determination of root canal length. PMID:26752880

  20. Detection of Procedural Errors with Stainless Steel and NiTi Instruments by Undergraduate Students Using Conventional Radiograph and Cone Beam Computed Tomography

    PubMed Central

    Alves, Regis Augusto Aleixo; Souza, João Batista; Gonçalves Alencar, Ana Helena; Pécora, Jesus Djalma; Estrela, Carlos

    2013-01-01

    Introduction This study investigated procedural errors made during root canal preparation using stainless steel and nickel-titanium (NiTi) instruments by undergraduate students, using two diagnostic imaging methods. Materials and Methods Sixty human molars were divided into three groups (n=20; group 1: K-Flexofile, group 2: K3, and group 3: BioRace). The root canals were filled with gutta-percha and AH Plus. Periapical radiographs and cone beam computed tomography (CBCT) images were obtained to detect procedural errors made by undergraduate students during root canal preparation. Two examiners evaluated the presence or absence of fractured instruments, perforations and canal transportations. The agreement between observers was assessed using the kappa coefficient. The Kolmogorov-Smirnov, Fisher exact, ANOVA and Tukey tests were used for statistical analysis. The level of significance was set at 5%. Results There were no significant differences in detecting procedural errors between two- and three-dimensional diagnostic imaging methods. There were no significant differences in procedural errors between stainless steel and NiTi instruments. Mean preparation time was recorded in minutes, and results were significantly different between the three groups. NiTi instruments had the lowest mean preparation time. Conclusion Both periapical radiographs and CBCT identified procedural errors, however, three-dimensional images offered more diagnostic resources. The frequency of procedural errors was low for any of the endodontic instruments despite being used by inexperienced operators. PMID:24171022

  1. Evaluation of Root Canal Configuration of Mandibular First Molars in a Palestinian Population by Using Cone-Beam Computed Tomography: An Ex Vivo Study

    PubMed Central

    Mukhaimer, Raed Hakam

    2014-01-01

    Aim. The purpose of this study was to investigate the number of canals and variations in root canal configuration in the mandibular permanent first molar teeth of a Palestinian population using cone-beam computed tomography (CBCT). Methods. A sample of 320 extracted double-rooted mandibular permanent first molars from Palestinian population was collected for this study and scanned with CBCT scanner. The following observations were made: number of root canals per root and canal configuration in each root based on Vertucci's classification. Results. Of the 320 mandibular first molars analyzed, 174 (54.4%) had three canals, 132 teeth (41.3%) had four canals, and only four teeth had two canals. The most common canal configuration in the mesial roots was Vertucci type IV (53.8%) followed by type II (38.8%). In the distal roots, the most prevalent canal configuration was Vertucci type I (57.5%) followed by type II ( 22.5%) and type III (10.6%). Conclusion. Our results showed that the number of canals and canal configuration in Palestinian population were consistent with previously reported data. The present study also indicates that CBCT is helpful as a diagnostic tool for the investigation of root canal morphology. PMID:27379321

  2. From 2-dimensional cephalograms to 3-dimensional computed tomography scans.

    PubMed

    Halazonetis, Demetrios J

    2005-05-01

    Computed tomography is entering the orthodontic specialty as a mainstream diagnostic modality. Radiation exposure and cost have decreased significantly, and the diagnostic value is very high compared with traditional radiographic options. However, 3-dimensional data present new challenges and need a different approach from traditional viewing of static images to make the most of the available possibilities. Advances in computer hardware and software now enable interactive display of the data on personal computers, with the ability to selectively view soft or hard tissues from any angle. Transfer functions are used to apply transparency and color. Cephalometric measurements can be taken by digitizing points in 3-dimensional coordinates. Application of 3-dimensional data is expected to increase significantly soon and might eventually replace many conventional orthodontic records that are in use today. PMID:15877045

  3. Superior performance of cone beam tomography in detecting a calcaneus fracture

    PubMed Central

    Lohse, Christian; Catala-Lehnen, Philip; Regier, Marc; Heiland, Max

    2015-01-01

    Cone beam computed tomography is a state-of-the-art imaging tool, initially developed for dental and maxillofacial application. With its high resolution and low radiation dose, cone beam tomography has been expanding its application fields, for example, to diagnosis of traumata and fractures in the head and neck area. In this study, we demonstrate superior and satisfactory performance of cone beam tomography for the imaging of a calcaneus fracture in comparison to conventional X-ray and computed tomography. PMID:26605132

  4. Low-dose 2.5 MV cone-beam computed tomography with thick CsI flat-panel imager.

    PubMed

    Tang, Grace; Moussot, Christopher; Morf, Daniel; Seppi, Edward; Amols, Howard

    2016-01-01

    Most of the treatment units, both new and old models, are equipped with a megavoltage portal imager but its use for volumetric imaging is limited. This is mainly due to the poor image quality produced by the high-energy treatment beam (> 6MV). A linac at our center is equipped with a prototype 2.5 MV imaging beam. This study evaluates the feasibility of low-dose megavoltage cone-beam imaging with the 2.5MV beam and a thick cesium iodide detector, which is a high-efficiency imager. Basic imaging properties such as spatial resolution and modulation transfer function were assessed for the 2.5 MV prototype imaging system. For image quality and imaging dose, a series of megavoltage cone-beam scans were acquired for the head, thorax, and pelvis of an anthropomorphic phantom and were compared to kilovoltage cone-beam and 6X megavoltage cone-beam images. To demonstrate the advantage of MV imaging, a phantom with metallic inserts was scanned and the image quality was compared to CT and kilovoltage cone-beam scans. With a lower energy beam and higher detector efficiency, the 2.5 MV imaging system generally yields better image quality than does the 6 MV imaging system with the conventional MV imager. In particular, with the anthropomorphic phantom studies, the contrast to noise of bone to tissue is generally improved in the 2.5 MV images compared to 6 MV. With an image quality sufficient for bony alignment, the imaging dose for 2.5 MV cone-beam images is 2.4-3.4 MU compared to 26 MU in 6 MV cone-beam scans for the head, thorax, and pelvis regions of the phantom. Unlike kilovoltage cone-beam, the 2.5 MV imaging system does not suffer from high-Z image artifacts. This can be very useful for treatment planning in cases where high-Z prostheses are present. PMID:27455493

  5. [Evaluation of absorbed dose from kilovoltage cone-beam computed tomography by radiotherapy planning system: influence on the radiation therapy for prostate cancer].

    PubMed

    Kawamura, Tetsuro; Murakami, Naoki; Okamura, Yoshiaki; Nishimura, Hideki; Miyawaki, Daisuke; Kimura, Kunihiko; Hase, Mamoru; Sasaki, Ryohei

    2013-05-01

    Image-guided radiation therapy (IGRT) is increasingly being used in modern radiation therapy, and it is now possible to verify a patient's position using kilo-voltage cone-beam computed tomography (kV-CBCT). However, if kV-CBCT is used frequently, the dose absorbed by the body cannot be disregarded. A number of studies have been made on the absorbed dose of kV-CBCT, in which absorbed dose measurements were made using a computed tomography dose index (CTDI) or a thermoluminescent dosimeter (TLD). Other methods include comparison of the absorbed dose between a kV-CBCT and other modalities. These techniques are now in common use. However, dose distribution within the patient varies with the patient's size, posture and the part of the body to which radiation therapy is applied. The chief purpose of this study was to evaluate the dose distribution of kV-CBCT by employing a radiotherapy planning system (RTPS); a secondary aim was to examine the influence of a dose of kV-CBCT radiation when used to treat prostate cancer. The beam data of an on-board imager (OBI) was registered in the RTPS, after which modeling was performed. The radiation dosimetry was arranged by the dosimeter in an elliptical phantom. Rotational radiation treatment was used to obtain the dose distribution of the kV-CBCT within the patient, and the patient dose was evaluated based on the simulation of the dose distribution. In radiation therapy for prostate cancer, if kV-CBCT was applied daily, the dose increment within the planning target volume (PTV) and the organ in question was about 1 Gy. PMID:23964528

  6. Usefulness of intra-procedural cone-beam computed tomography in modified balloon-occluded retrograde transvenous obliteration of gastric varices

    PubMed Central

    Lee, Edward Wolfgang; So, Naomi; Chapman, Ryan; McWilliams, Justin P; Loh, Christopher T; Busuttil, Ronald W; Kee, Stephen T

    2016-01-01

    AIM: To evaluate whether intra-procedural cone-beam computed tomography (CBCT) performed during modified balloon-occluded retrograde transvenous obliteration (mBRTO) can accurately determine technical success of complete variceal obliteration. METHODS: From June 2012 to December 2014, 15 patients who received CBCT during mBRTO for treatment of portal hypertensive gastric variceal bleeding were retrospectively evaluated. Three-dimensional (3D) CBCT images were performed and evaluated prior to the end of the procedure, and these were further analyzed and compared to the pre-procedure contrast-enhanced computed tomography to determine the technical success of mBRTO including: Complete occlusion/obliteration of: (1) gastrorenal shunt (GRS); (2) gastric varices; and (3) afferent feeding veins. Post-mBRTO contrast-enhanced CT was used to confirm the accuracy and diagnostic value of CBCT within 2-3 d. RESULTS: Intra-procedural 3D-CBCT images were 100% accurate in determining the technical success of mBRTO in all 15 cases. CBCT demonstrated complete occlusion/obliteration of GRS, gastric varices, collaterals and afferent feeding veins during mBRTO, which was confirmed with post-mBRTO CT. Two patients showed incomplete obliteration of gastric varices and feeding veins on CBCT, which therefore required additional gelfoam injections to complete the procedure. No patient required additional procedures or other interventions during their follow-up period (684 ± 279 d). CONCLUSION: CBCT during mBRTO appears to accurately and immediately determine the technical success of mBRTO. This may improve the technical and clinical success/outcome of mBRTO and reduce additional procedure time in the future. PMID:27158425

  7. Comparative evaluation of a novel smart-seal obturating system and its homogeneity of using cone beam computed tomography: In vitro simulated lateral canal study

    PubMed Central

    Arora, Shashank; Hegde, Vibha

    2014-01-01

    Aim: The aim was to evaluate and compare a novel polyamide polymer based obturating system and Gutta-percha and sealer in filling simulated lateral canals and their homogeneity when used for obturating the root canals. Materials and Methods: A total of 60 freshly extracted human single rooted teeth with fully formed apices were selected for this study. Teeth were de-coronated, and roots were standardized to a working length of 15 mm. Root canal preparation was carried out with rotary Protaper file system in all groups. The specimens were then randomly divided into three groups A, B, and C (n = 20). Ten samples from each group were decalcified and simulated lateral canals were made at 2, 4, and 6 mm from the root apex. Remaining ten samples from each group were maintained calcified. Group A was obturated with SmartSeal system (Prosmart-DRFP Ltd., Stamford, UK). Group B was obturated with sectional backfill method. Group C was obutrated with cold lateral compaction method (control). Decalcified samples from the respective groups were analyzed with digital radiography and photography and the measurement of the linear extension and area of lateral canal filling was done using UTHSCSA (UTHSCSA Image Tool for Windows version 3.0, San Antonio, TX, USA) software. Calcified samples were subjected to cone beam computed tomography image analysis sectioned axially. Results: Group A 92.46 ± 19.45 showed greatest extent of filling in lateral canals and denser homogeneity of oburation, followed by Group B 78.43 ± 26.45 and Group C 52.12 ± 36.67. Conclusions: Polyamide polymer obturation proved to have greater efficiency when compared with Gutta-percha system, when used for obturation with regards to adaptation of the sealer and penetration into the simulated lateral canals. PMID:25125851

  8. Evaluation of Anatomic Variations in Maxillary Sinus with the Aid of Cone Beam Computed Tomography (CBCT) in a Population in South of Iran

    PubMed Central

    Shahidi, Shoaleh; Zamiri, Barbad; Momeni Danaei, Shahla; Salehi, Setareh; Hamedani, Shahram

    2016-01-01

    Statement of the Problem Anatomic variations of the maxillary sinus can be detected in cone-beam computed tomography (CBCT) and may assist to locate the posterior superior alveolar artery (PSAA) and define the maxillary sinus morphology more accurately for a more strict surgical treatment plan. Purpose The study aimed to determine normal variations of the maxillary sinus with the aid of CBCT in a sample population in south of Iran. Materials and Method This cross-sectional prevalence study was based on evaluation of 198 projection data of CBCT scans of some Iranian patients aged 18-45 who referred to a private oral and maxillofacial radiology center in Shiraz from 2011 to 2013. CBCT scans were taken and analyzed with NewTom VGi device and software. The anatomic variations which were evaluated in the axial images included the presence of alveolar pneumatization, anterior pneumatization, exostosis, and hypoplasia. Moreover the location and height of sinus septa, and the location of PSAA were assessed. SPSS software (version 17.0) was used to analyze the data. Results In a total of 396 examined sinuses, maxillary sinus alveolar pneumatization was the most common anatomic variation detected. Anterior pneumatization was detected in 96 sinuses (24.2%). Antral septa were found in 180 sinuses (45.4%) and were mostly located in the anterior region. Meanwhile, PSAA was mostly detected intra-osseous in 242 sinuses (65.7%). Conclusion Anatomic variations of the maxillary sinus were common findings in CBCT of the maxilla. Preoperative imaging with CBCT seems to be very helpful for assessing the location of PSAA and the maxillary sinus morphology, which may be used to adjust the surgical treatment plan to yield more successful treatments. PMID:26966702

  9. Feasibility of patient dose reduction based on various noise suppression filters for cone-beam computed tomography in an image-guided patient positioning system.

    PubMed

    Kamezawa, Hidemi; Arimura, Hidetaka; Shirieda, Katsutoshi; Kameda, Noboru; Ohki, Masafumi

    2016-05-01

    We investigated the feasibility of patient dose reduction based on six noise suppression filters for cone-beam computed tomography (CBCT) in an image-guided patient positioning (IGPP) system. A midpoint dose was employed as a patient dose index. First, a reference dose (RD) and low-dose (LD)-CBCT images were acquired with a reference dose and various low doses. Second, an automated rigid registration was performed for three axis translations to estimate patient setup errors between a planning CT image and the LD-CBCT images processed by six noise suppression filters (averaging filter, median filter, Gaussian filter, edge-preserving smoothing filter, bilateral filter, and adaptive partial median filter (AMF)). Third, residual errors representing the patient positioning accuracy were calculated as Euclidean distances between the setup error vectors estimated using the LD-CBCT and RD-CBCT images. Finally, the residual errors as a function of the patient dose index were estimated for LD-CBCT images processed by six noise suppression filters, and then the patient dose indices for the filtered LD-CBCT images were obtained at the same residual error as the RD-CBCT image. This approach was applied to an anthropomorphic phantom and four cancer patients. The patient dose for the LD-CBCT images was reduced to 19% of that for the RD-CBCT image for the phantom by using AMF, while keeping a same residual error of 0.47 mm as the RD-CBCT image by applying the noise suppression filters to the LD-CBCT images. The average patient dose was reduced to 31.1% for prostate cancer patients, and it was reduced to 82.5% for a lung cancer patient by applying the AMF. These preliminary results suggested that the proposed approach based on noise suppression filters could decrease the patient dose in IGPP systems. PMID:27065312

  10. Quantifying the image quality and dose reduction of respiratory triggered 4D cone-beam computed tomography with patient-measured breathing

    NASA Astrophysics Data System (ADS)

    Cooper, Benjamin J.; O'Brien, Ricky T.; Kipritidis, John; Shieh, Chun-Chien; Keall, Paul J.

    2015-12-01

    Respiratory triggered four dimensional cone-beam computed tomography (RT 4D CBCT) is a novel technique that uses a patient’s respiratory signal to drive the image acquisition with the goal of imaging dose reduction without degrading image quality. This work investigates image quality and dose using patient-measured respiratory signals for RT 4D CBCT simulations. Studies were performed that simulate a 4D CBCT image acquisition using both the novel RT 4D CBCT technique and a conventional 4D CBCT technique. A set containing 111 free breathing lung cancer patient respiratory signal files was used to create 111 pairs of RT 4D CBCT and conventional 4D CBCT image sets from realistic simulations of a 4D CBCT system using a Rando phantom and the digital phantom, XCAT. Each of these image sets were compared to a ground truth dataset from which a mean absolute pixel difference (MAPD) metric was calculated to quantify the degradation of image quality. The number of projections used in each simulation was counted and was assumed as a surrogate for imaging dose. Based on 111 breathing traces, when comparing RT 4D CBCT with conventional 4D CBCT, the average image quality was reduced by 7.6% (Rando study) and 11.1% (XCAT study). However, the average imaging dose reduction was 53% based on needing fewer projections (617 on average) than conventional 4D CBCT (1320 projections). The simulation studies have demonstrated that the RT 4D CBCT method can potentially offer a 53% saving in imaging dose on average compared to conventional 4D CBCT in simulation studies using a wide range of patient-measured breathing traces with a minimal impact on image quality.

  11. Accuracy of Cone Beam Computed Tomography, Photostimulable Phosphor Plate Digital Radiography and Conventional Radiography for Detection of Artificial Cancellous Bone Defects

    PubMed Central

    Bardal, Roghieh; Jahanihashemi, Hassan; Mostafavi, Maryam; Kalhor, Esmaeil; Tofangchiha, Maryam; Dehghani, Mahdieh

    2015-01-01

    Objectives: The optimal goal of radiography is to provide high-quality diagnostic images with the least patient radiation dose. The aim of this study was to evaluate the accuracy of cone-beam computed tomography (CBCT) and intraoral photostimulable phosphor plate (PSP) digital and film-based conventional radiography for detection of artificial cancellous bone defects. Materials and Methods: Five dry human mandibles were used in this study. The mandibles were placed inside a water bath made of plexiglass plates; then PSP and CBCT scans were obtained. The mandibles were cut by a coping saw in buccolingual dimension and oval defects measuring 6.1×6.1 mm, 3×6.1 mm and 4×4 mm were created by a milling machine in the spongy bone. After fixing the two parts together (buccal and lingual), radiographs were repeated. Presence or absence of defects on images was evaluated and recorded by the two observers. Using SPSS 16, compatibility level, sensitivity, specificity and receiver operating curve (ROC) analysis were determined for each observer. Results: The intraobserver agreement in all three imaging modalities was low to moderate (kappa≤0.613). The inter-observer agreement in all the three imaging modalities was moderate (kappa=0.406). The area under the curve (AUC) of the imaging modalities in each observation was not significantly different. The area under the curve based on defect size for the two observers was not significantly different either. Conclusion: Defects confined to spongy bone can be identified on film and PSP radiographs and CBCT scans. However, interpretation of PSP images and CBCT scans needs greater expertise and skills. PMID:27507990

  12. The Effects of Septal Deviation, Concha Bullosa, and Their Combination on the Depth of Posterior Palatal Arch in Cone-Beam Computed Tomography

    PubMed Central

    Dalili Kajan, Zahra; Khademi, Jalil; Nemati, Somayeh; Niksolat, Elmira

    2016-01-01

    Statement of the Problem Nasal breathing is the major pattern of air intake. Changes in breathing pattern alter the posture of the head, jaws and tongue that could change pressure on the jaw and teeth and affect their growth. Purpose This study aimed to investigate the relationship between septal deviations (SD) per se and in combination with concha bullosa (CB) on maxilla; particularly the depth of palatal arch. Materials and Method This descriptive-comparative study was performed on 116 cone-beam computed tomography (CBCT) images. The images were categorized into four groups (n=29) as follows; group 1: SD+CB, group 2: only SD, group 3: neither SD nor CB, and group 4: only CB. In coronal images, deviated septal length (DSL), angle of deviated septal curve (DSCA), palatal arch depth (PAD), palatal interalveolar length (PIL), PAD/PIL ratio, septal vertical length (SVL), maxillopalatal arch angle (MPAA), interjugum distance (IJD), and jugum angle (JA) were measured. The data were statistically analyzed with Tukey's HSD and Chi-square tests. Results There were statistically significant differences in DSL and DSCA (p= 0.0001) among the four groups. The study groups were not statistically different regarding the IJD, JA, MPAA, PAD/PIL, PAD, PIL, and SVL. However, in group 1, PAD/PIL were significantly correlated with DSCA and DSL (p= 0.037, and p= 0.043, respectively). Conclusion Based on the findings of this study, simultaneous occurrence of SD and CB influenced the depth and curve of the palatal bone. The PAD/PIL ratio was negatively correlated with the DSCA angle. This correlation was associated with a decrease in PAD, indicating that concurrent occurrence of SD and CB remarkably affected the palatal base of maxilla. PMID:26966705

  13. Comparison of interradicular distances and cortical bone thickness in Thai patients with Class I and Class II skeletal patterns using cone-beam computed tomography

    PubMed Central

    Khumsarn, Nattida; Patanaporn, Virush; Jotikasthira, Dhirawat

    2016-01-01

    Purpose This study evaluated and compared interradicular distances and cortical bone thickness in Thai patients with Class I and Class II skeletal patterns, using cone-beam computed tomography (CBCT). Materials and Methods Pretreatment CBCT images of 24 Thai orthodontic patients with Class I and Class II skeletal patterns were included in the study. Three measurements were chosen for investigation: the mesiodistal distance between the roots, the width of the buccolingual alveolar process, and buccal cortical bone thickness. All distances were recorded at five different levels from the cementoenamel junction (CEJ). Descriptive statistical analysis and t-tests were performed, with the significance level for all tests set at p<0.05. Results Patients with a Class II skeletal pattern showed significantly greater maxillary mesiodistal distances (between the first and second premolars) and widths of the buccolingual alveolar process (between the first and second molars) than Class I skeletal pattern patients at 10 mm above the CEJ. The maxillary buccal cortical bone thicknesses between the second premolar and first molar at 8 mm above the CEJ in Class II patients were likewise significantly greater than in Class I patients. Patients with a Class I skeletal pattern showed significantly wider mandibular buccolingual alveolar processes than did Class II patients (between the first and second molars) at 4, 6, and 8 mm below the CEJ. Conclusion In both the maxilla and mandible, the mesiodistal distances, the width of the buccolingual alveolar process, and buccal cortical bone thickness tended to increase from the CEJ to the apex in both Class I and Class II skeletal patterns. PMID:27358819

  14. A Pilot Evaluation of a 4-Dimensional Cone-Beam Computed Tomographic Scheme Based on Simultaneous Motion Estimation and Image Reconstruction

    SciTech Connect

    Dang, Jun; Gu, Xuejun; Pan, Tinsu; Wang, Jing

    2015-02-01

    Purpose: To evaluate the performance of a 4-dimensional (4-D) cone-beam computed tomographic (CBCT) reconstruction scheme based on simultaneous motion estimation and image reconstruction (SMEIR) through patient studies. Methods and Materials: The SMEIR algorithm contains 2 alternating steps: (1) motion-compensated CBCT reconstruction using projections from all phases to reconstruct a reference phase 4D-CBCT by explicitly considering the motion models between each different phase and (2) estimation of motion models directly from projections by matching the measured projections to the forward projection of the deformed reference phase 4D-CBCT. Four lung cancer patients were scanned for 4 to 6 minutes to obtain approximately 2000 projections for each patient. To evaluate the performance of the SMEIR algorithm on a conventional 1-minute CBCT scan, the number of projections at each phase was reduced by a factor of 5, 8, or 10 for each patient. Then, 4D-CBCTs were reconstructed from the down-sampled projections using Feldkamp-Davis-Kress, total variation (TV) minimization, prior image constrained compressive sensing (PICCS), and SMEIR. Using the 4D-CBCT reconstructed from the fully sampled projections as a reference, the relative error (RE) of reconstructed images, root mean square error (RMSE), and maximum error (MaxE) of estimated tumor positions were analyzed to quantify the performance of the SMEIR algorithm. Results: The SMEIR algorithm can achieve results consistent with the reference 4D-CBCT reconstructed with many more projections per phase. With an average of 30 to 40 projections per phase, the MaxE in tumor position detection is less than 1 mm in SMEIR for all 4 patients. Conclusion: The results from a limited number of patients show that SMEIR is a promising tool for high-quality 4D-CBCT reconstruction and tumor motion modeling.

  15. Management of a Previously Treated, Calcified, and Dilacerated Maxillary Lateral Incisor: A Combined Nonsurgical/Surgical Approach Assisted by Cone-beam Computed Tomography.

    PubMed

    Dudeja, Pooja Gupta; Dudeja, Krishan Kumar; Garg, Arvind; Srivastava, Dhirendra; Grover, Shibani

    2016-06-01

    Teeth with calcified canals, dilacerated roots, and associated large periradicular lesions involving both cortical plates pose a challenge to dentists. In addition to the nonsurgical endodontic treatment, such teeth may require surgical intervention with concomitant use of bone grafting materials and barrier techniques. These techniques, when combined with the use of a host modulating agent such as platelet-rich fibrin (PRF), may improve the chances of success. A 26-year-old woman was referred for dental treatment with a recurrence of an intraoral sinus tract 2 months after periradicular surgery in the upper anterior region. Clinical and radiographic examinations revealed a calcified and perforated maxillary left lateral incisor with a severely dilacerated root as well as an associated large radiolucent lesion surrounding the roots of the maxillary left central and lateral incisors. A cone-beam computed tomographic scan of the anterior maxilla showed erosion of the labial and palatal cortical plates in the same region. A calcified canal in the lateral incisor was negotiated up to the straight line portion of the canal. Periradicular surgery with root-end resection was performed, and root-end filling was performed with mineral trioxide aggregate. The perforation present on the middle third of the labial surface of the root was repaired with mineral trioxide aggregate, and the canal was cleaned, shaped, and obturated. A PRF scaffold was prepared and used with a collagen membrane and a freeze-dried bone allograft. Follow-up visits after 3 months, 6 months, and 1 year revealed satisfactory clinical and radiographic healing. The combined use of nonsurgical and surgical modes of treatment cannot be overemphasized in this case. The use of PRF along with a bone graft and a barrier membrane may have enhanced the speed of healing and the resolution of periradicular radiolucency by enhancing bone regeneration. PMID:27140443

  16. Verification of Planning Target Volume Settings in Volumetric Modulated Arc Therapy for Stereotactic Body Radiation Therapy by Using In-Treatment 4-Dimensional Cone Beam Computed Tomography

    SciTech Connect

    Takahashi, Wataru; Yamashita, Hideomi; Kida, Satoshi; Masutani, Yoshitaka; Sakumi, Akira; Ohtomo, Kuni; Nakagawa, Keiichi; Haga, Akihiro

    2013-07-01

    Purpose: To evaluate setup error and tumor motion during beam delivery by using 4-dimensional cone beam computed tomography (4D CBCT) and to assess the adequacy of the planning target volume (PTV) margin for lung cancer patients undergoing volumetric modulated arc therapy for stereotactic body radiation therapy (VMAT-SBRT). Methods and Materials: Fifteen lung cancer patients treated by single-arc VMAT-SBRT were selected in this analysis. All patients were treated with an abdominal compressor. The gross tumor volumes were contoured on maximum inspiration and maximum expiration CT datasets from 4D CT respiratory sorting and merged into internal target volumes (ITVs). The PTV margin was isotropically taken as 5 mm. Registration was automatically performed using “pre-3D” CBCT. Treatment was performed with a D95 prescription of 50 Gy delivered in 4 fractions. The 4D tumor locations during beam delivery were determined using in-treatment 4D CBCT images acquired in each fraction. Then, the discrepancy between the actual tumor location and the ITV was evaluated in the lateral, vertical, and longitudinal directions. Results: Overall, 55 4D CBCT sets during VMAT-SBRT were successfully obtained. The amplitude of tumor motion was less than 10 mm in all directions. The average displacements between ITV and actual tumor location during treatment were 0.41 ± 0.93 mm, 0.15 ± 0.58 mm, and 0.60 ± 0.99 mm for the craniocaudal, left-right, and anteroposterior directions, respectively. The discrepancy in each phase did not exceed 5 mm in any direction. Conclusions: With in-treatment 4D CBCT, we confirmed the required PTV margins when the registration for moving target was performed using pre-3D CBCT. In-treatment 4D CBCT is a direct method for quantitatively assessing the intrafractional location of a moving target.

  17. Interfractional and intrafractional errors assessed by daily cone-beam computed tomography in nasopharyngeal carcinoma treated with intensity-modulated radiation therapy: a prospective study

    PubMed Central

    Lu, Heming; Lin, Hui; Feng, Guosheng; Chen, Jiaxin; Shu, Liuyang; Pang, Qiang; Cheng, Jinjian; Peng, Luxing; Wu, Danling; Liao, Chaolong; Mo, Ying

    2012-01-01

    This prospective study was to assess interfractional and intrafractional errors and to estimate appropriate margins for planning target volume (PTV) by using daily cone-beam computed tomography (CBCT) guidance in nasopharyngeal carcinoma (NPC). Daily pretreatment and post-treatment CBCT scans were acquired separately after initial patient setup and after the completion of each treatment fraction in 10 patients treated with IMRT. Online corrections were made before treatment if any translational setup error was found. Interfractional and intrafractional errors were recorded in the right–left (RL), superior–inferior (SI) and anterior–posterior (AP) directions. For the translational shifts, interfractional errors >2 mm occurred in 21.7% of measurements in the RL direction, 12.7% in the SI direction and 34.1% in the AP direction, respectively. Online correction resulted in 100% of residual errors ≤2 mm in the RL and SI directions, and 95.5% of residual errors ≤2 mm in the AP direction. No residual errors >3 mm occurred in the three directions. For the rotational shifts, a significant reduction was found in the magnitudes of residual errors compared with those of interfractional errors. A margin of 4.9 mm, 4.0 mm and 6.3 mm was required in the RL, SI and AP directions, respectively, when daily CBCT scans were not performed. With daily CBCT, the margins were reduced to 1.2 mm in all directions. In conclusion, daily CBCT guidance is an effective modality to improve the accuracy of IMRT for NPC. The online correction could result in a 70–81% reduction in margin size. PMID:22843373

  18. Feasibility of patient dose reduction based on various noise suppression filters for cone-beam computed tomography in an image-guided patient positioning system

    NASA Astrophysics Data System (ADS)

    Kamezawa, Hidemi; Arimura, Hidetaka; Shirieda, Katsutoshi; Kameda, Noboru; Ohki, Masafumi

    2016-05-01

    We investigated the feasibility of patient dose reduction based on six noise suppression filters for cone-beam computed tomography (CBCT) in an image-guided patient positioning (IGPP) system. A midpoint dose was employed as a patient dose index. First, a reference dose (RD) and low-dose (LD)-CBCT images were acquired with a reference dose and various low doses. Second, an automated rigid registration was performed for three axis translations to estimate patient setup errors between a planning CT image and the LD-CBCT images processed by six noise suppression filters (averaging filter, median filter, Gaussian filter, edge-preserving smoothing filter, bilateral filter, and adaptive partial median filter (AMF)). Third, residual errors representing the patient positioning accuracy were calculated as Euclidean distances between the setup error vectors estimated using the LD-CBCT and RD-CBCT images. Finally, the residual errors as a function of the patient dose index were estimated for LD-CBCT images processed by six noise suppression filters, and then the patient dose indices for the filtered LD-CBCT images were obtained at the same residual error as the RD-CBCT image. This approach was applied to an anthropomorphic phantom and four cancer patients. The patient dose for the LD-CBCT images was reduced to 19% of that for the RD-CBCT image for the phantom by using AMF, while keeping a same residual error of 0.47 mm as the RD-CBCT image by applying the noise suppression filters to the LD-CBCT images. The average patient dose was reduced to 31.1% for prostate cancer patients, and it was reduced to 82.5% for a lung cancer patient by applying the AMF. These preliminary results suggested that the proposed approach based on noise suppression filters could decrease the patient dose in IGPP systems.

  19. An assessment of interfractional bladder, rectum and vagina motion in postoperative cervical cancer based on daily cone-beam computed tomography

    PubMed Central

    WANG, XIN; YU, MIN; WANG, JIN; ZHONG, RENMING; SHEN, YALI; ZHAO, YAQIN; LI, ZHIPING; BAI, SEN; XU, FENG

    2016-01-01

    Interfractional variations of the bladder, rectum and vagina may affect the accuracy of postoperative intensity-modulated radiotherapy in patients with cervical cancer. This study aimed to assess the interfractional variations with daily kV cone-beam computed tomography (CBCT). All the patients were instructed to control the filling status of the bladder and rectum. CBCT images were obtained daily after set-up and the bladder, rectum and vagina were contoured on each CBCT scan. All the contours were transferred to the planning CT following image fusion. Interfractional variations in pelvic organs were assessed with CBCT based on two reference lines, which were identified as A (the midsaggital line across the superior border of pubic symphysis) and B (a parallel line 1.5 cm above line A). The mean volume (range) of the bladder and rectum was 156.5 (1.7–626.5) and 48.2 (11.3–139.7) ml, respectively. The uniform planning target volume (PTV) margin of 10 mm failed to encompass the vagina in 17.3 and 18.1% of the fractions on lines A and B, respectively. The motion of the vagina (standard deviation) was 0.3 (0.3) and 0.1 (0.5) cm on lines A and B, respectively. The anteroposterior dimension and position of the vagina were significantly affected by the filling status of the bladder (P<0.05), but not by that of the rectum. Although instructions were given, the interfractional variations of the vagina and other pelvic organs were significant, which may exceed the uniform PTV margin; therefore, more effective methods to decrease these variations should be investigated. PMID:26893874

  20. Utilization of Cone-Beam Computed Tomographic Angiography in Planning for Gamma Knife Radiosurgery of Arteriovenous Malformations: A Case Series and Early Report

    PubMed Central

    Safain, Mina G.; Rahal, Jason P.; Raval, Ami; Rivard, Mark J.; Mignano, John; Wu, Julian; Malek, Adel M.

