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Jonczyk, M., F. Collettini, D. Geisel, D. Schnapauff, G. Böning, G. Wieners, and G. Gebauer. "Radiation exposure during TACE procedures using additional cone-beam CT (CBCT) for guidance: safety and precautions." Acta Radiologica 59, no. 11 (February 28, 2018): 1277–84. http://dx.doi.org/10.1177/0284185118761203.
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Background During transarterial chemoembolization (TACE), cone-beam computed tomography (CBCT) can be used for tumor and feeding vessel detection as well as postembolization CT imaging. However, there will be additional radiation exposure from CBCT. Purpose To evaluate the additional dose raised through CBCT-assisted guidance in comparison to TACE procedures guided with pulsed digital subtraction angiography (DSA) alone. Material and Methods In 70 of 140 consecutive patients undergoing TACE for liver cancer, CBCT was used to facilitate the TACE. Cumulative dose area product (DAP), cumulative kerma(air), DAP values of DSA, total and cine specific fluoroscopy times (FT) of 1375 DSA runs, and DAP of 91 CBCTs were recorded and analyzed using Spearman's correlation, Mann–Whitney U-test, and Kruskal–Wallis test. P values < 0.05 were considered significant. Results Additional CBCT increased DAP by 2% ( P = 0.737), kerma(air) by 24.6% ( P = 0.206), and FT by 0.02% ( P = 0.453). Subgroup analysis revealed that postembolization CBCT for detection of ethiodized oil deposits added more DAP to the procedure. Performing CBCT-assisted TACE, DSA until first CBCT contributed about 38% to the total DAP. Guidance CBCT acquisitions conduced to 6% of the procedure's DAP. Additional DSA for guidance after CBCT acquisition required approximately 46% of the mean DAP. The last DSA run for documentation purposes contributed about 10% of the DAP. Conclusion CBCT adds radiation exposure in TACE. However, the capability of CBCT to detect vessels and overlay in real-time during fluoroscopy facilitates TACE with resultant reduction of DAPs up to 46%.
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Franks, K. N., A. Bezjak, J. Higgins, W. Li, T. G. Purdie, A. Brade, J. Cho, D. Payne, D. A. Jaffray, and J. Bissonnette. "Image-guided lung radiotherapy: Bringing technology into routine clinical practice." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 18093. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.18093.
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18093 Background: Cone-beam CT (CBCT), an imaging system integrated into the RT treatment unit, produces 3D images far superior to the conventional 2D portal images used for verification of patient (pt) set-up. This allows direct matching to the RT treatment planning CT images, potentially increasing the precision of RT delivery. We report on the broad implementation of this new RT image-guided paradigm in lung cancer patients at our center. Methods: All lung cancer pts undergoing radical RT were planned using 4DCT and imaged daily for repositioning with CBCT since 04/06. Initially, CBCT datasets were compared with the planning CT to assess the setup error (bone surrogate), using two immobilisation methods: evacuated bags (EB) and chest-board (ChB). Discrepancies >3 mm between the two datasets, in any direction, were corrected before the start of each RT fraction. Data were retrospectively analyzed to assess the initial and residual discrepancies (43 pts; 1,128 CBCTs).Alternative matching strategies were also tested (carina & tumor) using both manual and automatic methods (30 pts). Protocols had REB approval. Results: In total, 657 (58%) RT treatments required adjustment after initial positioning on the treatment couch. The two immobilization methods were equivalent (p=0.18); the mean pt shift required for ChB pts was 55±18mm and for EB pts was 69±32mm. Given that residual uncertainties were <3 mm, margin calculations reveal that large reductions (54–79%) may be possible for tumors not influenced by respiratory motion. The performance of automatic matching was reasonable for carina (correlation [r] 0.8–0.84) and bone (r 0.58–0.81) but discrepancies were seen for tumor (r 0.63–0.69). Conclusions: Daily CBCT provides greatly increased accuracy of set-up, to within 3 mm of the planned bony anatomy, which may improve tumor control by confirming geographic accuracy. The role of image-guided RT in reducing the volume of irradiated normal tissue may play an important role in addressing toxicity concerns associated with combined modality treatment and facilitate safe RT dose escalation. In addition to increasing RT precision, daily CBCT allows routine visualisation of the tumor as well as to bony anatomy, presenting an exciting opportunity to adapt the treatment plan based on an individual response. [Table: see text]
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Monserrate, Andrés, Benjamin Zussman, Alp Ozpinar, Ajay Niranjan, John C. Flickinger, and Peter C. Gerszten. "Stereotactic radiosurgery for intradural spine tumors using cone-beam CT image guidance." Neurosurgical Focus 42, no. 1 (January 2017): E11. http://dx.doi.org/10.3171/2016.9.focus16356.
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OBJECTIVE Cone-beam CT (CBCT) image guidance technology has been widely adopted for spine radiosurgery delivery. There is relatively little experience with spine radiosurgery for intradural tumors using CBCT image guidance. This study prospectively evaluated a series of intradural spine tumors treated with radiosurgery. Patient setup accuracy for spine radiosurgery delivery using CBCT image guidance for intradural spine tumors was determined. METHODS Eighty-two patients with intradural tumors were treated and prospectively evaluated. The positioning deviations of the spine radiosurgery treatments in patients were recorded. Radiosurgery was delivered using a linear accelerator with a beam modulator and CBCT image guidance combined with a robotic couch that allows positioning correction in 3 translational and 3 rotational directions. To measure patient movement, 3 quality assurance CBCTs were performed and recorded in 30 patients: before, halfway, and after the radiosurgery treatment. The positioning data and fused images of planning CT and CBCT from the treatments were analyzed to determine intrafraction patient movements. From each of 3 CBCTs, 3 translational and 3 rotational coordinates were obtained. RESULTS The radiosurgery procedure was successfully completed for all patients. Lesion locations included cervical (22), thoracic (17), lumbar (38), and sacral (5). Tumor histologies included schwannoma (27), neurofibromas (18), meningioma (16), hemangioblastoma (8), and ependymoma (5). The mean prescription dose was 17 Gy (range 12–27 Gy) delivered in 1–3 fractions. At the halfway point of the radiation, the translational variations and standard deviations were 0.4 ± 0.5, 0.5 ± 0.8, and 0.4 ± 0.5 mm in the lateral (x), longitudinal (y), and anteroposterior (z) directions, respectively. Similarly, the variations immediately after treatment were 0.5 ± 0.4, 0.5 ± 0.6, and 0.6 ± 0.5 mm along x, y, and z directions, respectively. The mean rotational angles were 0.3° ± 0.4°, 0.3° ± 0.4°, and 0.3° ± 0.4° along yaw, roll, and pitch, respectively, at the halfway point and 0.5° ± 0.5°, 0.4° ± 0.5°, and 0.2° ± 0.3° immediately after treatment. CONCLUSIONS Radiosurgery offers an alternative treatment option for intradural spine tumors in patients who may not be optimal candidates for open surgery. CBCT image guidance for patient setup for spine radiosurgery is accurate and successful in patients with intradural tumors.
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Gerszten, Peter C., Josef Novotny, Mubina Quader, Valerie C. Dewald, and John C. Flickinger. "Prospective evaluation of a dedicated spine radiosurgery program using the Elekta Synergy S system." Journal of Neurosurgery 113, Special_Supplement (December 2010): 236–41. http://dx.doi.org/10.3171/2010.8.gks10949.
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Object Cone beam CT (CBCT) image guidance has recently been adopted for the delivery of spine radiosurgery. In 2007, the authors' institution began a dedicated spine radiosurgery program using the Elekta Synergy S system, which incorporates CBCT technology. In this study, the authors prospectively evaluated the Synergy S platform as a dedicated spine radiosurgery delivery system, including an evaluation of the accuracy of patient positioning using this technology, as part of a quality assurance program. Methods One hundred sixty-six spine and paraspinal lesions were treated using the Elekta Synergy S 6-MV LINAC with a beam modulator and CBCT image guidance combined with a HexaPOD couch that allows correction of patient positioning in 3 translational and 3 rotational directions. Stratifying the lesion by location, there were 28 cervical, 69 thoracic, 48 lumbar, and 21 sacral lesions. The most common histological types for the metastatic lesions (136 cases total) were breast, lung, sarcomas, and renal cells. The most common benign tumors (30 cases total) included 10 schwannomas, 5 neurofibromas, and 5 meningiomas. Twenty-eight lesions (17%) were intradural. To measure intratreatment patient movement, 3 quality assurance CBCTs were performed and recorded at separate times: immediately before treatment started; at the first third of the procedure; and at the second third of the procedure. The positioning data and fused images of the planning CT and CBCT were analyzed to determine intrafraction patient movements. From each of 3 quality assurance CBCT images, 3 translational and 3 rotational coordinates were obtained. Results The prescribed dose to the gross tumor volume, delivered in a single fraction, ranged from 12 to 20 Gy (mean 16 Gy) in this cohort. This dose was delivered by between 7 and 14 coplanar intensity-modulated radiation therapy beams (mean 9 beams). The gross tumor volumes ranged from 1.2 to 491.7 cm3 (mean 39.2 cm3). Mean treatment time including setup was 64 minutes. At the first third of the treatment, the magnitude of the 3D translational vector (X, Y, Z) was 1.1 ± 0.7 mm. Similarly, the 3D translational vector at the second third of the treatment was 1.0 ± 0.6 mm. The means ± SDs of the rotational angles were 0.2° ± 0.4°, 0.4° ± 0.5°, and 0.3° ± 0.5° along yaw, roll, and pitch, respectively, at the first third of the treatment, and 0.2° ± 0.3°, 0.4° ± 0.5°, and 0.4° ± 0.5°, respectively, at the second third of the treatment. Conclusions Single-fraction spine radiosurgery performed using the Synergy S platform and incorporating CBCT image guidance was determined to be feasible, accurate, and safe. This technique provides an overall translational position accuracy of < 2.0 mm.
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Rothom, Ronnachat, and Patchanee Chuveera. "Differences in Healing of a Horizontal Root Fracture as Seen on Conventional Periapical Radiography and Cone-Beam Computed Tomography." Case Reports in Dentistry 2017 (2017): 1–5. http://dx.doi.org/10.1155/2017/2728964.
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Different locations and healing patterns of horizontal root fractures bear different prognoses. Conventional periapical radiographs have been routinely used for the evaluation of the locations and healing of horizontal root fractures, with the limitation of presenting two-dimensional images. The three-dimensional imaging technology, cone-beam computed tomography (CBCT), has recently gained interest in dental traumatology, in particular for locating and diagnosing root fractures. However, the assessment of healing patterns of horizontal root fracture using CBCT compared to conventional radiographs has not been established. This case report describes the different healing patterns evaluated by two-dimensional radiographs and CBCT of a horizontally root-fractured maxillary right central incisor treated with mineral trioxide aggregate (MTA) with a two-year follow-up. The findings suggest that the healing patterns of horizontal root fractures seen on conventional radiographs and CBCT may be different.
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Nanjannawar, Lalita G., Jiwanasha Manish Agrawal, Manish Suresh Agrawal, and Anita D. Parushetti. "CBCT in Orthodontics: The Wave of Future." Journal of Contemporary Dental Practice 14, no. 1 (2013): 153–57. http://dx.doi.org/10.5005/jp-journals-10024-1291.
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ABSTRACT Cone beam computed tomography (CBCT) has probably been one of the most revolutionary innovations in the field of dentistry in the past decade and it provides a novel platform for orthodontic diagnosis and treatment planning. Current imaging techniques are essentially two-dimensional (2D) representations of threedimensional (3D) objects and suffer from several limitations. Hence, fulfillment of ideal imaging goals has been limited. Twodimensional radiographs are insufficient, especially in complex cases like impacted teeth, supernumerary teeth and orthognathic surgeries. CBCT images provide far more detailed information than conventional 2D radiographs and are user friendly. Soft tissues, skull, airway and the dentition can be observed and measured on CBCT images in a 1:1 ratio. Clinical significance CBCT provides an excellent tool for accurate diagnosis, more predictable treatment planning, more efficient patient management and education, improved treatment outcome and patient satisfaction. This article focuses on various applications of cone beam CT technology in orthodontics. How to cite this article Agrawal JM, Agrawal MS, Nanjannawar LG, Parushetti AD. CBCT in Orthodontics: The Wave of Future. J Contemp Dent Pract 2013;14(1):153-157.
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Minami, Yasunori, Takamichi Murakami, Masayuki Kitano, Toshiharu Sakurai, Naoshi Nishida, and Masatoshi Kudo. "Cone-Beam CT Angiography for Hepatocellular Carcinoma: Current Status." Digestive Diseases 33, no. 6 (2015): 759–64. http://dx.doi.org/10.1159/000439100.
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Cone-beam CT (CBCT) is generated during a rotational sweep of the C-arm around the patient, and can be a valuable imaging technique, providing in situ cross-sectional imaging. It is easy to evaluate the morphologic characteristics of hepatic arteries from multiple views with the use of various reconstruction techniques, such as maximum intensity projection (MIP) and volume rendering. CBCT angiography is capable of providing more information than the standard 2-dimensional angiography in visualizing hepatocellular carcinomas (HCCs) and targeting tumors though precise microcatheter placement in close proximity to HCCs. It can also be useful in evaluating treatment success at the time of the procedure. It is anticipated that CBCT could reduce radiation exposure, the overall procedure time and contrast material use because it allows immediate feedback for an efficient angiographic procedure. Therefore, CBCT angiography is an exciting technology with the potential to significantly impact the practice of interventional radiology. The purpose of this article is to provide a review of the principles, clinical applications and technique of CBCT angiography for HCC treatment.
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Schnapauff, Dirk, Andreas Maxeiner, Gero Wieners, Timm Denecke, Bernd Hamm, Bernhard Gebauer, and Martin Jonczyk. "Semi-automatic prostatic artery detection using cone-beam CT during prostatic arterial embolization." Acta Radiologica 61, no. 8 (December 12, 2019): 1116–24. http://dx.doi.org/10.1177/0284185119891689.
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Background Due to the broad variability of the prostatic artery (PA), its origin, small calibers, and tortuous courses, prostatic arterial embolization (PAE) is challenging, time-consuming, and results in high radiation doses. Purpose To evaluate the accuracy of PA detection using cone-beam computed tomography (CBCT) performed from the aortic bifurcation in combination with a semi-automatic detection software in comparison to oblique view digital subtraction angiography (DSA) with internal iliac artery (IIA) injection. Material and Methods Twenty-two consecutive patients were included in this retrospective, IRB-approved study between July and December 2017. CBCT from the aorta and 30° oblique-view DSA from both IIAs were obtained for PA detection. Results of suggested PAs from the semi-automatic vessel detection software after CBCT and IIA DSA were compared. Moreover, dose area product (DAP) was recorded. Statistical analysis included Spearman’s correlation, Mann–Whitney U test, and the Wilcoxon test considering P<0.05 as significant. Results PA type was classified significantly better with CBCT compared to DSA ( P=0.047). In IIA DSA, PAs could not be identified in 18% on the left and in 17% on the right side. CBCT detected all PAs, although truncation occurred in 59% because of the limited field of view. Mean DAP of the whole procedure was 257,161.32±127,909.36 mGy*cm2. Mean DAPs were for a single DSA 14,502.51±9,437.67 mGy*cm2 and for one CBCT 15,589.23±2,722.49 mGy*cm2. A mean of 14.82 DSAs and only one CBCT were performed. CBCT accounted for 6% and DSA for 84% of the entire DAP of the procedure. Conclusion CBCT with semi-automatic feeding vessel detection software detects PAs more accurately than IIA DSA and may reduce radiation dose.
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Acharya, Pradip, G. Ren, MR Jaisani, A. Dongol, RP Yadav, AK Mahat, and F. Dong. "Application of cone-beam computed tomography (CBCT) for diagnosis and management of mandibular condyle fractures." Health Renaissance 13, no. 3 (August 3, 2017): 73–81. http://dx.doi.org/10.3126/hren.v13i3.17930.
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Background: Cone beam computed tomography (CBCT) provides precise imaging of temporomandibular joint anatomy without superimposition and distortion. CBCT is relatively a new imaging modality and used commonly in dental practice.Objective: The aim of this study is to present detailed imaging of emporomandibular joint in case of condyle fracture using CBCT for its use in diagnosis, surgical planning and evaluation of treatment.Method: In our study, we evaluated 3D - CBCT (three dimensional Cone beam computed tomography) examinations of 18 patients with mandibular condyle fractures. All of the fractures in our cases were overlooked on CBCT, thus providing axial, coronal and para-sagittal imaging of condylar head including 3D dimensional volumetric images of the condyle and surrounding structures.Result: Out of 18 condylar fracture patient’s CBCT, 8 radiographs showed condylar head (intracapsular) fracture, 2 condylar neck, 8 subcondylar fracture. 13 condylar fractures were unilateral and 5 were bilateral fracture. 9 of the condylar fractures were not associated with the mandible fracture. Out of the 9 associated condylar fractures; 3 were associated with symphysis fracture, 4 associated with parasymphysis fracture, 1 associated with body fracture and remaining 1 associated with mandibular angle fracture. 6 of the condylar fracture showed no signs of displacement of the fractured part and among 12 displaced condylar fracture parts 8 medially and 4 laterally displaced recorded in CBCT. All of the patients were given treatment on the basis of CBCT diagnosis and the results obtained from it was clinical satisfactory without complaints.Conclusion: We concluded that CBCT is the latest sophisticated technology which provides clear image of condylar head without superimposition of other structures, presented supplementary information for a more effective diagnosis and management of mandibular condyle fractures. Health Renaissance 2015;13 (3): 73-81
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Kailash, Sahithya. "CBCT's Cone Beam Computed Tomography." Journal of Academy of Dental Education 1, no. 1 (January 8, 2014): 9. http://dx.doi.org/10.18311/jade/2014/2423.
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Dental X- Rays are important for diagnosing and treating patients by helping to detect oral health issues when they can't be detected by visual or physical examination alone. Dental X-Ray take a much closer look and provide valuable information in the area of interest. Though 2 Dimensional X-Ray and Panoramic radiography can predict diagnosis in number of clinical cases, certain situations demand multiplanar imaging, one such technology is CBCT. CBCT is a specialised 3Dimensional Craniofacial imaging in which 3 Dimensional reconstruction is possible. The final reconstructed image produced, reveals multilayer images in 3 orthogonal planes (coronal, sagittal and transverse) This article focuses on CBCT and its applications in various fields of dentistry.
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Maret, Delphine, Jean-Noel Vergnes, Ove A. Peters, Christine Peters, Karim Nasr, and Paul Monsarrat. "Recent Advances in Cone-beam CT in Oral Medicine." Current Medical Imaging Formerly Current Medical Imaging Reviews 16, no. 5 (May 28, 2020): 553–64. http://dx.doi.org/10.2174/1573405615666190114152003.
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Background: The cone-beam computed tomography (CBCT) technology has continuously evolved since its appearance in oral medicine in the early 2000s. Objective: To present recent advances in CBCT in oral medicine: i) selection of recent and consensual evidence-based sources, ii) structured summary of the information based on an iterative framework and iii) compliance with ethical, public health and patient-centered concerns. Main Findings: We will focus on technological advances, such as sensors and reconstruction algorithms used to improve the constant quality of the image and dosimetry. CBCT examination is now performed in almost all disciplines of oral medicine: currently, the main clinical disciplines that use CBCT acquisitions are endodontics and oral surgery, with clearly defined indications. Periodontology and ear, nose and throat medicine are more recent fields of application. For a given application and indication, the smallest possible field of view must be used. One of the major challenges in contemporary healthcare is ensuring that technological developments do not take precedence over admitted standards of care. The entire volume should be reviewed in full, with a systematic approach. All findings are noted in the patient’s record and explained to the patient, including incidental findings. This presupposes the person reviewing the images is sufficiently trained to interpret such images, inform the patient and organize the clinical pathway, with referrals to other medical or oral medicine specialties as needed. Conclusion: A close collaboration between dentists, medical physicists, radiologists, radiographers and engineers is critical for all aspects of CBCT technology.
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Pradhan, Darpa, and Tang Tian. "Role of CBCT in diagnosis and treatment plan of Impacted teeth: A Case Report." Orthodontic Journal of Nepal 6, no. 2 (December 31, 2016): 41–44. http://dx.doi.org/10.3126/ojn.v6i2.17421.
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In recent years Cone Beam Computed Tomography (CBCT) has become a widely accepted radiographic tool for diagnosis, treatment planning and follow-up in dentistry. 3D imaging has improved diagnostic efficiency and the practice of dentistry in a variety of ways; from routine evaluation to complex analysis of unusual pathology and congenital deformities. The technology available today makes dentistry better, easier, and more accurate. The most recognized need for CBCT imaging in orthodontics is that of the impacted canine evaluation. This article reports a patient having impacted right maxillary lateral incisor and canine; which is evaluated by 3D CBCT and was found beneficial particularly in terms of anatomical detail of root resorption and labiolingual relationships of the impacted tooth with the roots of neighboring teeth. Linear and angular measurements on CBCT images were accurate and helped in determining the exact location of the impacted teeth making it convenient for the surgical exposure of impacted teet
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Li, Qingqing, Ke Chen, Lin Han, Yan Zhuang, Jingtao Li, and Jiangli Lin. "Automatic tooth roots segmentation of cone beam computed tomography image sequences using U-net and RNN." Journal of X-Ray Science and Technology 28, no. 5 (September 19, 2020): 905–22. http://dx.doi.org/10.3233/xst-200678.
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BACKGROUND: Automatic segmentation of individual tooth root is a key technology for the reconstruction of the three-dimensional dental model from Cone Beam Computed Tomography (CBCT) images, which is of great significance for the orthodontic, implant and other dental diagnosis and treatment planning. OBJECTIVES: Currently, tooth root segmentation is mainly done manually because of the similar gray of the tooth root and the alveolar bone from CBCT images. This study aims to explore the automatic tooth root segmentation algorithm of CBCT axial image sequence based on deep learning. METHODS: We proposed a new automatic tooth root segmentation method based on the deep learning U-net with AGs. Since CBCT sequence has a strong correlation between adjacent slices, a Recurrent neural network (RNN) was applied to extract the intra-slice and inter-slice contexts. To develop and test this new method for automatic segmentation of tooth roots using CBCT images, 24 sets of CBCT sequences containing 1160 images and 5 sets of CBCT sequences containing 361 images were used to train and test the network, respectively. RESULTS: Applying to the testing dataset, the segmentation accuracy measured by the intersection over union (IOU), dice similarity coefficient (DICE), average precision rate (APR), average recall rate (ARR), and average symmetrical surface distance (ASSD) are 0.914, 0.955, 95.8% , 95.3% , 0.145 mm, respectively. CONCLUSIONS: The study demonstrates that the new method combining attention U-net with RNN yields the promising results of automatic tooth roots segmentation, which has potential to help improve the segmentation efficiency and accuracy in future clinical practice.
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Lou, Yifei, Tianye Niu, Xun Jia, Patricio A. Vela, Lei Zhu, and Allen R. Tannenbaum. "Joint CT/CBCT deformable registration and CBCT enhancement for cancer radiotherapy." Medical Image Analysis 17, no. 3 (April 2013): 387–400. http://dx.doi.org/10.1016/j.media.2013.01.005.
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Bueno, Mike R., Carlos Estrela, Brunno C. Azevedo, and Anibal Diogenes. "Development of a New Cone-Beam Computed Tomography Software for Endodontic Diagnosis." Brazilian Dental Journal 29, no. 6 (December 2018): 517–29. http://dx.doi.org/10.1590/0103-6440201802455.
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Abstract Cone-beam computed tomography (CBCT) has promoted changes in approaches in Endodontics, and enhanced decision-making in complex clinical cases. Despite the technological advancements in CBCT hardware, the interpretation of the acquired images is still compromised by viewing software packages that often have limited navigational tools and lack adequate filters to overcome some challenges of the CBCT technology such as artefacts. This study reviews the current limitations of CBCT and the potential of a new CBCT software package (e-Vol DX, CDT- Brazil) to overcome these aspects and support diagnosing, planning and managing of endodontic cases. This imaging method provide high resolution images due to submillimeter voxel sizes, dynamic multi-plane imaging navigation and ability to change the volume parameters such as slice thickness and slice intervals and data correction applying imaging filters and manipulating brightness and contrast. The main differences between e-Vol DX and other software packages are: compatibility with all current CBCT scanners with the capacity to export DICOM Data, a more comprehensive brightness and contrast library, as other applications, in which adjustments are limited, do not usually support all the DICOM dynamic range features; Custom slice thickness adjustment, often limited and pre-defined in other applications; Custom Sharpening adjustment, often limited in other applications; advanced noise reduction algorithm that enhances image quality; preset imaging filters, dedicated endodontic volume rendering filters with the ability to zoom the image over 1000x (3D reconstructions) without loss of resolution and automatic imaging parameters customization for better standardization and opportunities for research; capture screen resolution of 192 dpi, with a 384 dpi option, in contrast to the 96 dpi of most similar applications. This new CBCT software package may support decision-making for the treatment of complex endodontic cases and improve diagnosis and treatment results. Effective improvement of image quality favors the rational prescription and interpretation of CBCT scans.
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Kawauchi, Satoru, Koichi Chida, Takashi Moritake, Yuji Matsumaru, Yusuke Hamada, Hideyuki Sakuma, Shogo Yoda, Lue Sun, Masayuki Sato, and Wataro Tsuruta. "ESTIMATION OF PATIENT LENS DOSE ASSOCIATED WITH C-ARM CONE-BEAM COMPUTED TOMOGRAPHY USAGE DURING INTERVENTIONAL NEURORADIOLOGY." Radiation Protection Dosimetry 184, no. 2 (November 17, 2018): 138–47. http://dx.doi.org/10.1093/rpd/ncy188.
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Abstract The purpose of this study was to investigate the dose distribution and lens doses associated with C-arm cone-beam computed tomography (CBCT), using a head phantom, and to estimate the contribution ratio of C-arm CBCT to each patient’s lens dose during interventional neuroradiology (‘lens dose ratio’) in 109 clinical cases. In the phantom study, the peak skin doses and respective right and left lens doses of C-arm CBCT were as follows: 63.0 ± 1.9 mGy, 19.7 ± 1.4 mGy and 21.9 ± 0.8 mGy in whole brain C-arm CBCT and 39.2 ± 1.4 mGy, 4.7 ± 0.9 mGy and 3.6 ± 0.3 mGy in high-resolution C-arm CBCT. In the clinical study, the lens dose ratios were 25.4 ± 8.7% in the right lens and 19.1 ± 9.8% in the left lens. This study shows that, on average, ~25% of patients’ total lens dose was contributed by C-arm CBCT.
