Comparison of measurements from digital cephalometric radiographs and 3D MDCT-synthetized cephalometric radiographs and the effect of head position

디지털 측방두부규격방사선사진과 MDCT의 3차원 재구성 영상을 이용한 합성측방두부규격방사선사진의 계측치 비교 및 머리 위치가 미치는 효과

  • Kim, Mi-Ja (Department of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National University) ;
  • Choi, Bo-Ram (Department of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National University) ;
  • Huh, Kyung-Hoe (Department of Oral and Maxillofacial Radiology, Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Yi, Won-Jin (Department of Oral and Maxillofacial Radiology, Dental Research Institute and BK21, School of Dentistry, Seoul National University) ;
  • Heo, Min-SUk (Department of Oral and Maxillofacial Radiology, Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Lee, Sam-Sun (Department of Oral and Maxillofacial Radiology, Dental Research Institute and BK21, School of Dentistry, Seoul National University) ;
  • Choi, Soon-Chul (Department of Oral and Maxillofacial Radiology, Dental Research Institute, School of Dentistry, Seoul National University)
  • 김미자 (서울대학교 치의학대학원 구강악안면방사선학교실) ;
  • 최보람 (서울대학교 치의학대학원 구강악안면방사선학교실) ;
  • 허경회 (서울대학교 치의학대학원 구강악안면방사선학교실, 치학연구소) ;
  • 이원진 (서울대학교 치의학대학원 구강악안면방사선학교실, 치학연구소 및 BK21) ;
  • 허민석 (서울대학교 치의학대학원 구강악안면방사선학교실, 치학연구소) ;
  • 이삼선 (서울대학교 치의학대학원 구강악안면방사선학교실, 치학연구소 및 BK21) ;
  • 최순철 (서울대학교 치의학대학원 구강악안면방사선학교실, 치학연구소)
  • Published : 2009.09.30

Abstract

Purpose : To investigate the reproducibilities and compare the measurements in digital and MDCT-synthesized cephalometric radiograph, and to investigate the effect of head position on the measurement during imaging with MDCT. Materials and Methods : Twenty-two dry skulls (combined with mandible) were used in this study. Conventional digital cephalometric radiograph was taken in standard position, and MDCT was taken in standard position and two rotated position ($10^{\circ}$ left rotation and $10^{\circ}$ right tilting). MDCT data were imported in $OnDemand^{(R)}$ and lateral cephalometric radiograph were synthesized from 3D virtual models. Two types of rotated MDCT data were synthesized with default mode and with corrected mode using both ear rods. For all six images, sixteen angular and eleven linear measurements were made in V-$Ceph^{(R)}$ three times. Reproducibility of measurements was assessed using repeated measures ANOV A and ICC. Linear and angular measurements were compared between digital and five MDCT-synthesized images by Student t-test. Results : All measurements in six types of cephalometric radiograph were not statistically different under ICC examination. Measurements were not different between digital and MDCT-synthesized images (P>.05). Measurements in MDCT-synthesized image in $10^{\circ}$ left rotation or $10^{\circ}$ right tilting position showed possibility of difference from digital image in some measurements, and possibility of improvement via realignment of head position using both ear rods. Conclusion : MDCT-synthesized cephalometric radiograph can substitute conventional cephalometric radiograph. The error on head position during imaging with MDCT have possibility that can produce measurement errors with MDCT-synthesized image, and these position error can be corrected by realignment of the head position using both ear rods.

Keywords

References

  1. Greiner M, Greiner A, Hirschfelder U. Variance of landmarks in digital evaluations: comparison between CT-based and conventional digital lateral cephalometric radiographs. J Orofac Orthop 2007; 68 :290-8. https://doi.org/10.1007/s00056-007-0710-5
  2. Chidiac JJ, Shofer FS, Al-Kutoub A, Laster LL, Ghafari J. Comparison of CT scanograms and cephalometric radiographs in craniofacial imaging. Orthod Craniofac Res 2002; 5 : 104-13. https://doi.org/10.1034/j.1600-0544.2002.01170.x
  3. Kumar V, Ludlow JB, Mol A, Cevidanes LH. Comparison of conventional and cone beam CT synthesized cephalograms. Dentomaxillofac Radiol 2007; 36 : 263-9. https://doi.org/10.1259/dmfr/98032356
  4. Kumar V, Ludlow J, Cevidanes LH, Mol A. In vivo comparison of conventional and cone beam CT synthesized cephalograms. Angle Orthod 2008; 78 : 873-9. https://doi.org/10.2319/082907-399.1
  5. Moshiri M, Scarfe WC, Hilgers ML, Scheetz JP, Silveira AM, Farman AG. Accuracy of linear measurements from imaging plate and lateral cephalometric images derived from cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2007; 132 : 550-60. https://doi.org/10.1016/j.ajodo.2006.09.046
  6. Malkoc S, Sari Z, Usumez S, Koyuturk AE. The effect of head rotation on cephalometric radiographs. Eur J Orthod 2005; 27 : 315-21. https://doi.org/10.1093/ejo/cjh098
  7. Yoon YJ, Kim KS, Hwang MS, Kim HJ, Choi EH, Kim KW. Effect of head rotation on lateral cephalometric radiographs. Angle Orthod 2001; 71 : 396-403.
  8. Hofrath H. Die bedeutung der roentgenfern und abstandsaufnahme fur die diagnostik der kieferanomalien. Fortschr Orthodont 1931; 1 : 232- 48. (cited from 1)
  9. Broadbent BH. A new X-ray technique and its application to orthodontics. Angle Orthod 1931; 1 : 45-66.
  10. Olszewski R, Zech F, Cosnard G, Nicolas V, Macq B, Reychler H. Three-dimensional computed tomography cephalometric craniofacial analysis: experimental validation in vitro. Int J Oral Maxillofac Surg 2007; 36 : 828-33. https://doi.org/10.1016/j.ijom.2007.05.022
  11. Kamiishi H, Miyasato Y, Kosaka M. Development of the 3D-cephalogram: A technical note. J Craniomaxillofac Surg 2007; 35 : 258-60. https://doi.org/10.1016/j.jcms.2007.04.004
  12. Olszewski R, Cosnard G, