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Sample records for 3-dimensional cone-beam computed

  1. Surgical orthodontic treatment for a patient with advanced periodontal disease: evaluation with electromyography and 3-dimensional cone-beam computed tomography.

    PubMed

    Nakajima, Kan; Yamaguchi, Tetsutaro; Maki, Koutaro

    2009-09-01

    We report here the case of a woman with Class III malocclusion and advanced periodontal disease who was treated with surgical orthodontic correction. Functional recovery after orthodontic treatment is often monitored by serial electromyography of the masticatory muscles, whereas 3-dimensional cone-beam computed tomography can provide detailed structural information about, for example, periodontal bone defects. However, it is unclear whether the information obtained via these methods is sufficient to determine the treatment goal. It might be useful to address this issue for patients with advanced periodontal disease because of much variability between patients in the determination of treatment goals. We used detailed information obtained by 3-dimensional cone-beam computed tomography to identify periodontal bone defects and set appropriate treatment goals for inclination of the incisors and mandibular surgery. Results for this patient included stable occlusion and improved facial esthetics. This case report illustrates the benefits of establishing treatment goals acceptable to the patient, based on precise 3-dimensional assessment of dentoalveolar bone, and by using masticatory muscle activity to monitor the stability of occlusion.

  2. Evaluation of the anterior mandibular donor site one year after secondary reconstruction of an alveolar cleft: 3-dimensional analysis using cone-beam computed tomography.

    PubMed

    van Bilsen, M W T; Schreurs, R; Meulstee, J W; Kuijpers, M A R; Meijer, G J; Borstlap, W A; Bergé, S J; Maal, T J J

    2015-10-01

    The aim of this study was to analyse changes in the volume of the chin after harvest of a bone graft for secondary reconstruction of an alveolar cleft. Cone-beam computed tomographic (CT) scans of 27 patients taken preoperatively, and immediately and one year postoperatively, were analysed, and 3-dimensional hard-tissue reconstructions made. The hard-tissue segmentation of the scan taken one year postoperatively was subtracted from the segmentation of the preoperative scan to calculate the alteration in the volume of bone at the donor site (chin). A centrally-orientated persistent concavity at the buccal side of the chin was found (mean (range) 160 (0-500) mm(3)). At the lingual side of the chin, a central concavity remained (mean (range) volume 20 (0-80) mm(3)). Remarkably, at the periphery of this concavity there was overgrowth of new bone (mean (range) volume 350 (0-1600) mm(3)). Re-attachment of the muscles of the tongue resulted in a significantly larger central lingual defect one year postoperatively (p=0.01). We also measured minor alterations in volume of the chin at one year. Whether these alterations influence facial appearance and long term bony quality is to be the subject of further research.

  3. 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

  4. 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

  5. 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.

  6. Cone beam computed tomography scanning and diagnosis for dental implants.

    PubMed

    Greenberg, Alex M

    2015-05-01

    Cone beam computed tomography (CBCT) has become an important new technology for oral and maxillofacial surgery practitioners. CBCT provides improved office-based diagnostic capability and applications for surgical procedures, such as CT guidance through the use of computer-generated drill guides. A thorough knowledge of the basic science of CBCT as well as the ability to interpret the images correctly and thoroughly is essential to current practice.

  7. 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

  8. 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.

  9. Incidental findings on cone beam computed tomography images.

    PubMed

    Allareddy, Veeratrishul; Vincent, Steven D; Hellstein, John W; Qian, Fang; Smoker, Wendy R K; Ruprecht, Axel

    2012-01-01

    Background. Cone beam computed tomography (CBCT) has gained widespread acceptance in dentistry for a variety of applications. Most dentists who are not radiologists/trained in radiology are generally not familiar with interpretation of anatomical structures and/or pathosis outside their area of primary interest, as often this was not within the scope of their training. Objectives. To assess that the number of incidental findings on a CBCT scan is high both within and outside of the primary area of interest, thereby emphasizing the importance of interpretation of all areas visualized on the scan. Materials and Methods. An oral and maxillofacial radiologist reviewed 1000 CBCT scans (382 males and 618 females) for findings both in- and outside the area of interest. Results. Of the 1000 subjects that were reviewed, 943 scans showed findings in the primary regions of interest and/or outside the regions of interest, and 76 different conditions were visualized in these scans both in and outside the areas of interest. Conclusion. From the wide scope of findings noted on these scans, it can be concluded that it is essential that a person trained in advanced interpretation techniques in radiology interprets cone beam computed tomography scans.

  10. 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

  11. 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

  12. Cone Beam Computed Tomography Evaluation of Inverted Mesiodentes.

    PubMed

    Al-Sehaibany, Fares S; Marzouk, Hazem M; Salama, Fouad S

    2016-01-01

    A mesiodens is the most common type of supernumerary teeth. The purpose of this report is to present a rare occurrence of non-syndromic impacted inverted mesiodentes in an 8.5-year-old boy who presented with a chief complaint of delayed eruption of his permanent maxillary left central incisor. Occlusal and panoramic radiographs, as well as cone beam computed tomography (CBCT) with a three-dimensional (3-D) reconstruction image, confirmed that one supernumerary tooth had perforated the nasal fossa floor and the other was in close approximation to the to the same site. Surgical removal of both mesiodentes was indicated. Radiographic evidence of complete healing was observed 12 months following surgical removal. The use of CBCT with a 3-D reconstruction image as a tool in diagnosis and evaluation of healing after surgical removal is recommended.

  13. 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

  14. 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.

  15. Cone Beam Computed Tomography Evaluation of Inverted Mesiodentes.

    PubMed

    Al-Sehaibany, Fares S; Marzouk, Hazem M; Salama, Fouad S

    2016-01-01

    A mesiodens is the most common type of supernumerary teeth. The purpose of this report is to present a rare occurrence of non-syndromic impacted inverted mesiodentes in an 8.5-year-old boy who presented with a chief complaint of delayed eruption of his permanent maxillary left central incisor. Occlusal and panoramic radiographs, as well as cone beam computed tomography (CBCT) with a three-dimensional (3-D) reconstruction image, confirmed that one supernumerary tooth had perforated the nasal fossa floor and the other was in close approximation to the to the same site. Surgical removal of both mesiodentes was indicated. Radiographic evidence of complete healing was observed 12 months following surgical removal. The use of CBCT with a 3-D reconstruction image as a tool in diagnosis and evaluation of healing after surgical removal is recommended. PMID:27620520

  16. Cone beam optical computed tomography-based gel dosimetry

    NASA Astrophysics Data System (ADS)

    Olding, Timothy Russell

    The complex dose distributions delivered by modern, conformal radiation therapy techniques present a considerable challenge in dose verification. Traditional measurement tools are difficult and laborious to use, since complete verification requires that the doses be determined in three dimensions (3D). The difficulty is further complicated by a required target accuracy of +/- 5% for the dose delivery. Gel dosimetry is an attractive option for realizing a tissue-equivalent, 3D dose verification tool with high resolution readout capabilities. However, much important work remains to be completed prior to its acceptance in the clinic. The careful development of easily accessible, fast optical readout tools such as cone beam optical computed tomography (CT) in combination with stable and reliable low-toxicity gel dosimeters is one key step in this process. In this thesis, the performance capabilities and limitations of the two main classes of cone beam optical CT-based absorbing and scattering gel dosimetry are characterized, and their measurement improved through careful matching of dosimeter and scanner performance. These systems are then applied to the evaluation of clinically relevant complex dose distributions. Three-dimensional quality assurance assessments of complex treatment plan dose distributions are shown to be feasible using an optically absorbing Fricke-xylenol-orange-gelatin-based gel dosimeter. Better than 95% voxel agreement is achieved between the plan and the delivery, using 3% dose difference and 3 mm spatial distance-to-agreement gamma function comparison criteria. Small field dose delivery evaluations are demonstrated to be viable using an optically scattering N-isopropylacrylamide (NIPAM)-based polymer gel, with the same comparison criteria. Full treatment process quality assurance is also possible using a NIPAM dosimeter in-phantom, but is limited in its accuracy due to the inherent difficulty of managing the effects of stray light pertubation in

  17. Is there a role for the use of volumetric cone beam computed tomography in periodontics?

    PubMed

    du Bois, A H; Kardachi, B; Bartold, P M

    2012-03-01

    Volumetric computed cone beam tomography offers a number of significant advantages over conventional intraoral and extraoral panoramic radiography, as well as computed tomography. To date, periodontal diagnosis has relied heavily on the assessment of both intraoral radiographs and extraoral panoramic radiographs. With emerging technology in radiology there has been considerable interest in the role that volumetric cone beam computed tomography might play in periodontal diagnostics. This narrative reviews the current evidence and considers whether there is a role for volumetric cone beam computed tomography in periodontics.

  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. Forensic imaging of projectiles using cone-beam computed tomography.

    PubMed

    von See, Constantin; Bormann, Kai-Hendrik; Schumann, Paul; Goetz, Friedrich; Gellrich, Nils-Claudius; Rücker, Martin

    2009-09-10

    In patients with gunshot injuries, it is easy to detect a projectile within the body due to the high-density of the object, but artefacts make it difficult to obtain information about the deformation and the exact location of the projectile in surrounding tissues. Cone-beam computed tomography (CBCT) is a new radiological imaging modality that allows radio-opaque objects to be localised and assessed in three dimensions. The full potential of the use of CBCT in forensic medicine has not yet been explored. In this study, three different modern projectiles were fired into the heads of pig cadavers (n=6) under standardised conditions. Tissue destruction and the location of the projectiles were analysed separately using CBCT and multi-slice computed tomography (MDCT). The projectiles had the same kinetic energy but showed considerable differences in deformation behaviour. Within the study groups, tissue destruction was reproducible. CBCT is less severely affected by metallic artefacts than MDCT. Therefore CBCT is superior in visualising bone destruction in the immediate vicinity of the projectile and projectile deformation, whereas MDCT allows soft tissue to be evaluated in more detail. CBCT is an improved diagnostic tool for the evaluation of gunshot injuries. In particular, it is superior to MDCT in detecting structural hard-tissue damage in the immediate vicinity of high-density metal projectiles and in identifying the precise location of a projectile in the body.

  20. Use of cone beam computed tomography in periodontology

    PubMed Central

    Acar, Buket; Kamburoğlu, Kıvanç

    2014-01-01

    Diagnosis of periodontal disease mainly depends on clinical signs and symptoms. However, in the case of bone destruction, radiographs are valuable diagnostic tools as an adjunct to the clinical examination. Two dimensional periapical and panoramic radiographs are routinely used for diagnosing periodontal bone levels. In two dimensional imaging, evaluation of bone craters, lamina dura and periodontal bone level is limited by projection geometry and superpositions of adjacent anatomical structures. Those limitations of 2D radiographs can be eliminated by three-dimensional imaging techniques such as computed tomography. Cone beam computed tomography (CBCT) generates 3D volumetric images and is also commonly used in dentistry. All CBCT units provide axial, coronal and sagittal multi-planar reconstructed images without magnification. Also, panoramic images without distortion and magnification can be generated with curved planar reformation. CBCT displays 3D images that are necessary for the diagnosis of intra bony defects, furcation involvements and buccal/lingual bone destructions. CBCT applications provide obvious benefits in periodontics, however; it should be used only in correct indications considering the necessity and the potential hazards of the examination. PMID:24876918

  1. [Role of cone-beam computed tomography in diagnostic otorhinolaryngological imaging].

    PubMed

    Perényi, Ádám; Bella, Zsolt; Baráth, Zoltán; Magyar, Péter; Nagy, Katalin; Rovó, László

    2016-01-10

    Accurate diagnosis and preoperative planning in modern otorhinolaryngology is strongly supported by imaging with enhanced visualization. Computed tomography is often used to examine structures within bone frameworks. Given the hazards of ionizing radiation, repetitive imaging studies exponentially increase the risk of damages to radiosensitive tissues. The authors compare multislice and cone-beam computed tomography and determine the role, advantages and disadvantages of cone-beam computed tomography in otorhinolaryngological imaging. They summarize the knowledge from the international literature and their individual imaging studies. They conclude that cone-beam computed tomography enables high-resolution imaging and reconstruction in any optional plane and in space with considerably lower effective radiation dose. Cone-beam computed tomography with appropriate indications proved to be an excellent diagnostic tool in otorhinolaryngological imaging. It makes an alternative to multislice computed tomography and it is an effective tool in perioperative and postoperative follow-up, especially in those cases which necessitate repetitive imaging with computed tomography.

  2. 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

  3. 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. PMID:27559345

  4. Use of dentomaxillofacial cone beam computed tomography in dentistry

    PubMed Central

    Kamburoğlu, Kıvanç

    2015-01-01

    Cone-beam computed tomography (CBCT) was developed and introduced specifically for dento-maxillofacial imaging. CBCT possesses a number of advantages over medical CT in clinical practice, such as lower effective radiation doses, lower costs, fewer space requirements, easier image acquisition, and interactive display modes such as mutiplanar reconstruction that are applicable to maxillofacial imaging. However, the disadvantages of CBCT include higher doses than two-dimensional imaging; the inability to accurately represent the internal structure of soft tissues and soft-tissue lesions; a limited correlation with Hounsfield Units for standardized quantification of bone density; and the presence of various types of image artifacts, mainly those produced by metal restorations. CBCT is now commonly used for a variety of purposes in oral implantology, dento-maxillofacial surgery, image-guided surgical procedures, endodontics, periodontics and orthodontics. CBCT applications provide obvious benefits in the assessment of dentomaxillofacial region, however; it should be used only in correct indications considering the necessity and the potential hazards of the examination. PMID:26120381

  5. Concrescence: Cone-Beam Computed Tomography Imaging Perspective

    PubMed Central

    Alluri, LeelaSubhashini Choudary; Mallela, Dhiraj

    2016-01-01

    Concrescence is a form of twinning, formed by the confluence of cementum of two teeth at the root level. The diagnosis of concrescence has largely relied on the conventional 2D imaging. The 2D imaging has inherent limitations such as distortion and superimposition. Cone-Beam CT eliminates these limitations. The aim of this article was to describe a case of dental abnormality using Cone-Beam CT imaging modality. Volumetric data demonstrated confluence of left mandibular third molar with a paramolar, a supernumerary tooth. To our knowledge, this is the second case in the dental literature reported demonstrating the use of Cone-Beam CT in the diagnosis of concrescence. PMID:27800194

  6. 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.

  7. 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

  8. Model based scatter correction for cone-beam computed tomography

    NASA Astrophysics Data System (ADS)

    Wiegert, Jens; Bertram, Matthias; Rose, Georg; Aach, Til

    2005-04-01

    Scattered radiation is a major source of image degradation and nonlinearity in flat detector based cone-beam CT. Due to the bigger irradiated volume the amount of scattered radiation in true cone-beam geometry is considerably higher than for fan beam CT. This on the one hand reduces the signal to noise ratio, since the additional scattered photons contribute only to the noise and not to the measured signal, and on the other hand cupping and streak artifacts arise in the reconstructed volume. Anti-scatter grids composed of lead lamellae and interspacing material decrease the SNR for flat detector based CB-CT geometry, because the beneficial scatter attenuating effect is overcompensated by the absorption of primary radiation. Additionally, due to the high amount of scatter that still remains behind the grid, cupping and streak artifacts cannot be reduced sufficiently. Computerized scatter correction schemes are therefore essential for achieving artifact-free reconstructed images in cone-beam CT. In this work, a fast model based scatter correction algorithm is proposed, aiming at accurately estimating the level and spatial distribution of scattered radiation background in each projection. This will allow for effectively reducing streak and cupping artifacts due to scattering in cone-beam CT applications.

  9. 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.

  10. 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.

  11. 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.

  12. 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

  13. A reconstruction method for cone-beam differential x-ray phase-contrast computed tomography.

    PubMed

    Fu, Jian; Velroyen, Astrid; Tan, Renbo; Zhang, Junwei; Chen, Liyuan; Tapfer, Arne; Bech, Martin; Pfeiffer, Franz

    2012-09-10

    Most existing differential phase-contrast computed tomography (DPC-CT) approaches are based on three kinds of scanning geometries, described by parallel-beam, fan-beam and cone-beam. Due to the potential of compact imaging systems with magnified spatial resolution, cone-beam DPC-CT has attracted significant interest. In this paper, we report a reconstruction method based on a back-projection filtration (BPF) algorithm for cone-beam DPC-CT. Due to the differential nature of phase contrast projections, the algorithm restrains from differentiation of the projection data prior to back-projection, unlike BPF algorithms commonly used for absorption-based CT data. This work comprises a numerical study of the algorithm and its experimental verification using a dataset measured with a three-grating interferometer and a micro-focus x-ray tube source. Moreover, the numerical simulation and experimental results demonstrate that the proposed method can deal with several classes of truncated cone-beam datasets. We believe that this feature is of particular interest for future medical cone-beam phase-contrast CT imaging applications.

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

    PubMed

    Ye, Ivan B; Wang, Ge

    2012-08-01

    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.

  15. 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.

  16. 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.

  17. AAE and AAOMR Joint Position Statement: Use of Cone Beam Computed Tomography in Endodontics 2015 Update.

    PubMed

    2015-10-01

    The following statement was prepared by the Special Committee to Revise the Joint American Association of Endodontists/American Academy of Oral and Maxillofacial Radiology Position on Cone Beam Computed Tomography, and approved by the AAE Board of Directors and AAOMR Executive Council in May 2015. AAE members may reprint this position statement for distribution to patients or referring dentists.

  18. Cone Beam Computed Tomography-Dawn of A New Imaging Modality in Orthodontics

    PubMed Central

    Mamatha, J; Chaitra, K R; Paul, Renji K; George, Merin; Anitha, J; Khanna, Bharti

    2015-01-01

    Today, we are in a world of innovations, and there are various diagnostics aids that help to take a decision regarding treatment in a well-planned way. Cone beam computed tomography (CBCT) has been a vital tool for imaging diagnostic tool in orthodontics. This article reviews case reports during orthodontic treatment and importance of CBCT during the treatment evaluation. PMID:26225116

  19. 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

  20. Cone Beam Computed Tomography-Dawn of A New Imaging Modality in Orthodontics.

    PubMed

    Mamatha, J; Chaitra, K R; Paul, Renji K; George, Merin; Anitha, J; Khanna, Bharti

    2015-01-01

    Today, we are in a world of innovations, and there are various diagnostics aids that help to take a decision regarding treatment in a well-planned way. Cone beam computed tomography (CBCT) has been a vital tool for imaging diagnostic tool in orthodontics. This article reviews case reports during orthodontic treatment and importance of CBCT during the treatment evaluation.

  1. 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

  2. Dimensional stability in composite cone beam computed tomography

    PubMed Central

    Kopp, S; Ottl, P

    2010-01-01

    An automated increase in the field of view (FOV) for multipurpose cone beam CT (CBCT) by “stitching” (joining) up to three component volumes to yield a larger composite volume must still ensure dimensional stability, especially if the image is to form the basis for a surgical splint. Dimensional stability, image discrepancies and the influence of movement artefacts between exposures were evaluated. The first consumer installation of the Kodak 9000 three-dimensional (3D) extraoral imaging system with stitching software was used for the evaluation of a human mandible with three endodontic instruments as markers. The distances between several reproducible points were measured directly and the results compared with the values measured on screen. Displacements of the mandible along all axes between exposures as well as angular displacements were conducted to test the capability of the system. The standard deviations (SD) of the results for the vertical distances varied between 0.212 mm and 0.409 mm (approximately 1–2 voxels; range, 0.6–1.3 mm) and may be considered the systematic error. The SD of the results for the horizontal and diagonal distances varied between 0.195 mm and 0.571 mm (approximately 1–3 voxels; range, 0.6–1.7 mm) if the group with overall horizontal angulations of 10° and a central rotation of 20° was omitted. In conclusion, the evaluated stitching software is a useful tool to expand the options of combined CBCT with an initial small FOV by allowing a merger of up to three component volumes to yield a larger FOV of about 80 × 80 × 37 mm. The dimensional stability was acceptable when seen in relation to the induced disturbance. Further evaluation of this composite CBCT/digital imaging and communications in medicine system for subsequent splint fabrication may yield promising results. PMID:21062945

  3. 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

  4. 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

  5. Prior image constrained scatter correction in cone-beam computed tomography image-guided radiation therapy

    NASA Astrophysics Data System (ADS)

    Brunner, Stephen; Nett, Brian E.; Tolakanahalli, Ranjini; Chen, Guang-Hong

    2011-02-01

    X-ray scatter is a significant problem in cone-beam computed tomography when thicker objects and larger cone angles are used, as scattered radiation can lead to reduced contrast and CT number inaccuracy. Advances have been made in x-ray computed tomography (CT) by incorporating a high quality prior image into the image reconstruction process. In this paper, we extend this idea to correct scatter-induced shading artifacts in cone-beam CT image-guided radiation therapy. Specifically, this paper presents a new scatter correction algorithm which uses a prior image with low scatter artifacts to reduce shading artifacts in cone-beam CT images acquired under conditions of high scatter. The proposed correction algorithm begins with an empirical hypothesis that the target image can be written as a weighted summation of a series of basis images that are generated by raising the raw cone-beam projection data to different powers, and then, reconstructing using the standard filtered backprojection algorithm. The weight for each basis image is calculated by minimizing the difference between the target image and the prior image. The performance of the scatter correction algorithm is qualitatively and quantitatively evaluated through phantom studies using a Varian 2100 EX System with an on-board imager. Results show that the proposed scatter correction algorithm using a prior image with low scatter artifacts can substantially mitigate scatter-induced shading artifacts in both full-fan and half-fan modes.

  6. 3D algebraic iterative reconstruction for cone-beam x-ray differential phase-contrast computed tomography.

    PubMed

    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.

  7. High temporal resolution and streak-free four-dimensional cone-beam computed tomography

    NASA Astrophysics Data System (ADS)

    Leng, Shuai; Tang, Jie; Zambelli, Joseph; Nett, Brian; Tolakanahalli, Ranjini; Chen, Guang-Hong

    2008-10-01

    Cone-beam computed tomography (CBCT) has been clinically used to verify patient position and to localize the target of treatment in image-guided radiation therapy (IGRT). However, when the chest and the upper abdomen are scanned, respiratory-induced motion blurring limits the utility of CBCT. In order to mitigate this blurring, respiratory-gated CBCT, i.e. 4D CBCT, was introduced. In 4D CBCT, the cone-beam projection data sets acquired during a gantry rotation are sorted into several respiratory phases. In these gated reconstructions, the number of projections for each respiratory phase is significantly reduced. Consequently, undersampling streaking artifacts are present in the reconstructed images, and the image contrast resolution is also significantly compromised. In this paper, we present a new method to simultaneously achieve both high temporal resolution (~100 ms) and streaking artifact-free image volumes in 4D CBCT. The enabling technique is a newly proposed image reconstruction method, i.e. prior image constrained compressed sensing (PICCS), which enables accurate image reconstruction using vastly undersampled cone-beam projections and a fully sampled prior image. Using PICCS, a streak-free image can be reconstructed from 10-20 cone-beam projections while the signal-to-noise ratio is determined by a denoising feature of the selected objective function and by the prior image, which is reconstructed using all of the acquired cone-beam projections. This feature of PICCS breaks the connection between the temporal resolution and streaking artifacts' level in 4D CBCT. Numerical simulations and experimental phantom studies have been conducted to validate the method.

  8. Incidental findings arising with cone beam computed tomography imaging of the orthodontic patient.

    PubMed

    Rogers, Sheelagh A; Drage, Nicholas; Durning, Peter

    2011-03-01

    Cone beam computed tomography (CBCT) of orthodontic patients is a diagnostic tool used increasingly in hospital and primary care settings. It offers a high-diagnostic yield, short scanning times, and a lower radiation dose than conventional computed tomography. This article reports on four incidental findings-that appear unrelated to the scan's original purpose-arising in patients for whom CBCT was carried out for orthodontic purposes. It underlines the need for complete reporting of the data set. PMID:21208090

  9. 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

  10. [The use of cone beam computed tomography for diagnostics of chronic suppurative otitis media].

    PubMed

    Vishniakov, V V; Lezhnev, D A; Sarakueva, A R

    2014-01-01

    The objective of the present study was to estimate the potential of cone beam computed tomography of the temporal bone as a diagnostic tool for chronic suppurative otitis media. This method was employed to study the temporal bones of 33 patients presenting with chronic suppurative otitis media (18 cases of one-sided and 15 cases of two-sided inflammatory process). The results of the total of 48 sessions of beam computed tomography of the temporal bones were available for analysis. The age of the patients varied from 16 to 80 years. Seven of them presented with chronic suppurative otitis media in combination with cholesteatoma. The clinical symptoms of chronic suppurative otitis media were revealed by cone beam computed tomography in conjunction with the peculiarities of visualization of bone tissue destruction using this technique (both in the presence of cholesteatoma and without it). The rationale has been developed for the use of cone beam computed tomography in diagnostics of chronic suppurative otitis media.

  11. 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

  12. 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

  13. 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.

  14. 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

  15. Accuracy of measurements of mandibular anatomy in cone beam computed tomography images

    PubMed Central

    Ludlow, John B.; Laster, William Stewart; See, Meit; Bailey, L’Tanya J.; Hershey, H. Garland

    2013-01-01

    Objectives Cone beam computed tomography (CBCT) images of ideally positioned and systematically mispositioned dry skulls were measured using two-dimensional and three-dimensional software measurement techniques. Image measurements were compared with caliper measurements of the skulls. Study design Cone beam computed tomography volumes of 28 skulls in ideal, shifted, and rotated positions were assessed by measuring distances between anatomic points and reference wires by using panoramic reconstructions (two-dimensional) and direct measurements from axial slices (three-dimensional). Differences between caliper measurements on skulls and software measurements in images were assessed with paired t tests and analysis of variance (ANOVA). Results Accuracy of measurement was not significantly affected by alterations in skull position or measurement of right or left sides. For easily visualized orthodontic wires, measurement accuracy was expressed by average errors less than 1.2% for two-dimensional measurement techniques and less than 0.6% for three-dimensional measurement techniques. Anatomic measurements were significantly more variable regardless of measurement technique. Conclusions Both two-dimensional and three-dimensional techniques provide acceptably accurate measurement of mandibular anatomy. Cone beam computed tomography measurement was not significantly influenced by variation in skull orientation during image acquisition. PMID:17395068

  16. Laplace operator based reconstruction algorithm for truncated spiral cone beam computed tomography.

    PubMed

    Zou, Xiaobing; Yu, Hengyong; Zeng, Li

    2013-01-01

    To reconstruct images from truncated projections collected along a spiral trajectory, the most common approach is to smoothly extrapolate each projection to suppress truncation artifacts. Based on the work of Dennerlein, a local reconstruction algorithm is developed for spiral cone beam computed tomography (CT), which does not need explicit projection extrapolation. This algorithm is a filtered-backprojection (FBP) format and contains three major steps: cosine weight, filtration, and backprojection. While the cosine weight and backprojection steps are the same as the classical Feldkamp - Davis - Kress (FDK) scheme, the filtering step contains two steps: Laplace filtering and Radon transform-based filtering. Numerical simulation results show that the proposed algorithm has a better performance than FDK algorithm for region-of-interest (ROI) reconstruction of spiral cone-beam CT.

  17. 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.

  18. 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

  19. 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.

  20. A post-reconstruction method to correct cupping artifacts in cone beam breast computed tomography

    SciTech Connect

    Altunbas, M. C.; Shaw, C. C.; Chen, L.; Lai, C.; Liu, X.; Han, T.; Wang, T.

    2007-07-15

    In cone beam breast computed tomography (CT), scattered radiation leads to nonuniform biasing of CT numbers known as a cupping artifact. Besides being visual distractions, cupping artifacts appear as background nonuniformities, which impair efficient gray scale windowing and pose a problem in threshold based volume visualization/segmentation. To overcome this problem, we have developed a background nonuniformity correction method specifically designed for cone beam breast CT. With this technique, the cupping artifact is modeled as an additive background signal profile in the reconstructed breast images. Due to the largely circularly symmetric shape of a typical breast, the additive background signal profile was also assumed to be circularly symmetric. The radial variation of the background signals was estimated by measuring the spatial variation of adipose tissue signals in front view breast images. To extract adipose tissue signals in an automated manner, a signal sampling scheme in polar coordinates and a background trend fitting algorithm were implemented. The background fits compared with targeted adipose tissue signal value (constant throughout the breast volume) to get an additive correction value for each tissue voxel. To test the accuracy, we applied the technique to cone beam CT images of mastectomy specimens. After correction, the images demonstrated significantly improved signal uniformity in both front and side view slices. The reduction of both intraslice and interslice variations in adipose tissue CT numbers supported our observations.

  1. Evaluation of Optic Canal and Surrounding Structures Using Cone Beam Computed Tomography: Considerations for Maxillofacial Surgery.

    PubMed

    Sinanoglu, Alper; Orhan, Kaan; Kursun, Sebnem; Inceoglu, Beste; Oztas, Bengi

    2016-07-01

    The optic canal connects the anterior cranial fossa and the orbit and maintains the optic nerve and the ophthalmic artery. Within the extent of the surgical approach of the region, risk of iatrogenic injury of the neural and vascular structures increases. The aim of this retrospective morphometric study is to investigate the radiological anatomy of orbita, optic canal, and its surrounding using cone beam computed tomography (CBCT) scans in a group of Turkish population.Cone beam computed tomography images of a total of 182 patients were evaluated by 2 observers. Anatomical parameters regarding optic canal and orbita were measured for all patients from axial, sagittal, and three-dimensional reconstructed images. To assess intraobserver reliability, the Wilcoxon matched-pairs test was used. Pearson χ test and Student t test were performed for statistical analysis of differences, sex, localization, and measurements (P < 0.05).Repeated CBCT evaluation and measurements indicated no significant inter and intra-observer difference were found (P > 0.05). The orbita width and height were larger for the males than females (P < 0.05). No significant difference was observed for optic canal shape, dimensions of infraorbital foramen (IOF) and supraorbital foramen (SOF), SOF-midline distance, and SOF-IOF distance according to sex and location (P > 0.05). Examination CBCT scans revealed that the shape of the optic canal was 70% funnel and 28% Hourglass shape, 2% amorph type round.These results provide detailed knowledge of the anatomical characteristics in the orbital area which may be of assistance for surgeons preoperatively. Cone beam computed tomography scans can be an alternative modality for multislice computed tomography with submillimeter resolution and lower dose in preoperative imaging of the orbit. PMID:27391501

  2. PI-line-based image reconstruction in helical cone-beam computed tomography with a variable pitch

    SciTech Connect

    Zou Yu; Pan Xiaochuan; Xia Dan; Wang Ge

    2005-08-15

    Current applications of helical cone-beam computed tomography (CT) involve primarily a constant pitch where the translating speed of the table and the rotation speed of the source-detector remain constant. However, situations do exist where it may be more desirable to use a helical scan with a variable translating speed of the table, leading a variable pitch. One of such applications could arise in helical cone-beam CT fluoroscopy for the determination of vascular structures through real-time imaging of contrast bolus arrival. Most of the existing reconstruction algorithms have been developed only for helical cone-beam CT with constant pitch, including the backprojection-filtration (BPF) and filtered-backprojection (FBP) algorithms that we proposed previously. It is possible to generalize some of these algorithms to reconstruct images exactly for helical cone-beam CT with a variable pitch. In this work, we generalize our BPF and FBP algorithms to reconstruct images directly from data acquired in helical cone-beam CT with a variable pitch. We have also performed a preliminary numerical study to demonstrate and verify the generalization of the two algorithms. The results of the study confirm that our generalized BPF and FBP algorithms can yield exact reconstruction in helical cone-beam CT with a variable pitch. It should be pointed out that our generalized BPF algorithm is the only algorithm that is capable of reconstructing exactly region-of-interest image from data containing transverse truncations.

  3. 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

  4. Conservative Management of Type III Dens in Dente Using Cone Beam Computed Tomography

    PubMed Central

    Pradeep, K.; Charlie, M.; Kuttappa, M. A.; Rao, Prasana Kumar

    2012-01-01

    Dens in dente, also known as dens invaginatus, dilated composite odontoma, or deep foramen caecum, is a developmental malformation that usually affects maxillary incisor teeth, particularly lateral incisors. It may occur in teeth anywhere within the jaws, other locations are comparatively rare. It can occur within both the crown and the root, although crown invaginations are more common. The use of cone beam computed tomography (CBCT) is very helpful in endodontic diagnosis of complex anatomic variations. In this case we demonstrate the use of CBCT in the evaluation and endodontic management of a Type III dens in dente (Oehler's Type III). PMID:23029634

  5. 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

  6. 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

  7. 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

  8. 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.

  9. 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

  10. 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.

  11. 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

  12. 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

  13. Cone beam x-ray luminescence computed tomography: A feasibility study

    SciTech Connect

    Chen Dongmei; Zhu Shouping; Yi Huangjian; Zhang Xianghan; Chen Duofang; Liang Jimin; Tian Jie

    2013-03-15

    Purpose: The appearance of x-ray luminescence computed tomography (XLCT) opens new possibilities to perform molecular imaging by x ray. In the previous XLCT system, the sample was irradiated by a sequence of narrow x-ray beams and the x-ray luminescence was measured by a highly sensitive charge coupled device (CCD) camera. This resulted in a relatively long sampling time and relatively low utilization of the x-ray beam. In this paper, a novel cone beam x-ray luminescence computed tomography strategy is proposed, which can fully utilize the x-ray dose and shorten the scanning time. The imaging model and reconstruction method are described. The validity of the imaging strategy has been studied in this paper. Methods: In the cone beam XLCT system, the cone beam x ray was adopted to illuminate the sample and a highly sensitive CCD camera was utilized to acquire luminescent photons emitted from the sample. Photons scattering in biological tissues makes it an ill-posed problem to reconstruct the 3D distribution of the x-ray luminescent sample in the cone beam XLCT. In order to overcome this issue, the authors used the diffusion approximation model to describe the photon propagation in tissues, and employed the sparse regularization method for reconstruction. An incomplete variables truncated conjugate gradient method and permissible region strategy were used for reconstruction. Meanwhile, traditional x-ray CT imaging could also be performed in this system. The x-ray attenuation effect has been considered in their imaging model, which is helpful in improving the reconstruction accuracy. Results: First, simulation experiments with cylinder phantoms were carried out to illustrate the validity of the proposed compensated method. The experimental results showed that the location error of the compensated algorithm was smaller than that of the uncompensated method. The permissible region strategy was applied and reduced the reconstruction error to less than 2 mm. The robustness

  14. Streaking artifacts reduction in four-dimensional cone-beam computed tomography.

    PubMed

    Leng, Shuai; Zambelli, Joseph; Tolakanahalli, Ranjini; Nett, Brian; Munro, Peter; Star-Lack, Joshua; Paliwal, Bhudatt; Chen, Guang-Hong

    2008-10-01

    Cone-beam computed tomography (CBCT) using an "on-board" x-ray imaging device integrated into a radiation therapy system has recently been made available for patient positioning, target localization, and adaptive treatment planning. One of the challenges for gantry mounted image-guided radiation therapy (IGRT) systems is the slow acquisition of projections for cone-beam CT (CBCT), which makes them sensitive to any patient motion during the scans. Aiming at motion artifact reduction, four-dimensional CBCT (4D CBCT) techniques have been introduced, where a surrogate for the target's motion profile is utilized to sort the cone-beam data by respiratory phase. However, due to the limited gantry rotation speed and limited readout speed of the on-board imager, fewer than 100 projections are available for the image reconstruction at each respiratory phase. Thus, severe undersampling streaking artifacts plague 4D CBCT images. In this paper, the authors propose a simple scheme to significantly reduce the streaking artifacts. In this method, a prior image is first reconstructed using all available projections without gating, in which static structures are well reconstructed while moving objects are blurred. The undersampling streaking artifacts from static structures are estimated from this prior image volume and then can be removed from the phase images using gated reconstruction. The proposed method was validated using numerical simulations, experimental phantom data, and patient data. The fidelity of stationary and moving objects is maintained, while large gains in streak artifact reduction are observed. Using this technique one can reconstruct 4D CBCT datasets using no more projections than are acquired in a 60 s scan. At the same time, a temporal gating window as narrow as 100 ms was utilized. Compared to the conventional 4D CBCT reconstruction, streaking artifacts were reduced by 60% to 70%.

  15. 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.

  16. Planar cone-beam computed tomography for high-resolution industrial application

    NASA Astrophysics Data System (ADS)

    Liu, Tong

    2009-12-01

    Traditional reconstruction algorithm in computed tomography (CT) requires a square reconstruction matrix, regardless of the particular object shape. It becomes inefficient when reconstructing planar objects such as IC chips which have a large area-to-thickness ratio. This article presents a modified cone-beam reconstruction algorithm which is efficient for planar multilayer objects. by detecting the orientation and dimension parameters of the object for the first projection, a reconstruction volume can be defined in a region that would exactly cover the object area and follow the actual orientation of the object. This new technology is demonstrated in both its general form and a targeted application. Compared to conventional cone-beam CT reconstruction, this new method uses much less computation time and storage, can achieve higher reconstruction resolution in the thickness dimension, and makes layer separation much easier for multilayer objects. These advantages will be demonstrated with two high-resolution CT inspection applications of a stacked IC and an advanced packaging device.

  17. 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.

  18. Detection of Foreign Bodies by Spiral Computed Tomography and Cone Beam Computed Tomography in Maxillofacial Regions

    PubMed Central

    Kaviani, Farzaneh; Javad Rashid, Reza; Shahmoradi, Zahra; Gholamian, Masoud

    2014-01-01

    Background and aims. The imaging techniques commonly used for foreign body detection include plain radiography, xeroradiography, computed tomography (CT) scans, magnetic resonance imaging (MRI) and ultrasonography. The aim of the present study was to compare cone-beam computed tomography (CBCT) with conventional CT scan in determination of the exact location of a foreign body in the maxillofacial area in vitro. Materials and methods. In this descriptive study, seven different materials were selected as foreign bodies with dimensions of approximately 2 mm, 1 mm, and 0.5 mm. These materials consisted of metal, glass, wood, stone, plastic, graphite and tooth. These foreign bodies were placed in a sheep head between the corpus of the mandible and muscle, in the tongue and in an air space. One conventional CT scan and two CBCT scans were made on the models. Results. Tooth, metal, stone and glass foreign bodies were seen clearly on CT and CBCT scans made by NewTom at the smallest size in air. However, CBCT scan by NewTom was a more effective technique for visualization of foreign bodies in air compared to conventional CT. Foreign bodies measuring 0.5 mm made of metal, stone, glass, graphite and teeth were detected by all devices in muscle tissue and adjacent bone. Conclusion. According to the results, CBCT scans of NewTom and Planmeca are appropriate tools for detecting foreign bodies with relative high density in the maxillofacial area. PMID:25346836

  19. 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.

  20. A novel image-domain-based cone-beam computed tomography enhancement algorithm

    NASA Astrophysics Data System (ADS)

    Li, Xiang; Li, Tianfang; Yang, Yong; Heron, Dwight E.; Saiful Huq, M.

    2011-05-01

    Kilo-voltage (kV) cone-beam computed tomography (CBCT) plays an important role in image-guided radiotherapy. However, due to a large cone-beam angle, scatter effects significantly degrade the CBCT image quality and limit its clinical application. The goal of this study is to develop an image enhancement algorithm to reduce the low-frequency CBCT image artifacts, which are also called the bias field. The proposed algorithm is based on the hypothesis that image intensities of different types of materials in CBCT images are approximately globally uniform (in other words, a piecewise property). A maximum a posteriori probability framework was developed to estimate the bias field contribution from a given CBCT image. The performance of the proposed CBCT image enhancement method was tested using phantoms and clinical CBCT images. Compared to the original CBCT images, the corrected images using the proposed method achieved a more uniform intensity distribution within each tissue type and significantly reduced cupping and shading artifacts. In a head and a pelvic case, the proposed method reduced the Hounsfield unit (HU) errors within the region of interest from 300 HU to less than 60 HU. In a chest case, the HU errors were reduced from 460 HU to less than 110 HU. The proposed CBCT image enhancement algorithm demonstrated a promising result by the reduction of the scatter-induced low-frequency image artifacts commonly encountered in kV CBCT imaging.

  1. Cone-Beam Computed Tomography contrast validation of an artificial periodontal phantom for use in endodontics.

    PubMed

    Michetti, Jerome; Basarab, Adrian; Tran, Michel; Diemer, Franck; Kouame, Denis

    2015-01-01

    Validation of image processing techniques such as endodontic segmentations in cone-beam computed tomography (CBCT) is a challenging issue because of the lack of ground truth in in vivo experiments. The purpose of our study was to design an artificial surrounding tissues phantom able to provide CBCT image quality of real extracted teeth, similar to in vivo conditions. Note that these extracted teeth could be previously scanned using micro computed tomography (μCT) to access true quantitative measurements of the root canal anatomy. Different design settings are assessed in our study by comparison to in vivo images, in terms of the contrast-to-noise ratio (CNR) obtained between different anatomical structures. Concerning the root canal and the dentine, the best design setup allowed our phantom to provide a CNR difference of only 3% compared to clinical cases. PMID:26738125

  2. 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.

  3. 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

  4. A technique for transferring a patient's smile line to a cone beam computed tomography (CBCT) image.

    PubMed

    Bidra, Avinash S

    2014-08-01

    Fixed implant-supported prosthodontic treatment for patients requiring a gingival prosthesis often demands that bone and implant levels be apical to the patient's maximum smile line. This is to avoid the display of the prosthesis-tissue junction (the junction between the gingival prosthesis and natural soft tissues) and prevent esthetic failures. Recording a patient's lip position during maximum smile is invaluable for the treatment planning process. This article presents a simple technique for clinically recording and transferring the patient's maximum smile line to cone beam computed tomography (CBCT) images for analysis. The technique can help clinicians accurately determine the need for and amount of bone reduction required with respect to the maximum smile line and place implants in optimal positions.

  5. Diagnosis and Treatment of a Type III Dens Invagination Using Cone-Beam Computed Tomography

    PubMed Central

    Bahmani, Mohsen; Adl, Alireza; Javanmardi, Samane; Naghizadeh, Sina

    2016-01-01

    A 20-year-old man presented with the history of pain and swelling in the anterior maxillary segment. The periapical radiography was indicative of a dental anomaly in right maxillary lateral incisor. Due to the insufficient information from conventional radiography, cone-beam computed tomography (CBCT) was ordered. CBCT showed apical root resorption, large apical lucency and two separate canals with distinct apical foramen (Oehlers type III dens invagination). The CBCT image was used as a guide for dentine removal with an ultrasonic tip. Conventional root canal therapy was done using lateral compaction technique. One-and two-year follow-up radiographies revealed periapical repair and absence of symptoms. PMID:27790268

  6. 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

  7. 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

  8. 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

  9. Presurgical planning in implant restorations: correct interpretation of cone-beam computed tomography for improved imaging.

    PubMed

    Kourtis, S; Skondra, E; Roussou, I; Skondras, E V

    2012-10-01

    Contemporary implant dentistry is a primarily prosthetically driven treatment. The implant position is defined during the diagnostic phase, and the radiographic guide (template) indicates accurately the area of concern on the cone-beam computed tomography (CBCT). CBCT is an essential diagnostic key to a successful treatment plan in many cases. The aim of this paper was to underline the importance of proper alignment of the scanning levels in CBCT in order to avoid distorted cross-sectional images. As demonstrated with two clinical cases in this preliminary study, the initial scanning images of the CBCT must be drawn parallel to the occlusal plane, as defined by the diagnostic wax-up of the final restoration. The radiographic template offers valuable information about the planned location and inclination of the implant and the restoration. Proper image reconstruction following the dental scan can contribute significantly to accurate cross-sectional images and detailed presurgical planning.

  10. 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

  11. 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

  12. 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

  13. Developmental salivary gland depression in the ascending mandibular ramus: A cone-beam computed tomography study

    PubMed Central

    Chen, Christine A.; Ahn, Yoonhee; Odell, Scott; Graham, David Mattew

    2016-01-01

    A static, unilateral, and focal bone depression located lingually within the ascending ramus, identical to the Stafne's bone cavity of the angle of the mandible, is being reported. During development of the mandible, submandibular gland inclusion may lead to the formation of a lingual concavity, which could contain fatty tissue, blood vessels, or soft tissue. However, similar occurrences in the ascending ramus at the level of the parotid gland are extremely rare. Similar cases were previously reported in dry, excavated mandibles, and 3 cases were reported in living patients. A 52-year-old African American male patient was seen for pain in the mandibular teeth. Panoramic radiography showed an unusual concavity within the left ascending ramus. Cone-beam computed tomography confirmed this incidental finding. The patient was cleared for the extraction of non-restorable teeth and scheduled for annual follow-up.

  14. Single Rooted Permanent Premolars and Molars - A Rare Clinical Presentation Confirmed using Cone Beam Computed Tomography

    PubMed Central

    Jeddy, Nadeem; Nithya, S.; Krithika, C.; Prabakar, Ramachandra

    2015-01-01

    The morphology of the root and root canal system plays a significant role in the treatment outcome of endodontic procedures. The necessity of clear and high contrast images for tissues like bone and teeth has made the usage of newer imaging techniques inevitable. This is a rare case report wherein, the permanent posterior dentition of both arches was single rooted. While sporadic cases of single rooted teeth have been reported, it is rare for all the premolars and molars to show such variation. This rare clinical observation has been enhanced by Cone Beam Computed Tomography (CBCT), which provides a clear image with added benefits of 3D (Three Dimensional) image reconstruction, low dosage and rapid scan time. PMID:26436065

  15. 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

  16. 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.

  17. Developmental salivary gland depression in the ascending mandibular ramus: A cone-beam computed tomography study.

    PubMed

    Chen, Christine A; Ahn, Yoonhee; Odell, Scott; Mupparapu, Mel; Graham, David Mattew

    2016-09-01

    A static, unilateral, and focal bone depression located lingually within the ascending ramus, identical to the Stafne's bone cavity of the angle of the mandible, is being reported. During development of the mandible, submandibular gland inclusion may lead to the formation of a lingual concavity, which could contain fatty tissue, blood vessels, or soft tissue. However, similar occurrences in the ascending ramus at the level of the parotid gland are extremely rare. Similar cases were previously reported in dry, excavated mandibles, and 3 cases were reported in living patients. A 52-year-old African American male patient was seen for pain in the mandibular teeth. Panoramic radiography showed an unusual concavity within the left ascending ramus. Cone-beam computed tomography confirmed this incidental finding. The patient was cleared for the extraction of non-restorable teeth and scheduled for annual follow-up.

  18. Developmental salivary gland depression in the ascending mandibular ramus: A cone-beam computed tomography study

    PubMed Central

    Chen, Christine A.; Ahn, Yoonhee; Odell, Scott; Graham, David Mattew

    2016-01-01

    A static, unilateral, and focal bone depression located lingually within the ascending ramus, identical to the Stafne's bone cavity of the angle of the mandible, is being reported. During development of the mandible, submandibular gland inclusion may lead to the formation of a lingual concavity, which could contain fatty tissue, blood vessels, or soft tissue. However, similar occurrences in the ascending ramus at the level of the parotid gland are extremely rare. Similar cases were previously reported in dry, excavated mandibles, and 3 cases were reported in living patients. A 52-year-old African American male patient was seen for pain in the mandibular teeth. Panoramic radiography showed an unusual concavity within the left ascending ramus. Cone-beam computed tomography confirmed this incidental finding. The patient was cleared for the extraction of non-restorable teeth and scheduled for annual follow-up. PMID:27672619

  19. 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.

  20. Current status of dental caries diagnosis using cone beam computed tomography

    PubMed Central

    Park, Young-Seok; Ahn, Jin-Soo; Kwon, Ho-Beom

    2011-01-01

    Purpose The purpose of this article is to review the current status of dental caries diagnosis using cone beam computed tomography (CBCT). Materials and Methods An online PubMed search was performed to identify studies on caries research using CBCT. Results Despite its usefulness, there were inherent limitations in the detection of caries lesions through conventional radiograph mainly due to the two-dimensional (2D) representation of caries lesions. Several efforts were made to investigate the three-dimensional (3D) image of lesion, only to gain little popularity. Recently, CBCT was introduced and has been used for diagnosis of caries in several reports. Some of them maintained the superiority of CBCT systems, however it is still under controversies. Conclusion The CBCT systems are promising, however they should not be considered as a primary choice of caries diagnosis in everyday practice yet. Further studies under more standardized condition should be performed in the near future. PMID:21977474

  1. 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

  2. Developmental salivary gland depression in the ascending mandibular ramus: A cone-beam computed tomography study.

    PubMed

    Chen, Christine A; Ahn, Yoonhee; Odell, Scott; Mupparapu, Mel; Graham, David Mattew

    2016-09-01

    A static, unilateral, and focal bone depression located lingually within the ascending ramus, identical to the Stafne's bone cavity of the angle of the mandible, is being reported. During development of the mandible, submandibular gland inclusion may lead to the formation of a lingual concavity, which could contain fatty tissue, blood vessels, or soft tissue. However, similar occurrences in the ascending ramus at the level of the parotid gland are extremely rare. Similar cases were previously reported in dry, excavated mandibles, and 3 cases were reported in living patients. A 52-year-old African American male patient was seen for pain in the mandibular teeth. Panoramic radiography showed an unusual concavity within the left ascending ramus. Cone-beam computed tomography confirmed this incidental finding. The patient was cleared for the extraction of non-restorable teeth and scheduled for annual follow-up. PMID:27672619

  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. 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

  5. C-arm Cone Beam Computed Tomographic Needle Path Overlay for Fluoroscopic-Guided Placement of Translumbar Central Venous Catheters

    SciTech Connect

    Tam, Alda; Mohamed, Ashraf; Pfister, Marcus; Rohm, Esther; Wallace, Michael J.

    2009-07-15

    C-arm cone beam computed tomography is an advanced 3D imaging technology that is currently available on state-of-the-art flat-panel-based angiography systems. The overlay of cross-sectional imaging information can now be integrated with real-time fluoroscopy. This overlay technology was used to guide the placement of three percutaneous translumbar inferior vena cava catheters.

  6. 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

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

    PubMed

    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

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

    PubMed

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

    2007-02-01

    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. 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.

  11. Stray light reduction in optical computed tomography using a convergent cone-beam source

    NASA Astrophysics Data System (ADS)

    Jordan, Kevin; Dekker, Kurtis; Battista, Jerry

    2015-01-01

    The planar diffuser light source for a cone-beam optical CT scanner was replaced with a filtered LED and large Fresnel lens. The source was focused on a camera and convergent cone-beam images were acquired. Images are sensitive to mismatches in the refractive index of vessels, samples and matching liquid. For PETE jars and water solutions, a loss of approximately 30% of the projections was demonstrated. Teflon PFA cylinders provided better refractive index matching and more accurate reconstructions. The convergent cone-beam source dramatically increased imaging efficiency by a factor of 1000 and reduced stray light levels by confining illumination to image forming rays.

  12. 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

  13. Digital replacement of the distorted dentition acquired by cone beam computed tomography (CBCT): a pilot study.

    PubMed

    Nairn, N J; Ayoub, A F; Barbenel, J; Moos, K; Naudi, K; Ju, X; Khambay, B S

    2013-11-01

    During cone beam computed tomography (CBCT) scanning, intra-oral metallic objects may produce streak artefacts, which impair the occlusal surface of the teeth. This study aimed to determine the accuracy of replacement of the CBCT dentition with a more accurate dentition and to determine the clinical feasibility of the method. Impressions of the teeth of six cadaveric skulls with unrestored dentitions were taken and acrylic base plates constructed incorporating radiopaque registration markers. Each appliance was fitted to the skull and a CBCT performed. Impressions were taken of the dentition with the devices in situ and dental models were produced. These were CBCT-scanned and the images of the skulls and models imported into computer-aided design/computer-aided manufacturing (CAD/CAM) software and aligned on the registration markers. The occlusal surfaces of each dentition were then replaced with the occlusal image of the corresponding model. The absolute mean distance between the registration markers in the skulls and the dental models was 0.09±0.02mm, and for the dentition was 0.24±0.09mm. When the method was applied to patients, the distance between markers was 0.12±0.04mm for the maxilla and 0.16±0.02mm for the mandible. It is possible to replace the inaccurate dentition on a CBCT scan using this method and to create a composite skull which is clinically acceptable.

  14. 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.

  15. 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

  16. 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

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

    NASA Astrophysics Data System (ADS)

    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°/s2, a velocity up to 100°/s and the acquisition of 80 projections per second

  18. 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

  19. Reliability of frontal sinus by cone beam-computed tomography (CBCT) for individual identification.

    PubMed

    Cossellu, Gianguido; De Luca, Stefano; Biagi, Roberto; Farronato, Giampietro; Cingolani, Mariano; Ferrante, Luigi; Cameriere, Roberto

    2015-12-01

    Analysis of the frontal sinus is an important tool in personal identification. Cone beam-computed tomography (CBCT) is also progressively replacing conventional radiography and multi-slice computed tomography (MSCT) in human identification. The aim of this study is to develop a reproducible technique and measurements from 3D reconstructions obtained with CBCT, for use in human identification. CBCT from 150 patients (91 female, 59 male), aged between 15 and 78 years, was analysed with the specific software program MIMICS 11.11 (Materialise N.V., Leuven, Belgium). Corresponding 3D volumes were generated and maximal dimensions along 3 directions (x, y, z), X M, Y M, Z M (in mm), total volume area (in mm(3)), V t, and total surface (in mm(2)), S t, were calculated. Correlation analysis showed that sinus surfaces were strongly correlated with their volume (r = 0.976). Frontal sinuses were separate in 21 subjects (14 %), fused in 67 (44.6 %) and found on only one side (unilateral) in 9 (6 %). A Prominent Middle of Fused Sinus (PMS) was found in 53 subjects (35.3 %). The intra- (0.963-0.999) and inter-observer variability (0.973-0.999) showed a great agreement and a substantial homogeneity of evaluation.

  20. 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.

  1. 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.

  2. Laser cone beam computed tomography scanner geometry for large volume 3D dosimetry

    NASA Astrophysics Data System (ADS)

    Jordan, K. J.; Turnbull, D.; Batista, J. J.

    2013-06-01

    A new scanner geometry for fast optical cone-beam computed tomography is reported. The system consists of a low power laser beam, raster scanned, under computer control, through a transparent object in a refractive index matching aquarium. The transmitted beam is scattered from a diffuser screen and detected by a photomultiplier tube. Modest stray light is present in the projection images since only a single ray is present in the object during measurement and there is no imaging optics to introduce further stray light in the form of glare. A scan time of 30 minutes was required for 512 projections with a field of view of 12 × 18 cm. Initial performance from scanning a 15 cm diameter jar with black solutions is presented. Averaged reconstruction coefficients are within 2% along the height of the jar and within the central 85% of diameter, due to the index mismatch of the jar. Agreement with spectrometer measurements was better than 0.5% for a minimum transmission of 4% and within 4% for a dark, 0.1% transmission sample. This geometry's advantages include high dynamic range and low cost of scaling to larger (>15 cm) fields of view.

  3. Scatter correction for cone-beam computed tomography using self-adaptive scatter kernel superposition

    NASA Astrophysics Data System (ADS)

    Xie, Shi-Peng; Luo, Li-Min

    2012-06-01

    The authors propose a combined scatter reduction and correction method to improve image quality in cone beam computed tomography (CBCT). The scatter kernel superposition (SKS) method has been used occasionally in previous studies. However, this method differs in that a scatter detecting blocker (SDB) was used between the X-ray source and the tested object to model the self-adaptive scatter kernel. This study first evaluates the scatter kernel parameters using the SDB, and then isolates the scatter distribution based on the SKS. The quality of image can be improved by removing the scatter distribution. The results show that the method can effectively reduce the scatter artifacts, and increase the image quality. Our approach increases the image contrast and reduces the magnitude of cupping. The accuracy of the SKS technique can be significantly improved in our method by using a self-adaptive scatter kernel. This method is computationally efficient, easy to implement, and provides scatter correction using a single scan acquisition.

  4. 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

  5. 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.

  6. 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.

  7. Metal artifact reduction in cone beam computed tomography using forward projected reconstruction information.

    PubMed

    Meilinger, Manuel; Schmidgunst, Christian; Schütz, Oliver; Lang, Elmar W

    2011-09-01

    In this work we present a new method to reduce artifacts, produced by high-density objects, especially metal implants, in X-ray cone beam computed tomography (CBCT). These artifacts influence clinical diagnostics and treatments using CT data, if metal objects are located in the field of view (FOV). Our novel method reduces metal artifacts by virtually replacing the metal objects with tissue objects of the same shape. First, the considered objects must be segmented in the original 2D projection data as well as in a reconstructed 3D volume. The attenuation coefficients of the segmented voxels are replaced with adequate attenuation coefficients of tissue (or water), then the required parts of the volume are projected onto the segmented 2D pixels, to replace the original information. This corrected 2D data can then be reconstructed with reduced artifacts, i. e. all metal objects virtually vanished. After the reconstruction, the segmented 3D metal objects were re-inserted into the corrected 3D volume. Our method was developed for mobile C-arm CBCTs; as it is necessary that they are of low weight, the C-arm results in unpredictable distortion. This misalignment between the original 2D data and the forward projection of the reconstructed 3D volume must be adjusted before the correction of the segmented 2D pixels. We applied this technique to clinical data and will now present the results.

  8. Three-dimensional localization of impacted canines and root resorption assessment using cone beam computed tomography.

    PubMed

    Almuhtaseb, Eyad; Mao, Jing; Mahony, Derek; Bader, Rawan; Zhang, Zhi-xing

    2014-06-01

    The purpose of this study was to develop a new way to localize the impacted canines from three dimensions and to investigate the root resorption of the adjacent teeth by using cone beam computed tomography (CBCT). Forty-six patients undergoing orthodontic treatments and having impacted canines in Tongji Hospital were examined. The images of CBCT scans were obtained from KaVo 3D exam vision. Angular and linear measurements of the cusp tip and root apex according to the three planes (mid-sagittal, occlusal and frontal) have been taken using the cephalometric tool of the InVivo Dental Anatomage Version 5.1.10. The measurements of the angular and linear coordinates of the maxillary and mandibular canines were obtained. Using this technique the operators could envision the location of the impacted canine according to the three clinical planes. Adjacent teeth root resorption of 28.26 % was in the upper lateral incisors while 17.39% in upper central incisors, but no lower root resorption was found in our samples. Accurate and reliable localization of the impacted canines could be obtained from the novel analysis system, which offers a better surgical and orthodontic treatment for the patients with impacted canines.

  9. 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

  10. Digital orthodontic radiographic set versus cone-beam computed tomography: an evaluation of the effective dose

    PubMed Central

    Chinem, Lillian Atsumi Simabuguro; Vilella, Beatriz de Souza; Maurício, Cláudia Lúcia de Pinho; Canevaro, Lucia Viviana; Deluiz, Luiz Fernando; Vilella, Oswaldo de Vasconcellos

    2016-01-01

    ABSTRACT Objective: The aim of this study was to compare the equivalent and effective doses of different digital radiographic methods (panoramic, lateral cephalometric and periapical) with cone-beam computed tomography (CBCT). Methods: Precalibrated thermoluminescent dosimeters were placed at 24 locations in an anthropomorphic phantom (Alderson Rando Phantom, Alderson Research Laboratories, New York, NY, USA), representing a medium sized adult. The following devices were tested: Heliodent Plus (Sirona Dental Systems, Bernsheim, Germany), Orthophos XG 5 (Sirona Dental Systems, Bernsheim, Germany) and i-CAT (Imaging Sciences International, Hatfield, PA, USA). The equivalent doses and effective doses were calculated considering the recommendations of the International Commission of Radiological Protection (ICRP) issued in 1990 and 2007. Results: Although the effective dose of the radiographic set corresponded to 17.5% (ICRP 1990) and 47.2% (ICRP 2007) of the CBCT dose, the equivalent doses of skin, bone surface and muscle obtained by the radiographic set were higher when compared to CBCT. However, in some areas, the radiation produced by the orthodontic set was higher due to the complete periapical examination. Conclusion: Considering the optimization principle of radiation protection, i-CAT tomography should be used only in specific and justified circumstances. Additionally, following the ALARA principle, single periapical radiographies covering restricted areas are more suitable than the complete periapical examination. PMID:27653266

  11. Localization of impacted maxillary canines using cone beam computed tomography. Review of the literature

    PubMed Central

    Rossini, Giulia; Cavallini, Costanza; Cassetta, Michele; Galluccio, Gabriella; Barbato, Ersilia

    2012-01-01

    Summary This review analyzed the literature focused on Cone- Beam Computed Tomography (CBCT) diagnostic accuracy and efficacy in detecting impacted maxillary canines, and evaluated the possible advantages in using CBCT technique compared with traditional radiographs. PubMed and Embase searches were performed selecting papers since 1998 up to September 2011, moreover reference lists were hand searched. Two reviewers selected relevant publications on the basis of predetermined inclusion criteria. The literature search yielded 94 titles, of which 5 were included in the review. Three studies used CBCT technique to 3D localize maxillary impacted canines and assess root resorption of adjacent teeth. Other two publications compared traditional radiographs with CBCT images in the diagnosis of maxillary impacted canines. Only three studies presented the results using statistical analysis. The present review highlighted that the use of CBCT has a potential diagnostic effect and may influence the outcome of treatment when compared with traditional panoramic radiography for the assessment of impacted maxillary canines. Furthermore it underlines the need of future studies performed according with high level methodological standards, investigating diagnostic accuracy and effectiveness of CBCT in the diagnosis of maxillary impacted teeth. PMID:22783450

  12. Fast three-dimensional superimposition of cone beam computed tomography for orthopaedics and orthognathic surgery evaluation

    PubMed Central

    Weissheimer, A.; Menezes, L. M.; Koerich, L.; Pham, J.; Cevidanes, L. H. S.

    2015-01-01

    The aim of this study was to validate a method for fast three-dimensional (3D) superimposition of cone beam computed tomography (CBCT) in growing patients and adults (surgical cases). The sample consisted of CBCT scans of 18 patients. For 10 patients, as the gold standard, the spatial position of the pretreatment CBCT was reoriented, saved as a reoriented volume, and then superimposed on the original image. For eight patients, four non-growing and four growing, the pre- and post-treatment scans were superimposed. Fast voxel-based superimposition was performed, with registration at the anterior cranial base. This superimposition process took 10–15 s. The fit of the cranial base superimposition was verified by qualitative visualization of the semi-transparent axial, sagittal, and coronal cross-sectional slices of all corresponding anatomical structures. Virtual 3D surface models of the skull were generated via threshold segmentation, and superimposition errors in the reoriented models and the results of treatment for the treated cases were evaluated by 3D surface distances on colour-coded maps. The superimposition error of the spatial reorientation and for growing and non-growing patients was <0.5 mm, which is acceptable and clinically insignificant. The voxel-based superimposition method evaluated was reproducible in different clinical conditions, rapid, and applicable for research and clinical practice. PMID:25935632

  13. 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.

  14. 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

  15. 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

  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. 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

  18. 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

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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

  4. Quantitative assessment of cervical vertebral maturation using cone beam computed tomography in Korean girls.

    PubMed

    Byun, Bo-Ram; Kim, Yong-Il; Yamaguchi, Tetsutaro; Maki, Koutaro; Son, Woo-Sung

    2015-01-01

    This study was aimed to examine the correlation between skeletal maturation status and parameters from the odontoid process/body of the second vertebra and the bodies of third and fourth cervical vertebrae and simultaneously build multiple regression models to be able to estimate skeletal maturation status in Korean girls. Hand-wrist radiographs and cone beam computed tomography (CBCT) images were obtained from 74 Korean girls (6-18 years of age). CBCT-generated cervical vertebral maturation (CVM) was used to demarcate the odontoid process and the body of the second cervical vertebra, based on the dentocentral synchondrosis. Correlation coefficient analysis and multiple linear regression analysis were used for each parameter of the cervical vertebrae (P < 0.05). Forty-seven of 64 parameters from CBCT-generated CVM (independent variables) exhibited statistically significant correlations (P < 0.05). The multiple regression model with the greatest R (2) had six parameters (PH2/W2, UW2/W2, (OH+AH2)/LW2, UW3/LW3, D3, and H4/W4) as independent variables with a variance inflation factor (VIF) of <2. CBCT-generated CVM was able to include parameters from the second cervical vertebral body and odontoid process, respectively, for the multiple regression models. This suggests that quantitative analysis might be used to estimate skeletal maturation status.

  5. 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

  6. 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.

  7. 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

  8. 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

  9. 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.

  10. Location and classification of Canalis sinuosus for cone beam computed tomography: avoiding misdiagnosis.

    PubMed

    Manhães Júnior, Luiz Roberto Coutinho; Villaça-Carvalho, Maria Fernanda Lima; Moraes, Mari Eli Leonelli; Lopes, Sérgio Lúcio Pereira de Castro; Silva, Milena Bortolotto Felippe; Junqueira, José Luiz Cintra

    2016-01-01

    The aim of this study was to assess the presence, location and, multiplanar distance of the canalis sinuosus (CS) between the incisive foramen and the anterior maxillary alveolar ridge using cone beam computed tomography (CBCT). Therefore, 500 CBCT maxillary images obtained from male and female patients aged 20 to 80 years were selected to assist in the dental treatment. Low-quality tomographic images were discarded. All images were captured with the i-CATTM Classic tomograph and assessed using the XoranCatTM software. The axial sections were analyzed at the incisive foramen in order to verify the CS presence in laterality and location. Furthermore, linear measurements of the nasal cavity floor, buccal cortical bone, and alveolar ridge crest were made. All the collected data were statistically analyzed. Results show a variation of the CS in relation to the classification and distance of anatomical structures, but no significant difference between the right and left sides. It should be highlighted that CBCT is necessary before invasive procedures in order to preserve important anatomical structures. In conclusion, the location of the CS varies in relation to the alveolar ridge crest and buccal cortical bone, assuming that it is going to be located by the upper lateral incisor palatine.

  11. Dosimetric study of mandible examinations performed with three cone-beam computed tomography scanners.

    PubMed

    Khoury, Helen J; Andrade, Marcos E; Araujo, Max Well; Brasileiro, Izabela V; Kramer, Richard; Huda, Amir

    2015-07-01

    The objective of this work was to evaluate the air kerma-area product (PKA) and the skin absorbed dose in the region of the eyes, salivary glands and thyroid of the patient from mandible examinations performed with three cone-beam computed tomography (CBCT) scanners, i.e. i-CAT classic, Gendex CB-500 and PreXion 3D. For the dosimetric evaluation, an anthropomorphic head phantom (model RS-250) was used to simulate an adult patient. The CBCT examinations were performed using standard and high-resolution protocols for mandible acquisitions for adult patients. During the phantom's exposure, the PKA was measured using an ionising chamber and the absorbed doses to the skin in the region of the eyes, thyroid and salivary glands were estimated using thermoluminescence dosemeters (TLDs) positioned on the phantom's surface. The PKA values estimated with the CBCT scanners varied from 26 to 138 µGy m(2). Skin absorbed doses in the region of the eyes varied from 0.07 to 0.34 mGy; at the parotid glands, from 1.31 to 5.93 mGy; at the submandibular glands, from 1.41 to 6.86 mGy; and at the thyroid, from 0.18 to 2.45 mGy. PKA and absorbed doses showed the highest values for the PreXion 3D scanner due to the use of the continuous exposure mode and a high current-time product.

  12. 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

  13. Prevalence and features of distolingual roots in mandibular molars analyzed by cone-beam computed tomography

    PubMed Central

    Choi, Mi-Ree; Moon, Young-Mi

    2015-01-01

    Purpose This study evaluated the prevalence of distolingual roots in mandibular molars among Koreans, the root canal system associated with distolingual roots, and the concurrent appearance of a distolingual root in the mandibular first molar and a C-shaped canal in the mandibular second molar. Materials and Methods Cone-beam computed tomographic images of 264 patients were screened and examined. Axial sections of 1056 mandibular molars were evaluated to determine the number of roots. The interorifice distances from the distolingual canal to the distobuccal canal were also estimated. Using an image analysis program, the root canal curvature was calculated. Pearson's chi-square test, the paired t-test, one-way analysis of variance, and post-hoc analysis were performed. Results Distolingual roots were observed in 26.1% of the subjects. In cases where a distolingual root was observed in the mandibular molar, a significant difference was observed in the root canal curvature between the buccolingual and mesiodistal orientations. The maximum root canal curvature was most commonly observed in the mesiodistal orientation in the coronal portion, but in the apical portion, maximum root canal curvature was most often observed in the buccolingual orientation. Conclusion The canal curvature of distolingual roots was found to be very complex, with a different direction in each portion. No correlation was found between the presence of a distolingual root in the mandibular first molar and the presence of a C-shaped canal in the mandibular second molar. PMID:26730369

  14. 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.

  15. 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.

  16. 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.

  17. Evaluation of location and dimensions of mandibular lingual canals: a cone beam computed tomography study.

    PubMed

    Wang, Y-M; Ju, Y-R; Pan, W-L; Chan, C-P

    2015-09-01

    This retrospective study evaluated the presence, location, and diameter of the mandibular lingual canals in a Taiwanese population using cone beam computed tomography (CBCT), to help improve the safety of mandibular surgical procedures. A total of 101 patients (46 men and 55 women), with a mean age of 55 years, were enrolled. Cross-sectional CBCT images of the mandible were used to define the orifice and diameter of each lingual canal detected. The relevance of all data for both sexes was assessed and analyzed statistically using non-paired t-tests. The canals were categorized as median (MLC) and lateral lingual canals (LLC) based on the position of the mandible. The midline of the symphysis showed the highest frequency of lingual canals (97.0%), and all patients exhibited at least one lingual perforating bone canal in the mandible. The lingual canal diameter ranged from 0.25 to 1.90 mm (mean 0.61 mm) in the midline region and from 0.25 to 1.60mm (mean 0.58 mm) in the lateral region. Significant differences in diameter were observed between the sexes in the MLC and LLC groups (men>women). The results suggest that mandibular lingual vascular canals are common and detected regularly using CBCT. PMID:25890920

  18. Fast three-dimensional superimposition of cone beam computed tomography for orthopaedics and orthognathic surgery evaluation.

    PubMed

    Weissheimer, A; Menezes, L M; Koerich, L; Pham, J; Cevidanes, L H S

    2015-09-01

    The aim of this study was to validate a method for fast three-dimensional (3D) superimposition of cone beam computed tomography (CBCT) in growing patients and adults (surgical cases). The sample consisted of CBCT scans of 18 patients. For 10 patients, as the gold standard, the spatial position of the pretreatment CBCT was reoriented, saved as a reoriented volume, and then superimposed on the original image. For eight patients, four non-growing and four growing, the pre- and post-treatment scans were superimposed. Fast voxel-based superimposition was performed, with registration at the anterior cranial base. This superimposition process took 10-15s. The fit of the cranial base superimposition was verified by qualitative visualization of the semi-transparent axial, sagittal, and coronal cross-sectional slices of all corresponding anatomical structures. Virtual 3D surface models of the skull were generated via threshold segmentation, and superimposition errors in the reoriented models and the results of treatment for the treated cases were evaluated by 3D surface distances on colour-coded maps. The superimposition error of the spatial reorientation and for growing and non-growing patients was <0.5mm, which is acceptable and clinically insignificant. The voxel-based superimposition method evaluated was reproducible in different clinical conditions, rapid, and applicable for research and clinical practice. PMID:25935632

  19. 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

  20. 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

  1. 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

  2. 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.

  3. A novel method for 4D cone-beam computer-tomography reconstruction

    NASA Astrophysics Data System (ADS)

    Zhang, Hao; Park, Justin C.; Chen, Yunmei; Lan, Guanghui; Lu, Bo

    2015-03-01

    Image quality of Four Dimensional Cone-Beam Computer-Tomography (4DCBCT) is severely impaired by highly insufficient amount of projection data available for each phase. Therefore, making good use of limited projection data is crucial to solve this problem. Noticing that usually only a portion of the images is affected by motion, we separate the moving part (different between phases) of the images from the static part (identical among all phases) with the help of prior image reconstructed using all projection data. Then we update the moving part and the static part of images alternatively through solving minimization problems based on a global (use full projection data) and several local (use projection data for respective phase) linear systems. In the other word, we rebuild a large over-determined linear system for static part from the original under-determined systems and we reduce the number of unknowns in the original system for each phase as well. As a result, image quality for both static part and moving part are greatly improved and reliable 4D CBCT images are then reconstructed.

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

    PubMed

    Chennoju, Sai Kiran; Pachigolla, Ramaswamy; Govada, Vanya Mahitha; Alapati, Satish; Balla, Smitha

    2016-05-01

    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.

  5. 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.

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

    PubMed

    Chennoju, Sai Kiran; Pachigolla, Ramaswamy; Govada, Vanya Mahitha; Alapati, Satish; Balla, Smitha

    2016-05-01

    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

  7. Artifacts in cone-beam computed tomography of a post and core restoration: a case report.

    PubMed

    Parirokh, Masoud; Ardjomand, Karim; Manochehrifar, Hamed

    2012-01-01

    Cone-beam computed tomography (CBCT) has been accepted as a useful tool for diagnosis and treatment in endodontics. Despite a growing trend toward using CBCT in endodontic practice the CBCT images should be interpreted carefully. This case report presents a case that showed radiolucency inside and around a tooth which was free of pathologic changes under a dental operative microscope and conventional radiographs. A male patient was referred to an endodontic office for evaluation of radiolucency inside and around tooth #21 in his CBCT images. The post and crown over the tooth was removed and the tooth was observed under a dental operative microscope. Clinical examination as well as direct observation under a dental operative microscope showed no pathological lesions inside and around the tooth. The misdiagnosis was based on an artifact on CBCT. Despite the advantages of CBCT images as a great radiographic aid in endodontic practice, in the presence of metallic structures such as post and core the images should be interpreted with caution.

  8. 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.

  9. Scatter correction for cone-beam computed tomography using moving blocker strips

    NASA Astrophysics Data System (ADS)

    Wang, Jing; Mao, Weihua; Solberg, Timothy

    2011-03-01

    One well-recognized challenge of cone-beam computed tomography (CBCT) is the presence of scatter contamination within the projection images. Scatter degrades the CBCT image quality by decreasing the contrast, introducing shading artifacts and leading to inaccuracies in the reconstructed CT number. We propose a blocker-based approach to simultaneously estimate scatter signal and reconstruct the complete volume within the field of view (FOV) from a single CBCT scan. A physical strip attenuator (i.e., "blocker"), consists of lead strips, is inserted between the x-ray source and the patient. The blocker moves back and forth along z-axis during the gantry rotation. The two-dimensional (2D) scatter fluence is estimated by interpolating the signal from the blocked regions. A modified Feldkamp-Davis-Kress (FDK) algorithm and an iterative reconstruction based on the constraint optimization are used to reconstruct CBCT images from un-blocked projection data after the scatter signal is subtracted. An experimental study is performed to evaluate the performance of the proposed scatter correction scheme. The scatter-induced shading/cupping artifacts are substantially reduced in CBCT using the proposed strategy. In the experimental study using a CatPhan©600 phantom, CT number errors in the selected regions of interest are reduced from 256 to less than 20. The proposed method allows us to simultaneously estimate the scatter signal in projection data, reduce the imaging dose and obtain complete volumetric information within the FOV.

  10. Impacted lower third molar fused with a supernumerary tooth--diagnosis and treatment planning using cone-beam computed tomography.

    PubMed

    Ferreira-Junior, Osny; de Avila, Luciana Dorigatti; Sampieri, Marcelo Bonifácio da Silva; Dias-Ribeiro, Eduardo; Chen, Wei-liang; Fan, Song

    2009-12-01

    This paper reported a case of fusion between an impacted third molar and a supernumerary tooth, in which a surgical intervention was carried out, with the objective of removing the dental elements. The panoramic radiography was complemented by the Donovan's radiographic technique; but because of the proximity of the dental element to the mandibular ramus, it was not possible to have a final fusion diagnosis. Hence, the Cone-Beam Computed Tomography-which provides precise three-dimensional information-was used to determinate the fusion diagnosis and also to help in the surgical planning. In this case report we observed that the periapical, occlusal and panoramic were not able to show details which could only be examined through the cone-beam computed tomography.

  11. Conservative Treatment of an Invaginated Maxillary Lateral Incisor with a C-shaped Canal Using Cone-Beam Computed Tomography

    PubMed Central

    Forghani, Maryam; Moghim Farooji, Elaheh; Abuchenari, Javad; Bidar, Maryam; Eslami, Neda

    2015-01-01

    This report describes the non-surgical treatment of an invaginated maxillary lateral incisor with two fused roots. The mesial root had a C-shaped canal, while the distal one had a type III dens invagination. Cone-beam computed tomography (CBCT) was used to help with the diagnosis and treatment decision making. Clinical and radiographic follow-up revealed satisfactory periapical repair and absence of symptoms after 15 months. PMID:26576164

  12. Management of synodontia between dilacerated permanent maxillary central incisor and supernumerary tooth with aid of cone-beam computed tomography

    PubMed Central

    Das, Suroopa; Warhadpande, Manjusha M.; Redij, Saurabh Anil; Sabir, Husain; Shirude, Tushar

    2015-01-01

    A malformed tooth characterized by one or more developmental disturbances is often difficult to treat. When such teeth are present in anterior region, they pose a technical challenge for the clinician to restore esthetics as well as function. This case describes endodontic, surgical, and restorative management of fused and dilacerated maxillary central incisor. Cone-beam computed tomography (CBCT) was used in the present case to aid in understanding of complicated tooth morphology and managing the case successfully. PMID:25829699

  13. 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

  14. 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.

  15. 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

  16. 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

  17. 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.

  18. Length and anatomic routes of the greater palatine canal as observed by cone beam computed tomography

    PubMed Central

    Sheikhi, Mahnaz; Zamaninaser, Asieh; Jalalian, Faranak

    2013-01-01

    Background: Greater palatine canal is used for maxillary nerve block. This procedure has some complications such as proptosis, blindness, and intravascular injection. This study aimed to determine the mean greater palatine canal length (CL) and its typical anatomic routes, as well as provide a reliable facial index for computing the CL by using cone beam computed tomography (CBCT) data. Materials and Methods: A total of 138 CBCT scans (65 females and 73 males) were evaluated. The path of the canal and the CL were determined by sex, age, and side. The mean distance from the inferior border of the infraorbital foramen (IOF) to the crest of alveolar bone between maxillary premolar(CMP) was measured and compared with the CL. Paired t-tests, independent t-test, and one-way analysis of variance (ANOVA) were used for statistical analysis. Results: The mean of CL was 31.82 ± 1.37 mm (31.70 ± 2.44 mm on the right side and 31.94 ± 2.40 mm on the left side), and the values were 32.49 ± 2.37 mm in males and 30.55 ± 1.76 mm among females (P = 0.001). The mean distance from the IOF to the CMP was 32.01 ± 2.18 mm, which was not significantly different to the CL (P = 0.336). Conclusions: The mean CL was significantly different according to sex and side. The mean distance from the IOF to CMP was significantly different according to sex. On comparing the mean distance from the IOF to the CMP with the CL, no significant difference was observed. Therefore, the mean distance from the IOF to CMP may be a reliable clinical index. PMID:23946729

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

    PubMed

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

    2014-08-28

    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.

  20. 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

  1. 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.

  2. 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

  3. Cone-beam breast computed tomography with a displaced flat panel detector array

    SciTech Connect

    Mettivier, Giovanni; Russo, Paolo; Lanconelli, Nico; Meo, Sergio Lo

    2012-05-15

    Purpose: In cone-beam computed tomography (CBCT), and in particular in cone-beam breast computed tomography (CBBCT), an important issue is the reduction of the image artifacts produced by photon scatter and the reduction of patient dose. In this work, the authors propose to apply the detector displacement technique (also known as asymmetric detector or ''extended view'' geometry) to approach this goal. Potentially, this type of geometry, and the accompanying use of a beam collimator to mask the unirradiated half-object in each projection, permits some reduction of radiation dose with respect to conventional CBBCT and a sizeable reduction of the overall amount of scatter in the object, for a fixed contrast-to-noise ratio (CNR). Methods: The authors consider a scan configuration in which the projection data are acquired from an asymmetrically positioned detector that covers only one half of the scan field of view. Monte Carlo simulations and measurements, with their CBBCT laboratory scanner, were performed using PMMA phantoms of cylindrical (70-mm diameter) and hemiellipsoidal (140-mm diameter) shape simulating the average pendant breast, at 80 kVp. Image quality was evaluated in terms of contrast, noise, CNR, contrast-to-noise ratio per unit of dose (CNRD), and spatial resolution as width of line spread function for high contrast details. Results: Reconstructed images with the asymmetric detector technique deviate less than 1% from reconstruction with a conventional symmetric detector (detector view) and indicate a reduction of the cupping artifact in CT slices. The maximum scatter-to-primary ratio at the center of the phantom decreases by about 50% for both small and large diameter phantoms (e.g., from 0.75 in detector view to 0.40 in extended view geometry at the central axis of the 140-mm diameter PMMA phantom). Less cupping produces an increase of the CT number accuracy and an improved image detail contrast, but the associated increase of noise observed may

  4. 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

  5. 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.

  6. 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

  7. 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.

  8. Clinical Evaluation of Soft Tissue Organ Boundary Visualization on Cone-Beam Computed Tomographic Imaging

    SciTech Connect

    Weiss, Elisabeth; Wu Jian; Sleeman, William; Bryant, Joshua; Mitra, Priya; Myers, Michael; Ivanova, Tatjana; Mukhopadhyay, Nitai; Ramakrishnan, Viswanathan; Murphy, Martin; Williamson, Jeffrey

    2010-11-01

    Purpose: Cone-beam computed tomographic images (CBCTs) are increasingly used for setup correction, soft tissue targeting, and image-guided adaptive radiotherapy. However, CBCT image quality is limited by low contrast and imaging artifacts. This analysis investigates the detectability of soft tissue boundaries in CBCT by performing a multiple-observer segmentation study. Methods and Materials: In four prostate cancer patients prostate, bladder and rectum were repeatedly delineated by five observers on CBCTs and fan-beam CTs (FBCTs). A volumetric analysis of contouring variations was performed by calculating coefficients of variation (COV: standard deviation/average volume). The topographical distribution of contouring variations was analyzed using an average surface mesh-based method. Results: Observer- and patient-averaged COVs for FBCT/CBCT were 0.09/0.19 for prostate, 0.05/0.08 for bladder, and 0.09/0.08 for rectum. Contouring variations on FBCT were significantly smaller than on CBCT for prostate (p < 0.03) and bladder (p < 0.04), but not for rectum (p < 0.37; intermodality differences). Intraobserver variations from repeated contouring of the same image set were not significant for either FBCT or CBCT (p < 0.05). Average standard deviations of individual observers' contour differences from average surface meshes on FBCT vs. CBCT were 1.5 vs. 2.1 mm for prostate, 0.7 vs. 1.4 mm for bladder, and 1.3 vs. 1.5 mm for rectum. The topographical distribution of contouring variations was similar for FBCT and CBCT. Conclusion: Contouring variations were larger on CBCT than FBCT, except for rectum. Given the well-documented uncertainty in soft tissue contouring in the pelvis, improvement of CBCT image quality and establishment of well-defined soft tissue identification rules are desirable for image-guided radiotherapy.

  9. 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.

  10. Motion-aware temporal regularization for improved 4D cone-beam computed tomography

    NASA Astrophysics Data System (ADS)

    Mory, Cyril; Janssens, Guillaume; Rit, Simon

    2016-09-01

    Four-dimensional cone-beam computed tomography (4D-CBCT) of the free-breathing thorax is a valuable tool in image-guided radiation therapy of the thorax and the upper abdomen. It allows the determination of the position of a tumor throughout the breathing cycle, while only its mean position can be extracted from three-dimensional CBCT. The classical approaches are not fully satisfactory: respiration-correlated methods allow one to accurately locate high-contrast structures in any frame, but contain strong streak artifacts unless the acquisition is significantly slowed down. Motion-compensated methods can yield streak-free, but static, reconstructions. This work proposes a 4D-CBCT method that can be seen as a trade-off between respiration-correlated and motion-compensated reconstruction. It builds upon the existing reconstruction using spatial and temporal regularization (ROOSTER) and is called motion-aware ROOSTER (MA-ROOSTER). It performs temporal regularization along curved trajectories, following the motion estimated on a prior 4D CT scan. MA-ROOSTER does not involve motion-compensated forward and back projections: the input motion is used only during temporal regularization. MA-ROOSTER is compared to ROOSTER, motion-compensated Feldkamp–Davis–Kress (MC-FDK), and two respiration-correlated methods, on CBCT acquisitions of one physical phantom and two patients. It yields streak-free reconstructions, visually similar to MC-FDK, and robust information on tumor location throughout the breathing cycle. MA-ROOSTER also allows a variation of the lung tissue density during the breathing cycle, similar to that of planning CT, which is required for quantitative post-processing.

  11. Measurement of skin dose from cone-beam computed tomography imaging

    PubMed Central

    2013-01-01

    Objective To measure surface skin dose from various cone-beam computed tomography (CBCT) scanners using point-dosimeters. Materials & methods A head anthropomorphic phantom was used with nanoDOT optically stimulated luminescence (OSL) dosimeters (Landauer Corp., Glenwood, IL) attached to various anatomic landmarks. The phantom was scanned using multiple exposure protocols for craniofacial evaluations in three different CBCT units and a conventional x-ray imaging system. The dosimeters were calibrated for each of the scan protocols on the different imaging systems. Peak skin dose and surface doses at the eye lens, thyroid, submandibular and parotid gland levels were measured. Results The measured skin doses ranged from 0.09 to 4.62 mGy depending on dosimeter positions and imaging systems. The average surface doses to the lens locations were ~4.0 mGy, well below the threshold for cataractogenesis (500 mGy). The results changed accordingly with x-ray tube output (mAs and kV) and also were sensitive to scan field of view (SFOV). As compared to the conventional panoramic and cephalometric imaging system, doses from all three CBCT systems were at least an order of magnitude higher. Conclusions Peak skin dose and surface doses at the eye lens, thyroid, and salivary gland levels measured from the CBCT imaging systems were lower than the thresholds to induce deterministic effects. However, our findings do not justify the routine use of CBCT imaging in orthodontics considering the lifetime-attributable risk to the individual. PMID:24192155

  12. 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

  13. Quantification of Organ Motion During Chemoradiotherapy of Rectal Cancer Using Cone-Beam Computed Tomography

    SciTech Connect

    Chong, Irene; Hawkins, Maria; Hansen, Vibeke; Thomas, Karen; McNair, Helen; O'Neill, Brian; Aitken, Alexandra; Tait, Diana

    2011-11-15

    Purpose: There has been no previously published data related to the quantification of rectal motion using cone-beam computed tomography (CBCT) during standard conformal long-course chemoradiotherapy. The purpose of the present study was to quantify the interfractional changes in rectal movement and dimensions and rectal and bladder volume using CBCT and to quantify the bony anatomy displacements to calculate the margins required to account for systematic ({Sigma}) and random ({sigma}) setup errors. Methods and Materials: CBCT images were acquired from 16 patients on the first 3 days of treatment and weekly thereafter. The rectum and bladder were outlined on all CBCT images. The interfraction movement was measured using fixed bony landmarks as references to define the rectal location (upper, mid, and low), The maximal rectal diameter at the three rectal locations was also measured. The bony anatomy displacements were quantified, allowing the calculation of systematic ({Sigma}) and random ({sigma}) setup errors. Results: A total of 123 CBCT data sets were analyzed. Analysis of variance for standard deviation from planning scans showed that rectal anterior and lateral wall movement differed significantly by rectal location. Anterior and lateral rectal wall movements were larger in the mid and upper rectum compared with the low rectum. The posterior rectal wall movement did not change significantly with the rectal location. The rectal diameter changed more in the mid and upper than in the low rectum. No consistent relationship was found between the rectal and bladder volume and time, nor was a significant relationship found between the rectal volume and bladder volume. Conclusions: In the present study, the anterior and lateral rectal movement and rectal diameter were found to change most in the upper rectum, followed by the mid rectum, with the smallest changes seen in the low rectum. Asymmetric margins are warranted to ensure phase 2 coverage.

  14. Vertical bone measurements from cone beam computed tomography images using different software packages.

    PubMed

    Vasconcelos, Taruska Ventorini; Neves, Frederico Sampaio; Moraes, Lívia Almeida Bueno; Freitas, Deborah Queiroz

    2015-01-01

    This article aimed at comparing the accuracy of linear measurement tools of different commercial software packages. Eight fully edentulous dry mandibles were selected for this study. Incisor, canine, premolar, first molar and second molar regions were selected. Cone beam computed tomography (CBCT) images were obtained with i-CAT Next Generation. Linear bone measurements were performed by one observer on the cross-sectional images using three different software packages: XoranCat®, OnDemand3D® and KDIS3D®, all able to assess DICOM images. In addition, 25% of the sample was reevaluated for the purpose of reproducibility. The mandibles were sectioned to obtain the gold standard for each region. Intraclass coefficients (ICC) were calculated to examine the agreement between the two periods of evaluation; the one-way analysis of variance performed with the post-hoc Dunnett test was used to compare each of the software-derived measurements with the gold standard. The ICC values were excellent for all software packages. The least difference between the software-derived measurements and the gold standard was obtained with the OnDemand3D and KDIS3D (-0.11 and -0.14 mm, respectively), and the greatest, with the XoranCAT (+0.25 mm). However, there was no statistical significant difference between the measurements obtained with the different software packages and the gold standard (p> 0.05). In conclusion, linear bone measurements were not influenced by the software package used to reconstruct the image from CBCT DICOM data.

  15. 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

  16. 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

  17. Cone Beam Computed Tomography- An Effective Tool in Detecting Caries Under Fixed Dental Prostheses

    PubMed Central

    Gondivkar, Shailesh Madhukar; Bhoosreddy, Ajay Ramesh; Shah, Karan Rajendra; Verma, Gaurav Ravishankar; Mehrotra, Gayatri Praveen; Nerkar, Ashwini Chandrakant

    2016-01-01

    Introduction Caries under restorations is the most common reason for re-treatment and replacement in restorative failures. To avoid failures of fixed dental prostheses, it is important to diagnose caries under it earlier. Without image degradation and metal artifacts, Cone Beam Computed Tomography (CBCT) can be the solution to detect caries without removing fixed dental prostheses. Aim The aim of this study was to determine the efficacy of CBCT in detecting caries under fixed dental prostheses. Materials and Methods Each specimen was scanned with CBCT for evaluation of secondary caries under fixed prostheses. Exposure parameters were 60 kVp and 3mA. Field of View (FOV) used was 8cm X 8cm. According to International Caries Detection and Assessment System (ICDAS) criteria, six Grade 6 carious extracted teeth were selected. All teeth were prepared with four different specimens - full metal, metal-ceramic, full ceramic and metal-acrylic crowns for each tooth. Each specimen was scanned by CBCT. T-test was performed for mean gray value differences between caries and noncaries regions of each material. Gray values were recorded and evaluated for different parameters using two-way analysis of variance. Results Significant differences were found with respect to material (full metal, metal-ceramic, full ceramic and metal-acrylic) and situation (caries/noncaries) (p<0.001). There were no significant differences with respect to location (anterior or posterior). Mean gray values of caries and noncaries regions were found to be different for each material. Conclusion CBCT can be used as a post-treatment diagnostic technique for detecting caries under fixed prostheses without removing it. PMID:27656548

  18. 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.

  19. 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.

  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. Sphenoid bone changes in rapid maxillary expansion assessed with cone-beam computed tomography

    PubMed Central

    Stepanko, Lucas S.

    2016-01-01

    Objective Rapid maxillary expansion (RME) is used to expand the maxilla and increase arch perimeter; yet, there are few reports on its effects on the sphenoid bone. With cone-beam computed topography (CBCT), it is possible to visualize sphenoid bone changes. The purpose of this study was to investigate sphenoid bone changes observed in conjunction with RME treatments, using CBCT. Methods Sixty patients (34 women and 26 men, aged 11–17 years) underwent RME as part of their orthodontic treatment. Patients were randomly assigned to one of three groups: a tooth-anchored group, a bone-anchored group, or a control group. Initial CBCT scans were performed preceding the RME treatment (T1) and again directly after the completion of expansion (T2). Statistical analysis included ANOVA, descriptive statistics, and the intraclass correlation coefficient (ICC). Results The reliability of the landmark location was at least 0.783, and the largest ICC mean measurement error was 2.32 mm. With regard to distances, the largest change was 0.78 mm, which was not statistically significant (p > 0.05). Statistical significance was established in patient groups of the same sex and treatment type for the following distance measurements: right anterior lateral pterygoid plate to the right edge of the hypophyseal fossa (d2), anterior distance between the medial pterygoid plates (d4), and anterior distance between the left medial and lateral plates (d8). Conclusions In this study, there were no clinically significant changes in the sphenoid bone due to RME treatments regardless of sex or treatment type.

  2. 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.

  3. Motion-aware temporal regularization for improved 4D cone-beam computed tomography

    NASA Astrophysics Data System (ADS)

    Mory, Cyril; Janssens, Guillaume; Rit, Simon

    2016-09-01

    Four-dimensional cone-beam computed tomography (4D-CBCT) of the free-breathing thorax is a valuable tool in image-guided radiation therapy of the thorax and the upper abdomen. It allows the determination of the position of a tumor throughout the breathing cycle, while only its mean position can be extracted from three-dimensional CBCT. The classical approaches are not fully satisfactory: respiration-correlated methods allow one to accurately locate high-contrast structures in any frame, but contain strong streak artifacts unless the acquisition is significantly slowed down. Motion-compensated methods can yield streak-free, but static, reconstructions. This work proposes a 4D-CBCT method that can be seen as a trade-off between respiration-correlated and motion-compensated reconstruction. It builds upon the existing reconstruction using spatial and temporal regularization (ROOSTER) and is called motion-aware ROOSTER (MA-ROOSTER). It performs temporal regularization along curved trajectories, following the motion estimated on a prior 4D CT scan. MA-ROOSTER does not involve motion-compensated forward and back projections: the input motion is used only during temporal regularization. MA-ROOSTER is compared to ROOSTER, motion-compensated Feldkamp-Davis-Kress (MC-FDK), and two respiration-correlated methods, on CBCT acquisitions of one physical phantom and two patients. It yields streak-free reconstructions, visually similar to MC-FDK, and robust information on tumor location throughout the breathing cycle. MA-ROOSTER also allows a variation of the lung tissue density during the breathing cycle, similar to that of planning CT, which is required for quantitative post-processing.

  4. Sphenoid bone changes in rapid maxillary expansion assessed with cone-beam computed tomography

    PubMed Central

    Stepanko, Lucas S.

    2016-01-01

    Objective Rapid maxillary expansion (RME) is used to expand the maxilla and increase arch perimeter; yet, there are few reports on its effects on the sphenoid bone. With cone-beam computed topography (CBCT), it is possible to visualize sphenoid bone changes. The purpose of this study was to investigate sphenoid bone changes observed in conjunction with RME treatments, using CBCT. Methods Sixty patients (34 women and 26 men, aged 11–17 years) underwent RME as part of their orthodontic treatment. Patients were randomly assigned to one of three groups: a tooth-anchored group, a bone-anchored group, or a control group. Initial CBCT scans were performed preceding the RME treatment (T1) and again directly after the completion of expansion (T2). Statistical analysis included ANOVA, descriptive statistics, and the intraclass correlation coefficient (ICC). Results The reliability of the landmark location was at least 0.783, and the largest ICC mean measurement error was 2.32 mm. With regard to distances, the largest change was 0.78 mm, which was not statistically significant (p > 0.05). Statistical significance was established in patient groups of the same sex and treatment type for the following distance measurements: right anterior lateral pterygoid plate to the right edge of the hypophyseal fossa (d2), anterior distance between the medial pterygoid plates (d4), and anterior distance between the left medial and lateral plates (d8). Conclusions In this study, there were no clinically significant changes in the sphenoid bone due to RME treatments regardless of sex or treatment type. PMID:27668190

  5. Cone-beam optical computed tomography for gel dosimetry II: imaging protocols

    NASA Astrophysics Data System (ADS)

    Olding, Tim; Schreiner, L. John

    2011-03-01

    This work develops imaging protocols for improved dose readout of a Fricke-xylenol orange-gelatin (FXG) gel-filled 1 L polyethylene terephthalate (PETE) jar dosimeter using a commercial VistaTM cone-beam optical computed tomography (CT) scanner from Modus Medical Devices Inc. (London, ON, Canada). To ensure good management of light source-detector stability, it was determined that (a) a minimum of 2 h warm-up time is necessary prior to dosimeter scanning, (b) the light source should be kept on until the completion of the last data scan except for the minimum amount of time required to acquire dark field images, and (c) the optional Vista software projection image normalization routine should be used in image reconstruction. The institution of dosimeter scan time and temperature control was strongly indicated from the experiments. A standard post-irradiation wait time of 30 min measured to within ±30 s was established to minimize the measurement uncertainties due to dosimeter development and diffusion. To alleviate thermochromic behavior leading to inaccurate dose readout, holding bath warm up and pre-scan temperature adjustment procedures were developed to control dosimeter temperature to within ±0.2 °C. The possibility of stray light minimizing protocols was also investigated and deemed to be unnecessary. The largest significant sources of stray light in the system were identified as being due to angled scatter from the dosimeter gelatin matrix and refraction from the jar wall interfaces. It was concluded that these phenomena would be better addressed through dosimeter modification and an inter-jar dose-to-attenuation calibration methodology, rather than by setting additional imaging protocols.

  6. 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.

  7. Quantitative evaluation of knee subchondral bone mineral density using cone beam computed tomography.

    PubMed

    Turunen, Mikael J; Töyräs, Juha; Kokkonen, Harri T; Jurvelin, Jukka S

    2015-10-01

    Contrast agent enhanced cone beam computed tomography (CE-CBCT), a technique capable of high-resolution in vivo imaging with small radiation dose, has been applied successfully for clinical diagnostics of cartilage degeneration, i.e., osteoarthritis (OA). As an X-ray technique, CE-CBCT may also detect changes in mineral density of subchondral bone (volumetric bone mineral density, vBMD), known to be characteristic for OA. However, its feasibility for density measurements is not clear due to limited signal-to-noise ratio and contrast of CBCT images. In the present study, we created clinically applicable hydroxyapatite phantoms and determined vBMDs of cortical bone, trabecular bone, subchondral trabecular bone and subchondral plate of 10 cadaver (ex vivo) and 10 volunteer (in vivo) distal femora using a clinical CBCT scanner, and for reference, also using a conventional CT scanner. Our results indicated strong linear correlations between the vBMD values measured with the CT and CBCT scanners , however, absolute vBMD values were dependent on the scanner in use. Further, the differences between the vBMDs of cortical bone, trabecular bone and subchondral bone were similar and independent of the scanner. The present results indicate that vBMD values might not be directly comparable between different instruments. However, based on our present and previous results, we propose that, for OA diagnostics, clinical CBCT enables not only quantitative analysis of articular cartilage but also subchondral bone vBMD. Quantitative information on both cartilage and subchondral bone could be beneficial in OA diagnostics.

  8. Respiratory triggered 4D cone-beam computed tomography: A novel method to reduce imaging dose

    PubMed Central

    Cooper, Benjamin J.; O’Brien, Ricky T.; Balik, Salim; Hugo, Geoffrey D.; Keall, Paul J.

    2013-01-01

    Purpose: A novel method called respiratory triggered 4D cone-beam computed tomography (RT 4D CBCT) is described whereby imaging dose can be reduced without degrading image quality. RT 4D CBCT utilizes a respiratory signal to trigger projections such that only a single projection is assigned to a given respiratory bin for each breathing cycle. In contrast, commercial 4D CBCT does not actively use the respiratory signal to minimize image dose. Methods: To compare RT 4D CBCT with conventional 4D CBCT, 3600 CBCT projections of a thorax phantom were gathered and reconstructed to generate a ground truth CBCT dataset. Simulation pairs of conventional 4D CBCT acquisitions and RT 4D CBCT acquisitions were developed assuming a sinusoidal respiratory signal which governs the selection of projections from the pool of 3600 original projections. The RT 4D CBCT acquisition triggers a single projection when the respiratory signal enters a desired acquisition bin; the conventional acquisition does not use a respiratory trigger and projections are acquired at a constant frequency. Acquisition parameters studied were breathing period, acquisition time, and imager frequency. The performance of RT 4D CBCT using phase based and displacement based sorting was also studied. Image quality was quantified by calculating difference images of the test dataset from the ground truth dataset. Imaging dose was calculated by counting projections. Results: Using phase based sorting RT 4D CBCT results in 47% less imaging dose on average compared to conventional 4D CBCT. Image quality differences were less than 4% at worst. Using displacement based sorting RT 4D CBCT results in 57% less imaging dose on average, than conventional 4D CBCT methods; however, image quality was 26% worse with RT 4D CBCT. Conclusions: Simulation studies have shown that RT 4D CBCT reduces imaging dose while maintaining comparable image quality for phase based 4D CBCT; image quality is degraded for displacement based RT 4D

  9. 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.

  10. 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

  11. 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.

  12. 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

  13. 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

  14. 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.

  15. 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

  16. 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

  17. 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.

  18. 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

  19. Respiratory correlated cone-beam computed tomography on an isocentric C-arm

    NASA Astrophysics Data System (ADS)

    Kriminski, Sergey; Mitschke, Matthias; Sorensen, Stephen; Wink, Nicole M.; Chow, Phillip E.; Tenn, Steven; Solberg, Timothy D.

    2005-11-01

    A methodology for 3D image reconstruction from retrospectively gated cone-beam CT projection data has been developed. A mobile x-ray cone-beam device consisting of an isocentric C-arm equipped with a flat panel detector was used to image a moving phantom. Frames for reconstruction were retrospectively selected from complete datasets based on the known rotation of the C-arm and a signal from a respiratory monitor. Different sizes of gating windows were tested. A numerical criterion for blur on the reconstructed image was suggested. The criterion is based on minimization of an Ising energy function, similar to approaches used in image segmentation or restoration. It is shown that this criterion can be used for the determination of the optimal gating window size. Images reconstructed from the retrospectively gated projection sequences using the optimal gating window data showed a significant improvement compared to images reconstructed from the complete projection datasets.

  20. Cone beam optical computed tomography for gel dosimetry I: scanner characterization

    NASA Astrophysics Data System (ADS)

    Olding, Tim; Holmes, Oliver; Schreiner, L. John

    2010-05-01

    The ongoing development of easily accessible, fast optical readout tools promises to remove one of the barriers to acceptance of gel dosimetry as a viable tool in cancer clinics. This paper describes the characterization of a number of basic properties of the Vista™ cone beam CCD-based optical scanner, which can obtain high resolution reconstructed data in less than 20 min total imaging and reconstruction time. The suitability of a filtered back projection cone beam reconstruction algorithm is established for optically absorbing dosimeters using this scanner configuration. The system was then shown to be capable of imaging an optically absorbing media-filled 1 L polyethylene terephthalate (PETE) jar dosimeter to a reconstructed voxel resolution of 0.5 × 0.5 × 0.5 mm3. At this resolution, more than 60% of the imaged volume in the dosimeter exhibits minimal spatial distortion, a measurement accuracy of 3-4% and the mean to standard deviation signal-to-noise ratio greater than 100 over an optical absorption range of 0.06-0.18 cm-1. An inter-day scan precision of 1% was demonstrated near the upper end of this range. Absorption measurements show evidence of stray light perturbation causing artifacts in the data, which if better managed would improve the accuracy of optical readout. Cone beam optical attenuation measurements of scattering dosimeters, on the other hand, are nonlinearly affected by angled scatter stray light. Scatter perturbation leads to significant cupping artifacts and other inaccuracies that greatly limit the readout of scattering polymer gel dosimeters with cone beam optical CT.

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

    PubMed

    Sidky, Emil Y; Pan, Xiaochuan

    2008-09-01

    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 the 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.

  2. Correction for patient table-induced scattered radiation in cone-beam computed tomography (CBCT)

    SciTech Connect

    Sun Mingshan; Nagy, Tamas; Virshup, Gary; Partain, Larry; Oelhafen, Markus; Star-Lack, Josh

    2011-04-15

    Purpose: In image-guided radiotherapy, an artifact typically seen in axial slices of x-ray cone-beam computed tomography (CBCT) reconstructions is a dark region or ''black hole'' situated below the scan isocenter. The authors trace the cause of the artifact to scattered radiation produced by radiotherapy patient tabletops and show it is linked to the use of the offset-detector acquisition mode to enlarge the imaging field-of-view. The authors present a hybrid scatter kernel superposition (SKS) algorithm to correct for scatter from both the object-of-interest and the tabletop. Methods: Monte Carlo simulations and phantom experiments were first performed to identify the source of the black hole artifact. For correction, a SKS algorithm was developed that uses separate kernels to estimate scatter from the patient tabletop and the object-of-interest. Each projection is divided into two regions, one defined by the shadow cast by the tabletop on the imager and one defined by the unshadowed region. The region not shadowed by the tabletop is processed using the recently developed fast adaptive scatter kernel superposition (fASKS) method which employs asymmetric kernels that best model scatter transport through bodylike objects. The shadowed region is convolved with a combination of slab-derived symmetric SKS kernels and asymmetric fASKS kernels. The composition of the hybrid kernels is projection-angle-dependent. To test the algorithm, pelvis phantom and in vivo data were acquired using a CBCT test stand, a Varian Acuity simulator, and a Varian On-Board Imager, all of which have similar geometries and components. Artifact intensities and Hounsfield unit (HU) accuracies in the reconstructions were assessed before and after the correction. Results: The hybrid kernel algorithm provided effective correction and produced substantially better scatter estimates than the symmetric SKS or asymmetric fASKS methods alone. HU nonuniformities in the reconstructed pelvis phantom were

  3. 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.

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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.

  9. 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

  10. 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

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

    PubMed Central

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

    2015-01-01

    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

  12. 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

  13. 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

  14. In vitro comparison of cone beam computed tomography with different voxel sizes for detection of simulated external root resorption.

    PubMed

    Neves, Frederico S; de Freitas, Deborah Q; Campos, Paulo S F; de Almeida, Solange M; Haiter-Neto, Francisco

    2012-09-01

    The present study compared the efficacy of cone beam computed tomography using different voxel sizes in the diagnosis of simulated external root resorption. The presence or absence of simulated defects on buccal, mesial and distal root surfaces of 20 premolars was evaluated. The defects were small (0.26 mm in diameter and 0.08 mm deep), medium (0.62 mm in diameter and 0.19 mm deep) and large (1.05 mm in diameter and 0.24 mm deep), equally distributed on each root surface. Images were obtained using Classic i-CAT cone beam computed tomography with different voxel sizes: 0.12, 0.20, 0.25 and 0.30 mm. Five oral radiologists evaluated the images. Accuracy, sensitivity, specificity, positive and negative predictive values were determined. The sensitivity decreased and specificity increased as voxel size increased. Accuracy values were the highest for the smallest voxel size (0.12 mm). The results for voxel sizes 0.20 mm and 0.25 mm were similar. Positive and negative predictive values were similar in all protocols, except with 0.30 mm, in which they were the lowest. In conclusion, external root resorption was more easily diagnosed when a smaller voxel size was used.

  15. Accuracy in the Diagnosis of the Mental Nerve Loop. A Comparative Study Between Panoramic Radiography and Cone Beam Computed Tomography

    PubMed Central

    do Couto-Filho, Carlos Eduardo Gomes; de Moraes, Paulo Hemerson; Alonso, Maria Beatriz Carrazzone; Haiter-Neto, Francisco; Olate, Sergio; de Albergaria-Barbosa, José Ricardo

    2016-01-01

    Summary Dental implant and chin osteotomy are executed on the mandible body and the mental nerve is an important anatomical limit. The aim of this research was to know the position of the mental nerve loop comparing result in panoramic radiography and cone beam computed tomography. We analyzed 94 hemimandibles and the patient sample comprised female and male subjects of ages ranging from 18 to 52 years (mean age, 35 years) selected randomly from the database of patients at the Division of Oral Radiology at Piracicaba Dental School State University of Campinas; the anterior loop (AL) of the mental nerve was evaluated regarding the presence or absence, which was classified as rectilinear or curvilinear and measurement of its length was obtained. The observations were made in the digital panoramic radiography (PR) and the cone beam computed tomography (CBCT) according to a routine technique. The frequencies of the AL identified through PR and CBCT were different: in PR the loop was identified in 42.6% of cases, and only 12.8% were bilateral. In contrast, the AL was detected in 29.8% of the samples using CBCT, with 6.4% being bilateral; Statistical comparison between PR and CBCT showed that the PR led to false-positive diagnosis of the AL in this sample. According to the results of this study, the frequency of AL is low. Thus, it can be assumed that it is not a common condition in this population. PMID:27667898

  16. Measurement of eye lens dose for Varian On-Board Imaging with different cone-beam computed tomography acquisition techniques.

    PubMed

    Deshpande, Sudesh; Dhote, Deepak; Thakur, Kalpna; Pawar, Amol; Kumar, Rajesh; Kumar, Munish; Kulkarni, M S; Sharma, S D; Kannan, V

    2016-01-01

    The objective of this work was to measure patient eye lens dose for different cone-beam computed tomography (CBCT) acquisition protocols of Varian's On-Board Imaging (OBI) system using optically stimulated luminescence dosimeter (OSLD) and to study the variation in eye lens dose with patient geometry and distance of isocenter to the eye lens. During the experimental measurements, OSLD was placed on the patient between the eyebrows of both eyes in line of nose during CBCT image acquisition to measure eye lens doses. The eye lens dose measurements were carried out for three different cone-beam acquisition protocols (standard dose head, low-dose head [LDH], and high-quality head [HQH]) of Varian OBI. Measured doses were correlated with patient geometry and distance between isocenter and eye lens. Measured eye lens doses for standard head and HQH protocols were in the range of 1.8-3.2 mGy and 4.5-9.9 mGy, respectively. However, the measured eye lens dose for the LDH protocol was in the range of 0.3-0.7 mGy. The measured data indicate that eye lens dose to patient depends on the selected imaging protocol. It was also observed that eye lens dose does not depend on patient geometry but strongly depends on distance between eye lens and treatment field isocenter. However, undoubted advantages of imaging system should not be counterbalanced by inappropriate selection of imaging protocol, especially for very intense imaging protocol. PMID:27651564

  17. 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.

  18. 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.

  19. 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.

  20. Management of a maxillary first molar having atypical anatomy of two roots diagnosed using cone beam computed tomography

    PubMed Central

    Sharma, Sarang; Mittal, Meenu; Passi, Deepak; Grover, Shibani

    2015-01-01

    Most often, a clinician working on maxillary first molar when anticipates an aberration thinks of an extra canal but rarely does he preempt fewer canals. Maxillary first molar is a tooth, which has been extensively reviewed with respect to its external and internal morphology. Abundant literature related to its anatomy is available, but reports on incidence of two roots and two root canals in maxillary first molar are very limited. Here, a case of maxillary first molar is presented that had two roots: one palatal root with Type I canal configuration and one bulbous fused buccal root with Type V canal configuration; a unique root and canal configuration not seen in any of the earlier reported cases. Diagnosis of root canal aberrancy and subsequently, accurate management of the tooth was greatly facilitated by cone beam computed tomography (CBCT) scan. The relevance of CBCT in improving treatment prognosis is greatly emphasized in this report. PMID:26180423

  1. 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

  2. Cone Beam Computed Topographic Evaluation and Endodontic Management of a Rare Mandibular First Molar with Four Distal Canals

    PubMed Central

    Sinha, Nidhi; Singh, Bijay; Langaliya, Akshay; Mirdha, Nitin; Huda, Irfanul

    2014-01-01

    Root canal system is complex to understand because of its unpredictable nature. It differs for different teeth and for the same teeth in different individuals. Successful endodontic therapy thus depends on the clinician's ability to anticipate and look for these variations. A mandibular first molar with six root canals represents a rare anatomical variant, particularly when four canals are found in distal root. This case report discusses successful nonsurgical endodontic management of two-root mandibular first molar with four distal canals and two mesial canals reported for the first time in Indian population. Cone beam computed tomography was used as a diagnostic method to confirm the position and presence of 4 root canals in the distal root. PMID:25525525

  3. 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.

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

    PubMed

    Jadhav, Aniket B; Tadinada, Aditya; Rengasamy, Kandasamy; Fellows, Douglas; Lurie, Alan G

    2014-06-01

    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. 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.

  6. 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

  7. Cone beam computed tomography in the differential diagnosis of mental neuropathy (numb chin syndrome) in metastatic colon cancer.

    PubMed

    Friedrich, Reinhard E; Heiland, Max; Assaf, Alexandre T; Riecke, Björn

    2013-04-01

    Neuropathy of the mental nerve, also referred to as numb chin syndrome (NCS), is a rare finding that demands for accurate differential diagnosis and therapy. This is a report of two patients with a history of colonic cancer, who experienced a progressive hypaesthesia of one side of the corner of the mouth, lower lip and chin, associated with intermittent phases of pain some weeks prior to admission to hospital. Orthopantomograms were insufficient to disclose the relationship between the osseous lesion and the nerve canal. Cone beam computed tomography (CBCT) clearly disclosed the widely spreading, in-growing tumour of the mandible and the affection of the canal's boundary. CBCT is recommended as the imaging modality of primary choice to disclose apparent osseous affections of the mandibular canal and foramina associated with NCS, in particular in the diagnostics of outpatients admitted to specialized clinics and in the dental office.

  8. 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.

  9. 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

  10. 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

  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. 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.

  14. 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.

  15. 3D Quantification of Mandibular Asymmetry through Cone Beam Computed Tomography

    PubMed Central

    Cevidanes, Lucia H.S.; Alhadidi, Abeer; Paniagua, Beatriz; Styner, Martin; Ludlow, John; Mol, Andre; Turvey, Timothy; Proffit, William R.; Rossouw, Paul Emile

    2011-01-01

    Objective To determine if 3D shape analysis precisely diagnoses right and left differences in asymmetry patients Study Design Cone-beam CT data was acquired pretreatment from 20 patients with mandibular asymmetry. 3D shape analysis was used to localize and quantify the extent of virtually simulated asymmetry. Two approaches were used: (1) mirroring on the midsagittal plane determined from landmarks and (2) mirroring on an arbitrary plane, then registering on the cranial base of the original image. The validation presented in this study used simulated data and has been applied to three clinical cases. Results For mirroring on the midsagittal plane there was a >99% probability that the difference between measured and simulated asymmetry was less than 0.5 mm. For mirroring with cranial base registration, there was a >84% probability of differences less than 0.5 mm. Conclusions Mandibular asymmetry can be precisely quantified with both mirroring methods. Cranial base registration has the potential to be used for patients with trauma situations or when key landmarks are unreliable or absent. PMID:21497527

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

    PubMed

    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.

  17. 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

  18. Management of complete impacted maxillary second deciduous molar with the aid of cone-beam computed tomography: Case report and a review of the literature

    PubMed Central

    Hashim, Hayder A; Al-Qahtani, Abdulmueen A; Taha, Samir M; Tharupeedikayil, Shailaja; Ahmed, Mutaz F

    2013-01-01

    Complete impaction of primary teeth is a very rare condition and less seen at the dental office compared with permanent dentition. To report the use of cone-beam computed tomography in the management of a 7-year-old boy with completely impacted maxillary second deciduous molar due to the presence of odontoma and a cystic lesion. PMID:24987655

  19. Management of complete impacted maxillary second deciduous molar with the aid of cone-beam computed tomography: Case report and a review of the literature.

    PubMed

    Hashim, Hayder A; Al-Qahtani, Abdulmueen A; Taha, Samir M; Tharupeedikayil, Shailaja; Ahmed, Mutaz F

    2013-10-01

    Complete impaction of primary teeth is a very rare condition and less seen at the dental office compared with permanent dentition. To report the use of cone-beam computed tomography in the management of a 7-year-old boy with completely impacted maxillary second deciduous molar due to the presence of odontoma and a cystic lesion.

  20. Measurement of eye lens dose for Varian On-Board Imaging with different cone-beam computed tomography acquisition techniques

    PubMed Central

    Deshpande, Sudesh; Dhote, Deepak; Thakur, Kalpna; Pawar, Amol; Kumar, Rajesh; Kumar, Munish; Kulkarni, M. S.; Sharma, S. D.; Kannan, V.

    2016-01-01

    The objective of this work was to measure patient eye lens dose for different cone-beam computed tomography (CBCT) acquisition protocols of Varian's On-Board Imaging (OBI) system using optically stimulated luminescence dosimeter (OSLD) and to study the variation in eye lens dose with patient geometry and distance of isocenter to the eye lens. During the experimental measurements, OSLD was placed on the patient between the eyebrows of both eyes in line of nose during CBCT image acquisition to measure eye lens doses. The eye lens dose measurements were carried out for three different cone-beam acquisition protocols (standard dose head, low-dose head [LDH], and high-quality head [HQH]) of Varian OBI. Measured doses were correlated with patient geometry and distance between isocenter and eye lens. Measured eye lens doses for standard head and HQH protocols were in the range of 1.8–3.2 mGy and 4.5–9.9 mGy, respectively. However, the measured eye lens dose for the LDH protocol was in the range of 0.3–0.7 mGy. The measured data indicate that eye lens dose to patient depends on the selected imaging protocol. It was also observed that eye lens dose does not depend on patient geometry but strongly depends on distance between eye lens and treatment field isocenter. However, undoubted advantages of imaging system should not be counterbalanced by inappropriate selection of imaging protocol, especially for very intense imaging protocol. PMID:27651564

  1. 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.

  2. Examining Margin Reduction and Its Impact on Dose Distribution for Prostate Cancer Patients Undergoing Daily Cone-Beam Computed Tomography

    SciTech Connect

    Hammoud, Rabih Patel, Samir H.; Pradhan, Deepak; Kim, Jinkoo; Guan, Harrison; Li Shidong; Movsas, Benjamin

    2008-05-01

    Purpose: To examine the dosimetric impact of margin reduction and quantify residual error after three-dimensional (3D) image registration using daily cone-beam computed tomography (CBCT) for prostate cancer patients. Methods and Materials: One hundred forty CBCTs from 5 prostate cancer patients were examined. Two intensity-modulated radiotherapy plans were generated on CT simulation on the basis of two planning target volume (PTV) margins: 10 mm all around the prostate and seminal vesicles except 6 mm posteriorly (10/6) and 5 mm all around except 3 mm posteriorly (5/3). Daily CBCT using the Varian On-Board Imaging System was acquired. The 10/6 and 5/3 simulation plans were overlaid onto each CBCT, and each CBCT plan was calculated. To examine residual error, PlanCT/CBCT intensity-based 3D image registration was performed for prostate localization using center of mass and maximal border displacement. Results: Prostate coverage was within 2% between the 10/6 and 5/3 plans. Seminal vesicle coverage was reduced with the 5/3 plan compared with the 10/6 plan, with coverage difference within 7%. The 5/3 plan allowed 30-50% sparing of bladder and rectal high-dose regions. For residual error quantification, center of mass data show that 99%, 93%, and 96% of observations fall within 3 mm in the left-right, anterior-posterior, and superior-inferior directions, respectively. Maximal border displacement observations range from 79% to 99%, within 5 mm for all directions. Conclusion: Cone-beam CT dosimetrically validated a 10/6 margin when soft-tissue localization is not used. Intensity-based 3D image registration has the potential to improve target localization and to provide guidelines for margin definition.

  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. Measurement of Mandibular Growth Using Cone-Beam Computed Tomography: A Miniature Pig Model Study

    PubMed Central

    Li, Jia-Da; Lu, Tung-Wu; Chang, Hau-Hung; Hu, Chih-Chung

    2014-01-01

    The purpose of this study was to measure the long-term growth of the mandible in miniature pigs using 3D Cone-Beam Computerized Tomography (CBCT). The mandibles of the pigs were scanned monthly over 12 months using CBCT and the 3D mandibular models were reconstructed from the data. Seventeen anatomical landmarks were identified and classified into four groups of line segments, namely anteroposterior, superoinferior, mediolateral and anteroinferior. The inter-marker distances, inter-segmental angles, volume, monthly distance changes and percentage of changes were calculated to describe mandibular growth. The total changes of inter-marker distances were normalized to the initial values. All inter-marker distances increased over time, with the greatest mean normalized total changes in the superoinferior and anteroposterior groups (p<0.05). Monthly distance changes were greatest during the first four months and then reduced over time. Percentages of inter-marker distance changes were similar among the groups, reaching half of the overall growth around the 4th month. The mandibular volume growth increased non-linearly with time, accelerating during the first five months and slowing during the remaining months. The growth of the mandible was found to be anisotropic and non-homogeneous within the bone and non-linear over time, with faster growth in the ramus than in the body. These growth patterns appeared to be related to the development of the dentition, providing necessary space for the teeth to grow upward for occlusion and for the posterior teeth to erupt. PMID:24801528

  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. 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

  7. 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.

  8. 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.

  9. 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.

  10. 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

  11. A new method for the integration of digital dental models and cone-beam computed tomography images.

    PubMed

    Lin, Hsiu-Hsia; Chiang, Wen-Chung; Lo, Lun-Jou; Wang, Chien-Hsuan

    2013-01-01

    This study introduces a regional-surface-based registration without markers for integration of laser-scanned dental images into maxillofacial cone-beam computed tomography (CBCT) images. The method just needs to manually select three similar areas without artifact on the digital dental image and CBCT image, and then the process is automatically complete the fusion (superimposition) of maxillofacial model and the digital dental model. Then the differences such as mean error and root-mean-square (RMS) error are automatically computed between the 2 images according to the selected surfaces and expressed in a color scale. Experimental results show that the mean errors between the 2 models at the integrated model range from 0.15 mm to 0.45 mm and the RMS errors range 0.18 mm to 0.49 mm. The numbers are similar to the results of previous methods and reach a desirable error. Moreover, it is robust feasibility for especially serious artifacts CBT images. It is worth mentioning that all measurements of intra-operator reproducibility and inter-operator reliability are excellent. PMID:24110191

  12. 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.

  13. 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.

  14. 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

    2016-05-17

    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.

  15. 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

  16. Regenerative Endodontic Treatment of an Infected Immature Dens Invaginatus with the Aid of Cone-Beam Computed Tomography

    PubMed Central

    Kaya-Büyükbayram, Işıl; Özalp, Şerife; Aydemir, Seda

    2014-01-01

    Dens invaginatus is a developmental anomaly that results in an enamel-lined cavity intruding into the crown or root before the mineralization phase. This report presents regenerative endodontic treatment of a necrotic immature tooth with Oehler's type III dens invaginatus of a nine-year-old female patient. A diagnosis of dens invaginatus (Oehler's type III) and a large periapical lesion was established with the aid of cone-beam computed tomography (CBCT). In the presented case contrary to the classic revascularization protocol, mechanical instrumentation was performed which apparently did not interfere with the regeneration process. After mechanical instrumentation of the invaginated canal by manual K-files, the invaginated canal space was disinfected by triple antibiotic paste followed by blood clot induction from the periapical tissues and the placement of mineral trioxide aggregate. At one-year follow-up, the tooth remained clinically asymptomatic. Radiographic examination revealed complete healing of the periapical lesion. At the 20-month follow-up, the radiographic examination also showed that the open apex was closed and the walls of the root canal were thickened. PMID:25530890

  17. 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

  18. 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

  19. Use of cone-beam computed tomography to characterize daily urinary bladder variations during fractionated radiotherapy for canine bladder cancer.

    PubMed

    Nieset, Jessica R; Harmon, Joseph F; Larue, Susan M

    2011-01-01

    Urinary bladder cancer is difficult to treat accurately with fractionated radiation therapy (RT) due to daily positional changes of the bladder and surrounding soft-tissue structures. We quantified the daily motion experienced by the canine bladder with patients in dorsal vs. sternal vs. lateral recumbency. We also described the dose distribution for three different planning target volume expansions (5, 10, and 15 mm) for each of the three positions to ensure adequate bladder dose and minimize irradiation of nearby healthy tissues. Analysis was based on data from retrospective daily cone-beam computed tomography (CT) (CBCT) images obtained for positioning of canine patients undergoing routine RT. Organs of interest were contoured on each CBCT data set and the images, along with the contours, were registered to the original planning CT. All measurements were made relative to the planning CT and dosimetric data for the organs of interest was determined using a dose volume histogram generated from sample parallel-opposed beam configuration. There was a wide range in bladder position throughout treatment. The least amount of bladder variation and the lowest rectal dose was with dogs in lateral recumbency. It was also determined that a margin of 10 mm would allow for sufficient dose to be delivered to the bladder while minimizing rectal dose.

  20. Cone-beam computed tomographic evaluation of styloid process: a retrospective study of 208 patients with orofacial pain

    PubMed Central

    2014-01-01

    Introduction The purpose of this study was to assess the structural characteristics of styloid process (SP) by cone-beam computed tomography (CBCT) examination in a patient population suffering from orofacial pain. The second aim was to assess the prevalence of elongated SP and its relation to gender, site and subjective symptoms in the study population. Methods Clinical and radiographic records of 208 patients were evaluated retrospectively. Radiological examinations including measurements of the structure, length, and medial angulations of SP were performed on CBCT images. Results Out of 208 patients, 96 (46%) had not-elongated SP, 28 (13%) had left side, 16 (8%) had right side, and 68 (33%) had bilateral elongation of SP. The patients with elongated SP had significantly decreased angle values. There were no statistically significant differences in length values of SP between males and females in both groups. Significantly increased prevalence of symptoms except headache was observed in patients with elongated SP. Conclusions This study presents the CBCT as an alternative method to CT or panoramic radiographs for the measurement and the assessment of the styloid process. Patients suffering from orofacial pain, who also had elongated SP, had increased rate of corresponding neurological complaints compared with non-elongated ones. PMID:24528515

  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. Preliminary evaluation of the dosimetric accuracy of cone-beam computed tomography for cases with respiratory motion

    NASA Astrophysics Data System (ADS)

    Kim, Dong Wook; Bae, Sunhyun; Chung, Weon Kuu; Lee, Yoonhee

    2014-04-01

    Cone-beam computed tomography (CBCT) images are currently used for patient positioning and adaptive dose calculation; however, the degree of CBCT uncertainty in cases of respiratory motion remains an interesting issue. This study evaluated the uncertainty of CBCT-based dose calculations for a moving target. Using a phantom, we estimated differences in the geometries and the Hounsfield units (HU) between CT and CBCT. The calculated dose distributions based on CT and CBCT images were also compared using a radiation treatment planning system, and the comparison included cases with respiratory motion. The geometrical uncertainties of the CT and the CBCT images were less than 0.15 cm. The HU differences between CT and CBCT images for standard-dose-head, high-quality-head, normal-pelvis, and low-dose-thorax modes were 31, 36, 23, and 33 HU, respectively. The gamma (3%, 0.3 cm)-dose distribution between CT and CBCT was greater than 1 in 99% of the area. The gamma-dose distribution between CT and CBCT during respiratory motion was also greater than 1 in 99% of the area. The uncertainty of the CBCT-based dose calculation was evaluated for cases with respiratory motion. In conclusion, image distortion due to motion did not significantly influence dosimetric parameters.

  3. Quantitative performance characterization of image quality and radiation dose for a CS 9300 dental cone beam computed tomography machine.

    PubMed

    Abouei, Elham; Lee, Sierra; Ford, Nancy L

    2015-10-01

    This paper aims to characterize the radiation dose and image quality (IQ) performance of a dental cone beam computed tomography (CBCT) unit over a range of fields of view (FOV). IQ and dose were measured using a Carestream 9300 dental CBCT. Phantoms were positioned in the FOV to imitate clinical positioning. IQ was assessed by scanning a SEDENTEXCT IQ phantom, and images were analyzed in ImageJ. Dose index 1 was obtained using a thimble ionization chamber and SEDENTEXCT DI phantom. Mean gray values agreed within 93.5% to 99.7% across the images, with pixel-to-pixel fluctuations of 6% to 12.5%, with poorer uniformity and increased noise for child protocols. CNR was fairly constant across FOVs, with higher CNR for larger patient settings. The measured limiting spatial resolution agreed well with 10% MTF and bar pattern measurements. Dose was reduced for smaller patient settings within a given FOV; however, smaller FOVs obtained with different acquisition settings did not necessarily result in reduced dose. The use of patient-specific acquisition settings decreased the radiation dose for smaller patients, with minimal impact on the IQ. The full set of IQ and dose measurements is reported to allow dental professionals to compare the different FOV settings for clinical use. PMID:26587550

  4. Diagnostic performance of cone-beam computed tomography on detection of mechanically-created artificial secondary caries

    PubMed Central

    Prapayasatok, Sangsom; Janhom, Apirum; Pongsiriwet, Surawut; Verochana, Karune; Mahasantipiya, Phattaranant

    2011-01-01

    Purpose The aim of this study was to compare the diagnostic accuracy of cone-beam computed tomography (CBCT) images and bitewing images in detection of secondary caries. Materials and Methods One hundred and twenty proximal slots of Class II cavities were randomly prepared on human premolar and molar teeth, and restored with amalgam (n=60) and composite resin (n=60). Then, artificial secondary caries lesions were randomly created using round steel No. 4 bur. The teeth were radiographed with a conventional bitewing technique and two CBCT systems; Pax-500ECT and Promax 3D. All images were evaluated by five observers. The area under the receiver operating characteristic (ROC) curve (Az) was used to evaluate the diagnostic accuracy. Significant difference was tested using the Friedman test (p value<0.05). Results The mean Az values for bitewing, Pax-500ECT, and Promax 3D imaging systems were 0.882, 0.995, and 0.978, respectively. Significant differences were found between the two CBCT systems and film (p=0.007). For CBCT systems, the axial plane showed the greatest Az value. Conclusion Based on the design of this study, CBCT images were better than bitewing radiographs in detection of secondary caries. PMID:22232722

  5. Cone-Beam Computed Tomography Evaluation of Maxillary First and Second Molars in Iranian Population: A Morphological Study

    PubMed Central

    Rouhani, Armita; Bagherpour, Ali; Akbari, Majid; Azizi, Majid; Nejat, Amirhosein; Naghavi, Neda

    2014-01-01

    Introduction: The aim of this in vitro study was to identify the root and canal morphology of maxillary first and second molars in Iranian population by taking and analyzing cone-beam computed tomography (CBCT) scans. Methods and Materials: Extracted maxillary first (n=125) and second (n=125) molars were collected from native Iranians and scanned by using a CBCT scanner. The number of roots and configuration of root canal system were classified according to Vertucci’s classification. Results: Two (1.6%) maxillary first and two (1.6%) maxillary second molars had four roots. Prevalence of root fusion was 2.4% and 8.8% in maxillary first and second molars, respectively. The most common canal morphology in the mesiobuccal roots of three-rooted first and second molars was type I (46.4% and 80.8%, respectively), followed by type VI (17.6%) in first molars. The predominant morphology of distobuccal and palatal roots in first and second molars was type I. Additional canal types were also identified. Conclusion: Profound knowledge of anatomic variations is necessary prior to cleaning and obturation of the root canal system. The most common discovered root morphology was three separate roots in both tooth types. The greatest variation in canal anatomy was discovered in the MB canals of both the first and second molars. PMID:25031592

  6. Cone Beam Computed Tomographic Analysis of the Shape, Height, and Location of the Mandibular Lingula in a Population of Children

    PubMed Central

    Sekerci, Ahmet Ercan; Cantekin, Kenan; Aydinbelge, Mustafa

    2013-01-01

     Objectives. This is the first study to identify and classify the different morphological shapes of the mandibular lingula (ML) in children using cone-beam computed tomography (CBCT). Material and Methods. A retrospective study was performed to evaluate the shape, height, and location of the ML in relation to the surrounding structures using CBCT images of mandibles obtained from 269 children. The shape of the ML was classified into triangular, truncated, nodular, or assimilated types. The location was determined by five distances. The height of the lingula was also measured from the lingular tip to the mandibular foramen. Results. A nodular shape of the ML was most commonly found (48.3%, n = 260) followed by truncated (23.4%, n = 126), assimilated (14.4%, n = 78), and triangular (13.7%, n = 74). The mean distance of ML from the anterior and posterior borders of mandibular ramus was 13.3 ± 2.3 mm and 10.2 ± 1.6 mm, respectively. In the majority of the mandibles studied, the ML was located above the occlusal plane. Conclusion. The present study provides new information to the literature concerning the shape, height, and location of the lingula in a Turkish pediatric population. This finding may assist clinicians to localize the lingula and avoid intraoperative complications. PMID:24490173

  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. 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

  9. Monte-Carlo scatter correction for cone-beam computed tomography with limited scan field-of-view

    NASA Astrophysics Data System (ADS)

    Bertram, Matthias; Sattel, Timo; Hohmann, Steffen; Wiegert, Jens

    2008-03-01

    In flat detector cone-beam computed tomography (CBCT), scattered radiation is a major source of image degradation, making accurate a posteriori scatter correction inevitable. A potential solution to this problem is provided by computerized scatter correction based on Monte-Carlo simulations. Using this technique, the detected distributions of X-ray scatter are estimated for various viewing directions using Monte-Carlo simulations of an intermediate reconstruction. However, as a major drawback, for standard CBCT geometries and with standard size flat detectors such as mounted on interventional C-arms, the scan field of view is too small to accommodate the human body without lateral truncations, and thus this technique cannot be readily applied. In this work, we present a novel method for constructing a model of the object in a laterally and possibly also axially extended field of view, which enables meaningful application of Monte-Carlo based scatter correction even in case of heavy truncations. Evaluation is based on simulations of a clinical CT data set of a human abdomen, which strongly exceeds the field of view of the simulated C-arm based CBCT imaging geometry. By using the proposed methodology, almost complete removal of scatter-caused inhomogeneities is demonstrated in reconstructed images.

  10. Evaluation of stability after pre-orthodontic orthognathic surgery using cone-beam computed tomography: A comparison with conventional treatment

    PubMed Central

    Ann, Hye-Rim; Jung, Young-Soo; Lee, Kee-Joon

    2016-01-01

    Objective The aim of this study was to evaluate the skeletal and dental changes after intraoral vertical ramus osteotomy (IVRO) with and without presurgical orthodontics by using cone-beam computed tomography (CBCT). Methods This retrospective cohort study included 24 patients (mean age, 22.1 years) with skeletal Class III malocclusion who underwent bimaxillary surgery with IVRO. The patients were divided into the preorthodontic orthognathic surgery (POGS) group (n = 12) and conventional surgery (CS) group (n = 12). CBCT images acquired preoperatively, 1 month after surgery, and 1 year after surgery were analyzed to compare the intergroup differences in postoperative three-dimensional movements of the maxillary and mandibular landmarks and the changes in lateral cephalometric variables. Results Baseline demographics (sex and age) were similar between the two groups (6 men and 6 women in each group). During the postsurgical period, the POGS group showed more significant upward movement of the mandible (p < 0.05) than did the CS group. Neither group showed significant transverse movement of any of the skeletal landmarks. Moreover, none of the dental and skeletal variables showed significant intergroup differences 1 year after surgery. Conclusions Compared with CS, POGS with IVRO resulted in significantly different postsurgical skeletal movement in the mandible. Although both groups showed similar skeletal and dental outcomes at 1 year after surgery, upward movement of the mandible during the postsurgical period should be considered to ensure a more reliable outcome after POGS. PMID:27668193

  11. Evaluation of stability after pre-orthodontic orthognathic surgery using cone-beam computed tomography: A comparison with conventional treatment

    PubMed Central

    Ann, Hye-Rim; Jung, Young-Soo; Lee, Kee-Joon

    2016-01-01

    Objective The aim of this study was to evaluate the skeletal and dental changes after intraoral vertical ramus osteotomy (IVRO) with and without presurgical orthodontics by using cone-beam computed tomography (CBCT). Methods This retrospective cohort study included 24 patients (mean age, 22.1 years) with skeletal Class III malocclusion who underwent bimaxillary surgery with IVRO. The patients were divided into the preorthodontic orthognathic surgery (POGS) group (n = 12) and conventional surgery (CS) group (n = 12). CBCT images acquired preoperatively, 1 month after surgery, and 1 year after surgery were analyzed to compare the intergroup differences in postoperative three-dimensional movements of the maxillary and mandibular landmarks and the changes in lateral cephalometric variables. Results Baseline demographics (sex and age) were similar between the two groups (6 men and 6 women in each group). During the postsurgical period, the POGS group showed more significant upward movement of the mandible (p < 0.05) than did the CS group. Neither group showed significant transverse movement of any of the skeletal landmarks. Moreover, none of the dental and skeletal variables showed significant intergroup differences 1 year after surgery. Conclusions Compared with CS, POGS with IVRO resulted in significantly different postsurgical skeletal movement in the mandible. Although both groups showed similar skeletal and dental outcomes at 1 year after surgery, upward movement of the mandible during the postsurgical period should be considered to ensure a more reliable outcome after POGS.

  12. Canal Transportation and Centering Ability of Twisted File and Reciproc: A Cone-Beam Computed Tomography Assessment

    PubMed Central

    Nazari Moghadam, Kiumars; Shahab, Shahriar; Rostami, Golriz

    2014-01-01

    Introduction: The purpose of this in vitro study was to compare the canal transportation and centering ability of Twisted File (TF) to that of Reciproc system. Methods and Materials: Forty noncalcified roots with mature apices, minimum length of 19 mm and an apical curvature of 15-30 degrees (according to Schneider’s method), from freshly extracted mandibular and maxillary teeth, were selected for this study. Samples were randomly divided into two groups (n=20) and canal preparation with either TF or Reciproc was performed according to manufacturers' instruction. Pre- and post-instrumentation cone-beam computed tomography (CBCT) images were captured and the extent of canal transportation and centering ability of the files were calculated, using the NNT Viewer software and Photoshop CS5, at levels of 3, 4, and 5 mm from the apex. The Mann-Whitney U test was used to analyze the statistical significance between the two groups. Results: One fracture occurred in the TF group. TF produced more transportation than Reciproc in both mesiodistal and buccolingual directions; however, the difference between the two systems were not statistically significant except for the TF group at 5-mm distance from the working length, where the difference was significant (P>0.05). Conclusion: Both file systems were able keep the original curvature of the canal and thus can be considered safe for clinical application. PMID:25031589

  13. 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

  14. 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.

  15. Cone-Beam Computed Tomographic Assessment of Mandibular Condylar Position in Patients with Temporomandibular Joint Dysfunction and in Healthy Subjects

    PubMed Central

    Paknahad, Maryam; Shahidi, Shoaleh; Iranpour, Shiva; Mirhadi, Sabah; Paknahad, Majid

    2015-01-01

    Statement of the Problem. The clinical significance of condyle-fossa relationships in the temporomandibular joint is a matter of controversy. Different studies have evaluated whether the position of the condyle is a predictor of the presence of temporomandibular disorder. Purpose. The purpose of the present study was to investigate the condylar position according to gender in patients with temporomandibular disorder (TMD) and healthy controls using cone-beam computed tomography. Materials and Methods. CBCT of sixty temporomandibular joints in thirty patients with TMD and sixty joints of thirty subjects without TMJ disorder was evaluated in this study. The condylar position was assessed on the CBCT images. The data were analyzed using Pearson chi-square test. Results. No statistically significant differences were found regarding the condylar position between symptomatic and asymptomatic groups. Posterior condylar position was more frequently observed in women and anterior condylar position was more prevalent in men in the symptomatic group. However, no significant differences in condylar position were found in asymptomatic subjects according to gender. Conclusion. This study showed no apparent association between condylar positioning and clinical findings in TMD patients. PMID:26681944

  16. 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.

  17. 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

  18. 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.

  19. SICAT function: anatomical real-dynamic articulation by merging cone beam computed tomography and jaw motion tracking data.

    PubMed

    Hanssen, N; Ruge, S; Kordass, B

    2014-01-01

    Diagnostic imaging and jaw motion tracking are among the most important technologies used to document and assess the functional status of the stomatognathic system and to plan complex prosthetic restorations. However, the two technologies have not been used together until now. This article introduces SICAT Function (SICAT, Bonn, Germany), a new software application that directly combines and merges three-dimensional cone beam computed tomography (CBCT) and electronic jaw motion tracking (JMT) data. The software can also import digital impressions acquired with intraoral scanners and integrate them in functional movement displays. The result is an anatomically precise yet real-dynamic rendering of jaw movement, ready for comprehensive evaluation and analysis. Moreover, changes in the joint space (gap between the condyle and mandibular fossa) at defined mandibular resting positions or during mandibular movements can be directly measured and displayed. Only one CBCT scan is needed for patient-specific assessment of condylar positions (centric and therapeutic), which are displayed together with the joint space. All other positions are derived via correlation with electronic measurements. PMID:24791466

  20. A cone-beam computed tomography evaluation of facial asymmetry in unilateral cleft lip and palate individuals.

    PubMed

    Yang, Li'an; Chen, Zhenqi; Zhang, Xiaoyue

    2016-01-01

    Our study aimed to examine facial asymmetry in patients with unilateral cleft lip and palates (UCLP) using cone-beam computed tomography (CBCT) and explore the factors responsible for lower facial asymmetry in these individuals. The experimental group included 21 adolescent patients with non-syndromic UCLP while the control group comprised 14 patients without any facial cleft defects. The maxillofacial regions of the patients in the two groups were scanned using CBCT, and the Mimics 10.01 software was used to analyze the images. Multiple linear stepwise regression analysis was used to explore the factors related to the deviation of the pogonion point (Pog). Comparison of the two groups showed that the position of the lateral point of the pyriform aperture and the length of the mandibular body exhibited significant asymmetry (P < 0.05). Pog in the UCLP group deviated to the cleft side (1.24 ± 2.28 mm), and was related to B6L(R) to Sagittal plane, CdL(R) to Sagittal plane, and U6L(R) to LS plane. We concluded that significant differences between the cleft and non-cleft sides existed only around the cleft, and not in the deeper regions of the maxillary complex. Functional adaption may be the main reason responsible for chin deviation in UCLP individuals. (J Oral Sci 58, 109-115, 2016).

  1. 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

  2. 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

  3. 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

  4. Comparison of cone-beam computed tomography and periapical radiography in predicting treatment decision for periapical lesions: a clinical study.

    PubMed

    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 (χ(2)(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.

  5. Evaluation of Pneumatization in the Articular Eminence and Roof of the Glenoid Fossa with Cone-Beam Computed Tomography

    PubMed Central

    İlgüy, Mehmet; Dölekoğlu, Semanur; Fişekçioğlu, Erdoğan; Ersan, Nilüfer; İlgüy, Dilhan

    2015-01-01

    Background: Detection of air cavities, so called pneumatizations, nearby to the temporomandibular joint (TMJ) area is important, as they represent sites of minimal resistance and facilitate the spread of various pathologies into the joint as inflammation, tumor or fractures and serve as a possible complicating factor in TMJ surgery. Aims: To determine the prevalence of pneumatization of the articular eminence (PAT) and roof of the glenoid fossa (PRGF) using cone-beam computed tomography (CBCT). Study Design: Cross-sectional study. Methods: Acquired images of 111 patients (222 TMJs) were evaluated. The presence of pneumatization was recorded at the articular eminence and roof of the glenoid fossa. Age and gender were recorded for all patients and type (unilocular or multilocular) and laterality were noted for the cases of pneumatization. Results: The mean age of the study group was 48.86±18.31 years. Among all the patients, 73 (65.8%) had PAT, while 13 (11.7%) had PRGF. Forty-two (37.8%) of the patients had PAT bilaterally; whereas 3 of them (2.7%) presented PRGF bilaterally. The percentage of PAT was higher for females (73.6%) than males (51.3%) (p<0.05). Conclusion: CBCT images are an accurate and reliable means of detection of the exact size and type of pneumatization and the relationship of pneumatization to the adjacent tissues. This is especially significant before a surgical intervention is planned in this region, in order to make a sound diagnosis. PMID:25759774

  6. Gender difference and root canal morphology in mandibular premolars: A cone-beam computed tomography study in an Iranian population

    PubMed Central

    Kazemipoor, Maryam; Hajighasemi, Afrooz; Hakimian, Roqayeh

    2015-01-01

    Background: Mandibular premolars are of the most difficult teeth to treat endodontically. Aims: To compare the root canal morphology of mandibular premolars between two genders in an Iranian population. Settings and Design: Totally, 230 cone-beam computed tomography images of the mandibles belonged to 115 males and 115 females were evaluated in the three spatial planes. Materials and Methods: The total number of roots and canals in the mandibular premolars was counted, and the difference between males and females were analyzed. Statistical Analysis: Data were analyzed using Chi-square test. The significance level was set as P < 0.05. Results: The majority of mandibular first and second premolars had one root (85.7% and 94.8%, respectively) and one canal (63.9% and 78.3%, respectively). The number of roots in the mandibular first premolars had statistically significant difference between two genders (P = 0.001). There was no significant difference between two genders in the number of roots (P = 0.208) and canals (P = 0.498) in the mandibular second premolars. Conclusion: According to the results of this study, the root canal morphology in the mandibular first premolars had statistically significant difference between two genders. PMID:26321843

  7. Impacted Lower Third Molar Fused with a Supernumerary Tooth —Diagnosis and Treatment Planning Using Cone-Beam Computed Tomography

    PubMed Central

    Ferreira-Junior, Osny; de Ávila, Luciana Dorigatti; da Silva Sampieri, Marcelo Bonifácio; Dias-Ribeiro, Eduardo; Chen, Wei-liang; Fan, Song

    2009-01-01

    This paper reported a case of fusion between an impacted third molar and a supernumerary tooth, in which a surgical intervention was carried out, with the objective of removing the dental elements. The panoramic radiography was complemented by the Donovan's radiographic technique; but because of the proximity of the dental element to the mandibular ramus, it was not possible to have a final fusion diagnosis. Hence, the Cone-Beam Computed Tomography—which provides precise three-dimensional information—was used to determinate the fusion diagnosis and also to help in the surgical planning. In this case report we observed that the periapical, occlusal and panoramic were not able to show details which could only be examined through the cone-beam computed tomography. PMID:20690426

  8. 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.

  9. 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

  10. 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

  11. 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.

  12. 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.

  13. 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

  14. Respiration correlated cone-beam computed tomography and 4DCT for evaluating target motion in Stereotactic Lung Radiation Therapy.

    PubMed

    Purdie, Thomas G; Moseley, Douglas J; Bissonnette, Jean-Pierre; Sharpe, Michael B; Franks, Kevin; Bezjak, Andrea; Jaffray, David A

    2006-01-01

    An image-guidance process for using cone-beam computed tomography (CBCT) for stereotactic body radiation therapy (SBRT) of peripheral lung lesions is presented. Respiration correlated CBCT on the treatment unit and four dimensional computed tomography (4DCT) from planning are evaluated for assessing respiration-induced target motion during planning and treatment fractions. Image-guided SBRT was performed for 12 patients (13 lesions) with inoperable early stage non-small cell lung carcinoma. Kilovoltage (kV) projections were acquired over a 360 degree gantry rotation and sorted based on the pixel value of an image-based aperture located at the air-tissue interface of the diaphragm. The sorted projections were reconstructed to provide volumetric respiration correlated CBCT image datasets at different phases of the respiratory cycle. The 4D volumetric datasets were directly compared with 4DCT datasets acquired at the time of planning. For ten of 12 patients treated, the lung tumour motion, as measured by respiration correlated CBCT on the treatment unit, was consistent with the tumour motion measured by 4DCT at the time of planning. However, in two patients, maximum discrepancies observed were 6 and 10 mm in the anterior-posterior and superior-inferior directions, respectively. Respiration correlated CBCT acquired on the treatment unit allows target motion to be assessed for each treatment fraction, allows target localization based on different phases on the breathing cycle, and provides the facility for adaptive margin design in radiation therapy of lung malignancies. The current study has shown that the relative motion and position of the tumour at the time of treatment may not match that of the planning 4DCT scan. Therefore, application of breathing motion data acquired at simulation for tracking or gating radiation therapy may not be suitable for all patients - even those receiving short course treatment techniques such as SBRT.

  15. Potential of dosage reduction in cone-beam-computed tomography (CBCT) for radiological diagnostics of the paranasal sinuses.

    PubMed

    Güldner, C; Ningo, A; Voigt, J; Diogo, I; Heinrichs, J; Weber, R; Wilhelm, T; Fiebich, M

    2013-03-01

    More than 10 years ago, cone-beam-computed tomography (CBCT) was introduced in ENT radiology. Until now, the focus of research was to evaluate clinical limits of this technique. The aim of this work is the evaluation of specific dosages and the identification of potential optimization in the performance of CBCT of the paranasal sinuses. Based on different tube parameters (tube current, tube voltage, and rotation angles), images of the nose and the paranasal sinuses were taken on a phantom head with the Accu-I-tomo F17 (Morita, Kyoto, Japan). The dosages applied to the lens and parotid gland were measured with OSL dosimetry. The imaging quality was evaluated by independent observers. All datasets were reviewed according to a checklist of surgically important anatomic structures. Even for lowest radiation exposure (4 mA, 76 kV, 180°, computed tomography dosage index (CTDI) = 1.8 mGy), the imaging quality was sufficient. Of course a significant reduction of the imaging quality could be seen, so a reliable mean was set for 4 mA, 84 kV, and 180° rotation angle (CTDI = 2.4 mGy). In this combination, a reduction of 92 % in lens-dose and of 77 % of dosage at the parotid gland was observed in comparison to the maximal possible adjustments (8 mA, 90 kV, 360°, CTDI = 10.9 mGy). There is potential for optimization in CBCT. Changing the rotation angle (180° instead of 360°) leads to a dose reduction of 50 %. Furthermore from clinical point of view in case of chronic rhinosinusitis a relevant reduction of dosage is possible. Therefore, it is necessary to intensify the interdisciplinary discussion about the disease specifics required quality of imaging.

  16. 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

  17. Assessment of linear measurements of bone for implant sites in the presence of metallic artefacts using cone beam computed tomography and multislice computed tomography.

    PubMed

    Cremonini, C C; Dumas, M; Pannuti, C M; Neto, J B C; Cavalcanti, M G P; Lima, L A

    2011-08-01

    The objective was to evaluate the influence of dental metallic artefacts on implant sites using multislice and cone-beam computed tomography techniques. Ten dried human mandibles were scanned twice by each technique, with and without dental metallic artefacts. Metallic restorations were placed at the top of the alveolar ridge adjacent to the mental foramen region for the second scanning. Linear measurements (thickness and height) for each cross-section were performed by a single examiner using computer software. All mandibles were analysed at both the right and the left mental foramen regions. For the multislice technique, dental metallic artefact produced an increase of 5% in bone thickness and a reduction of 6% in bone height; no significant differences (p>0.05) were detected when comparing measurements performed with and without metallic artefacts. With respect to the cone-beam technique, dental metallic artefact produced an increase of 6% in bone thickness and a reduction of 0.68% in bone height. No significant differences (p>0.05) were observed when comparing measurements performed with and without metallic artefacts. The presence of dental metallic artefacts did not alter the linear measurements obtained with both techniques, although its presence made the location of the alveolar bone crest more difficult.

  18. [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.

  19. [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

  20. 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)

  1. 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

  2. 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

  3. 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

  4. 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

  5. Observation of Interfractional Variations in Lung Tumor Position Using Respiratory Gated and Ungated Megavoltage Cone-Beam Computed Tomography

    SciTech Connect

    Chang, Jenghwa . E-mail: changj@mskcc.org; Mageras, Gig S.; Yorke, Ellen; De Arruda, Fernando; Sillanpaa, Jussi; Rosenzweig, Kenneth E.; Hertanto, Agung; Pham, Hai; Seppi, Edward; Pevsner, Alex; Ling, C. Clifton; Amols, Howard

    2007-04-01

    Purpose: To evaluate the use of megavoltage cone-beam computed tomography (MV CBCT) to measure interfractional variation in lung tumor position. Methods and Materials: Eight non-small-cell lung cancer patients participated in the study, 4 with respiratory gating and 4 without. All patients underwent MV CBCT scanning at weekly intervals. Contoured planning CT and MV CBCT images were spatially registered based on vertebral anatomy, and displacements of the tumor centroid determined. Setup error was assessed by comparing weekly portal orthogonal radiographs with digitally reconstructed radiographs generated from planning CT images. Hypothesis testing was performed to test the statistical significance of the volume difference, centroid displacement, and setup uncertainty. Results: The vertebral bodies and soft tissue portions of tumor within lung were visible on the MV CBCT scans. Statistically significant systematic volume decrease over the course of treatment was observed for 1 patient. The average centroid displacement between simulation CT and MV CBCT scans were 2.5 mm, -2.0 mm, and -1.5 mm with standard deviations of 2.7 mm, 2.7 mm, and 2.6 mm in the right-left, anterior-posterior and superior-inferior directions. The mean setup errors were smaller than the centroid shifts, while the standard deviations were comparable. In most cases, the gross tumor volume (GTV) defined on the MV CBCT was located on average at least 5 mm inside a 10 mm expansion of the GTV defined on the planning CT scan. Conclusions: The MV CBCT technique can be used to image lung tumors and may prove valuable for image-guided radiotherapy. Our conclusions must be verified in view of the small patient number.

  6. 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

  7. 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

  8. 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.

  9. 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

  10. Association Between the Lateral Wall Thickness of the Maxillary Sinus and the Dental Status: Cone Beam Computed Tomography Evaluation

    PubMed Central

    Khajehahmadi, Saeedeh; Rahpeyma, Amin; Hoseini Zarch, Seyed Hosein

    2014-01-01

    Background: Assessment of the lateral wall thickness of the maxillary sinus is very important in decision making for many surgical interventions. The association between the thickness of the lateral wall of the maxillary sinus and the dental status is not well identified. Objectives: To compare the thickness of the lateral wall of the maxillary sinus in individuals with and without teeth to determine if extraction of the teeth can lead to a significant reduction in the thickness of the maxillary sinus lateral wall or not. Patients and Methods: In a retrospective study on fifty patients with an edentulous space, the thickness of the lateral wall of the maxillary sinus,one centimeter above the sinus floor in the second premolar (P2), first molar (M1) and second molar (M2) areas was determined by cone beam computed tomography scans(CBCTs) and a digital ruler in Romexis F software (Planmeca Romexis 2.4.2.R) and it was compared with values measured in fifty dentated individuals. Three way analysis of variance was applied for comparison after confirmation of the normal distribution of data. Results: The mean of the wall thickness in each of these points was lower in patients with edentulous spaces; however it was not significant. There was no association between gender and the thickness of the lateral wall of the maxillary sinus, but location was associated with different thicknesses. Conclusions: The differences in the thickness based on the location and dental status necessitates assessment of the wall thickness of the maxillary sinus in addition to the current evaluation of bone thickness between the sinus floor and the edentulous crest before maxillary sinus surgery. PMID:24693302

  11. Monitoring tumor motion with on-line mega-voltage cone-beam computed tomography imaging in a cine mode

    NASA Astrophysics Data System (ADS)

    Reitz, Bodo; Gayou, Olivier; Parda, David S.; Miften, Moyed

    2008-02-01

    Accurate daily patient localization is becoming increasingly important in external-beam radiotherapy (RT). Mega-voltage cone-beam computed tomography (MV-CBCT) utilizing a therapy beam and an on-board electronic portal imager can be used to localize tumor volumes and verify the patient's position prior to treatment. MV-CBCT produces a static volumetric image and therefore can only account for inter-fractional changes. In this work, the feasibility of using the MV-CBCT raw data as a fluoroscopic series of portal images to monitor tumor changes due to e.g. respiratory motion was investigated. A method was developed to read and convert the CB raw data into a cine. To improve the contrast-to-noise ratio on the MV-CB projection data, image post-processing with filtering techniques was investigated. Volumes of interest from the planning CT were projected onto the MV-cine. Because of the small exposure and the varying thickness of the patient depending on the projection angle, soft-tissue contrast was limited. Tumor visibility as a function of tumor size and projection angle was studied. The method was well suited in the upper chest, where motion of the tumor as well as of the diaphragm could be clearly seen. In the cases of patients with non-small cell lung cancer with medium or large tumor masses, we verified that the tumor mass was always located within the PTV despite respiratory motion. However for small tumors the method is less applicable, because the visibility of those targets becomes marginal. Evaluation of motion in non-superior-inferior directions might also be limited for small tumor masses. Viewing MV-CBCT data in a cine mode adds to the utility of MV-CBCT for verification of tumor motion and for deriving individualized treatment margins.

  12. Monitoring tumor motion with on-line mega-voltage cone-beam computed tomography imaging in a cine mode.

    PubMed

    Reitz, Bodo; Gayou, Olivier; Parda, David S; Miften, Moyed

    2008-02-21

    Accurate daily patient localization is becoming increasingly important in external-beam radiotherapy (RT). Mega-voltage cone-beam computed tomography (MV-CBCT) utilizing a therapy beam and an on-board electronic portal imager can be used to localize tumor volumes and verify the patient's position prior to treatment. MV-CBCT produces a static volumetric image and therefore can only account for inter-fractional changes. In this work, the feasibility of using the MV-CBCT raw data as a fluoroscopic series of portal images to monitor tumor changes due to e.g. respiratory motion was investigated. A method was developed to read and convert the CB raw data into a cine. To improve the contrast-to-noise ratio on the MV-CB projection data, image post-processing with filtering techniques was investigated. Volumes of interest from the planning CT were projected onto the MV-cine. Because of the small exposure and the varying thickness of the patient depending on the projection angle, soft-tissue contrast was limited. Tumor visibility as a function of tumor size and projection angle was studied. The method was well suited in the upper chest, where motion of the tumor as well as of the diaphragm could be clearly seen. In the cases of patients with non-small cell lung cancer with medium or large tumor masses, we verified that the tumor mass was always located within the PTV despite respiratory motion. However for small tumors the method is less applicable, because the visibility of those targets becomes marginal. Evaluation of motion in non-superior-inferior directions might also be limited for small tumor masses. Viewing MV-CBCT data in a cine mode adds to the utility of MV-CBCT for verification of tumor motion and for deriving individualized treatment margins.

  13. 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.

  14. Evaluation of root morphology and root canal configuration of premolars in the Turkish individuals using cone beam computed tomography

    PubMed Central

    Bulut, Duygu Goller; Kose, Emre; Ozcan, Gozde; Sekerci, Ahmet Ercan; Canger, Emin Murat; Sisman, Yıldıray

    2015-01-01

    Objective: The aim of the present study is to assess the root and root canal morphology of maxillary and mandibular premolars in a Turkish population by using cone beam computed tomography (CBCT). Materials and Methods: In this study, CBCT images of 2134 premolars (987 maxillary, 1147 mandibular) were obtained from 404 patients. Details of gender, age, number of roots and canals, and canal configuration in each root were recorded. The canal configuration was classified and evaluated according to Vertucci's criteria. Results: The majority of maxillary premolars had two separate roots; although, three roots were identified in 1% of maxillary first premolars. However, most of the mandibular premolars had a single root. The two canals (69.9%) and type I (62.6%) and type II (34.1%) configuration for upper first premolar, one canal (82.1%) and type I (77.6%) canal configuration for second premolar was the most prevalent root canal frequency. The most prevalent root canal frequency was the one canal (96.2%) and type I (94.2%) and type V (3.2%) configuration for mandibular first premolar, one canal (98.9%) and type I (98.9%) canal configuration for second premolar. There was no difference in the root canal configurations and the numbers of canals between the left and the right side of both females and males (P > 0.05). Conclusions: Recognition of morphology and anatomy of the root canal system is one of the most important factors for successful endodontic treatment. Preoperative CBCT examination allows determination of root canal configuration of premolar teeth and helps clinicians in root canal treatment. PMID:26929695

  15. 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

  16. Clinical Application of Cone-Beam Computed Tomography of the Rabbit Head: Part 1 – Normal Dentition

    PubMed Central

    Riggs, G. G.; Arzi, Boaz; Cissell, Derek D.; Hatcher, David C.; Kass, Philip H.; Zhen, Amy; Verstraete, Frank J. M.

    2016-01-01

    Domestic rabbits (Oryctolagus cuniculus) are increasingly popular as household pets; therefore, veterinarians need to be familiar with the most common diseases afflicting rabbits including dental diseases. Diagnostic approaches for dental disease include gross oral examination, endoscopic oral examination, skull radiography, and computed tomography (CT). CT overcomes many limitations of standard radiography by permitting cross-sectional images of the rabbit head in multiple planes without superimposition of anatomic structures. Cone-beam CT (CBCT) is an oral and maxillofacial imaging modality that produces high-resolution images. The objective of this study was to describe and compare the normal anatomic features of the dentition and surrounding maxillofacial structures in healthy rabbits on CBCT and conventional CT. Ten New Zealand white rabbit cadaver heads were scanned using CBCT and conventional CT. Images were evaluated using Anatomage Invivo 5 software. The maxillofacial anatomy was labeled on CBCT images, and the mean lengths and widths of the teeth were determined. The visibility of relevant dental and anatomic features (pulp cavity, germinal center, tooth outline, periodontal ligament) were scored and compared between conventional CT and CBCT. The thinnest teeth were the maxillary second incisor teeth at 1.29 ± 0.26 mm and the maxillary third molar teeth at 1.04 ± 0.10 mm. In general, it was found that CBCT was superior to conventional CT when imaging the dentition. Importantly, the periodontal ligament was significantly (P < 0.01) more visible on CBCT than on conventional CT. Ability to see the periodontal ligament with such detail may allow earlier detection and treatment of periodontal disease in rabbits. This study is the first of its kind and shows the feasibility and yield of CBCT when evaluating the maxillofacial features and dentition in rabbits. PMID:27800485

  17. 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.

  18. 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.

  19. 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

  20. Cone Beam Computed Tomography Assessment of the Maxillary Incisive Canal and Foramen: Considerations of Anatomical Variations When Placing Immediate Implants

    PubMed Central

    Al-Amery, Samah M.; Nambiar, Phrabhakaran; Jamaludin, Marhazlinda; John, Jacob; Ngeow, Wei Cheong

    2015-01-01

    Introduction The maxillary incisive canal connects the roof of the oral cavity with the floor of nasal cavity and has the incisive and nasal foramina respectively at its two opposite ends. Its close proximity with the anterior incisors affects one’s ability to place immediate implants in ideal position. Objective To avoid causing complication, variations in their dimensions were studied. Material and Methods Images of ninety Mongoloids patients examined with i-CAT Cone Beam Computed Tomography were included. The sizes of the nasopalatine foramen, the incisive canal and foramen, and anterior maxillary bone thickness were measured. The direction and course of the canals were assessed. Results The mean labiopalatal and mesiodistal measurements of the incisive foramen were 2.80mm and 3.49 mm respectively, while the labiopalatal width of the nasal foramen was 6.06mm. The incisive canal was 16.33mm long and 3.85 mm wide. The anterior maxillary bone has an average thickness of 7.63 mm. The dimensions of the incisive foramen and incisive canal, and anterior maxillary bone thickness demonstrated gender differences with males showing greater values. The anterior maxillary bone thickness was affected by age but this difference was not observed in canal dimensions. The majority of subjects have a funnel shape-like incisive canal with the broader opening located at its superior. They seem to have a longer slanted-curve canal with one channel at its middle portion and a narrower incisive foramen opening than those reported elsewhere. Conclusions This study found that gender is an important factor that affected the characteristics of the IC and the amount of bone anterior to it. Male generally had bigger IC and thicker anterior bone. In addition, the anterior maxillary bone thickness was affected by aging, where it becomes thinner with increased age even though the subjects were fully dentate. PMID:25679505

  1. Bilateral cleft lip and palate: A morphometric analysis of facial skeletal form using cone beam computed tomography.

    PubMed

    Starbuck, John M; Ghoneima, Ahmed; Kula, Katherine

    2015-07-01

    Bilateral cleft lip and palate (BCLP) is caused by a lack of merging of maxillary and nasal facial prominences during development and morphogenesis. BCLP is associated with congenital defects of the oronasal facial region that can impair ingestion, mastication, speech, and dentofacial development. Using cone beam computed tomography (CBCT) images, 7- to 18-year old individuals born with BCLP (n = 15) and age- and sex-matched controls (n = 15) were retrospectively assessed. Coordinate values of three-dimensional facial skeletal anatomical landmarks (n = 32) were measured from each CBCT image. Data were evaluated using principal coordinates analysis (PCOORD) and Euclidean Distance Matrix Analysis (EDMA). PCOORD axes 1-3 explain approximately 45% of the morphological variation between samples, and specific patterns of morphological differences were associated with each axis. Approximately, 30% of facial skeletal measures significantly differ by confidence interval testing (α = 0.10) between samples. While significant form differences occur across the facial skeleton, strong patterns of differences are localized to the lateral and superioinferior aspects of the nasal aperture. In conclusion, the BCLP deformity significantly alters facial skeletal morphology of the midface and oronasal regions of the face, but morphological differences were also found in the upper facial skeleton and to a lesser extent, the lower facial skeleton. This pattern of strong differences in the oronasal region of the facial skeleton combined with differences across the rest of the facial complex underscores the idea that bones of the craniofacial skeleton are integrated. PMID:25752824

  2. 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.

  3. 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

  4. Accuracy of image guidance using free-breathing cone-beam computed tomography for stereotactic lung radiotherapy.

    PubMed

    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.

  5. Cone beam computed tomographic analyses of alveolar bone anatomy at the maxillary anterior region in Chinese adults.

    PubMed

    Zhou, Zhixuan; Chen, Wu; Shen, Ming; Sun, Chao; Li, Jun; Chen, Ning

    2014-11-01

    To provide an anatomical basis for clinical implant esthetics, we evaluated the morphology of the nasopalatine canal (NPC) and analyzed labial and interproximal bone anatomy at the maxillary anterior region. We sought to investigate the effect of maxillary protrusion and tooth labiolingual inclination on labial bone anatomy in Chinese adults. Three dimensional (3D) images were reconstructed using cone-beam computed tomography (CBCT) images from 80 Chinese subjects and by SimPlant 11.04. The dimensions of the NPC, the thickness and profile of the labial bone, the width and height of the interproximal bone, angle sella-nasion-subspinale (SNA) and angle upper central incisor-nasion,subspinale (U1-NA) were measured. The incisive foramen of the NPC was markedly wider than its nasal foramen. The dimension of its labial bone wall demonstrated an increasing width from the crestal to apical measurements. The labial bone at the maxillary anterior region was rather thin, especially at 3 mm below the cemento-enamel junction (CEJ) and the mid-root level; the profile of the labial bone was more curved at the central incisor, and the interproximal bone became wider and shorter posteriorly. There were significant relationships between maxillary protrusion and labial bone profile, tooth labiolingual inclination and labial bone thickness (P < 0.02). To achieve optimal esthetic outcome of implant, bone augmentation is necessary at the maxillary anterior region. For immediate or early placement at the maxillary anterior region, the implant should be located palatally to reduce labial bone resorption and marginal recession; its apex should be angulated palatally to avoid labial perforation at the apical region. To protect the NPC, implants at the central incisor region should be placed away from NPC. PMID:25469120

  6. Impacted maxillary canines and root resorptions of neighbouring teeth: a radiographic analysis using cone-beam computed tomography.