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Horner, Keith. "Cone-Beam Computed Tomography: Time for an Evidence-Based Approach." Primary Dental Journal 2, no. 1 (March 2013): 22–31. http://dx.doi.org/10.1308/205016813804971582.
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Cone-beam computed tomography (CBCT) is an imaging technology that has revolutionised dental imaging in the last decade. Although of particular value to specialists performing implant treatment, it is increasingly being adopted by general dental practitioners. As the radiation dose is higher than that of conventional radiography, it is important to consider its diagnostic efficacy for the common tasks performed in general dental practice, such as caries diagnosis, endodontics and the detection of periapical pathosis. Any new imaging technique needs to have proven advantages over existing techniques before it is adopted, yet the evidence remains quite limited. Furthermore, image quality and radiation doses vary enormously between different manufacturers’ equipment, so that extrapolating results of one piece of research from one CBCT machine to another is fraught with pitfalls. Radiation doses with CBCT are typically an order of magnitude higher than conventional radiography. There is scope, however, for reducing these doses by judicious adjustment of exposure factors and limiting the field of view to the smallest dimensions consistent with the clinical situation. There is still a long way to go before we understand the value of CBCT in dentistry. High quality research evidence is needed, particularly with regard to assessing whether using CBCT improves patient outcomes.
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Gerszten, Peter C., Edward A. Monaco, Mubina Quader, Josef Novotny, Jong Oh Kim, John C. Flickinger, and M. Saiful Huq. "Setup accuracy of spine radiosurgery using cone beam computed tomography image guidance in patients with spinal implants." Journal of Neurosurgery: Spine 12, no. 4 (April 2010): 413–20. http://dx.doi.org/10.3171/2009.10.spine09249.
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Object Cone beam computed tomography (CBCT) image guidance technology has been adopted for use in spine radiosurgery. There is concern regarding the ability to safely and accurately perform spine radiosurgery without the use of implanted fiducials for image guidance in postsurgical cases in which titanium instrumentation and/or methylmethacrylate (MMA) has been implanted. In this study the authors prospectively evaluated the accuracy of the patient setup for spine radiosurgery by using CBCT image guidance in the context of orthopedic hardware at the site of disease. Methods The positioning deviations of 31 single-fraction spine radiosurgery treatments in patients with spinal implants were prospectively evaluated using the Elekta Synergy S 6-MV linear accelerator with a beam modulator and CBCT image guidance combined with a robotic couch that allows positioning correction in 3 translational and 3 rotational directions. To measure patient movement, 3 quality-assurance CBCT studies were performed and recorded: before, halfway through, and after radiosurgical treatment. The positioning data and fused images of planning CTs and CBCTs from the treatments were analyzed to determine intrafractional patient movements. From each of 3 CBCTs, 3 translational and 3 rotational coordinates were obtained. Results The prescribed dose to the gross tumor volume for the cohort was 12–18 Gy (mean 14 Gy) utilizing 9–14 coplanar intensity-modulated radiation therapy (IMRT) beams (mean 10 beams). At the halfway point of the radiosurgery, the translational variations and standard deviations were 0.6 ± 0.6, 0.4 ± 0.4, and 0.5 ± 0.5 mm in the lateral (X), longitudinal (Y), and anteroposterior (Z) directions, respectively. The magnitude of the 3D vector (X,Y,Z) was 1.1 ± 0.7 mm. Similarly, the variations immediately after treatment were 0.5 ± 0.3, 0.4 ± 0.4, and 0.5 ± 0.6 mm along the X, Y, and Z directions, respectively. The 3D vector was 1.0 ± 0.6 mm. The mean rotational angles were 0.3 ± 0.4, 0.5 ± 0.6, and 0.3 ± 0.4° along yaw, roll, and pitch, respectively, at the halfway point and 0.3 ± 0.4, 0.6 ± 0.6, and 0.4 ± 0.5° immediately after treatment. Conclusions Cone beam CT image guidance used for patient setup for spine radiosurgery was highly accurate despite the presence of spinal instrumentation and/or MMA at the level of the target volume. The presence of such spinal implants does not preclude safe treatment via spine radiosurgery in these patients.
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Dawson, George A., Alice V. Cheuk, Shruti Jolly, Ruchika Gutt, Helen Fosmire, Stephen T. Lutz, Mitchell Steven Anscher, et al. "Advanced radiation oncology technology within the Veterans Health Administration (VHA)." Journal of Clinical Oncology 32, no. 30_suppl (October 20, 2014): 52. http://dx.doi.org/10.1200/jco.2014.32.30_suppl.52.
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52 Background: The rapid evolution of technology in the treatment of cancer has paralleled other technological advancements in modern society. Intensity Modulated Radiotherapy (IMRT), Image Guided Radiotherapy (IGRT), Brachytherapy (BT), Cone Beam Computed Tomography (CBCT), Stereotactic Radiosurgery (SRS), and Stereotactic Body Radiotherapy (SBRT) facilitate treatment with higher, more conformal radiation doses, potentially improving cancer control while reducing normal tissue toxicity. Recent Surveillance, Epidemiology and End Results (SEER) program data and physician surveys indicate prostate BT is declining and the integration of SRS and SBRT is slower compared to IMRT. As utilization of technology increases, an understanding of its availability within the VHA is necessary to ensure quality and patient safety. Methods: An electronic survey was sent to 82 Radiation Oncologists (ROs)at 38 active VHA Radiation Oncology Centers with subsequent follow-up phone calls. The survey occurred from May-June 2014. ROs were queried on the availability of advanced RT technologies including IMRT, IGRT, BT, CBCT, SRS and SBRT at their facility. Practitioner specific details: years in practice, academic appointment and VHA employment status were collected. Results: Responses were obtained from 62 ROs representing 75% of VHA ROs and 34 or 89% of facilities. Full time VHA employees made up 60% of respondents with 35% in practice for <5 years and 34% practicing for >20 years; 71% held an academic appointment. The Table shows on site availability of advanced RT technologies within the 34 VHA sites that responded. Conclusions: For veterans receiving cancer treatment, VHA ROs are able to routinely use IMRT and IGRT with CBCT capabilities. However, stereotactic (SRS and SBRT) and BT services are less available, and may require referrals externally or to other VHA facilities. Limited availability of SRS and SBRT parallels the community experience. Likewise the decreasing utilization of BT is common to the VHA and private sector. SBRT, SRS and BT require significant expertise and technology. [Table: see text]
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Jaroma, Antti, Juha-Sampo Suomalainen, Lea Niemitukia, Tarja Soininvaara, Jari Salo, and Heikki Kröger. "Imaging of symptomatic total knee arthroplasty with cone beam computed tomography." Acta Radiologica 59, no. 12 (March 1, 2018): 1500–1507. http://dx.doi.org/10.1177/0284185118762247.
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Background Computed tomography (CT) can be used to assess the rotational alignment of prosthesis components to identify possible underlying causes of symptomatic total knee arthroplasty (TKA). The use of cone beam computed tomography (CBCT) for the imaging of extremities is relatively new, although it has been widely used in dental imaging. Purpose To assess the intra- and inter-observer reproducibility of CBCT, as well as to validate CBCT for TKA component and periprosthetic bone diagnostics. Material and Methods CBCT scans were performed on 18 patients the day before a scheduled revision TKA, from which the intra- and inter-observer reproducibility were assessed. Component rotation and loosening were evaluated. Perioperative bone defects were classified. Results The inter-observer intraclass coefficient correlation (ICC) for femoral component rotation was 0.41 (95% confidence interval [CI] = 0.12–0.69). For the tibial component, the ICC was 0.87 (95% CI = 0.74–0.94). Intra-observer reproducibilities were 0.70 (95% CI = 0.35–0.87) and 0.92 (95% CI = 0.80–0.97), respectively. The sensitivity for tibial component loosening was 97% and the specificity was 85%. The reliability of bone defect classification was only weak to moderate. Conclusion Two-dimensional (2D) CBCT scanning provides reliable and reproducible data for determining the rotation of femoral and tibial components, while showing minor overestimation of tibial component loosening. CBCT is a promising new tool for the evaluation of symptomatic knee arthroplasty patients, with a substantially lower radiation dose compared to conventional 2D multi-slice CT.
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Afrashtehfar, Kelvin Ian, and David MacDonald. "Vertical Tooth Root Fracture Detection through Cone-beam Computed Tomography: An Umbrella Review Protocol Testing Four Hypotheses." Open Dentistry Journal 13, no. 1 (December 31, 2019): 449–53. http://dx.doi.org/10.2174/1874210601913010449.