    2014-01-01

    Background The effectiveness of Gamma Knife radiosurgery (GKR) for cerebral arteriovenous malformations (AVM) is predicated on inclusion of the entire nidus while excluding normal tissue. As such, GKR may be limited by the resolution and accuracy of the imaging modality used in targeting. Objective We present the first case series to demonstrate the feasibility of utilizing ultra-high-resolution C-arm cone beam computed tomography angiography (CBCT-A) in AVM targeting. Methods From June 2009 to June 2013, CBCT-A was utilized for targeting of all patients with AVMs treated with GKR at our institution. Patients underwent Leksell stereotactic head frame placement followed by catheter-based biplane 2-D digital subtraction angiography (DSA), 3-D rotational angiography (3DRA), as well as CBCT-A. The CBCT-A dataset was used for stereotactic planning for GKR. Patients were followed up at 1, 3, 6, and 12 months, and then annually thereafter. Results CBCT-A-based targeting was used in twenty-two consecutive patients. CBCT-A provided detailed spatial resolution and sensitivity of nidal angioarchitecture enabling treatment. The average radiation dose to the margin of the AVM nidus corresponding to the 50% percent isodose line was 15.6 Gy. No patient had treatment-associated hemorrhage. At early follow-up (mean=16 months), 84% of patients had a decreasing or obliterated AVM nidus. Conclusion CBCT-A-guided radiosurgery is feasible and useful because it provides sufficient detailed resolution and sensitivity for imaging brain AVMs. PMID:24584136

  1. Megavoltage Cone Beam Computed Tomography Dose and the Necessity of Reoptimization for Imaging Dose-Integrated Intensity-Modulated Radiotherapy for Prostate Cancer

    SciTech Connect

    Akino, Yuichi; Koizumi, Masahiko; Sumida, Iori; Takahashi, Yutaka; Ogata, Toshiyuki; Ota, Seiichi; Isohashi, Fumiaki; Konishi, Koji; Yoshioka, Yasuo

    2012-04-01

    Purpose: Megavoltage cone beam computed tomography (MV-CBCT) dose can be integrated with the patient's prescription. Here, we investigated the effects of imaging dose and the necessity for additional optimization when using intensity-modulated radiotherapy (IMRT) to treat prostate cancer. Methods and Materials: An arc beam mimicking MV-CBCT was generated using XiO (version 4.50; Elekta, Stockholm, Sweden). The monitor units (MU) for dose calculation were determined by conforming the calculated dose to the dose measured using an ionization chamber. IMRT treatment plans of 22 patients with prostate cancer were retrospectively analyzed. Arc beams of 3, 5, 8, and 15 MU were added to the IMRT plans, and the dose covering 95% of the planning target volume (PTV) was normalized to the prescribed dose with (reoptimization) or without optimization (compensation). Results: PTV homogeneity and conformality changed negligibly with MV-CBCT integration. For critical organs, an imaging dose-dependent increase was observed for the mean rectal/bladder dose (D{sub mean}), and reoptimization effectively suppressed the D{sub mean} elevations. The bladder generalized equivalent uniform dose (gEUD) increased with imaging dose, and reoptimization suppressed the gEUD elevation when 5- to 15-MU CBCT were added, although rectal gEUD changed negligibly with any imaging dose. Whereas the dose elevation from the simple addition of the imaging dose uniformly increased rectal and bladder dose, the rectal D{sub mean} increase of compensation plans was due mainly to low-dose volumes. In contrast, bladder high-dose volumes were increased by integrating the CBCT dose, and reoptimization reduced them when 5- to 15-MU CBCT were added. Conclusion: Reoptimization is clearly beneficial for reducing dose to critical organs, elevated by addition of high-MU CBCT, especially for the bladder. For low-MU CBCT aimed at bony structure visualization, compensation is sufficient.

  2. Cone-Beam Computed Tomography for On-Line Image Guidance of Lung Stereotactic Radiotherapy: Localization, Verification, and Intrafraction Tumor Position

    SciTech Connect

    Purdie, Thomas G. . E-mail: Tom.Purdie@rmp.uhn.on.ca; Bissonnette, Jean-Pierre; Franks, Kevin; Bezjak, Andrea; Payne, David; Sie, Fanny; Sharpe, Michael B.; Jaffray, David A.

    2007-05-01

    Purpose: Cone-beam computed tomography (CBCT) in-room imaging allows accurate inter- and intrafraction target localization in stereotactic body radiotherapy of lung tumors. Methods and Materials: Image-guided stereotactic body radiotherapy was performed in 28 patients (89 fractions) with medically inoperable Stage T1-T2 non-small-cell lung carcinoma. The targets from the CBCT and planning data set (helical or four-dimensional CT) were matched on-line to determine the couch shift required for target localization. Matching based on the bony anatomy was also performed retrospectively. Verification of target localization was done using either megavoltage portal imaging or CBCT imaging; repeat CBCT imaging was used to assess the intrafraction tumor position. Results: The mean three-dimensional tumor motion for patients with upper lesions (n = 21) and mid-lobe or lower lobe lesions (n = 7) was 4.2 and 6.7 mm, respectively. The mean difference between the target and bony anatomy matching using CBCT was 6.8 mm (SD, 4.9, maximum, 30.3); the difference exceeded 13.9 mm in 10% of the treatment fractions. The mean residual error after target localization using CBCT imaging was 1.9 mm (SD, 1.1, maximum, 4.4). The mean intrafraction tumor deviation was significantly greater (5.3 mm vs. 2.2 mm) when the interval between localization and repeat CBCT imaging (n = 8) exceeded 34 min. Conclusion: In-room volumetric imaging, such as CBCT, is essential for target localization accuracy in lung stereotactic body radiotherapy. Imaging that relies on bony anatomy as a surrogate of the target may provide erroneous results in both localization and verification.

  3. Cone beam computed tomographic analysis of maxillary premolars and molars to detect the relationship between periapical and marginal bone loss and mucosal thickness of maxillary sinus

    PubMed Central

    Sekerci, Ahmet-Ercan; Köse, Emre; Sisman, Yildiray

    2015-01-01

    Background This study assessed the relationship between mucosal thickness (MT) of the maxillary sinus and periodontal bone loss (PBL) and periapical condition of related teeth. We also aimed to identify the association between root apices and the inferior wall of the maxillary sinus using Cone beam computed tomography (CBCT). Material and Methods In this study, CBCT images of 205 patients with 410 maxillary sinuses were examined, retrospectively. A total of 582 maxillary molars and 587 premolars were observed. The relationship of each root with maxillary sinus and apical lesions of these roots were classified, PBL was examined and the situations of adjacent teeth were estimated. The effect of these conditions on sinus mucosal thickness (MT) was evaluated. Results There was a significant correlation between MT of maxillary sinus and both PBL and age (r = 0.52, p=0.000 and r = 0.111, p= 0.002, respectively). The frequency of MT increased as the severity of apical lesion enlarged. A positive correlation was found between MT and degree of PBL and periapical lesions. To reveal the association between MT and pulpoperiapical condition bivariate correlation was done and a significant relationship between the pulpoperiapical condition and MT was found (r = 0.17, p=0.000). Conclusions This retrospective study showed that MT of the maxillary sinus was common among patients with PBL and MT was significantly associated with PBL and apical lesions. The relationship of maxillary sinus to adjacent teeth had also positive correlation with MT. CBCT imaging enabled better evaluation of maxillary sinus, posterior teeth and surrounding structures compared to other imaging tools. Key words:Maxillary sinus mucosal thickness, apical periodontitis, periodontal bone loss, CBCT. PMID:26241459

  4. In Vitro Comparison of Cone Beam Computed Tomography with Digital Periapical Radiography for Detection of Vertical Root Fracture in Posterior Teeth

    PubMed Central

    Abdinian, Mehrdad; Razavian, Hamid; Jenabi, Nastaran

    2016-01-01

    Statement of the Problem The diagnosis of vertical root fracture (VRF) is a challenging task. Purpose This in vitro study compared cone beam computed tomography (CBCT) imaging with digital periapical radiography (DPR) made by three different horizontal angels (20°mesial, 0° and 20° distal) for accurate diagnosis of VRF. Materials and Method Among 120 posterior teeth included in this study, 60 were vertically fractured. Fractured and non-fractured teeth were randomly distributed into three groups defined as group 1 with no filling in the root canal, group 2 with gutta-percha in the canal, and group 3 with the intracanal post. All samples were placed in a dry mandible and imaged with CBCT and DPR techniques. Two blind observers investigated the images. Results CBCT had higher sensitivity but lower specificity compared with DPR, except for the intracanal post group in which the sensitivity of DPR was higher; though the chi-square test showed the differences to be statistically insignificant. The sensitivity, specificity, and accuracy of CBCT and DPR were reduced in the cases that gutta-percha or post were present in the canal. Inter-observer agreement was higher for CBCT. A set of three DPRs with different horizontal angels were significantly more sensitive for VRF recognition than a single orthogonal DPR. Conclusion Based on our results, there was no significant difference between CBCT and a set of three DPRs with different angulations for VRF detection in posterior teeth. Therefore, it is suggested to consider DPRs with three different horizontal angels (20°mesial, 0° and 20° distal) for radiographic evaluation before CBCT examination. PMID:27284552

  5. Development and Clinical Evaluation of a Three-Dimensional Cone-Beam Computed Tomography Estimation Method Using a Deformation Field Map

    SciTech Connect

    Ren, Lei; Chetty, Indrin J.; Zhang Junan; Jin Jianyue; Wu, Q. Jackie; Yan Hui; Brizel, David M.; Lee, W. Robert; Movsas, Benjamin; Yin Fangfang

    2012-04-01

    Purpose: To develop a three-dimensional (3D) cone-beam computed tomography (CBCT) estimation method using a deformation field map, and to evaluate and optimize the efficiency and accuracy of the method for use in the clinical setting. Methods and Materials: We propose a method to estimate patient CBCT images using prior information and a deformation model. Patients' previous CBCT data are used as the prior information, and the new CBCT volume to be estimated is considered as a deformation of the prior image volume. The deformation field map is solved by minimizing deformation energy and maintaining new projection data fidelity using a nonlinear conjugate gradient method. This method was implemented in 3D form using hardware acceleration and multi-resolution scheme, and it was evaluated for different scan angles, projection numbers, and scan directions using liver, lung, and prostate cancer patient data. The accuracy of the estimation was evaluated by comparing the organ volume difference and the similarity between estimated CBCT and the CBCT reconstructed from fully sampled projections. Results: Results showed that scan direction and number of projections do not have significant effects on the CBCT estimation accuracy. The total scan angle is the dominant factor affecting the accuracy of the CBCT estimation algorithm. Larger scan angles yield better estimation accuracy than smaller scan angles. Lung cancer patient data showed that the estimation error of the 3D lung tumor volume was reduced from 13.3% to 4.3% when the scan angle was increased from 60 Degree-Sign to 360 Degree-Sign using 57 projections. Conclusions: The proposed estimation method is applicable for 3D DTS, 3D CBCT, four-dimensional CBCT, and four-dimensional DTS image estimation. This method has the potential for significantly reducing the imaging dose and improving the image quality by removing the organ distortion artifacts and streak artifacts shown in images reconstructed by the conventional

  6. 2D–3D radiograph to cone-beam computed tomography (CBCT) registration for C-arm image-guided robotic surgery

    PubMed Central

    Liu, Wen Pei; Otake, Yoshito; Azizian, Mahdi; Wagner, Oliver J.; Sorger, Jonathan M.; Armand, Mehran; Taylor, Russell H.

