Evaluation of the effects of positioning and configuration on contrast-to-noise ratio in the quality control of a 3D Accuitomo 170 dental CBCT system

Does the size of an object containing dental implant affect the expression of artifacts in cone beam computed tomography imaging?

Background

Artifacts fault image quality but handling several factors can affect it. This study was conducted to investigate the effect of object size on artifacts in cone-beam computed tomography systems.

Methods

Five phantoms, each containing a titanium implant in a sheep bone block, were fabricated of various sizes ranging from XS to XL: The M phantom was the same size as the device’s field of view (FOV). The L and XL phantoms were 20 and 40% larger than the FOV while the S and XS phantoms were 20 and 40% smaller than FOV, respectively. Ballistic gelatin was used to fill the phantoms. Phantoms were scanned by NewTom VGI and HDXWill Q-FACE. The mean and standard deviation (SD) of gray values in each 120 ROI was obtained by OnDemand software. The contrast to noise ratio (CNR) was also calculated.

Results

The gray value in S and M phantoms were more homogenous. The lowest SD value (10.20) was found in S phantom. The highest value for SD (125.16) was observed in XL phantom. The lowest (4.47) and highest (9.92) CNR were obtained in XL and S phantoms, respectively. HDXWill Q-FACE recorded a higher SD and a lower CNR than NewTom VGI (P < 0.05).

Conclusion

Object dimensions of the FOV size or up to 20% smaller provided better image quality. Since the dimensions of soft tissue in most patients are larger than the selective FOV, it is recommended that in CBCT artifacts studies, an object with dimensions closer to the patient’s dimensions be used to better relate the results with the clinical condition, because the sample dimensions affect the amount of artifacts.

Evaluation of cone-beam computed tomography over a small field of view in a water bath based on the modulation transfer function with repeating-edge oversampling

PURPOSE

The spatial resolution of cone-beam computed tomography (CBCT) in small fields of view (FOVs) is important for clinical applications. However, it is difficult to measure spatial resolution reliably due to error factors such as noise. The aim of this study was to obtain a modulation transfer function (MTF) more accurately.

METHODS

A CBCT apparatus was used with small FOV. An aluminum pipe slightly tilted at an inclination ratio of 77/3 (25.7) was used as the measurement phantom. The MTF was calculated from the edge image of the phantom. The actual oversampling ratio was determined by regression analysis. The experiment was repeated 16 times and the edge-spread function (ESF) was approximated by the least-square method. Furthermore, a low-pass filter (LPF) was applied to eliminate the component at frequencies above the Nyquist frequency. Finally, the MTF was calculated from the pre-processed ESF.

RESULTS

Results showed that pre-processing reduced the noise of the ESF. The MTFs at frequencies of 1.0 and 2.0 LP/mm were 0.59 and 0.18, respectively, in air and 0.52 and 0.16, respectively, in water.

CONCLUSION

The repeating-edge oversampling method combined with ESF pre-processing improved the accuracy of the MTF under clinically relevant conditions with a phantom.

Distribution of metal artifacts arising from the exomass in small field-of-view cone beam computed tomography scans

OBJECTIVES

To evaluate the distribution of metal artifacts from the exomass in small field-of-view (FOV) cone beam computed tomography (CBCT) scans.

STUDY DESIGN

An image phantom was scanned by using 3 CBCT units. Metal objects were positioned in the exomass, and additional CBCT scans were obtained. Mean gray values were obtained from 16 homogeneous areas and the standard deviation was calculated to quantify gray level inhomogeneity according to distinct zones of the FOV: total area and outer, inner, right, left, and mid-zones. The discrepancy between each zone and the total area was calculated to compare different CBCT units. Mean gray, gray level inhomogeneity, and discrepancy values were separately assessed by using analysis of variance (ANOVA) and Tukey's test (α = 0.05).

RESULTS

Overall, the mean gray values were significantly lower in the inner zone, and the gray level inhomogeneity values were significantly higher in the inner and mid-zones irrespective of the presence of metal objects in the exomass. The 3 CBCT units presented significantly different discrepancy values in most conditions.