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Detecting vertical root fractures represents an immense challenge for oral health professionals. One of the main tools used to detect this type of biological complication is the periapical radiograph. However, conventional radiography consists of two-dimensional imaging that is limited by the superimposition of bony structures that complicate the detection of root fractures. The alternative, a Cone-Beam Computed Tomography (CBCT) scan, cannot be prescribed in every case since radiation should be kept to a minimum as stipulated by the “As Low As Reasonably Achievable” (ALARA) principle. Therefore, to justify the use of a CBCT scan to detect a vertical tooth root fracture, the clinician must prove that it has significant benefits over traditional imaging. Since few systematic reviews have compared CBCT technology to traditional radiography for the diagnosis of vertical root fractures, it is of utmost importance in clinical practice, especially in endodontology and clinical dental medicine, where the available reviews are examined to generate a clinical recommendation. The four hypotheses of this protocol are that (1) CBCT is superior to traditional radiography for detecting vertical root fractures of vital teeth; (2) CBCT is superior to traditional radiography for detecting longitudinal root fractures of vital teeth with radiopaque restorations; (3) CBCT is superior to traditional radiography for detecting vertical root fractures of root-filled teeth without a radiopaque post that may cause artifacts; and (4) CBCT is superior to traditional radiography for detecting vertical root fractures of root-filled teeth with a radiopaque post regardless of its longitude. To test these hypotheses, all the current secondary resources related to the aim of this meta-review are evaluated. If there is sufficient evidence to support clinical decisions, then the appropriate recommendations will be formulated. PROSPERO ID: CRD42018067792
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Gillan, Caitlin, Winnie Li, and Nicole Harnett. "Radiation therapist perspectives on cone-beam computed tomography practices and response to information." Journal of Radiotherapy in Practice 12, no. 3 (May 16, 2013): 237–44. http://dx.doi.org/10.1017/s1460396913000149.
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AbstractIntroductionWith recent technological advances in image-guided radiation therapy (IGRT), through cone-beam computed tomography (CBCT), more image-related clinical information is being collected, at more frequent intervals throughout the treatment course. As radiation therapy (RT) programmes further develop IGRT technology, the aim of this study is to assess whether the distribution and communication of professional responsibilities is evolving to ensure appropriate use of the technology.MethodsRadiation therapists practicing at any of the 14 Ontario RT centres were sent an electronic survey (n = 400). Closed-ended quantitative items addressed perceptions regarding policies, comfort, and professional responsibility in addressing CBCT concerns. Focus was on gynaecological, lung, head and neck (H&N) disease sites. Options for qualitative comments and explanations were included where appropriate.ResultsSeventy-nine surveys were submitted. Respondents from 12/14 (85·7%) centres used CBCT for at least one of three disease sites, most commonly on a daily basis. Five of these centres (41·7%) did not require radiation oncologist CBCT review, with others requiring it Day 1 or weekly. Potential CBCT observations of concern were grouped as set-up issues, tumour changes, organ-at-risk (OAR) changes, contour changes and ancillary findings (especially lung and airway changes). Respondents believed they consulted another professional about a CBCT in 20·2% of H&N patients, 19·6% of lung patients and 9·7% of gynaecological patients. The level of comfort in doing so varied from 77·0% for H&N to 89·5% for lung. Respondents were most likely to believe themselves responsible for changes in OARs (92·2% believing themselves responsible), and least likely for ancillary findings (62·7%).ConclusionsThrough preliminary insight from Ontario therapists, a degree of inconsistency is apparent between perceptions, practices and assigned roles in the management of CBCT information. Clear definition of the scope and nature of therapists’ responsibility for interpreting and addressing changes on CBCT images should be developed within each centre.
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Santos, Caroline Chepernate Vieira dos, Izabella Sol, Karen Rawen Tonini, Leda Maria Pescinini Salzedas, Fernanda Costa Yogui, and Daniela Ponzoni. "Evaluation of the size and location of the mental foramen and anterior loop of the lower alveolar nerve in the Brazilian population using cone beam computed tomography." Research, Society and Development 10, no. 8 (July 14, 2021): e36410817216. http://dx.doi.org/10.33448/rsd-v10i8.17216.
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Objective: The aim of this study was to evaluate the size, shape and location of the mental foramen (MF) and anterior loop (AL) in the Brazilian population through the analysis of cone beam computed tomography (CBCT) and panoramic radiography (PR). Method: We analyzed the location, shape and size of the MF, the distance between the upper wall of the MF and the alveolar crest (AC), the size of the AL and the presence of lingual anastomosis. Results: Fifty PR and CBCT exams were analyzed. In relation to the MF, the most common location was between premolars (56%), the most common shape was the oval shape (83%) and the average size in the PR was 3.63 mm and in the CBCT was3.66 mm. The average distance from the MF to the AC in the PR was 17.29 mm and in the CBCT was 11.48 mm. The average AL size was 3 mm, the smallest being 1 mm and the largest being 5 mm. Static analysis was performed to verify the relationship between the distance from the foramen to the AC with the values that were found in the PR and CBCT, which showed a statistically significant difference (p=<0.001) between them. Lingual anastomosis could be seen in 22% of the analyzed hemimandibles. Conclusion: CBCT is a reliable diagnostic test for planning rehabilitation near the MF. The distance between the implant and the foramen must be analyzed individually.
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Sun, Tao, Nanbo Sun, Jing Wang, and Shan Tan. "Iterative CBCT reconstruction using Hessian penalty." Physics in Medicine and Biology 60, no. 5 (February 12, 2015): 1965–87. http://dx.doi.org/10.1088/0031-9155/60/5/1965.
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Olszewski, Raphael. "Artifacts related to cone beam computed tomography technology (CBCT) and their significance for clinicians: illustrated review of medical literature." NEMESIS 11, no. 1 (April 3, 2020): 1–29. http://dx.doi.org/10.14428/nemesis.v11i1.54393.
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Objective: to explain the meaning and to illustrate technical artifacts (aliasing as well as the ring artifact) and beam hardening (metal artifact) that can be present in the dentomaxillofacial cone beam computed tomography (CBCT), and to check the accessibility of free illustrations of these artifacts in medical publications.
Material and methods: One observer applied five search equations using database PubMed. The exclusion criteria were: experimental studies, animal studies, studies not related to dentomaxillofacial area, and articles with closed access. There was no time limit for the search of articles. We limited our search to English and French language.
Results: Only 3 articles out of 434 publications were retained after application of inclusion/exclusion criteria. In these articles only 4 annotated figures were freely accessible in medical publications from PubMed.
In this paper we presented examples of aliasing, ring artifact, and beam artifacts from I-CAT, Carestream 9000 3D (Kodak), and Planmeca Promax 3D Mid CBCT. The intensity of beam hardening artifact varies from major degradation of image (i.e., subperiosteal implants, bridges, crowns, dental implants, and orthodontic fix appliances), through mean degradation (screws securing titanium mesh, head of mini-implant) to no beam hardening on metallic devices (orthodontic anchorage, orthodontic contention wire) or on dense objects (endodontic treatments, impression materials, Lego box). Some beam hardening artifacts arising from nasal piercing, hairs, or hearing aid device may be present on the image but they will not disturb the evaluation of the field of view.
Conclusions: reduction of aliasing artifact is related with the improvement of detectors quality. The presence of ring artifact means that CBCT device has lost its calibration. The field of view (FOV) needs to be reduce in order to avoid scanning regions susceptible to beam hardening (e.g., metallic restorations, dental implants). Finally, the accessibility to open knowledge on technique -related CBCT artifacts seems extremely limited when searching at PubMed database.
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Timme, Maximilian, Jens Borkert, Nina Nagelmann, Adam Streeter, André Karch, and Andreas Schmeling. "Age-dependent decrease in dental pulp cavity volume as a feature for age assessment: a comparative in vitro study using 9.4-T UTE-MRI and CBCT 3D imaging." International Journal of Legal Medicine 135, no. 4 (April 26, 2021): 1599–609. http://dx.doi.org/10.1007/s00414-021-02603-1.
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AbstractEvaluation of secondary dentin formation is generally suitable for age assessment. We investigated the potential of modern magnetic resonance imaging (MRI) technology to visualize the dental pulp in direct comparison with cone beam computed tomography (CBCT). To this end, we examined 32 extracted human teeth (teeth 11–48 [FDI]) using 9.4-T ultrashort echo time (UTE)-MRI and CBCT (methods). 3D reconstruction was performed via both manual and semi-automatic segmentation (settings) for both methods in two runs by one examiner. Nine teeth were also examined by a second examiner. We evaluated the agreement between examiners, scan methods, and settings. CBCT was able to determine the pulp volume for all teeth. This was not possible for two teeth on MRI due to MRI artifacts. The mean pulp volume estimated by CBCT was consistently higher (~ 43%) with greater variability. With lower variability in its measurements, evaluation of pulp volume using the MRI method exhibited greater sensitivity to differences between settings (p = 0.016) and between examiners (p = 0.009). The interactions of single-rooted teeth and multi-rooted teeth and method or setting were not found to be significant. For examiner agreement, the mean pulp volumes were similar with overlapping measurements (ICC > 0.995). Suitable for use in age assessment is 9.4-T UTE-MRI with good reliability and lower variation than CBCT. For MRI, manual segmentation is necessary due to a more detailed representation of the interior of the pulp cavity. Since determination of pulp volume is expected to be systematically larger using CBCT, method-specific reference values are indispensable for practical age assessment procedures. The results should be verified under in vivo conditions in the future.