    2015-01-01

    Purpose C-arm radiographs are commonly used for intraoperative image guidance in surgical interventions. Fluoroscopy is a cost-effective real-time modality, although image quality can vary greatly depending on the target anatomy. Cone-beam computed tomography (CBCT) scans are sometimes available, so 2D–3D registration is needed for intra-procedural guidance. C-arm radiographs were registered to CBCT scans and used for 3D localization of peritumor fiducials during a minimally invasive thoracic intervention with a da Vinci Si robot. Methods Intensity-based 2D–3D registration of intraoperative radiographs to CBCT was performed. The feasible range of X-ray projections achievable by a C-arm positioned around a da Vinci Si surgical robot, configured for robotic wedge resection, was determined using phantom models. Experiments were conducted on synthetic phantoms and animals imaged with an OEC 9600 and a Siemens Artis zeego, representing the spectrum of different C-arm systems currently available for clinical use. Results The image guidance workflow was feasible using either an optically tracked OEC 9600 or a Siemens Artis zeego C-arm, resulting in an angular difference of Δθ : ~ 30°. The two C-arm systems provided TREmean ≤ 2.5 mm and TREmean ≤ 2.0 mm, respectively (i.e., comparable to standard clinical intraoperative navigation systems). Conclusions C-arm 3D localization from dual 2D–3D registered radiographs was feasible and applicable for intraoperative image guidance during da Vinci robotic thoracic interventions using the proposed workflow. Tissue deformation and in vivo experiments are required before clinical evaluation of this system. PMID:25503592

  7. Evaluation of diagnostic accuracy of conventional and digital periapical radiography, panoramic radiography, and cone-beam computed tomography in the assessment of alveolar bone loss

    PubMed Central

    Takeshita, Wilton Mitsunari; Vessoni Iwaki, Lilian Cristina; Da Silva, Mariliani Chicarelli; Tonin, Renata Hernandes

    2014-01-01

    Background: To evaluate the diagnostic accuracy of different radiographic methods in the assessment of proximal alveolar bone loss (ABL). Materials and Methods: ABL, the distance between cement-enamel junction and alveolar bone crest, was measured in 70 mandibular human teeth – directly on the mandibles (control), using conventional periapical radiography with film holders (Rinn XCP and Han-Shin), digital periapical radiography with complementary metal-oxide semiconductor sensor, conventional panoramic, and cone-beam computed tomography (CBCT). Three programs were used to measure ABL on the images: Image tool 3.0 (University of Texas Health Sciences Center, San Antonio, Texas, USA), Kodak Imaging 6.1 (Kodak Dental Imaging 6.1, Carestream Health®, Rochester, NY, USA), and i-CAT vision 1.6.20. Statistical analysis used ANOVA and Tukey's test at 5% significance level. Results: The tomographic images showed the highest means, whereas the lowest were found for periapical with Han-Shin. Controls differed from periapical with Han-Shin (P < 0.0001). CBCT differed from panoramic (P = 0.0130), periapical with Rinn XCP (P = 0.0066), periapical with Han-Shin (P < 0.0001), and digital periapical (P = 0.0027). Conventional periapicals with film holders differed from each other (P = 0.0007). Digital periapical differed from conventional periapical with Han-Shin (P = 0.0004). Conclusions: Conventional periapical with Han-Shin film holder was the only method that differed from the controls. CBCT had the closest means to the controls. PMID:25191066

  8. Analysis of C-shaped root canal configuration in maxillary molars in a Korean population using cone-beam computed tomography

    PubMed Central

    Jo, Hyoung-Hoon; Min, Jeong-Bum

    2016-01-01

    Objectives The purpose of this study was to investigate the incidence of root fusion and C-shaped root canals in maxillary molars, and to classify the types of C-shaped canal by analyzing cone-beam computed tomography (CBCT) in a Korean population. Materials and Methods Digitized CBCT images from 911 subjects were obtained in Chosun University Dental Hospital between February 2010 and July 2012 for orthodontic treatment. Among them, a total of selected 3,553 data of maxillary molars were analyzed retrospectively. Tomography sections in the axial, coronal, and sagittal planes were displayed by PiViewstar and Rapidia MPR software (Infinitt Co.). The incidence and types of root fusion and C-shaped root canals were evaluated and the incidence between the first and the second molar was compared using Chi-square test. Results Root fusion was present in 3.2% of the first molars and 19.5% of the second molars, and fusion of mesiobuccal and palatal root was dominant. C-shaped root canals were present in 0.8% of the first molars and 2.7% of the second molars. The frequency of root fusion and C-shaped canal was significantly higher in the second molar than the first molar (p < 0.001). Conclusions In a Korean population, maxillary molars showed total 11.3% of root fusion and 1.8% of C-shaped root canals. Furthermore, root fusion and C-shaped root canals were seen more frequently in the maxillary second molars. PMID:26877991

  9. Cone-Beam Computed Tomography Assessment of Lower Facial Asymmetry in Unilateral Cleft Lip and Palate and Non-Cleft Patients with Class III Skeletal Relationship

    PubMed Central

    Lin, Yifan; Chen, Gui; Fu, Zhen; Ma, Lian; Li, Weiran

    2015-01-01

    Introduction To evaluate, using cone-beam computed tomography (CBCT), both the condylar-fossa relationships and the mandibular and condylar asymmetries between unilateral cleft lip and palate (UCLP) patients and non-cleft patients with class III skeletal relationship, and to investigate the factors of asymmetry contributing to chin deviation. Methods The UCLP and non-cleft groups consisted of 30 and 40 subjects, respectively, in mixed dentition with class III skeletal relationships. Condylar-fossa relationships and the dimensional and positional asymmetries of the condyles and mandibles were examined using CBCT. Intra-group differences were compared between two sides in both groups using a paired t-test. Furthermore, correlations between each measurement and chin deviation were assessed. Results It was observed that 90% of UCLP and 67.5% of non-cleft subjects had both condyles centered, and no significant asymmetry was found. The axial angle and the condylar center distances to the midsagittal plane were significantly greater on the cleft side than on the non-cleft side (P=0.001 and P=0.028, respectively) and were positively correlated with chin deviation in the UCLP group. Except for a larger gonial angle on the cleft side, the two groups presented with consistent asymmetries showing shorter mandibular bodies and total mandibular lengths on the cleft (deviated) side. The average chin deviation was 1.63 mm to the cleft side, and the average absolute chin deviation was significantly greater in the UCLP group than in the non-cleft group (P=0.037). Conclusion Compared with non-cleft subjects with similar class III skeletal relationships, the subjects with UCLP showed more severe lower facial asymmetry. The subjects with UCLP presented with more asymmetrical positions and rotations of the condyles on axial slices, which were positively correlated with chin deviation. PMID:26237311

  10. WE-G-BRF-05: Feasibility of Markerless Motion Tracking Using Dual Energy Cone Beam Computed Tomography (DE-CBCT) Projections

    SciTech Connect

    Panfil, J; Patel, R; Surucu, M; Roeske, J

    2014-06-15

    Purpose: To compare markerless template-based tracking of lung tumors using dual energy (DE) cone-beam computed tomography (CBCT) projections versus single energy (SE) CBCT projections. Methods: A RANDO chest phantom with a simulated tumor in the upper right lung was used to investigate the effectiveness of tumor tracking using DE and SE CBCT projections. Planar kV projections from CBCT acquisitions were captured at 60 kVp (4 mAs) and 120 kVp (1 mAs) using the Varian TrueBeam and non-commercial iTools Capture software. Projections were taken at approximately every 0.53° while the gantry rotated. Due to limitations of the phantom, angles for which the shoulders blocked the tumor were excluded from tracking analysis. DE images were constructed using a weighted logarithmic subtraction that removed bony anatomy while preserving soft tissue structures. The tumors were tracked separately on DE and SE (120 kVp) images using a template-based tracking algorithm. The tracking results were compared to ground truth coordinates designated by a physician. Matches with a distance of greater than 3 mm from ground truth were designated as failing to track. Results: 363 frames were analyzed. The algorithm successfully tracked the tumor on 89.8% (326/363) of DE frames compared to 54.3% (197/363) of SE frames (p<0.0001). Average distance between tracking and ground truth coordinates was 1.27 +/− 0.67 mm for DE versus 1.83+/−0.74 mm for SE (p<0.0001). Conclusion: This study demonstrates the effectiveness of markerless template-based tracking using DE CBCT. DE imaging resulted in better detectability with more accurate localization on average versus SE. Supported by a grant from Varian Medical Systems.

  11. SU-E-J-183: Quantifying the Image Quality and Dose Reduction of Respiratory Triggered 4D Cone-Beam Computed Tomography with Patient- Measured Breathing

    SciTech Connect

    Cooper, B; OBrien, R; Kipritidis, J; Keall, P

    2014-06-01

    Purpose: Respiratory triggered four dimensional cone-beam computed tomography (RT 4D CBCT) is a novel technique that uses a patient's respiratory signal to drive the image acquisition with the goal of imaging dose reduction without degrading image quality. This work investigates image quality and dose using patient-measured respiratory signals for RT 4D CBCT simulations instead of synthetic sinusoidal signals used in previous work. Methods: Studies were performed that simulate a 4D CBCT image acquisition using both the novel RT 4D CBCT technique and a conventional 4D CBCT technique from a database of oversampled Rando phantom CBCT projections. A database containing 111 free breathing lung cancer patient respiratory signal files was used to create 111 RT 4D CBCT and 111 conventional 4D CBCT image datasets from realistic simulations of a 4D RT CBCT system. Each of these image datasets were compared to a ground truth dataset from which a root mean square error (RMSE) metric was calculated to quantify the degradation of image quality. The number of projections used in each simulation is counted and was assumed as a surrogate for imaging dose. Results: Based on 111 breathing traces, when comparing RT 4D CBCT with conventional 4D CBCT the average image quality was reduced by 7.6%. However, the average imaging dose reduction was 53% based on needing fewer projections (617 on average) than conventional 4D CBCT (1320 projections). Conclusion: The simulation studies using a wide range of patient breathing traces have demonstrated that the RT 4D CBCT method can potentially offer a substantial saving of imaging dose of 53% on average compared to conventional 4D CBCT in simulation studies with a minimal impact on image quality. A patent application (PCT/US2012/048693) has been filed which is related to this work.

  12. Locoregional Control of Non-Small Cell Lung Cancer in Relation to Automated Early Assessment of Tumor Regression on Cone Beam Computed Tomography

    SciTech Connect

    Brink, Carsten; Bernchou, Uffe; Bertelsen, Anders; Hansen, Olfred; Schytte, Tine; Bentzen, Soren M.

    2014-07-15

    Purpose: Large interindividual variations in volume regression of non-small cell lung cancer (NSCLC) are observable on standard cone beam computed tomography (CBCT) during fractionated radiation therapy. Here, a method for automated assessment of tumor volume regression is presented and its potential use in response adapted personalized radiation therapy is evaluated empirically. Methods and Materials: Automated deformable registration with calculation of the Jacobian determinant was applied to serial CBCT scans in a series of 99 patients with NSCLC. Tumor volume at the end of treatment was estimated on the basis of the first one third and two thirds of the scans. The concordance between estimated and actual relative volume at the end of radiation therapy was quantified by Pearson's correlation coefficient. On the basis of the estimated relative volume, the patients were stratified into 2 groups having volume regressions below or above the population median value. Kaplan-Meier plots of locoregional disease-free rate and overall survival in the 2 groups were used to evaluate the predictive value of tumor regression during treatment. Cox proportional hazards model was used to adjust for other clinical characteristics. Results: Automatic measurement of the tumor regression from standard CBCT images was feasible. Pearson's correlation coefficient between manual and automatic measurement was 0.86 in a sample of 9 patients. Most patients experienced tumor volume regression, and this could be quantified early into the treatment course. Interestingly, patients with pronounced volume regression had worse locoregional tumor control and overall survival. This was significant on patient with non-adenocarcinoma histology. Conclusions: Evaluation of routinely acquired CBCT images during radiation therapy provides biological information on the specific tumor. This could potentially form the basis for personalized response adaptive therapy.