    PubMed

    Lai, Caroline S; Bornstein, Michael M; Mock, Lothar; Heuberger, Benjamin M; Dietrich, Thomas; Katsaros, Christos

    2013-08-01

    The study analyses the location of impacted maxillary canines and factors influencing root resorptions of adjacent teeth using cone-beam computed tomography (CBCT). In addition, the interrater reliability between observers of two different dental specialties for radiographic parameters will be evaluated. CBCT images of patients who were referred for radiographic localization of impacted maxillary canines and/or suspicion of root resorptions of adjacent teeth were included. The study analysed the exact three-dimensional location of the impacted canines in the anterior maxilla, frequency and extent of root resorptions, and potential influencing factors. To assess interrater agreement, Cohen's correlation parameters were calculated. This study comprises 113 patients with CBCT scans, and 134 impacted canines were analysed retrospectively. In the patients evaluated, 69 impacted canines were located palatally (51.49 per cent), 41 labially (30.60 per cent), and 24 (17.91 per cent) in the middle of the alveolar process. Root resorptions were found in 34 lateral incisors (25.37 per cent), 7 central incisors (5.22 per cent), 6 first premolars (4.48 per cent), and 1 second premolar (0.75 per cent). There was a significant correlation between root resorptions on adjacent teeth and localization of the impacted canine in relation to the bone, as well as vertical localization of the canine. Interrater agreement showed values of 0.546-0.877. CBCT provides accurate information about location of the impacted canine and prevalence and degree of root resorption of neighbouring teeth with high interrater correlation. This information is of great importance for surgeons and orthodontists for accurate diagnostics and interdisciplinary treatment planning.

  7. 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. PMID:27605988

  8. LBP-based penalized weighted least-squares approach to low-dose cone-beam computed tomography reconstruction

    NASA Astrophysics Data System (ADS)

    Ma, Ming; Wang, Huafeng; Liu, Yan; Zhang, Hao; Gu, Xianfeng; Liang, Zhengrong

    2014-03-01

    Cone-beam computed tomography (CBCT) has attracted growing interest of researchers in image reconstruction. The mAs level of the X-ray tube current, in practical application of CBCT, is mitigated in order to reduce the CBCT dose. The lowering of the X-ray tube current, however, results in the degradation of image quality. Thus, low-dose CBCT image reconstruction is in effect a noise problem. To acquire clinically acceptable quality of image, and keep the X-ray tube current as low as achievable in the meanwhile, some penalized weighted least-squares (PWLS)-based image reconstruction algorithms have been developed. One representative strategy in previous work is to model the prior information for solution regularization using an anisotropic penalty term. To enhance the edge preserving and noise suppressing in a finer scale, a novel algorithm combining the local binary pattern (LBP) with penalized weighted leastsquares (PWLS), called LBP-PWLS-based image reconstruction algorithm, is proposed in this work. The proposed LBP-PWLS-based algorithm adaptively encourages strong diffusion on the local spot/flat region around a voxel and less diffusion on edge/corner ones by adjusting the penalty for cost function, after the LBP is utilized to detect the region around the voxel as spot, flat and edge ones. The LBP-PWLS-based reconstruction algorithm was evaluated using the sinogram data acquired by a clinical CT scanner from the CatPhan® 600 phantom. Experimental results on the noiseresolution tradeoff measurement and other quantitative measurements demonstrated its feasibility and effectiveness in edge preserving and noise suppressing in comparison with a previous PWLS reconstruction algorithm.

  9. Optimizing 4D cone beam computed tomography acquisition by varying the gantry velocity and projection time interval.

    PubMed

    O'Brien, Ricky T; Cooper, Benjamin J; Keall, Paul J

    2013-03-21

    Four dimensional cone beam computed tomography (4DCBCT) is an emerging clinical image guidance strategy for tumour sites affected by respiratory motion. In current generation 4DCBCT techniques, both the gantry rotation speed and imaging frequency are constant and independent of the patient's breathing which can lead to projection clustering. We present a mixed integer quadratic programming (MIQP) model for respiratory motion guided-4DCBCT (RMG-4DCBCT) which regulates the gantry velocity and projection time interval, in response to the patient's respiratory signal, so that a full set of evenly spaced projections can be taken in a number of phase, or displacement, bins during the respiratory cycle. In each respiratory bin, an image can be reconstructed from the projections to give a 4D view of the patient's anatomy so that the motion of the lungs, and tumour, can be observed during the breathing cycle. A solution to the full MIQP model in a practical amount of time, 10 s, is not possible with the leading commercial MIQP solvers, so a heuristic method is presented. Using parameter settings typically used on current generation 4DCBCT systems (4 min image acquisition, 1200 projections, 10 respiratory bins) and a sinusoidal breathing trace with a 4 s period, we show that the root mean square (RMS) of the angular separation between projections with displacement binning is 2.7° using existing constant gantry speed systems and 0.6° using RMG-4DCBCT. For phase based binning the RMS is 2.7° using constant gantry speed systems and 2.5° using RMG-4DCBCT. The optimization algorithm presented is a critical step on the path to developing a system for RMG-4DCBCT.

  10. 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

  11. 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.

  12. 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.

  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. Intraoperative use of cone-beam computed tomography in a cadaveric ossified cochlea model

    PubMed Central

    Barker, Emma; Trimble, Keith; Chan, Harley; Ramsden, James; Nithiananthan, Sajendra; James, Adrian; Bachar, Gideon; MikeDaly; Irish, Jonathan; Siewerdsen, Jeff

    2010-01-01

    Objectives To describes a cadaveric temporal bone model of labyrinthitis ossificans and investigate the utility of intra-operative C-arm computed tomography (CBCT) in facilitating cochlear implantation. Design Cadaveric temporal bone study. Methods Five cadaveric heads had cement introduced into the 10 cochleas. CBCT and a conventional CT scans were compared to asses the extent of cochlear obliteration. The cement was drilled-out (under CBCT guidance, if required) and a cochlear implant electrode arrays (from 3 different manufacturers) inserted. Results CBCT images demonstrated temporal bone anatomy and the extent of cochlear obliteration as clearly as conventional CT in all cases. Intra-operative CBCT guided drilling and facilitated electrode placement in 2 out of 5 heads (3/10 ears). Streak-artifact from the electrodes of two devices partially obscured image clarity. Conclusions The obliterated cochlear model reproduced a disease-ossified cochlear both radiographically and surgically. CBCT is useful for intra-operative imaging, to facilitate electrode array placement in the obliterated or congenitally abnormal cochlea. PMID:19393414

  15. Cone beam x-ray luminescence computed tomography reconstruction with a priori anatomical information

    NASA Astrophysics Data System (ADS)

    Lo, Pei-An; Lin, Meng-Lung; Jin, Shih-Chun; Chen, Jyh-Cheng; Lin, Syue-Liang; Chang, C. Allen; Chiang, Huihua Kenny

    2014-09-01

    X-ray luminescence computed tomography (XLCT) is a novel molecular imaging modality that reconstructs the optical distribution of x-ray-excited phosphor particles with prior informational of anatomical CT image. The prior information improves the accuracy of image reconstruction. The system can also present anatomical CT image. The optical system based on a high sensitive charge coupled device (CCD) is perpendicular with a CT system. In the XLCT system, the xray was adopted to excite the phosphor of the sample and CCD camera was utilized to acquire luminescence emitted from the sample in 360 degrees projection free-space. In this study, the fluorescence diffuse optical tomography (FDOT)-like algorithm was used for image reconstruction, the structural prior information was incorporated in the reconstruction by adding a penalty term to the minimization function. The phosphor used in this study is Gd2O2S:Tb. For the simulation and experiments, the data was collected from 16 projections. The cylinder phantom was 40 mm in diameter and contains 8 mm diameter inclusion; the phosphor in the in vivo study was 5 mm in diameter at a depth of 3 mm. Both the errors were no more than 5%. Based on the results from these simulation and experimental studies, the novel XLCT method has demonstrated the feasibility for in vivo animal model studies.

  16. 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.

  17. 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

    2014-03-06

    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.

  18. 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

  19. 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.

  20. 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

  1. 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.

  2. IMRT planning and delivery incorporating daily dose from mega-voltage cone-beam computed tomography imaging.

    PubMed

    Miften, Moyed; Gayou, Olivier; Reitz, Bodo; Fuhrer, Russell; Leicher, Brian; Parda, David S

    2007-10-01

    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 degrees 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 V65 and V70 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 allows

  3. 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

  4. Dosimetric characterization and application of an imaging beam line with a carbon electron target for megavoltage cone beam computed tomography.

    PubMed

    Flynn, Ryan T; Hartmann, Julia; Bani-Hashemi, Ali; Nixon, Earl; Alfredo, R; Siochi, C; Pennington, Edward C; Bayouth, John E

    2009-06-01

    Imaging dose from megavoltage cone beam computed tomography (MVCBCT) can be significantly reduced without loss of image quality by using an imaging beam line (IBL), with no flattening filter and a carbon, rather than tungsten, electron target. The IBL produces a greater keV-range x-ray fluence than the treatment beam line (TBL), which results in a more optimal detector response. The IBL imaging dose is not necessarily negligible, however. In this work an IBL was dosimetrically modeled with the Philips Pinnacle3 treatment planning system (TPS), verified experimentally, and applied to clinical cases. The IBL acquisition dose for a 200 degrees gantry rotation was verified in a customized acrylic cylindrical phantom at multiple imaging field sizes with 196 ion chamber measurements. Agreement between the measured and calculated IBL dose was quantified with the 3D gamma index. Representative IBL and TBL imaging dose distributions were calculated for head and neck and prostate patients and included in treatment plans using the imaging dose incorporation (IDI) method. Surface dose was measured for the TBL and IBL for four head and neck cancer patients with MOSFETs. The IBL model, when compared to the percentage depth dose and profile measurements, had 97% passing gamma indices for dosimetric and distance acceptance criteria of 3%, 3 mm, and 100% passed for 5.2%, 5.2 mm. For the ion chamber measurements of phantom image acquisition dose, the IBL model had 93% passing gamma indices for acceptance criteria of 3%, 3 mm, and 100% passed for 4%, 4 mm. Differences between the IBL- and TBL-based IMRT treatment plans created with the IDI method were dosimetrically insignificant for both the prostate and head and neck cases. For IBL and TBL beams with monitor unit values that would result in the delivery of the same dose to the depth of maximum dose under standard calibration conditions, the IBL imaging surface dose was higher than the TBL imaging surface dose by an average of 18

  5. 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

  6. 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

  7. 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

  8. 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.

  9. 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

  10. Quantifying Interfraction and Intrafraction Tumor Motion in Lung Stereotactic Body Radiotherapy Using Respiration-Correlated Cone Beam Computed Tomography

    SciTech Connect

    Bissonnette, Jean-Pierre; Franks, Kevin N.; Purdie, Thomas G.; Moseley, Douglas J.; Sonke, Jan-Jakob; Jaffray, David A.; Dawson, Laura A.; Bezjak, Andrea

    2009-11-01

    Purpose: Stereotactic body radiation therapy (SBRT) is an effective treatment for medically inoperable Stage I non-small-cell lung cancer. However, changes in the patient's breathing patterns during the course of SBRT may result in a geographic miss or an overexposure of healthy tissues to radiation. However, the precise extent of these changes in breathing pattern is not well known. We evaluated the inter- and intrafractional changes in tumor motion amplitude (DELTAM) over an SBRT course. Methods and Materials: Eighteen patients received image-guided SBRT delivered in three fractions; this therapy was done with abdominal compression in four patients. For each fraction, cone beam computed tomography (CBCT) was performed for tumor localization (+- 3-mm tolerance) and then repeated to confirm geometric accuracy. Additional CBCT images were acquired at the midpoint and end of each SBRT fraction. Respiration-correlated CBCT (rcCBCT) reconstructions allowed retrospective assessment of inter- and intrafractional DELTAM by a comparison of tumor displacements in all four-dimensional CT and rcCBCT scans. The DELTAM was measured in mediolateral, superior-inferior, and anterior-posterior directions. Results: A total of 201 rcCBCT images were analyzed. The mean time from localization of the tumor to the end-fraction CBCT was 35 +- 7 min. Compared with the motion recorded on four-dimensional CT, the mean DELTAM was 0.4, 1.0, and 0.4 mm, respectively, in the mediolateral, superior-inferior, and anterior-posterior directions. On treatment, the observed DELTAM was, on average, <1 mm; no DELTAM was statistically different with respect to the initial rcCBCT. However, patients in whom abdominal compression was used showed a statistically significant difference (p < 0.05) in the variance of DELTAM with respect to the initial rcCBCT in the superior-inferior direction. Conclusions: The inter- and intrafractional DELTAM that occur during a course of lung SBRT are small. However

  11. Computed Analysis of Three-Dimensional Cone-Beam Computed Tomography Angiography for Determination of Tumor-Feeding Vessels During Chemoembolization of Liver Tumor: A Pilot Study

    SciTech Connect

    Deschamps, Frederic; Solomon, Stephen B.; Thornton, Raymond H.; Rao, Pramod; Hakime, Antoine; Kuoch, Viseth; Baere, Thierry de

    2010-12-15

    The purpose of this study was to evaluate computed analysis of three-dimensional (3D) cone-beam computed tomography angiography (CTA) of the liver for determination of subsegmental tumor-feeding vessels (FVs). Eighteen consecutive patients underwent transarterial chemoembolization (TACE) from January to October 2008 for 25 liver tumors (15 hepatocellular carcinomas [HCCs] and 10 neuroendocrine metastases). Anteroposterior projection angiogram (two-dimensional [2D]) and 3D cone-beam CTA images were acquired by injection of the common hepatic artery. Retrospectively, FVs were independently identified by three radiology technologists using a software package (S) that automatically determines FVs by analysis of 3D images. Subsequently, three interventional radiologists (IRs) independently identified FVs by reviewing the 2D images followed by examination of the 3D images. Finally, the 'ground truth' for the number and location of FVs was obtained by consensus among the IRs, who were allowed to use any imaging-including 2D, 3D, and all oblique or selective angiograms-for such determination. Sensitivities, durations, and degrees of agreement for review of 2D, 3D, and S results were evaluated. Sensitivity of 3D (73%) was higher than 2D (64%) images for identification of FVs (P = 0.036). The sensitivity of S (93%) was higher than 2D (P = 0.02) and 3D (P = 0.005) imaging. The duration for review of 3D imaging was longer than that for 2D imaging (187 vs. 94 s, P = 0.0001) or for S (135 s, P = 0.0001). The degree of agreement between the IRs using 2D and 3D imaging were 54% and 62%, respectively, whereas it was 82% between the three radiology technologists using S. These preliminary data show that computed determination of FVs is both accurate and sensitive.

  12. Evaluation of Interforaminal Mandible Region of Individuals With Pierre Robin Sequence and Treacher Collins Syndrome Through the Cone-Beam Computed Tomography.

    PubMed

    Tucunduva, Rosana Mara Adami; Imada, Thaís Sumie Nozu; Lopes, Ivna Albano; Rubira-Bullen, Izabel Regina Fischer; de Carvalho, Izabel Maria Marchi

    2016-01-01

    The Pierre Robin sequence (PRS) and the Treacher Collins syndrome (TCS) are conditions that cause significant abnormalities of jaw. This study was conducted in anticipation of evaluating the morphology of interforaminal region and identify the anatomic variations: anterior loop and mandibular incisive canal, in individuals with PRS and TCS by cone-beam computed tomography and compare them with individuals without craniofacial anomalies. By applying the t-test, the results showed no statistically significant difference, allowing to infer that there are no significant differences in interforaminal mandible morphology between groups and indicated that the prevalence and location of the studied anatomic variations are consistent with those described in literature.

  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. Cone-Beam Computed Tomography Correlates with Conventional Helical Computed Tomography in Evaluation of Lipiodol Accumulation in HCC after Chemoembolization

    PubMed Central

    Ishikawa, Toru; Abe, Satoshi; Hoshii, Asami; Yamada, Yumi; Iiduka, Akihiko; Nemoto, Takeo; Takeda, Keiko; Yoshida, Toshiaki

    2016-01-01

    Background & Aims The amount of drug-loaded lipiodol in an HCC tumor post-transarterial chemoembolization (TACE) correlates with the risk of local tumor recurrence. Lipiodol enhancement of a tumor on conventional CT, measured in Hounsfield units (HU), can predict tumor response. Here we investigate whether cone-beam CT (CBCT) can also be used to predict tumor response, providing the benefit of being able to optimize the patient’s treatment plan intra-procedurally. Methods A total of 82 HCC nodules (82 patients), ≤5 cm in diameter, were treated with balloon-occluded TACE using miriplatin between December 2013 and November 2014. For each patient, both CBCT and conventional CT images were obtained post-TACE. The degree of correlation between CBCT and conventional CT was determined by comparing identical regions of interest for each imaging modality using pixel values. Results The pixel values from conventional CT and CBCT were highly correlated, with a Pearson correlation coefficient of 0.912 (p<0.001). The location of the nodules within the liver did not affect the results; the correlation coefficient was 0.891 (p<0.001) for the left lobe and 0.926 (p<0.001) for the right lobe. The mean pixel value for conventional CT was 439 ± 279 HU, and the mean pixel value for CBCT was 416 ± 311 HU. Conclusions CBCT may be used as a substitute for conventional CT to quantitatively evaluate the amount of drug-loaded lipiodol within an HCC nodule and, hence, the efficacy of TACE treatment. The major benefit of using CBCT is the ability to predict the likelihood of local recurrence intra-procedurally, enabling subsequent treatment optimization. PMID:26752696

  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. 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

  17. 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

  18. 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

  19. 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

  20. Implant Supported Distal Extension over Denture Retained by Two Types of Attachments. A Comparative Radiographic Study by Cone Beam Computed Tomography

    PubMed Central

    Mahrous, Ahmed I; Aldawash, Hussien A; Soliman, Tarek A; Banasr, Fahad H; Abdelwahed, Ahmed

    2015-01-01

    Background: This study was conducted to compare and evaluate the effect of two different attachments (locator attachment and ball and socket [B&S] attachment) on implants and natural abutments supporting structures, in cases of limited inter-arch spaces in mandibular Kennedy Class I implant supported removable partial over dentures by measuring the bone height changes through the cone beam radiographic technology. Materials and Methods: Two implants were positioned in the first or second molar area following the two-stage surgical protocol. Two equal groups were divided ten for each: Group I: Sides were the placed implants restored by the locator attachment. Group II: The other sides, implants were restored by B&S attachment. Evaluation of the implants and main abutments supporting structures of each group was done at the time of removable partial over denture insertion, 6, 12 and 18 months by measuring the bone height changes using cone beam computed tomography. Results: Implants with locator attachment showed marginal bone height better effects on implants and main abutments supporting structures. Conclusion: Implants restored by locator attachment shows better effects on bone of both main natural abutments and implant than those restored with ball and socket. PMID:26028894

  1. Comparison of Diagnostic Accuracy of Radiation Dose-Equivalent Radiography, Multidetector Computed Tomography and Cone Beam Computed Tomography for Fractures of Adult Cadaveric Wrists

    PubMed Central

    Neubauer, Jakob; Benndorf, Matthias; Reidelbach, Carolin; Krauß, Tobias; Lampert, Florian; Zajonc, Horst; Kotter, Elmar; Langer, Mathias; Fiebich, Martin; Goerke, Sebastian M.

    2016-01-01

    Purpose To compare the diagnostic accuracy of radiography, to radiography equivalent dose multidetector computed tomography (RED-MDCT) and to radiography equivalent dose cone beam computed tomography (RED-CBCT) for wrist fractures. Methods As study subjects we obtained 10 cadaveric human hands from body donors. Distal radius, distal ulna and carpal bones (n = 100) were artificially fractured in random order in a controlled experimental setting. We performed radiation dose equivalent radiography (settings as in standard clinical care), RED-MDCT in a 320 row MDCT with single shot mode and RED-CBCT in a device dedicated to musculoskeletal imaging. Three raters independently evaluated the resulting images for fractures and the level of confidence for each finding. Gold standard was evaluated by consensus reading of a high-dose MDCT. Results Pooled sensitivity was higher in RED-MDCT with 0.89 and RED-MDCT with 0.81 compared to radiography with 0.54 (P = < .004). No significant differences were detected concerning the modalities’ specificities (with values between P = .98). Raters' confidence was higher in RED-MDCT and RED-CBCT compared to radiography (P < .001). Conclusion The diagnostic accuracy of RED-MDCT and RED-CBCT for wrist fractures proved to be similar and in some parts even higher compared to radiography. Readers are more confident in their reporting with the cross sectional modalities. Dose equivalent cross sectional computed tomography of the wrist could replace plain radiography for fracture diagnosis in the long run. PMID:27788215

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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

  8. Cone beam computed tomography (CBCT) as a tool for the analysis of nonhuman skeletal remains in a medico-legal setting.

    PubMed

    Lucena, Joaquin; Mora, Esther; Rodriguez, Lucia; Muñoz, Mariela; Cantin, Mario G; Fonseca, Gabriel M

    2016-09-01

    To confirm the nature and forensic significance of questioned skeletal material submitted a medico-legal setting is a relatively common procedure, although not without difficulties when the remains are fragmented or burned. Different methodologies have been described for this purpose, many of them invasive, time and money consuming or dependent on the availability of the analytical instrument. We present a case in which skeletal material with unusual conditions of preservation and curious discovery was sent to a medico-legal setting to determine its human/nonhuman origin. A combined strategy of imagenological procedures (macroscopic, radiographic and cone beam computed tomography - CBCT-technology) was performed as non-invasive and rapid methods to assess the nonhuman nature of the material, specifically of pig (Sus scrofa) origin. This hypothesis was later confirmed by DNA analysis. CBCT data sets provide accurate three-dimensional reconstructions, which demonstrate its reliable use as a forensic tool. PMID:27372746

  9. Facial soft-tissue asymmetry in three-dimensional cone-beam computed tomography images of children with surgically corrected unilateral clefts.

    PubMed

    Starbuck, John Marlow; Ghoneima, Ahmed; Kula, Katherine

    2014-03-01

    Cleft lip with or without cleft palate (CL/P) is a relatively common craniofacial malformation involving bony and soft-tissue disruptions of the nasolabial and dentoalveolar regions. The combination of CL/P and subsequent craniofacial surgeries to close the cleft and improve appearance of the cutaneous upper lip and nose can cause scarring and muscle pull, possibly resulting in soft-tissue depth asymmetries across the face. We tested the hypothesis that tissue depths in children with unilateral CL/P exhibit differences in symmetry across the sides of the face. Twenty-eight tissue depths were measured on cone-beam computed tomography images of children with unilateral CL/P (n = 55), aged 7 to 17 years, using Dolphin software (version 11.5). Significant differences in tissue depth symmetry were found around the cutaneous upper lip and nose in patients with unilateral CL/P. PMID:24531247

  10. Cone beam computed tomography (CBCT) as a tool for the analysis of nonhuman skeletal remains in a medico-legal setting.

    PubMed

    Lucena, Joaquin; Mora, Esther; Rodriguez, Lucia; Muñoz, Mariela; Cantin, Mario G; Fonseca, Gabriel M

    2016-09-01

    To confirm the nature and forensic significance of questioned skeletal material submitted a medico-legal setting is a relatively common procedure, although not without difficulties when the remains are fragmented or burned. Different methodologies have been described for this purpose, many of them invasive, time and money consuming or dependent on the availability of the analytical instrument. We present a case in which skeletal material with unusual conditions of preservation and curious discovery was sent to a medico-legal setting to determine its human/nonhuman origin. A combined strategy of imagenological procedures (macroscopic, radiographic and cone beam computed tomography - CBCT-technology) was performed as non-invasive and rapid methods to assess the nonhuman nature of the material, specifically of pig (Sus scrofa) origin. This hypothesis was later confirmed by DNA analysis. CBCT data sets provide accurate three-dimensional reconstructions, which demonstrate its reliable use as a forensic tool.

  11. 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

  12. 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.

  13. 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

  14. Accelerating an Ordered-Subset Low-Dose X-Ray Cone Beam Computed Tomography Image Reconstruction with a Power Factor and Total Variation Minimization.

    PubMed

    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

  15. Generalized odontodysplasia in a 5-year-old patient with Hallermann-Streiff syndrome: clinical aspects, cone beam computed tomography findings, and conservative clinical approach.

    PubMed

    Damasceno, Juliana Ximenes; Couto, José Luciano Pimenta; Alves, Karla Shangela da Silva; Chaves, Cauby Maia; Costa, Fábio Wildson Gurgel; Pimenta, Alynne de Menezes Vieira; Fonteles, Cristiane Sá Roriz

    2014-08-01

    This article aims to report the main clinical aspects, cone beam computed tomography (CBCT) findings, and conservative oral rehabilitation in a child born from a consanguineous marriage who presented with Hallermann-Streiff syndrome (HSS) and generalized odontodysplasia. A 5-year-old girl presented with a diagnosis of HSS for oral evaluation. Radiographically, all teeth showed wide pulp chambers and roots with thin dentinal walls and open apices, resembling ghost teeth and indicating a diagnosis of odontodysplasia. Oral rehabilitation consisted of partial dentures that were regularly adjusted to conform the device with the pattern of growth and development of the child. CBCT scan provided great insight into HSS, allowing a detailed view of the morphologic aspects and associated trabecular bone pattern. Treatment of these 2 rare conditions in young children must consider the stage of growth and development. Although extremely rare in HSS, odontodysplasia should be investigated and conservatively managed in young children.

  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. 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.

  18. 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

  19. 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.

  20. 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. PMID:27547064

  1. 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.

  2. 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.

  3. Endodontic management of a maxillary first molar with three roots and seven root canals with the aid of cone-beam computed tomography

    PubMed Central

    Singh, Kamal Krishan; Shekhar, Rhitu

    2015-01-01

    Variation in root canal morphology, especially in maxillary first molar presents a constant challenge for a clinician in their detection and management. This case report describes the successful root canal treatment of a three rooted right maxillary first molar presenting with three canals each in the mesiobuccal and distobuccal roots and one canal in the palatal root. The clinical detection of this morphologic aberration was made using a dental operating microscope, and the canal configuration was established after correlating and computing the clinical, radiographic and cone-beam computed tomography (CBCT) scan findings. CBCT images confirmed the configuration of the canals in the mesiobuccal and distobuccal roots to be Al-Qudah and Awawdeh type (3-2) and type (3-2-1), respectively, whereas the palatal root had a Vertucci type I canal pattern. This report reaffirms the importance of careful examination of the floor of the pulp chamber with a dental operating microscope and the use of multiangled preoperative radiographs along with advanced diagnostic aids such as CBCT in identification and successful management of aberrant canal morphologies. PMID:26295029

  4. 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.

  5. Evaluation of Four-Dimensional Computed Tomography to Four-Dimensional Cone-Beam Computed Tomography Deformable Image Registration for Lung Cancer Adaptive Radiation Therapy

    PubMed Central

    Balik, Salim; Weiss, Elisabeth; Jan, Nuzhat; Roman, Nicholas; Sleeman, William C.; Fatyga, Mirek; Christensen, Gary E.; Zhang, Cheng; Murphy, Martin J.; Lu, Jun; Keall, Paul; Williamson, Jeffrey F.; Hugo, Geoffrey D.

    2013-01-01

    Purpose To evaluate two deformable image registration (DIR) algorithms for the purpose of contour mapping to support image guided adaptive radiotherapy with four-dimensional cone beam computed tomography (4DCBCT). Methods and Materials One planning 4D fan-beam CT (4DFBCT) and 7 weekly 4DCBCT scans were acquired for 10 locally advanced non-small cell lung cancer patients. The gross tumor volume (GTV) was delineated by a physician in all 4D images. End-of-inspiration phase planning 4DFBCT was registered to the corresponding phase in weekly 4DCBCT images for day-to-day registrations. For phase-to-phase registration, the end-of-inspiration phase from each 4D image was registered to the end-of-expiration phase. Two DIR algorithms—small deformation inverse consistent linear elastic (SICLE) and Insight Toolkit diffeomorphic demons (DEMONS)—were evaluated. Physician-delineated contours were compared to the warped contours by using the Dice similarity coefficient (DSC), average symmetric distance (ASD), false positive and false negative indices. The DIR results are compared to rigid registration of tumor. Results For day-to-day registrations, the mean DSC was 0.75 ± 0.09 with SICLE, 0.70 ± 0.12 with DEMONS, 0.66 ± 0.12 with rigid-tumor registration and 0.60 ± 0.14 with rigid-bone registration. Results were comparable to intra-observer variability calculated from phase-to-phase registrations as well as measured inter-observer variation for one patient. SICLE and DEMONS, when compared to rigid-bone (4.1 mm) and rigid-tumor (3.6 mm) registration, respectively reduced the ASD to 2.6 and 3.3 mm. On average, SICLE and DEMONS increased the DSC to 0.80 and 0.79 respectively, compared to rigid-tumor (0.78) registrations for 4DCBCT phase-to-phase registrations. Conclusions DIR achieved comparable accuracy to reported inter-observer delineation variability and higher accuracy than rigid-tumor registration. DIR performance varied with the algorithm and the patient. PMID

  6. 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

    2014-11-17

    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.