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Vasconcelos, Karla de Faria, Yuri Nejaim, Francisco Haiter Neto, and Frab Norberto Bóscolo. "Diagnosis of invasive cervical resorption by using cone beam computed tomography: report of two cases." Brazilian Dental Journal 23, no. 5 (October 2012): 602–7. http://dx.doi.org/10.1590/s0103-64402012000500023.
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A radiographic interpretation is essential to the diagnosis of invasive cervical resorption (ICR) and the difficulty in distinguishing this lesion from internal root resorption has been highlighted in the literature. This paper reports the use of cone beam computed tomography (CBCT) in the diagnosis of ICR. The cases reports describe how CBCT can be used to make a differential diagnosis and also show that the use of this technology can provide relevant information on the location and nature of root resorption, which conventional radiographs cannot. As a result, the root canal treatment was not initially considered. The patients will be monitored and will undergo a scan after a short period of time to detect any small changes. It was observed that both cases benefited from CBCT in the diagnosis of ICR, because this imaging modality determined the real extent of resorption and possible points of communication with the periodontal space.
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Jiao, Dechao, Na Xie, Gang Wu, JianZhuang Ren, and Xinwei Han. "C-arm cone-beam computed tomography with stereotactic needle guidance for percutaneous adrenal biopsy: initial experience." Acta Radiologica 58, no. 5 (September 30, 2016): 617–24. http://dx.doi.org/10.1177/0284185116661882.
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Background Metastasis to the adrenal glands is frequent in patients with various cancers and adrenal gland biopsy is routinely performed using ultrasound or computed tomographic (CT) guidance. However, this method is technically challenging, especially in the case of small masses. Purpose To determine whether the new real-time stereotactic needle guidance technique C-arm cone-beam CT (CBCT) allows safe and accurate biopsy of adrenal gland masses, especially those in hard-to-reach anatomical locations. Material and Methods CBCT guidance was used to perform 60 stereotactic biopsy procedures of lesions that were inaccessible with ultrasound or CT guidance. The needle path was carefully planned and calculated on the CBCT virtual navigation guidance system, which acquired 3D CT-like cross-sectional images. The adrenal biopsy procedures were performed with fluoroscopic feedback. Technical success rate, sensitivity, specificity, accuracy, and complications were investigated. Results The technical success rate of adrenal biopsy under CBCT virtual navigation was 100%, with a mean total procedure time of 14.6 ± 3.6 min. Of the 60 lesions, 46 were malignant, 11 were benign, and three were non-diagnostic. The three non-diagnostic lesions proved to be malignant. Thus, the sensitivity, specificity, and accuracy were 93.8%, 100%, and 95.0%, respectively. Minor bleeding occurred in two (3.3%) cases. Conclusion CBCT guidance allows safe and accurate biopsy of adrenal gland masses and may be especially useful for hard-to-reach anatomical locations.
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Li, Chenshuang, Leanne Lin, Zhong Zheng, and Chun-Hsi Chung. "A User-Friendly Protocol for Mandibular Segmentation of CBCT Images for Superimposition and Internal Structure Analysis." Journal of Clinical Medicine 10, no. 1 (January 1, 2021): 127. http://dx.doi.org/10.3390/jcm10010127.
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Background: Since cone-beam computed tomography (CBCT) technology has been widely adopted in orthodontics, multiple attempts have been made to devise techniques for mandibular segmentation and 3D superimposition. Unfortunately, as the software utilized in these methods are not specifically designed for orthodontics, complex procedures are often necessary to analyze each case. Thus, this study aimed to establish an orthodontist-friendly protocol for segmenting the mandible from CBCT images that maintains access to the internal anatomic structures. Methods: The “sculpting tool” in the Dolphin 3D Imaging software was used for segmentation. The segmented mandible images were saved as STL files for volume matching in the 3D Slicer to validate the repeatability of the current protocol and were exported as DICOM files for internal structure analysis and voxel-based superimposition. Results: The mandibles of all tested CBCT datasets were successfully segmented. The volume matching analysis showed high consistency between two independent segmentations for each mandible. The intraclass correlation coefficient (ICC) analysis on 20 additional CBCT mandibular segmentations further demonstrated the high consistency of the current protocol. Moreover, all of the anatomical structures for superimposition identified by the American Board of Orthodontics were found in the voxel-based superimposition, demonstrating the ability to conduct precise internal structure analyses with the segmented images. Conclusion: An efficient and precise protocol to segment the mandible while retaining access to the internal structures was developed on the basis of CBCT images.
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Monsarrat, Paul, Antoine Galibourg, Karim Nasr, Norbert Telmon, and Delphine Maret. "Incidental findings in dental radiology are concerning for family doctors." Open Medicine 14, no. 1 (July 31, 2019): 467–78. http://dx.doi.org/10.1515/med-2019-0050.
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AbstractCone Beam Computerized Tomography (CBCT) is an imaging technology increasingly used in dentistry. Depending on the size of the examination area, visualization of anatomical structures outside the indication area may reveal incidental findings (IF). The aims of this systematic review and meta-analysis were to 1) evaluate the frequency, location and different types of incidental findings (IF) revealed during CBCT examinations; 2) identify potential influencing factors such as gender or age; 3) highlight what the family doctor should know about CBCT and the benefits for medical care.70 retrospective studies were included. 60% of IF are in the naso-oropharyngeal airway and paranasal sinuses. Carotid calcifications were observed with a mean prevalence of 9% CI95% [2-21]). Meta-regression showed a significant association of this prevalence with age, irrespective of gender.Given the high frequency of IF, with varying severity, the whole medical community is fully involved, and its opinion should be sought to ensure the best possible management for the patients. Physicians may also require CBCT examinations that would have been previously prescribed by a dentist, that may serve to better orientate investigations toward another imaging technique. The family doctor is therefore the dentist’s main interlocutor and the main coordinator of the follow-up of IF.
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Lewis, John H., Ruijiang Li, Xun Jia, W. Tyler Watkins, Yifei Lou, William Y. Song, and Steve B. Jiang. "Mitigation of motion artifacts in CBCT of lung tumors based on tracked tumor motion during CBCT acquisition." Physics in Medicine and Biology 56, no. 17 (August 3, 2011): 5485–502. http://dx.doi.org/10.1088/0031-9155/56/17/003.
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Ierardi, Anna Maria, Filippo Pesapane, Nicola Rivolta, Enrico Maria Fumarola, Salvatore Alessio Angileri, Filippo Piacentino, and Gianpaolo Carrafiello. "Type 2 endoleaks in endovascular aortic repair: cone beam CT and automatic vessel detection to guide the embolization." Acta Radiologica 59, no. 6 (August 31, 2017): 681–87. http://dx.doi.org/10.1177/0284185117729184.
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Background Dual-phase cone beam computed tomography (DP-CBCT) and automatic vessel detection (AVD) software are helpful tools for detecting arteries before planned endovascular interventions. Purpose To evaluate the usefulness of DP-CBCT and AVD software in guiding the trans-arterial embolization (TAE) of challenging T2 lumbar endoleaks (T2-L-EL). Material and Methods Ten patients with T2-L-EL were included in this study. The accuracy of DP-CBCT and the AVD software was defined by the ability to detect the endoleak and arterial feeding vessel, respectively. Technical success was defined as the correct positioning of the microcatheter using AVD software and the successful embolization of the endoleak. Clinical success was defined as the absence of recurrent endoleaks during follow-up and the stability of the sac diameter for persistent endoleaks. The total volume of iodinated contrast medium, overall procedure time, mean procedural radiation dose, and mean fluoroscopy time were recorded. Results The EL was detected by DP-CBCT in all patients. The AVD software identified the feeding arterial branch in all cases. In one patient, the nidus of the endoleak was not reached due to the small caliber of the feeding artery, even though the software had clearly identified the vessel route. The mean contrast volume was 109 mL, the mean overall procedural time was 74.3 min. The mean procedural radiation dose was 140.97 Gy cm2, and the mean fluoroscopy time was 29.8 min. Conclusion The use of DP-CBCT and the AVD software is feasible and may facilitate successful embolization in challenging occult T2-L-EL with complex vasculature.
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Guckenberger, Matthias. "Image-guided Radiotherapy Based on Kilovoltage Cone-beam Computed Tomography — A Review of Technology and Clinical Outcome." European Oncology & Haematology 07, no. 02 (2011): 121. http://dx.doi.org/10.17925/eoh.2011.07.02.121.