  13. On-Board Patient Positioning for Head-and-Neck IMRT: Comparing Digital Tomosynthesis to Kilovoltage Radiography and Cone-Beam Computed Tomography

    SciTech Connect

    Wu, Q. Jackie Godfrey, Devon J.; Wang Zhiheng; Zhang Junan; Zhou Sumin; Yoo Sua; Brizel, David M.; Yin Fangfang

    2007-10-01

    Purpose: High-precision intensity-modulated radiotherapy demands high patient positioning accuracy. On-board digital tomosynthesis (DTS) provides three-dimensional (3D) image guidance for daily positioning with a lower imaging dose, faster acquisition, and more geometric flexibility than 3D cone-beam computed tomography (CBCT). This clinical study evaluated DTS as a daily imaging technique for patient positioning and compared the results with 3D CBCT and two-dimensional (2D) radiography. Methods and Materials: Head and neck cancer patients undergoing intensity-modulated radiotherapy were studied. For each session, the patient was positioned using laser marks. On-board imaging data sets, including 2D kilovoltage radiographs, DTS, and CBCT, were obtained to measure the daily patient positioning variations. The mean and standard deviations of the positioning variations in the translational and rotational directions were calculated. The positioning differences among 2D radiography, DTS, and CBCT were analyzed. Results: Image data sets were collected from 65 treatment fractions for 10 patients. The systematic patient positioning variation was <0.10 cm and 1.0 deg. one dimensionally. The random variations were 0.27-0.34 cm in the translational and 0.93{sup o}-1.99{sup o} in the rotational direction. The mean vector isocenter variation was 0.48 cm. DTS with 40 deg. and 20 deg. scan angles in the coronal or sagittal directions yielded the same results for patient positioning. DTS performance was comparable to that of CBCT, with positioning differences of <0.1 cm and 0.5{sup o}. The positioning difference between 2D radiography and DTS was {approx}0.1 cm and 0.2 cm in the vertical/longitudinal and lateral directions. Conclusion: Our results have demonstrated that DTS is a comparable 3D imaging technique to CBCT for daily patient positioning of head-and-neck patients as determined by manual registration of bony anatomy.

  14. A study of the distobuccal root canal orifice of the maxillary second molars in Chinese individuals evaluated by cone-beam computed tomography

    PubMed Central

    HAN, Xuan; YANG, Haibing; LI, Guoju; YANG, Lin; TIAN, Cheng; WANG, Yan

    2012-01-01

    As is commonly understood, the root canal morphology of the maxillary molars is usually complex and variable. It is sometimes difficult to detect the distobuccal root canal orifice of a maxillary second molar with root canal treatment. No literature related to the distobuccal root canals of the maxillary second molars has been published. Objective To investigate the position of the distobuccal root canal orifice of the maxillary second molars in a Chinese population using cone-beam computed tomography (CBCT). Material and methods In total, 816 maxillary second molars from 408 patients were selected from a Chinese population and scanned using CBCT. The following information was recorded: (1) the number of root canals per tooth, (2) the distance between the mesiobuccal and distobuccal root canal orifice (DM), (3) the distance between the palatal and distobuccal root canal orifice (DP), (4) the angle formed by the mesiobuccal, distobuccal and palatal root canal orifices (∠ PDM). DM, DP and ∠ PDM of the teeth with three or four root canals were analyzed and evaluated. Results In total, 763 (93.51%) of 816 maxillary second molars had three or four root canals. The distance between the mesiobuccal and distobuccal orifice was 0.7 to 4.8 mm. 621 (81.39%) of 763 teeth were distributed within 1.5-3.0 mm. The distance between the palatal and distobuccal orifice ranged from 0.8 mm to 6.7 mm; 585 (76.67%) and were distributed within 3.0-5.0 mm. The angle (∠ PDM) ranged from 69. 4º to 174.7º in 708 samples (92.80%), the angle ranged from 90º to 140º. Conclusions The position of the distobuccal root canal orifice of the maxillary second molars with 3 or 4 root canals in a Chinese population was complex and variable. Clinicians should have a thorough knowledge of the anatomy of the maxillary second molars. PMID:23138744

  15. Comparison of high-resolution and standard zoom imaging modes in cone beam computed tomography for detection of longitudinal root fracture: An in vitro study

    PubMed Central

    Taramsari, Mehran; Bashirzadeh, Parinaz; Salamat, Fatemeh

    2013-01-01

    Purpose The purpose of this study was to compare the efficacy of two imaging modes in a cone beam computed tomography (CBCT) system in detecting root fracture in endodontically-treated teeth with fiber posts or screw posts by selecting two fields of view. Materials and Methods In this study, 78 endodontically-treated single canal premolars were included. A post space was created in all of them. Then the teeth were randomly set in one of 6 artificial dental arches. In 39 of the 78 teeth set in the 6 dental arches, a root fracture was intentionally created. Next, a fiber post and a screw post were cemented into 26 teeth having equal the root fractures. High resolution (HiRes) and standard zoom images were provided by a CBCT device. Upon considering the reconstructed images, two observers in agreement with each other confirmed the presence or absence of root fracture. A McNemar test was used for comparing the results of the two modes. Results The frequency of making a correct diagnosis using the HiRes zoom imaging mode was 71.8% and in standard zoom was 59%. The overall sensitivity and specificity in diagnosing root fracture in the HiRes mode were 71.79% and 46.15% and in the standard zoom modes were 58.97% and 33.33%, respectively. Conclusion There were no significant differences between the diagnostic values of the two imaging modes used in the diagnosis of root fracture or in the presence of root canal restorations. In both modes, the most true-positive results were reported in the post space group. PMID:24083210

  16. Correlation between skeletal and dental changes after mandibular setback surgery-first orthodontic treatment: Cone-beam computed tomography-generated half-cephalograms

    PubMed Central

    Rhee, Chang-Hoon; Choi, Youn-Kyung; Kim, Seong-Sik; Park, Soo-Byung; Son, Woo-Sung

    2015-01-01

    Objective To investigate skeletal and dental changes after application of a mandibular setback surgery-first orthodontic treatment approach in cases of skeletal Class III malocclusion. Methods A retrospective study of 34 patients (23 men, 11 women; mean age, 26.2 ± 6.6 years) with skeletal Class III deformities, who underwent surgery-first orthodontic treatment, was conducted. Skeletal landmarks in the maxilla and mandible at three time points, pre-treatment (T0), immediate-postoperative (T1), and post-treatment (T2), were analyzed using cone-beam computed tomography (CBCT)-generated half-cephalograms. Results The significant T0 to T1 mandibular changes occurred -9.24 ± 3.97 mm horizontally. From T1 to T2, the mandible tended to move forward 1.22 ± 2.02 mm, while the condylar position (Cd to Po-perpendicular plane) shifted backward, and the coronoid process (Cp to FH plane) moved vertically. Between T1 and T2, the vertical dimension changed significantly (p < 0.05). Changes in the vertical dimension were significantly correlated to T1 to T2 changes in the Cd to Po-perpendicular plane (r = -0.671, p = 0.034), and in the Cp to FH plane (r = 0.733, p = 0.016), as well as to T0 to T1 changes in the Cp to Po-perpendicular plane (r = 0.758, p = 0.011). Conclusions Greater alterations in the vertical dimension caused larger post-treatment (T2) stage skeletal changes. Studying the mandibular position in relation to the post-surgical vertical dimension emphasized the integral importance of vertical dimension control and proximal segment management to the success of surgery-first orthodontic treatment. PMID:25798411

  17. Measurement of the Interantral Bone in Implant Dentistry Using Panoramic Radiography and Cone Beam Computed Tomography: A Human Radiographic Study

    PubMed Central

    Kopecka, D; Simunek, A; Streblov, J; Slezak, R; Capek, L

    2014-01-01

    ABSTRACT Objective: To analyse the dimensions of interantral bone available for dental implant placement in the fully edentulous maxilla. Methods: Interantral bone height (IBH) was measured using panoramic radiography and computed tomography (CT). Interantral bone width (IBW) was measured by means of CT. Results: The difference between both imaging methods in IBH assessment was highly statistically significant (p < 0.001) in the canine area, whereas in other areas, it was found to not be significant. Measured in the CT scans, bone is significantly higher in the canine area compared to the area of central and lateral incisors (p < 0.001). Significant variations in IBW were found in all three locations: bone in the central incisor area is the widest, in the area of the lateral incisor, the narrowest (p < 0.001). Conclusion: Panoramic radiography is a sufficiently accurate method for IBH imaging in the incisor area, but not in the canine area. PMID:25781290

  18. A computer simulation study comparing lesion detection accuracy with digital mammography, breast tomosynthesis, and cone-beam CT breast imaging

    SciTech Connect

    Gong Xing; Glick, Stephen J.; Liu, Bob; Vedula, Aruna A.; Thacker, Samta

    2006-04-15

    Although conventional mammography is currently the best modality to detect early breast cancer, it is limited in that the recorded image represents the superposition of a three-dimensional (3D) object onto a 2D plane. Recently, two promising approaches for 3D volumetric breast imaging have been proposed, breast tomosynthesis (BT) and CT breast imaging (CTBI). To investigate possible improvements in lesion detection accuracy with either breast tomosynthesis or CT breast imaging as compared to digital mammography (DM), a computer simulation study was conducted using simulated lesions embedded into a structured 3D breast model. The computer simulation realistically modeled x-ray transport through a breast model, as well as the signal and noise propagation through a CsI based flat-panel imager. Polyenergetic x-ray spectra of Mo/Mo 28 kVp for digital mammography, Mo/Rh 28 kVp for BT, and W/Ce 50 kVp for CTBI were modeled. For the CTBI simulation, the intensity of the x-ray spectra for each projection view was determined so as to provide a total average glandular dose of 4 mGy, which is approximately equivalent to that given in conventional two-view screening mammography. The same total dose was modeled for both the DM and BT simulations. Irregular lesions were simulated by using a stochastic growth algorithm providing lesions with an effective diameter of 5 mm. Breast tissue was simulated by generating an ensemble of backgrounds with a power law spectrum, with the composition of 50% fibroglandular and 50% adipose tissue. To evaluate lesion detection accuracy, a receiver operating characteristic (ROC) study was performed with five observers reading an ensemble of images for each case. The average area under the ROC curves (A{sub z}) was 0.76 for DM, 0.93 for BT, and 0.94 for CTBI. Results indicated that for the same dose, a 5 mm lesion embedded in a structured breast phantom was detected by the two volumetric breast imaging systems, BT and CTBI, with statistically

  19. Expectation maximization reconstruction for circular orbit cone-beam CT

    NASA Astrophysics Data System (ADS)

    Dong, Baoyu

    2008-03-01

    Cone-beam computed tomography (CBCT) is a technique for imaging cross-sections of an object using a series of X-ray measurements taken from different angles around the object. It has been widely applied in diagnostic medicine and industrial non-destructive testing. Traditional CT reconstructions are limited by many kinds of artifacts, and they give dissatisfactory image. To reduce image noise and artifacts, we propose a statistical iterative approach for cone-beam CT reconstruction. First the theory of maximum likelihood estimation is extended to X-ray scan, and an expectation-maximization (EM) formula is deduced for direct reconstruction of circular orbit cone-beam CT. Then the EM formula is implemented in cone-beam geometry for artifact reduction. EM algorithm is a feasible iterative method, which is based on the statistical properties of Poisson distribution. It can provide good quality reconstructions after a few iterations for cone-beam CT. In the end, experimental results with computer simulated data and real CT data are presented to verify our method is effective.

  20. The stability of mechanical calibration for a kV cone beam computed tomography system integrated with linear accelerator

    SciTech Connect

    Sharpe, Michael B.; Moseley, Douglas J.; Purdie, Thomas G.

    2006-01-15

    The geometric accuracy and precision of an image-guided treatment system were assessed. Image guidance is performed using an x-ray volume imaging (XVI) system integrated with a linear accelerator and treatment planning system. Using an amorphous silicon detector and x-ray tube, volumetric computed tomography images are reconstructed from kilovoltage radiographs by filtered backprojection. Image fusion and assessment of geometric targeting are supported by the treatment planning system. To assess the limiting accuracy and precision of image-guided treatment delivery, a rigid spherical target embedded in an opaque phantom was subjected to 21 treatment sessions over a three-month period. For each session, a volumetric data set was acquired and loaded directly into an active treatment planning session. Image fusion was used to ascertain the couch correction required to position the target at the prescribed iso-center. Corrections were validated independently using megavoltage electronic portal imaging to record the target position with respect to symmetric treatment beam apertures. An initial calibration cycle followed by repeated image-guidance sessions demonstrated the XVI system could be used to relocate an unambiguous object to within less than 1 mm of the prescribed location. Treatment could then proceed within the mechanical accuracy and precision of the delivery system. The calibration procedure maintained excellent spatial resolution and delivery precision over the duration of this study, while the linear accelerator was in routine clinical use. Based on these results, the mechanical accuracy and precision of the system are ideal for supporting high-precision localization and treatment of soft-tissue targets.