  7. Development of a phantom and a methodology for evaluation of depth kerma and kerma index for dental cone beam computed tomography.

    PubMed

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

    2013-12-01

    Basically, all modalities of diagnostic radiology require phantoms suitable for dosimetric evaluations. New technologies frequently arise unaccompanied of tools for dosimetric evaluations and quality control. In this study, a low-cost phantom and a consequent proposed methodology for dosimetric evaluations in cone beam computed tomography (CBCT) were presented. The developed phantom has typical dimensions of the human face, was built in polymethyl methacrylate and filled with water. Three devices with different technological concepts were evaluated and a proposed index, kerma index-height product (PKIH), was defined as an option to the use of air kerma-area product. The results of this study show relatively uniform kerma profiles for scanners with field of views (FOVs) of large diameters and non-uniform for FOVs of small diameters. With regard to the values obtained for the kerma indexes, much higher values were found for the equipment FOVs with small diameter compared with the values of the two other equipment that have larger diameters. The results indicate that (1) there is a need for special phantoms for use in CBCT, (2) the use of P(KA) in the evaluation of protocols on different equipment can lead to false interpretations and (3) the new index is a suitable alternative for the use of P(KA) in CBCT.

  8. 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

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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

  14. A morphological study of the multi infraorbital canals of the maxilla in the Japanese macaque by cone-beam computed tomography.

    PubMed

    Zaizen, Tomonori; Sato, Iwao

    2014-06-01

    The infraorbital canal in the Japanese macaque is composed of main and accessory canals. However, the morphological features of the infraorbital canal, such as the canal course and the supply of infraorbital vessels and nerves in the maxilla, are poorly characterized. In this study, we show the structure of the infraorbital canal of the Japanese macaque (adults; 10 male, 9 female), including the distribution of these vessels and nerves, using cone-beam computed tomography and a macroscopic apparatus. The superior and lateral margins of the orbit were correlated with the infraorbital canal on three-dimensional reconstruction images (P<0.05). We classified three types of multi infraorbital foramina as follows: type 1 had one accessory foramen, type 2 had two accessory foramina, and type 3 had three accessory foramina in the infraorbital canal. The infraorbital canal also formed three structures, specifically, a tube-like shape, a funnel shape, and a pinched shape. The accessory canals also contained nerves and blood vessels, and the canals ran downward and supplied the maxillary sinus, teeth, and midfacial region of the craniofacial skeleton, while passing through a few branch canals. These accessory canals proved valuable for blood vessels and nerves and allowed us to recognize the maxilla in the Japanese macaque skull.

  15. 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

  16. Cone Beam Computed Tomography Evaluation of the Diagnosis, Treatment Planning, and Long-Term Followup of Large Periapical Lesions Treated by Endodontic Surgery: Two Case Reports

    PubMed Central

    Shekhar, Vijay; Shashikala, K.

    2013-01-01

    The aim of this case report is to present two cases where cone beam computed tomography (CBCT) was used for the diagnosis, treatment planning, and followup of large periapical lesions in relation to maxillary anterior teeth treated by endodontic surgery. Periapical disease may be detected sooner using CBCT, and their true size, extent, nature, and position can be assessed. It allows clinician to select the most relevant views of the area of interest resulting in improved detection of periapical lesions. CBCT scan may provide a better, more accurate, and faster method to differentially diagnose a solid (granuloma) from a fluid-filled lesion or cavity (cyst). In the present case report, endodontic treatment was performed for both the cases followed by endodontic surgery. Biopsy was done to establish the confirmatory histopathological diagnosis of the periapical lesions. Long-term assessment of the periapical healing following surgery was done in all the three dimensions using CBCT and was found to be more accurate than IOPA radiography. It was concluded that CBCT was a useful modality in making the diagnosis and treatment plan and assessing the outcome of endodontic surgery for large periapical lesions. PMID:23762646

  17. 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

  18. Use of cone-beam computed tomography and three-dimensional modeling for assessment of anomalous pulp canal configuration: a case report

    PubMed Central

    Helvacioglu-Yigit, Dilek; Mutlu, Ibrahim

    2015-01-01

    Three-dimensional (3D) reconstruction of cone-beam computed tomography (CBCT) scans appears to be a valuable method for assessing pulp canal configuration. The aim of this report is to describe endodontic treatment of a mandibular second premolar with aberrant pulp canal morphology detected by CBCT and confirmed by 3D modeling. An accessory canal was suspected during endodontic treatment of the mandibular left second premolar in a 21 year old woman with a chief complaint of pulsating pain. Axial cross-sectional CBCT scans revealed that the pulp canal divided into mesiobuccal, lingual, and buccal canals in the middle third and ended as four separate foramina. 3D modeling confirmed the anomalous configuration of the fused root with a deep lingual groove. Endodontic treatment of the tooth was completed in two appointments. The root canals were obturated using lateral compaction of gutta-percha and root canal sealer. The tooth remained asymptomatic and did not develop periapical pathology until 12 months postoperatively. CBCT and 3D modeling enable preoperative evaluation of aberrant root canal systems and facilitate endodontic treatment. PMID:25984479

  19. Study of Anatomical Relationship between Posterior Teeth and Maxillary Sinus Floor in a Subpopulation of the Brazilian Central Region Using Cone-Beam Computed Tomography - Part 2.

    PubMed

    Estrela, Carlos; Nunes, Carla A B C M; Guedes, Orlando Aguirre; Alencar, Ana Helena G; Estrela, Cynthia R A; Silva, Ricardo Gariba; Pécora, Jesus Djalma; Sousa-Neto, Manoel Damião

    2016-01-01

    This study evaluated the anatomical relationship between posterior teeth root apices and maxillary sinus floor (MSF) on 202 cone beam computed tomography (CBCT) exams. The distance between the root apices and the MSF, as well as the MSF thickness of the cortical bone closest to root apices and furcation regions were measured. The vertical and horizontal relationships of the MSF with the molar roots were classified into categories adapted from the criteria proposed by Kwak et al. (14). The shortest distances between MSF and the root apices were observed in the mesiobuccal root of the second molar (0.36±1.17 mm) and the palatal root of the first molar (0.45±1.10 mm) and the widest in buccal roots of the first premolars (5.47±4.43 mm). Significant differences were observed between the distance of MSF to the root apices of single-rooted first and second premolars. The cortical thickness ranged from 0.65±0.41 mm over the mesiobuccal root of the second molar to 1.28±0.42 mm over the buccal root of the first premolar. The most observed vertical and horizontal relationships were type II and 2H, respectively. The maxillary molar roots showed greater proximity to the MSF. The thickness of the MSF cortical bone closest to the apices and furcation regions was found to be similar only for premolars. PMID:27007338

  20. 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

  1. 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

  2. Cone beam computed tomographic evaluation of two access cavity designs and instrumentation on the thickness of peri-cervical dentin in mandibular anterior teeth

    PubMed Central

    Varghese, Vinny Sara; George, John V.; Mathew, Sylvia; Nagaraja, Shruthi; Indiresha, H. N.; Madhu, K. S.

    2016-01-01

    Background and Objectives: The aim of the study was to determine the effect of two access cavity designs on the peri-cervical dentin thickness before and after instrumentation using cone beam computed tomography (CBCT). Materials and Methods: Sixty mandibular anterior teeth were divided into two groups of thirty teeth each: Group I: conventional access cavity preparation, where access was prepared just above the cingulum and Group II: incisal access cavity preparation, where access was prepared in proximity to the incisal edge. CBCT scans were taken preoperatively, following access cavity preparation and post instrumentation. 200 μm thick slices were obtained 4mm apical and coronal to the cemento-enamel junction. The peri-cervical dentin thickness was calculated on the facial, lingual, mesial, and distal for all the three obtained scans. Results: The analysis showed that access cavity preparation and instrumentation resulted in a significant loss of tooth structure in Group I on all surfaces, but in Group II, there was a significant loss of tooth structure only in the mesial, lingual, and distal surfaces (P < 0.05). Conclusion: Incisal access cavity preparation resulted in lesser loss of dentin in the peri-cervical region.

  3. 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

  4. Evaluation of opening pattern and bone neoformation at median palatal suture area in patients submitted to surgically assisted rapid maxillary expansion (SARME) through cone beam computed tomography

    PubMed Central

    SALGUEIRO, Daniel Gomes; RODRIGUES, Vitor Hugo Leite de Oliveira; TIEGHI, Victor; de MENEZES, Carolina Carmo; GONÇALES, Eduardo Sanches; FERREIRA, Osny

    2015-01-01

    Surgically assisted rapid maxillary expansion (SARME) is the treatment of choice to adult patients even with severe transversal maxillary discrepancies. However, the adequate retention period to achieve the bone remodeling, thus assuring treatment stability, is controversial. Objective To evaluate the opening pattern and bone neoformation process at the midpalatal suture in patients submitted to surgically assisted (SARME) through cone beam computed tomography (CBCT). Material and Methods Fourteen patients were submitted to SARME through subtotal Le Fort I osteotomy. Both the opening pattern and the mean bone density at midpalatal suture area to evaluate bone formation were assessed pre- and post-operatively (15, 60 and 180 days) through CBCT. Results Type I opening pattern (from anterior to posterior nasal spine) occurred in 12 subjects while type II opening pattern (from anterior nasal spine to transverse palatine suture) occurred in 2 individuals. The 180-day postoperative mean (PO 180) of bone density value was 49.9% of the preoperative mean (Pre) value. Conclusions The opening pattern of midpalatal suture is more related to patients’ age (23.9 years in type I and 33.5 years in type II) and surgical technique. It was not possible to observe complete bone formation at midpalatal suture area at the ending of the retention period studied (180 days). PMID:26398512

  5. 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

  6. Evaluation of opening pattern and bone neoformation at median palatal suture area in patients submitted to surgically assisted rapid maxillary expansion (SARME) through cone beam computed tomography.

    PubMed

    Salgueiro, Daniel Gomes; Rodrigues, Vitor Hugo Leite de Oliveira; Tieghi Neto, Victor; Menezes, Carolina Carmo de; Gonçales, Eduardo Sanches; Ferreira Júnior, Osny

    2015-01-01

    Surgically assisted rapid maxillary expansion (SARME) is the treatment of choice to adult patients even with severe transversal maxillary discrepancies. However, the adequate retention period to achieve the bone remodeling, thus assuring treatment stability, is controversial.Objective To evaluate the opening pattern and bone neoformation process at the midpalatal suture in patients submitted to surgically assisted (SARME) through cone beam computed tomography (CBCT).Material and Methods Fourteen patients were submitted to SARME through subtotal Le Fort I osteotomy. Both the opening pattern and the mean bone density at midpalatal suture area to evaluate bone formation were assessed pre- and post-operatively (15, 60 and 180 days) through CBCT.Results Type I opening pattern (from anterior to posterior nasal spine) occurred in 12 subjects while type II opening pattern (from anterior nasal spine to transverse palatine suture) occurred in 2 individuals. The 180-day postoperative mean (PO 180) of bone density value was 49.9% of the preoperative mean (Pre) value.Conclusions The opening pattern of midpalatal suture is more related to patients' age (23.9 years in type I and 33.5 years in type II) and surgical technique. It was not possible to observe complete bone formation at midpalatal suture area at the ending of the retention period studied (180 days).

  7. Volumetric analysis of implanted biphasic calcium phosphate/collagen composite by three-dimensional cone beam computed tomography head model superimposition.

    PubMed

    Grybauskas, Simonas; Locs, Janis; Salma, Ilze; Salms, Girts; Berzina-Cimdina, Liga

    2015-01-01

    Facial onlay augmentation is often performed as an ancillary procedure simultaneously with orthognathic surgery to improve facial appearance, with hydroxyapatite (HAp) and HAp-based composites often used as the materials of choice. The ability to apply HAp in a granular rather than solid shape form may be responsible for its comparatively reduced rate of complications. However, a known complication of HAp and HAp composites is reduction of implant volume over time associated with resorption of the material. Evaluation of the volumetric changes of implanted biphasic calcium phosphate (HAp/β-TCP)/collagen composite in the malar areas from baseline to 4 months, 9-12 months, and 18-24 months after surgery using cone beam computed tomography (CBCT) surface superimposition and volumetric subtraction was done. The average decrease of volume of implanted HAp/β-TCP 4 months after surgery was 18.6%. Further volumetric decreases were negligible and a mean total volume loss of 21.65% was found at 18-24 months postoperatively. PMID:25491277

  8. 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

  9. 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

  10. 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.

  11. Cone beam computed tomographic evaluation of two access cavity designs and instrumentation on the thickness of peri-cervical dentin in mandibular anterior teeth

    PubMed Central

    Varghese, Vinny Sara; George, John V.; Mathew, Sylvia; Nagaraja, Shruthi; Indiresha, H. N.; Madhu, K. S.

    2016-01-01

    Background and Objectives: The aim of the study was to determine the effect of two access cavity designs on the peri-cervical dentin thickness before and after instrumentation using cone beam computed tomography (CBCT). Materials and Methods: Sixty mandibular anterior teeth were divided into two groups of thirty teeth each: Group I: conventional access cavity preparation, where access was prepared just above the cingulum and Group II: incisal access cavity preparation, where access was prepared in proximity to the incisal edge. CBCT scans were taken preoperatively, following access cavity preparation and post instrumentation. 200 μm thick slices were obtained 4mm apical and coronal to the cemento-enamel junction. The peri-cervical dentin thickness was calculated on the facial, lingual, mesial, and distal for all the three obtained scans. Results: The analysis showed that access cavity preparation and instrumentation resulted in a significant loss of tooth structure in Group I on all surfaces, but in Group II, there was a significant loss of tooth structure only in the mesial, lingual, and distal surfaces (P < 0.05). Conclusion: Incisal access cavity preparation resulted in lesser loss of dentin in the peri-cervical region. PMID:27656065

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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

  1. Volumetric changes in pharyngeal airway in Class II division 1 patients treated with Forsus-fixed functional appliance: A three-dimensional cone-beam computed tomography study

    PubMed Central

    Temani, Parul; Jain, Pradeep; Rathee, Pooja; Temani, Ruchira

    2016-01-01

    Objective: Recent years have witnessed a renewed interest to determine a quantifiable relationship between mandibular advancement performed with an orthodontic appliance and the resulting airway volume. The study was conducted to evaluate the volumetric changes in pharyngeal airway space using cone-beam computed tomography (CBCT) in Class II division 1 patients with retrognathic mandible treated by Forsus-fixed functional appliance and to compare them with their pretreatment findings. Materials and Methods: Thirty patients with Class II division 1 malocclusion of age group 10–17 years were selected randomly and evaluated for changes in pharyngeal airway volume with and without Forsus-fixed functional appliance. Patients in each group underwent CBCT scan of head and neck region at pretreatment stage and 6 months after the initial scan. Institutional approval for the project was obtained from the Ethical Committee. Volumetric changes of upper (oropharynx) and lower (hypopharynx) pharyngeal airways were measured on scanogram using computer software and intragroup comparisons were done. Results: There was a statistically significant increase in the volume of both hypopharynx and oropharynx and also total airway volume in patients treated with Forsus-fixed functional appliance. Three-dimensional reconstruction of the airway also demonstrates a considerable increase in pharyngeal airway space. Conclusion: Forsus-fixed functional appliance can be a promising appliance for improving pharyngeal airway volume in Class II division 1 patients with retrognathic mandible thus preventing obstructive sleep apnea and other respiratory problems in future. However, the long-term implications of this treatment modality need further consideration and a longer period of follow-up. PMID:27041897

  2. Usefulness of Cone-Beam Computed Tomography During Ultraselective Transcatheter Arterial Chemoembolization for Small Hepatocellular Carcinomas that Cannot be Demonstrated on Angiography

    SciTech Connect

    Miyayama, Shiro Yamashiro, Masashi; Okuda, Miho; Yoshie, Yuichi; Sugimori, Natsuki; Igarashi, Saya; Nakashima, Yoshiko; Matsui, Osamu

    2009-03-15

    This study evaluated the usefulness of cone-beam computed tomography (CBCT) during ultraselective transcatheter arterial chemoembolization (TACE) for hepatocellular carcinomas (HCC) that could not be demonstrated on angiography. Twenty-eight patients with 33 angiographically occult tumors (mean diameter 1.3 {+-} 0.3 cm) were enrolled in the study. The ability of CBCT during arterial portography (CBCTAP), during hepatic arteriography (CBCTHA), and after iodized oil injection (LipCBCT) to detect HCC lesions was retrospectively analyzed. The technical success of TACE was divided into three grades: complete (the embolized area included the entire tumor with at least a 5-mm wide margin), adequate (the embolized area included the entire tumor but without a 5-mm wide margin in parts), and incomplete (the embolized area did not include the entire tumor) according to computed axial tomographic (CAT) images obtained 1 week after TACE. Local tumor progression was also evaluated. CBCTAP, CBCTHA, and LipCBCT detected HCC lesions in 93.9% (31 of 33), 96.7% (29 of 30), and 100% (29 of 29) of patients, respectively. A single branch was embolized in 28 tumors, and 2 branches were embolized in five tumors. Twenty-seven tumors (81.8%) were classed as complete, and 6 (18.2%) were classed as adequate. None of the tumors were classed as incomplete. Twenty-five tumors (75.8%) had not recurred during 12.0 {+-} 6.2 months. Eight tumors (24.2%), 5 (18.5%) of 27 complete success and 3 (50%) of 6 adequate success, recurred during 10.1 {+-} 6.2 months. CBCT during TACE is useful in detecting and treating small HCC lesions that cannot not be demonstrated on angiography.

  3. A comparative study of accuracy of linear measurements using cone beam and multi-slice computed tomographies for evaluation of mandibular canal location in dry mandibles

    PubMed Central

    Naser, Asieh Zamani; Mehr, Bahar Behdad

    2013-01-01

    Background: Cross- sectional tomograms have been used for optimal pre-operative planning of dental implant placement. The aim of the present study was to assess the accuracy of Cone Beam Computed Tomography (CBCT) measurements of specific distances around the mandibular canal by comparing them to those obtained from Multi-Slice Computed Tomography (MSCT) images. Materials and Methods: Ten hemi-mandible specimens were examined using CBCT and MSCT. Before imaging, wires were placed at 7 locations between the anterior margin of the third molar and the anterior margin of the second premolar as reference points. Following distances were measured by two observers on each cross-sectional CBCT and MSCT image: Mandibular Width (W), Length (L), Upper Distance (UD), Lower Distance (LD), Buccal Distance (BD), and Lingual Distance (LID). The obtained data were evaluated using SPSS software, applying paired t-test and intra-class correlation coefficient (ICC). Results: There was a significant difference between the values obtained by MSCT and CBCT measurement for all areas such as H, W, UD, LD, BD, and LID, (P < 0.001), with a difference less than 1 mm. The ICC for all distances by both techniques, measured by a single observer with a one week interval and between 2 observers was 99% and 98%, respectively. Comparing the obtained data of both techniques indicates that the difference between two techniques is 2.17% relative to MSCT. Conclusion: The results of this study showed that there is significant difference between measurements obtained by CBCT and MSCT. However, the difference is not clinically significant. PMID:23878558

  4. 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

  5. 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.

  6. 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

  7. 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

  8. 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.

  9. Differences in the morphology of the maxillary sinus and roots of teeth between Macaca fuscata and Macaca fuscata yakui determined using cone beam computed tomography.

    PubMed

    Zaizen, Tomonori; Sato, Iwao; Miwa, Yoko; Sunohara, Masataka; Yosue, Takashi; Mine, Kazuharu; Koseki, Hirohisa; Shimada, Kazuyuki

    2013-01-01

    The Japanese macaque is an endemic species consisting of two subspecies: Macaca fuscata fuscata (MFF) and Macaca fuscata yakui (MFY). The MFY is indigenous to Yakushima Island and represents a subspecies of MFF that lives from Honshu to Shikoku and Kyushu, Japan. However, the differences in the skulls of the MFY and MFF are unknown, despite these subspecies having different skull sizes. The maxillary sinus (MS) indicates that the features of the frontal view reflect the transversal growth of the maxilla of the skull. In this study, we show the MS structures of the MFF (n = 9, 18 sides) and MFY (n = 10, 20 sides) using a cone-beam computed tomography instrument. Base on three-dimensional (3D) reconstructed images the MS and nasal cavity were found to present almost to no significant differences between MFF and MFY. However, we designated three classifications of the sinus floor based on the 3D MS images of these Japanese macaques: a round-like shape (type a, MFF = 66.7% (12/18), MFY = 45% (9/20)), a flat-like shape (type b, MFF = 22.2% (4/18), MFY = 35% (7/20)), and an irregular shape (type c, MFF = 11.1% (2/18), MFY = 20.0% (4/20)). The sinus floor shapes of the MFF were mostly type a, while those of the MFY were mostly type b. The prevalence of a root contacting the cortical bone is higher in the canine (26.7%, (8/30)) and second premolar (20%, (6/30) of the MFY at the nasal cavity, moreover, this value is higher in the third molar (42.9%, (9/21)) of the MS in the MFY. These results suggest that the features of the floor of the MS are related to the differences in maxillary root apices teeth between MMF and MMF.

  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. 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

  12. 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

  13. 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.

  14. 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

  15. Dosimetric Effect of Intrafraction Motion and Residual Setup Error for Hypofractionated Prostate Intensity-Modulated Radiotherapy With Online Cone Beam Computed Tomography Image Guidance

    SciTech Connect

    Adamson, Justus; Wu Qiuwen; Yan Di

    2011-06-01

    Purpose: To quantify the dosimetric effect and margins required to account for prostate intrafractional translation and residual setup error in a cone beam computed tomography (CBCT)-guided hypofractionated radiotherapy protocol. Methods and Materials: Prostate position after online correction was measured during dose delivery using simultaneous kV fluoroscopy and posttreatment CBCT in 572 fractions to 30 patients. We reconstructed the dose distribution to the clinical tumor volume (CTV) using a convolution of the static dose with a probability density function (PDF) based on the kV fluoroscopy, and we calculated the minimum dose received by 99% of the CTV (D{sub 99}). We compared reconstructed doses when the convolution was performed per beam, per patient, and when the PDF was created using posttreatment CBCT. We determined the minimum axis-specific margins to limit CTV D{sub 99} reduction to 1%. Results: For 3-mm margins, D{sub 99} reduction was {<=}5% for 29/30 patients. Using post-CBCT rather than localizations at treatment delivery exaggerated dosimetric effects by {approx}47%, while there was no such bias between the dose convolved with a beam-specific and patient-specific PDF. After eight fractions, final cumulative D{sub 99} could be predicted with a root mean square error of <1%. For 90% of patients, the required margins were {<=}2, 4, and 3 mm, with 70%, 40%, and 33% of patients requiring no right-left (RL), anteroposterior (AP), and superoinferior margins, respectively. Conclusions: For protocols with CBCT guidance, RL, AP, and SI margins of 2, 4, and 3 mm are sufficient to account for translational errors; however, the large variation in patient-specific margins suggests that adaptive management may be beneficial.

  16. 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

  17. Danger zone analysis using cone beam computed tomography after apical enlargement with K3 and K3XF in a manikin model

    PubMed Central

    Olivier, Juan-Gonzalo; García-Font, Marc; Gonzalez-Sanchez, Jose-Antonio; Roig-Cayon, Miguel

    2016-01-01

    Background The objective of the study was to evaluate and compare how apical enlargement with K3 and K3XF nickel-titanium (NiTi) rotary instruments reduces the root thickness in the danger zone and affects canal transportation and centering ability in mandibular molar mesial canals in a manikin extracted tooth model. Material and Methods Seventy-two mesial root canals of first mandibular molars were instrumented. Initial and post-instrumentation Cone Beam Computed Tomography scans were performed after root canal preparation up to size 25, 30, 35 and 40 files. Canal transportation, canal centering and remaining root dentin thickness toward the danger zone were calculated in sections 1, 2 and 3 mm under the furcation level. Data were analyzed using non-parametric Kruskal-Wallis analysis of variance at a significance level of P < 0.05. Results K3 instruments removed more dentin toward the danger zone compared with K3XF instruments (P< .05) and significant differences in dentin thickness were found when canal enlargement was performed to a #35-40 with both systems (P< 0.05). No significant differences in canal transportation and centering ability were found between systems, except when canal enlargement was performed to a #40 (P = 0,0136). No differences were observed when comparing the number of uses in both systems (P> 0.05). Conclusions Under the conditions of this study K3 removed a significant amount of dentin at the furcation level compared with the R-Phase K3XF rotary system in curved root canals. Enlargement to a 35-40/04 file removed significantly more dentin with both systems. Key words:K3, K3XF, R-phase, center ability, canal transportation, dentin thickness, increased apical enlargement, danger zone, dentin thickness. PMID:27703602

  18. 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

  19. 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.

  20. Comparison of canal transportation and centering ability of rotary protaper, one shape system and wave one system using cone beam computed tomography: An in vitro study

    PubMed Central

    Tambe, Varsha Harshal; Nagmode, Pradnya Sunil; Abraham, Sathish; Patait, Mahendra; Lahoti, Pratik Vinod; Jaju, Neha

    2014-01-01

    Aim: The aim of the present study was to compare the canal transportation and centering ability of Rotary ProTaper, One Shape and Wave One systems using cone beam computed tomography (CBCT) in curved root canals to find better instrumentation technique for maintaining root canal geometry. Materials and Methods: Total 30 freshly extracted premolars having curved root canals with at least 10 degrees of curvature were divided into three groups of 10 teeth each. All teeth were scanned by CBCT to determine the root canal shape before instrumentation. In Group 1, the canals were prepared with Rotary ProTaper files, in Group 2 the canals were prepared with One Shape files and in Group 3 canals were prepared with Wave One files. After preparation, post-instrumentation scan was performed. Pre-instrumentation and post-instrumentation images were obtained at three levels, 3 mm apical, 3 mm coronal and 8 mm apical above the apical foramen were compared using CBCT software. Amount of transportation and centering ability were assessed. The three groups were statistically compared with analysis of variance and Tukey honestly significant. Results: All instruments maintained the original canal curvature with significant differences between the different files. Data suggested that Wave One files presented the best outcomes for both the variables evaluated. Wave One files caused lesser transportation and remained better centered in the canal than One Shape and Rotary ProTaper files. Conclusion: The canal preparation with Wave One files showed lesser transportation and better centering ability than One Shape and ProTaper. PMID:25506145

  1. Influence of the glide path on various parameters of root canal prepared with WaveOne reciprocating file using cone beam computed tomography

    PubMed Central

    Dhingra, Anil; Nagar, Nidhi; Sapra, Vipul

    2015-01-01

    Background: Nickel–titanium (NiTi) rotary instrumentation carries a risk of fracture, mainly as a result of flexural (fatigue fracture) and torsional (shear failure) stresses. This risk might be reduced by creating a glide path before NiTi rotary instrumentation. The aim of this study was to compare various root canal parameters with the new WaveOne single-file reciprocating system in mesial canals of mandibular molars with and without glide path using cone beam computed tomography (CBCT). Materials and Methods: One hundred mandibular molar teeth with canal curvature between 20° and 30° were divided into two groups of 50 teeth each. In Group 1, no glide path was created, whereas in Group 2, a glide path was created with PathFiles at working length (WL). In both groups, canals were shaped with WaveOne primary reciprocating files to the WL. Canals were scanned in a CBCT unit before and after instrumentation. Postinstrumentation changes in canal curvature, cross-sectional area, centric ability, residual dentin thickness, and the extent of canal transportation were calculated using image analysis software and subjected to statistical analysis. Data were analyzed using Student's t-test and Mann–Whitney U-test (P < 0.05). Results: The mean difference of root canal curvature, cross-sectional area, centric ability, and residual dentin thickness increased, whereas it reduced significantly for canal transportation in Group 2. Conclusion: WaveOne NiTi files appeared to maintain the original canal anatomy and the presence of a glide path further improves their performance and was found to be beneficial for all the parameters tested in this study. PMID:26759589

  2. 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

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