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In this article an overview about the technology and clinical application of gantry-mounted kilovoltage cone-beam computed tomography (CBCT) systems for image-guided high-precision radiotherapy is provided. The emphasis will be on the body sites that are most frequently targeted in daily clinical routine (prostate, lung and head-and-neck region).
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Godoy-Santos, Alexandre Leme, Alessio Bernasconi, Marcelo Bordalo-Rodrigues, François Lintz, Carlos Felipe Teixeira Lôbo, and Cesar de Cesar Netto. "Weight-bearing cone-beam computed tomography in the foot and ankle specialty: where we are and where we are going - an update." Radiologia Brasileira 54, no. 3 (June 2021): 177–84. http://dx.doi.org/10.1590/0100-3984.2020.0048.
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Abstract Cone-beam computed tomography (CBCT) has been applied in dentistry and medicine for nearly two decades. Its application in the foot and ankle specialty has grown exponentially in recent years. Weight-bearing CBCT allows clinicians to obtain weight-bearing images that can be viewed in all three planes and to construct three-dimensional models, similar to those constructed from traditional CT scans, as well as exposing patients to less radiation than do traditional CT scans. This technology has revolutionized diagnoses, improving the understanding of various lesions and surgical planning in the foot and ankle specialty. Ongoing studies of the use of weight-bearing CBCT in foot and ankle surgery are focused on fully automated and semi-automated three-dimensional measurements, as well as bone segmentation, mapping of the distances/orientation of the joints, and the production of customized implants. The aims of this review article are to show the evolution of this emerging tool in the foot and ankle specialty, to update those in related specialties on its use in current clinical practice, and to indicate where the research community is heading.
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Huang, Jin-Feng, Xiao-Zhao Chen, and Hong Wang. "Quality Control in Dental Cone-Beam Computed Tomography." Applied Sciences 11, no. 17 (September 2, 2021): 8162. http://dx.doi.org/10.3390/app11178162.
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Poor medical equipment may lead to misdiagnosis and missed diagnosis by doctors, leading to medical accidents. Given the differences in imaging methods, the performance determination method for conventional computed tomography (CT) does not apply to dental cone-beam computed tomography (CBCT). Therefore, a detection method that is more suitable for the characteristics of dental CBCT and more convenient for on-site operation in hospitals needs to be urgently developed. Hence, this study aimed to design a robust and convenient detection method to control the quality of dental CBCT, grasp the safety information of the equipment in a timely and effective manner, discover and evaluate equipment risks, and take reasonable and necessary countermeasures, thereby, reducing the risk of medical malpractice. This study adopted dose-area product to measure dose parameters and used objective quantitative evaluation methods instead of subjective evaluation methods for spatial resolution, contrast-to-noise ratio index, and uniformity. The dental CBCT of 10 dental hospitals and clinics were tested, and the findings revealed that the testing methods used had good accuracy and applicability.
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Pasha, Shiraz, Bathula Vimala Chaitanya, and Kusum Valli Somisetty. "Cone Beam Computed Tomographic Evaluation and Diagnosis of Mandibular First Molar with 6 Canals." Case Reports in Dentistry 2016 (2016): 1–4. http://dx.doi.org/10.1155/2016/1016985.
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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.
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Abd Fattah, Syed Yusoff Alzawawi Syed, Firdaus Hariri, Phrabhakaran Nambiar, Zulkiflee Abu Bakar, and Zainal Ariff Abdul Rahman. "Determining the Accuracy of the Mandibular Canal Region in 3D Biomodels Fabricated from CBCT Scanned Data: A Cadaveric Study." Current Medical Imaging Formerly Current Medical Imaging Reviews 15, no. 7 (August 26, 2019): 645–53. http://dx.doi.org/10.2174/1573405614666181012144745.
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Objective:To validate the accuracy of the mandibular canal region in 3D biomodel produced by using data obtained from Cone-Beam Computed Tomography (CBCT) of cadaveric mandibles.Methods:Six hemi-mandible samples were scanned using the i-CAT CBCT system. The scanned data was transferred to the OsiriX software for measurement protocol and subsequently into Mimics software to fabricate customized cutting jigs and 3D biomodels based on rapid prototyping technology. The hemi-mandibles were segmented into 5 dentoalveolar blocks using the customized jigs. Digital calliper was used to measure six distances surrounding the mandibular canal on each section. The same distances were measured on the corresponding cross-sectional OsiriX images and the 3D biomodels of each dentoalveolar block.Results:Statistically no significant difference was found when measurements from OsiriX images and 3D biomodels were compared to the “gold standard” -direct digital calliper measurement of the cadaveric dentoalveolar blocks. Moreover, the mean value difference of the various measurements between the different study components was also minimal.Conclusion:Various distances surrounding the mandibular canal from 3D biomodels produced from the CBCT scanned data was similar to that of direct digital calliper measurements of the cadaveric specimens.
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Wang, Yu-Tzu, Jian-Hong Yu, Lun-Jou Lo, Pin-Hsin Hsu, and CHun-Li Lin. "Developing Customized Dental Miniscrew Surgical Template from Thermoplastic Polymer Material Using Image Superimposition, CAD System, and 3D Printing." BioMed Research International 2017 (2017): 1–8. http://dx.doi.org/10.1155/2017/1906197.
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This study integrates cone-beam computed tomography (CBCT)/laser scan image superposition, computer-aided design (CAD), and 3D printing (3DP) to develop a technology for producing customized dental (orthodontic) miniscrew surgical templates using polymer material. Maxillary bone solid models with the bone and teeth reconstructed using CBCT images and teeth and mucosa outer profile acquired using laser scanning were superimposed to allow miniscrew visual insertion planning and permit surgical template fabrication. The customized surgical template CAD model was fabricated offset based on the teeth/mucosa/bracket contour profiles in the superimposition model and exported to duplicate the plastic template using the 3DP technique and polymer material. An anterior retraction and intrusion clinical test for the maxillary canines/incisors showed that two miniscrews were placed safely and did not produce inflammation or other discomfort symptoms one week after surgery. The fitness between the mucosa and template indicated that the average gap sizes were found smaller than 0.5 mm and confirmed that the surgical template presented good holding power and well-fitting adaption. This study addressed integrating CBCT and laser scan image superposition; CAD and 3DP techniques can be applied to fabricate an accurate customized surgical template for dental orthodontic miniscrews.
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Allen, Kevin, Parker Sheehan, Ruby Bolla, Kathy Mah, and Erler Darby. "Quality Assessment of Turbo CBCT for Lung SBRT." Journal of Medical Imaging and Radiation Sciences 47, no. 1 (March 2016): S1. http://dx.doi.org/10.1016/j.jmir.2015.12.005.
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Nagib, Riham, Camelia Szuhanek, Bogdan Moldoveanu, Meda Lavinia Negrutiu, Virgil Florin Duma, Cosmin Sinescu, and Silviu Brad. "Dimensional Study of Impacted Maxillary Canine Replicas 3D Printed Using Two Types of Resin Materials." Materiale Plastice 55, no. 2 (June 30, 2018): 190–91. http://dx.doi.org/10.37358/mp.18.2.4992.
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3D printing paired with CBCT imaging technology could provide a more individualised approach to orthodontic diagnosis and tratment. The aim of the present study is to asses dimensional differences between the CBCT image and 2 types of 3D printed replicas of an impacted maxillary canine, and to determine whether this method could be used in the future development of customised orthodontic attachments. Ten replicas were printed using the STL file of the impacted canine using two types of resin- five of each, with the same printer. Linear measurements of maximum height, length and width, were made. Mean dimensional erorrs were 0.184 mm and 0.068 mm. The largest discrepancy was in lenght - 0.362 mm. More reasearch is needed, but in this study we obtained printed resin replicas that provide sufficient dimensional accuracy to be used in orthodontics.
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Abdelsalam, Mohamed E., Tomas M. Appleton Figueira, Joe Ensor, Alda L. Tam, Rony Avritscher, Ahmed O. Kaseb, and Sanjay Gupta. "Survival impact of C-Arm cone-beam computed tomography on hepatocellular carcinoma patients undergoing chemoembolization." American Journal of Interventional Radiology 5 (June 4, 2021): 9. http://dx.doi.org/10.25259/ajir_7_2021.