  1. The stability of mechanical calibration for a kV cone beam computed tomography system integrated with linear accelerator.

    PubMed

    Sharpe, Michael B; Moseley, Douglas J; Purdie, Thomas G; Islam, Mohammad; Siewerdsen, Jeffrey H; Jaffray, David A

    2006-01-01

    The geometric accuracy and precision of an image-guided treatment system were assessed. Image guidance is performed using an x-ray volume imaging (XVI) system integrated with a linear accelerator and treatment planning system. Using an amorphous silicon detector and x-ray tube, volumetric computed tomography images are reconstructed from kilovoltage radiographs by filtered backprojection. Image fusion and assessment of geometric targeting are supported by the treatment planning system. To assess the limiting accuracy and precision of image-guided treatment delivery, a rigid spherical target embedded in an opaque phantom was subjected to 21 treatment sessions over a three-month period. For each session, a volumetric data set was acquired and loaded directly into an active treatment planning session. Image fusion was used to ascertain the couch correction required to position the target at the prescribed iso-center. Corrections were validated independently using megavoltage electronic portal imaging to record the target position with respect to symmetric treatment beam apertures. An initial calibration cycle followed by repeated image-guidance sessions demonstrated the XVI system could be used to relocate an unambiguous object to within less than 1 mm of the prescribed location. Treatment could then proceed within the mechanical accuracy and precision of the delivery system. The calibration procedure maintained excellent spatial resolution and delivery precision over the duration of this study, while the linear accelerator was in routine clinical use. Based on these results, the mechanical accuracy and precision of the system are ideal for supporting high-precision localization and treatment of soft-tissue targets. PMID:16485420

  2. A study on planning organ at risk volume for the rectum using cone beam computed tomography in the treatment of prostate cancer

    SciTech Connect

    Prabhakar, Ramachandran; Oates, Richard; Jones, Daryl; Kron, Tomas; Cramb, Jim; Foroudi, Farshad; Geso, Moshi; Gill, Suki

    2014-04-01

    In this study, we analyzed planning organ at risk volume (PRV) for the rectum using a series of cone beam computed tomographies (CBCTs) acquired during the treatment of prostate cancer and evaluated the dosimetric effect of different PRV definitions. Overall, 21 patients with prostate cancer were treated radically with 78 Gy in 39 fractions had in total 418 CBCTs, each acquired at the end of the first 5 fractions and then every alternate fraction. The PRV was generated from the Boolean sum volume of the rectum obtained from first 5 fractions (PRV-CBCT-5) and from all CBCTs (PRV-CBCT-All). The PRV margin was compared at the superior, middle, and inferior slices of the contoured rectum to compare PRV-CBCT-5 and PRV-CBCT-All. We also compared the dose received by the planned rectum (Rectum-computed tomography [CT]), PRV-CBCT-5, PRV-CBCT-All, and average rectum (CBCT-AV-dose-volume histogram [DVH]) at critical dose levels. The average measured rectal volume for all 21 patients for Rectum-CT, PRV-CBCT-5, and PRV-CBCT-All was 44.3 ± 15.0, 92.8 ± 40.40, and 121.5 ± 36.7 cm{sup 3}, respectively. For PRV-CBCT-All, the mean ± standard deviation displacement in the anterior, posterior, right, and left lateral directions in centimeters was 2.1 ± 1.1, 0.9 ± 0.5, 0.9 ± 0.8, and 1.1 ± 0.7 for the superior rectum; 0.8 ± 0.5, 1.1 ± 0.5, 1.0 ± 0.5, and 1.0 ± 0.5 for the middle rectum; and 0.3 ± 0.3; 0.9 ± 0.5; 0.4 ± 0.2, and 0.5 ± 0.3 for the inferior rectum, respectively. The first 5 CBCTs did not predict the PRV for individual patients. Our study shows that the PRV margin is different for superior, middle, and the inferior parts of the rectum, it is wider superiorly and narrower inferiorly. A uniform PRV margin does not represent the actual rectal variations during treatment for all treatment fractions. The large variation in interpatient rectal size implies a potential role for adaptive radiotherapy for prostate cancer.

  3. SU-E-E-11: Novel Matching Module for Respiration-Gated Motion Tumor of Cone-Beam Computed Tomography (CBCT) to 4DCT

    SciTech Connect

    Yu, P; Tsai, Y; Nien, H; Chiu, Y; Chang, H; Lin, C; Fu, P; Chang, C; Wu, C

    2015-06-15

    Purpose: Four dimensional computed tomography (4DCT) scans reliably record whole respiratory phase and generate internal target volumes (ITV) for radiotherapy planning. However, image guiding with cone-beam computed tomography (CBCT) cannot acquire all or specific respiratory phases. This study was designed to investigate the correlation between average CT and Maximum Intensity Projection (MIP) from 4DCT and CBCT. Methods: Retrospective respiratory gating were performed by GE Discovery CT590 RT. 4DCT and CBCT data from CRIS Dynamic Thorax Phantom with simulated breathing mode were analyzed. The lung tissue equivalent material encompassed 3 cm sphere tissue equivalent material. Simulated breathing cycle period was set as 4 seconds, 5 seconds and 6 seconds for representing variation of patient breathing cycle time, and the sphere material moved toward inferior and superior direction with 1 cm amplitude simulating lung tumor motion during respiration. Results: Under lung window, the volume ratio of CBCT scans to ITVs derived from 10 phases average scans was 1.00 ± 0.02, and 1.03 ± 0.03 for ratio of CBCT scans to MIP scans. Under abdomen window, the ratio of CBCT scans to ITVs derived from 10 phases average scans was 0.39 ± 0.06, and 0.06 ± 0.00 for ratio of CBCT scans to MIP scans. There was a significant difference between lung window Result and abdomen window Result. For reducing image guiding uncertainty, CBCT window was set with width 500 and level-250. The ratio of CBCT scans to ITVs derived from 4 phases average scans with abdomen window was 1.19 ± 0.02, and 1.06 ± 0.01 for ratio of CBCT to MIP scans. Conclusion: CBCT images with suitable window width and level can efficiently reduce image guiding uncertainty for patient with mobile tumor. By our setting, we can match motion tumor to gating tumor location on planning CT more accurately neglecting other motion artifacts during CBCT scans.

  4. Using cone beam computed tomography to detect the relationship between the periodontal bone loss and mucosal thickening of the maxillary sinus

    PubMed Central

    Sheikhi, Mahnaz; Pozve, Nasim Jafari; Khorrami, Ladan

    2014-01-01

    Background: Maxillary sinuses are covered by a 1 mm thick mucous membrane that when this membrane becomes inflamed, the thickness may increase 10-15 times. The common causes of odontogenic sinusitis are dental abscesses and periodontal disease. Computed tomography (CT) is considered the gold standard for sinus diagnosis. Recently, cone beam computed tomography (CBCT) has been introduced for dental and maxillofacial imaging, which has several advantages over traditional CT, including lower radiation dose and chairside process. This study aims to find the association between mucosal thickening (MT) of the sinus and periodontal bone loss (PBL) and pulpoperiapical condition. Materials and Methods: A total of 180 CBCT images were reviewed. PBL was assessed in six points under each sinus at the mesial and distal sides of the upper second premolar and first and second molars by measuring the distance from the alveolar crest to the point 2 mm under the cemento-enamel junction (CEJ). The MT was assessed at six points in the floor of the sinus precisely over the mentioned points. To assess the possible role of pulpoperiapical condition on the sinus MT, the existing teeth were classified into five groups due to the probable effect of each condition on the pulp and peri-apex. The statistical association between MT of sinus and PBL and pulpoperiapical condition was assessed using SPSS software (SPSS Inc., version 16.0, Chicago, IL, USA) and bivariate correlation and binary linear regression statistical tests (P < 0.05). Results: MT was observed in 39.4% of patients (mean = 4.68 ± 5.25 mm). PBL was seen in 33% of the patients (mean = 1.87 ± 1.63 mm). Linear regression test showed that there is an association between both PBL and pulpoperiapical condition and MT, but the effect of PBL was about 4 times stronger. Conclusion: This study showed that MT of the maxillary sinus was common among patients with PBL and MT of the maxillary sinus was significantly associated with PBL

  5. Scatter corrections for cone beam optical CT

    NASA Astrophysics Data System (ADS)

    Olding, Tim; Holmes, Oliver; Schreiner, L. John

    2009-05-01

    Cone beam optical computed tomography (OptCT) employing the VISTA scanner (Modus Medical, London, ON) has been shown to have significant promise for fast, three dimensional imaging of polymer gel dosimeters. One distinct challenge with this approach arises from the combination of the cone beam geometry, a diffuse light source, and the scattering polymer gel media, which all contribute scatter signal that perturbs the accuracy of the scanner. Beam stop array (BSA), beam pass array (BPA) and anti-scatter polarizer correction methodologies have been employed to remove scatter signal from OptCT data. These approaches are investigated through the use of well-characterized phantom scattering solutions and irradiated polymer gel dosimeters. BSA corrected scatter solutions show good agreement in attenuation coefficient with the optically absorbing dye solutions, with considerable reduction of scatter-induced cupping artifact at high scattering concentrations. The application of BSA scatter corrections to a polymer gel dosimeter lead to an overall improvement in the number of pixel satisfying the (3%, 3mm) gamma value criteria from 7.8% to 0.15%.

  6. Daily Image Guidance With Cone-Beam Computed Tomography for Head-and-Neck Cancer Intensity-Modulated Radiotherapy: A Prospective Study

    SciTech Connect

    Den, Robert B.; Doemer, Anthony; Kubicek, Greg; Bednarz, Greg; Galvin, James M.; Keane, William M.; Xiao Ying; Machtay, Mitchell

    2010-04-15

    Purpose: To report on a prospective clinical trial of the use of daily kilovoltage cone-beam computed tomography (CBCT) to evaluate the interfraction and residual error motion of patients undergoing intensity-modulated radiotherapy for head-and-neck cancer. Methods and Materials: Patients were treated with intensity-modulated radiotherapy with an Elekta linear accelerator using a mounted CBCT scanner. CBCT was performed before every treatment, and translational (but not rotational) corrections were performed. At least once per week, a CBCT scan was obtained after intensity-modulated radiotherapy. Variations were measured in the medial-lateral, superoinferior, and anteroposterior dimensions, as well as in the rotation around these axes. Results: A total of 28 consecutive patients (1,013 CBCT scans) were studied. The average interfraction shift was 1.4 +- 1.4, 1.7 +- 1.9, and 1.8 +- 2.1 mm in the medial-lateral, superoinferior, and anteroposterior dimensions, respectively. The corresponding average residual error shifts were 0.7 +- 0.8, 0.9 +- 0.9, and 0.9 +- 0.9 mm. These data indicate that in the absence of daily CBCT image-guided radiotherapy, a clinical target volume to planning target volume margin of 3.9, 4.1, and 4.9 mm is needed in the medial-lateral, superoinferior, and anteroposterior dimensions, respectively. With daily CBCT, corresponding margins of 1.6, 2.5, and 1.9 mm should be acceptable. Subgroup analyses showed that larynx cancers and/or intratreatment weight loss indicate a need for slightly larger clinical target volume to planning target volume margins. Conclusion: The results of our study have shown that image-guided radiotherapy using CBCT for head-and-neck cancer is effective. These data suggest it allows a reduction in the clinical target volume to planning target volume margins by about 50%, which could facilitate future studies of dose escalation and/or improved toxicity reduction. Caution is particularly warranted for cases in which the