CONCLUSIONS

The distribution of metal artifacts from the exomass follows the inherent gray value dispersion of CBCT images, with greater inhomogeneity in the inner zone of the FOV. This is exacerbated when metal objects are in the exomass.

Contrast-to-noise ratios of different dental restorative materials: an in-vitro cone beam computed tomography study

Purpose

In radiological views, strong beam hardening and streaking artifacts occur due to high-density structures and polyenergetic X-ray beams, and these lead to misdiagnosis. This study was performed in vitro to compare the contrast-to-noise ratio (CNR) of commonly used dental restorative materials by using Cone Beam Computed Tomography (CBCT) images with and without artifact reduction (AR) mode.

Materials and methods

A total of 108 molar teeth were restored with nine different groups of restorative materials, with each group containing 12 teeth. Teeth were placed in a dry human mandible and scanned, one by one, via Planmeca 3D ProMax (Planmeca, Helsinki, Finland) with and without AR mode. Images were analyzed using ImageJ software (National Institutes of Health, Bethesda, MD) to calculate the CNR.

Results

CNR was calculated to be the highest in compomer (Glassiosite) images without AR mode (mean: 3.36) and with AR mode (mean: 3.61). CNR was calculated to be the lowest in amalgam (Tytin) images without AR mode (mean: 0.21) and with AR mode (mean: 0.23). A significant difference was found between materials in terms of CNR measurements (p ≤ 0.05). CNR measurements were increased after the AR mode application (p ≤ 0.05).

Conclusion

AR mode was effective in reducing artifacts arising from dental materials on CBCT images, so it is necessary to use AR mode for correct diagnoses.

Evaluation of a metal artefact reduction tool on different positions of a metal object in the FOV

OBJECTIVES

To evaluate the action of a metal artefact reduction (MAR) tool when artefact-generator metal object is at different positions in the field of view (FOV).

METHODS

A cylindrical utility wax phantom, with a metal alloy sample inside, was made. The phantom was positioned centrally and peripherally in the FOV for image acquisition, with and without the MAR tool activation. The standard deviation values (image noise levels) from areas around the metal sample and the control area were obtained. The numbers were compared by Student's t-test (α = 0.05).

RESULTS

When the tool was activated, a significant difference of image noise was observed for central and peripheral positioning, for both control area (p = 0.0012) and metal area (p = 0.03), and a smaller level of noise was observed for images with phantoms in central positioning. A decrease in image noise with the tool activated was found only in phantoms with the metal object positioned centrally in the FOV.

CONCLUSIONS

For the MAR tool to be effective, the artefact-generator object needs to be in the central region of the FOV.

Quality assurance phantoms for cone beam computed tomography: a systematic literature review

OBJECTIVES

To undertake a systematic review on quality assurance (QA) phantoms for CBCT imaging, including studies on the development and application of phantoms.

METHODS

The MEDLINE (PubMed) bibliographic database was searched until May 2016 for studies evaluating the development and use of phantoms in CBCT image QA. The search strategy was restricted to English language publications using the following combined terms: (Cone Beam CT) OR (Cone Beam Computed Tomography) OR (Cone-Beam Computed Tomography) OR (CBCT) AND (quality OR phantom). It was assessed which of the six image quality parameters stated by the European Commission could be evaluated with each phantom and which of them actually were.

RESULTS

The search strategy yielded 37 studies, which had developed and used (25 studies) or only used (12 studies) a phantom in CBCT image QA. According to the literature, in 7 phantoms, it is possible to evaluate 4 or more image quality parameters while in 11 phantoms, merely 1 parameter can be evaluated. Only two phantoms permit the evaluation of the six image quality parameters stated by the European Commission. The parameters, which can most often be evaluated using a phantom, are image density values, spatial resolution and geometric accuracy. The SEDENTEXCT phantom was used most frequently. In two studies, all quality parameters suggested by the European Commission were evaluated.

CONCLUSIONS

QA phantoms rarely allow all image quality parameters stated by the European Commission to be evaluated. Furthermore, alternative phantoms, which allow all image quality parameters to be evaluated in a single exposure, even for a small field of view, should be developed.