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Objectives: The objectives of the study were to evaluate the use of C-arm cone-beam computed tomography (CBCT) for tumor targeting for transarterial chemoembolization (TACE) and its impact on overall survival (OS) in hepatocellular carcinoma patients. Material and Methods: Two groups were retrospectively evaluated according to the date of the first TACE session before and after C-arm CBCT installation in late 2005 (group A [n = 34], 2004–2005; group B [n = 104], 2008+). The years 2006 and 2007 were excluded to allow for the incorporation of this new imaging technology into clinical practice. The vessel selection order was recorded for all TACE sessions. Univariate and multivariate analyses were performed to assess the impact on and predictors of survival. Results: The average TACE selection order for each patient was significantly higher in group B than in group A (P < 0.0001). The median OS was significantly longer in group B (29.34 months) than in group A (19.65 months; P = 0.0088), and the difference in duration was most pronounced in patients with tumor burdens < 25% (n = 93; P = 0.0075), in whom the 3-year survival rate was 56.1% in group B and 15.3% in group A. In these 93 patients, the OS was significant longer (P = 0.018) for high (41.07 months) versus low (19.65 months) vessel selection order across both groups. In multivariate analyses, both the period in which TACE was performed (P = 0.022) and the use of C-arm CBCT (P = 0.0075) were significant predictors of improved OS. Conclusion: Use of advanced C-arm CBCT during TACE enhances the operating physician’s ability to deliver targeted, effective therapy for hepatocellular carcinoma, an aggressive approach that favorably impacts survival.
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Trindade, Hugo, Inês Morais, and Abigail Moreira. "EXTRAORAL AND CBCT DENTAL EXPOSURES IN PORTUGAL." Radiation Protection Dosimetry 190, no. 3 (July 2020): 283–88. http://dx.doi.org/10.1093/rpd/ncaa102.
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Abstract Data from dental extraoral and cone beam computed tomography (CBCT) exposures in Portugal (2019) were gathered, and patient doses for standard adult exams were evaluated. In panoramic X-rays, 442 units (34% of the existing licensed units) were tested, with a third quartile value (PKA) of 82 mGy.cm2. For cephalometric radiography (88 units), the third quartile value (Ki) was 0.3 mGy for the posteroanterior projection and 0.2 mGy for lateral projection. In CBCT (69 units), the doses for the placement of an upper first molar implant were evaluated with a third quartile value (PKA) of 820 mGy.cm2. Due to the wide range of values (74–3687 mGy.cm2), the CBCT data were divided by FOV dimensions: for small FOV (average FOV of 7 ×8 cm), a value of 580 mGy.cm2 was obtained and for medium FOV (average FOV of 13 × 12 cm) a value of 1167 mGy.cm2. The number of annual panoramic X-rays made in Portugal was 208 per 1000 inhabitants, which is higher than the value for other countries.
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Liu, Liang, Xinxin Li, Kai Xiang, Jing Wang, and Shan Tan. "Low-Dose CBCT Reconstruction Using Hessian Schatten Penalties." IEEE Transactions on Medical Imaging 36, no. 12 (December 2017): 2588–99. http://dx.doi.org/10.1109/tmi.2017.2766185.
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Kamburoğlu, Kıvanç, Eray Kolsuz, Hakan Kurt, Cenk Kılıç, Tuncer Özen, and Candan Semra Paksoy. "Accuracy of CBCT Measurements of a Human Skull." Journal of Digital Imaging 24, no. 5 (September 21, 2010): 787–93. http://dx.doi.org/10.1007/s10278-010-9339-9.
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Kim, Jinwoo, Hosang Jeon, and Ho Kyung Kim. "MONTE CARLO DOSE ASSESSMENT IN DENTAL CONE-BEAM COMPUTED TOMOGRAPHY." Radiation Protection Dosimetry 193, no. 3-4 (March 2021): 190–99. http://dx.doi.org/10.1093/rpd/ncab039.
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Abstract Most dental cone-beam computed tomography (CBCT) uses an x-ray beam field covering the maxillomandibular region and the width-truncated detector geometry. The spatial dose distribution in dental CBCT is analyzed in terms of local primary and remote secondary doses by using a list-mode analysis of x-ray interactions obtained from the Monte Carlo simulations. The patient-dose benefit due to the width-truncated detector geometry is also investigated for a wide range of detector offsets. The developed dose estimation agrees with the measurement in a relative error of 7.7%. The secondary dose outside of the irradiation field becomes larger with increasing tube voltage. The dose benefit with the width-truncated geometry linearly increases as the detector-offset width is decreased. Leaving the CT image quality out of the account, the MC results reveal that the operation of dental CBCT with a lower tube voltage and a smaller detector-offset width is beneficial to the patient dose.
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Santos, L. A. N., L. J. Lopes, G. D. Roque-Torres, V. F. Oliveira, and D. Q. Freitas. "Complex Odontoma: A Case Report with Micro-Computed Tomography Findings." Case Reports in Dentistry 2016 (2016): 1–6. http://dx.doi.org/10.1155/2016/3584751.
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Odontomas are the most common benign tumors of odontogenic origin. They are normally diagnosed on routine radiographs, due to the absence of symptoms. Histopathologic evaluation confirms the diagnosis especially in cases of complex odontoma, which may be confused during radiographic examination with an osteoma or other highly calcified bone lesions. The micro-CT is a new technology that enables three-dimensional analysis with better spatial resolution compared with cone beam computed tomography. Another great advantage of this technology is that the sample does not need special preparation or destruction in the sectioned area as in histopathologic evaluation. An odontoma with CBCT and microtomography images is presented in a 26-year-old man. It was first observed on panoramic radiographs and then by CBCT. The lesion and the impacted third molar were surgically excised using a modified Neumann approach. After removal, it was evaluated by histopathology and microtomography to confirm the diagnostic hypothesis. According to the results, micro-CT enabled the assessment of the sample similar to histopathology, without destruction of the sample. With further development, micro-CT could be a powerful diagnostic tool in future research.
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Lu, Ke, Lei Ren, and Fang-Fang Yin. "A geometry-guided deep learning technique for CBCT reconstruction." Physics in Medicine & Biology 66, no. 15 (July 30, 2021): 15LT01. http://dx.doi.org/10.1088/1361-6560/ac145b.
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Chen, Hu, Hong Li, Fei Lin, Yi-Jiao Zhao, Yu-Jiao Guo, Xin-yue Zhang, Yong Wang, and Peijun Lyu. "3D printing of drill guide template for access cavity preparation in human molars: a preliminary study." Rapid Prototyping Journal 24, no. 5 (July 9, 2018): 914–19. http://dx.doi.org/10.1108/rpj-05-2017-0081.
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Purpose This paper aims to use cone-beam computed tomography (CBCT) and computer-aided design/3D printing technology to design and fabricate a drill guide template for access cavity preparation of permanent molars, and conduct a preliminary evaluation of its effectiveness. Design/methodology/approach CBCT scans were performed on two permanent maxillary first molars extracted due to periodontitis. Based on the scans, guide templates of access cavities were designed. The angle of the guiding cylinders was determined based on the direction of the long axis of the tooth. A 3D resin printer with high resolution was used to print the guide templates. The printed guide templates were used by a dentist with specialized clinical experience to perform access cavity preparation in a dental simulator. Then the prepared access cavities were scanned again by CBCT, and scan data were compared to the design data. Findings The 3D printed drill guide template had a close fit with the extracted tooth fit. The access cavity prepared using the guide template enabled the removal of the pulp chamber roof, and formed a straight-line access. Points were selected for measurement at regularly spaced intervals of 0.5 mm along the side wall of the access cavity. The mean deviation between the actual access cavities of the two permanent maxillary first molars and the designed cavities was less than 0.1 mm, with a maximum deviation of about 0.5 mm, showing a good conformance between the actual cavity and the designed cavity. Originality/value A drill guide template was designed and fabricated by 3D printing technology, which easily guided burs to complete the access cavity preparation work forming an ideal cavity shape with satisfying accuracy, and thus may reduce the complications during pulp chamber entry.
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Cabanas, Ana M., Mauricio Arriagada-Benítez, Carlos Ubeda, Oliver Meseguer-Ruiz, and Pedro Arce. "Dose Estimation by Geant4-Based Simulations for Cone-Beam CT Applications: A Systematic Review." Applied Sciences 11, no. 13 (July 1, 2021): 6136. http://dx.doi.org/10.3390/app11136136.
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The last two decades have witnessed increasing use of X-ray imaging and, hence, the exposure of humans to potentially harmful ionizing radiation. Computed tomography accounts for the largest portion of medically-related X-ray exposure. Accurate knowledge of ionizing radiation dose from Cone-Beam CT (CBCT) imaging is of great importance to estimate radiation risks and justification of imaging exposures. This work aimed to review the published evidence on CBCT dose estimation by focusing on studies that employ Geant4-based toolkits to estimate radiation dosage. A systematic review based on a scientometrics approach was conducted retrospectively, from January 2021, for a comprehensive overview of the trend, thematic focus, and scientific production in this topic. The search was conducted using WOS, PubMed, and Scopus databases, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. In total, 93 unique papers were found, of which only 34 met the inclusion criteria. We opine that the findings of this study provides a basis to develop accurate simulations of CBCT equipment for optimizing the trade-off between clinical benefit and radiation risk.
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Park, Chang-Seo, Jae-Kyu Park, Huijun Kim, Sang-Sun Han, Ho-Gul Jeong, and Hyok Park. "Comparison of conventional lateral cephalograms with corresponding CBCT radiographs." Imaging Science in Dentistry 42, no. 4 (2012): 201. http://dx.doi.org/10.5624/isd.2012.42.4.201.
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