  7. Effect of Object Position in Cone Beam Computed Tomography Field of View for Detection of Root Fractures in Teeth with Intra-Canal Posts

    PubMed Central

    Valizadeh, Solmaz; Vasegh, Zahra; Rezapanah, Samin; Safi, Yaser; Khaeazifard, Mohamad Javad

    2015-01-01

    Background: Vertical root fracture (VRF) is a common problem in endodontically treated teeth. Due to its poor prognosis, a reliable technique must be used to make an accurate diagnosis. Cone beam computed tomography (CBCT) has been recently introduced for maxillofacial imaging. Despite the high diagnostic value of this method, metal artifacts resulting from intra-canal posts still make the detection of VRFs challenging. Objectives: This study aimed to assess the effect of object position in the field of view (FOV) of CBCT on detection of VRFs in teeth with intra-canal posts. Materials and Methods: The crowns of 60 extracted premolar teeth were cut at the level of cementoenamel junction (CEJ). Root canals were filled with gutta-percha and filling of the coronal 2/3 of the root canals was subsequently removed to fabricate intra-canal cast posts. The teeth were randomly divided into two groups of 30. Fracture was induced in group one using an Instron machine. Group two was considered as the control group with no fracture. All teeth were then randomly positioned and scanned in five different positions starting at the center of the FOV as well as right, left anterior and posterior relative to the center (3, 9, 12, and 6 O’clock) via the New Tom VGI CBCT unit. Two observers evaluated images for VRFs. Sensitivity and specificity of fracture diagnosis in each position was calculated in comparison with the gold standard. Wilcoxon test was used for data analysis. Results: Considering deterministic and probabilistic diagnostic parameters, probabilistic sensitivity was similar in all positions; but probabilistic specificity of the center position (65.1%) was significantly higher than that of 6 and 12 O’clock positions. Considering the deterministic diagnostic parameters, the overall sensitivity and specificity values decreased in all positions in FOV, but sensitivity of the center position of FOV was significantly higher than that of other positions; specificity was

  8. Reduction in Tumor Volume by Cone Beam Computed Tomography Predicts Overall Survival in Non-Small Cell Lung Cancer Treated With Chemoradiation Therapy

    SciTech Connect

    Jabbour, Salma K.; Kim, Sinae; Haider, Syed A.; Xu, Xiaoting; Wu, Alson; Surakanti, Sujani; Aisner, Joseph; Langenfeld, John; Yue, Ning J.; Haffty, Bruce G.; Zou, Wei

    2015-07-01

    Purpose: We sought to evaluate whether tumor response using cone beam computed tomography (CBCT) performed as part of the routine care during chemoradiation therapy (CRT) could forecast the outcome of unresectable, locally advanced, non-small cell lung cancer (NSCLC). Methods and Materials: We manually delineated primary tumor volumes (TV) of patients with NSCLC who were treated with radical CRT on days 1, 8, 15, 22, 29, 36, and 43 on CBCTs obtained as part of the standard radiation treatment course. Percentage reductions in TV were calculated and then correlated to survival and pattern of recurrence using Cox proportional hazard models. Clinical information including histologic subtype was also considered in the study of such associations. Results: We evaluated 38 patients with a median follow-up time of 23.4 months. The median TV reduction was 39.3% (range, 7.3%-69.3%) from day 1 (D1) to day 43 (D43) CBCTs. Overall survival was associated with TV reduction from D1 to D43 (hazard ratio [HR] 0.557, 95% CI 0.39-0.79, P=.0009). For every 10% decrease in TV from D1 to D43, the risk of death decreased by 44.3%. For patients whose TV decreased ≥39.3 or <39.3%, log-rank test demonstrated a separation in survival (P=.02), with median survivals of 31 months versus 10 months, respectively. Neither local recurrence (HR 0.791, 95% CI 0.51-1.23, P=.29), nor distant recurrence (HR 0.78, 95% CI 0.57-1.08, P=.137) correlated with TV decrease from D1 to D43. Histologic subtype showed no impact on our findings. Conclusions: TV reduction as determined by CBCT during CRT as part of routine care predicts post-CRT survival. Such knowledge may justify intensification of RT or application of additional therapies. Assessment of genomic characteristics of these tumors may permit a better understanding of behavior or prediction of therapeutic outcomes.

  9. Cone-Beam Computed Tomography–Guided Positioning of Laryngeal Cancer Patients with Large Interfraction Time Trends in Setup and Nonrigid Anatomy Variations

    SciTech Connect

    Gangsaas, Anne Astreinidou, Eleftheria; Quint, Sandra; Levendag, Peter C.; Heijmen, Ben

    2013-10-01

    Purpose: To investigate interfraction setup variations of the primary tumor, elective nodes, and vertebrae in laryngeal cancer patients and to validate protocols for cone beam computed tomography (CBCT)-guided correction. Methods and Materials: For 30 patients, CBCT-measured displacements in fractionated treatments were used to investigate population setup errors and to simulate residual setup errors for the no action level (NAL) offline protocol, the extended NAL (eNAL) protocol, and daily CBCT acquisition with online analysis and repositioning. Results: Without corrections, 12 of 26 patients treated with radical radiation therapy would have experienced a gradual change (time trend) in primary tumor setup ≥4 mm in the craniocaudal (CC) direction during the fractionated treatment (11/12 in caudal direction, maximum 11 mm). Due to these trends, correction of primary tumor displacements with NAL resulted in large residual CC errors (required margin 6.7 mm). With the weekly correction vector adjustments in eNAL, the trends could be largely compensated (CC margin 3.5 mm). Correlation between movements of the primary and nodal clinical target volumes (CTVs) in the CC direction was poor (r{sup 2}=0.15). Therefore, even with online setup corrections of the primary CTV, the required CC margin for the nodal CTV was as large as 6.8 mm. Also for the vertebrae, large time trends were observed for some patients. Because of poor CC correlation (r{sup 2}=0.19) between displacements of the primary CTV and the vertebrae, even with daily online repositioning of the vertebrae, the required CC margin around the primary CTV was 6.9 mm. Conclusions: Laryngeal cancer patients showed substantial interfraction setup variations, including large time trends, and poor CC correlation between primary tumor displacements and motion of the nodes and vertebrae (internal tumor motion). These trends and nonrigid anatomy variations have to be considered in the choice of setup verification protocol

  10. Image Guidance During Head-and-Neck Cancer Radiation Therapy: Analysis of Alignment Trends With In-Room Cone-Beam Computed Tomography Scans

    SciTech Connect

    Zumsteg, Zachary; DeMarco, John; Lee, Steve P.; Steinberg, Michael L.; Lin, Chun Shu; McBride, William; Lin, Kevin; Wang, Pin-Chieh; Kupelian, Patrick; Lee, Percy

    2012-06-01

    Purpose: On-board cone-beam computed tomography (CBCT) is currently available for alignment of patients with head-and-neck cancer before radiotherapy. However, daily CBCT is time intensive and increases the overall radiation dose. We assessed the feasibility of using the average couch shifts from the first several CBCTs to estimate and correct for the presumed systematic setup error. Methods and Materials: 56 patients with head-and-neck cancer who received daily CBCT before intensity-modulated radiation therapy had recorded shift values in the medial-lateral, superior-inferior, and anterior-posterior dimensions. The average displacements in each direction were calculated for each patient based on the first five or 10 CBCT shifts and were presumed to represent the systematic setup error. The residual error after this correction was determined by subtracting the calculated shifts from the shifts obtained using daily CBCT. Results: The magnitude of the average daily residual three-dimensional (3D) error was 4.8 {+-} 1.4 mm, 3.9 {+-} 1.3 mm, and 3.7 {+-} 1.1 mm for uncorrected, five CBCT corrected, and 10 CBCT corrected protocols, respectively. With no image guidance, 40.8% of fractions would have been >5 mm off target. Using the first five CBCT shifts to correct subsequent fractions, this percentage decreased to 19.0% of all fractions delivered and decreased the percentage of patients with average daily 3D errors >5 mm from 35.7% to 14.3% vs. no image guidance. Using an average of the first 10 CBCT shifts did not significantly improve this outcome. Conclusions: Using the first five CBCT shift measurements as an estimation of the systematic setup error improves daily setup accuracy for a subset of patients with head-and-neck cancer receiving intensity-modulated radiation therapy and primarily benefited those with large 3D correction vectors (>5 mm). Daily CBCT is still necessary until methods are developed that more accurately determine which patients may benefit from

  11. On-Line Use of Three-Dimensional Marker Trajectory Estimation From Cone-Beam Computed Tomography Projections for Precise Setup in Radiotherapy for Targets With Respiratory Motion

    SciTech Connect

    Worm, Esben S.; Hoyer, Morten; Fledelius, Walther; Nielsen, Jens E.; Larsen, Lars P.; Poulsen, Per R.

    2012-05-01

    Purpose: To develop and evaluate accurate and objective on-line patient setup based on a novel semiautomatic technique in which three-dimensional marker trajectories were estimated from two-dimensional cone-beam computed tomography (CBCT) projections. Methods and Materials: Seven treatment courses of stereotactic body radiotherapy for liver tumors were delivered in 21 fractions in total to 6 patients by a linear accelerator. Each patient had two to three gold markers implanted close to the tumors. Before treatment, a CBCT scan with approximately 675 two-dimensional projections was acquired during a full gantry rotation. The marker positions were segmented in each projection. From this, the three-dimensional marker trajectories were estimated using a probability based method. The required couch shifts for patient setup were calculated from the mean marker positions along the trajectories. A motion phantom moving with known tumor trajectories was used to examine the accuracy of the method. Trajectory-based setup was retrospectively used off-line for the first five treatment courses (15 fractions) and on-line for the last two treatment courses (6 fractions). Automatic marker segmentation was compared with manual segmentation. The trajectory-based setup was compared with setup based on conventional CBCT guidance on the markers (first 15 fractions). Results: Phantom measurements showed that trajectory-based estimation of the mean marker position was accurate within 0.3 mm. The on-line trajectory-based patient setup was performed within approximately 5 minutes. The automatic marker segmentation agreed with manual segmentation within 0.36 {+-} 0.50 pixels (mean {+-} SD; pixel size, 0.26 mm in isocenter). The accuracy of conventional volumetric CBCT guidance was compromised by motion smearing ({<=}21 mm) that induced an absolute three-dimensional setup error of 1.6 {+-} 0.9 mm (maximum, 3.2) relative to trajectory-based setup. Conclusions: The first on-line clinical use of

  12. Volumetric and dosimetric assessment by cone-beam computed tomography scans in head and neck radiation therapy: a monitoring in four phases of treatment.

    PubMed

    Cozzolino, M; Fiorentino, A; Oliviero, C; Pedicini, P; Clemente, S; Califano, G; Caivano, R; Chiumento, C; Fusco, V

    2014-08-01

    Due to the anatomical changes frequently occurring during the course of head and neck (H&N) cancer radiotherapy, the dose distribution, which was actually delivered to the patient, might significantly differ from that planned. The aim of this paper is to investigate these volumetric changes and the resulting dosimetric implications on organs at risk (OARs) and clinical target volumes (CTVs) by cone beam computed tomography (CBCT) scans throughout the treatment. Ten H&N patients, treated by Intensity Modulated Radiotherapy, were analyzed. CTVs and OARs were delineated on four CBCT, acquired at the 10(th), 15(th), 20(th) and 25(th) treatment session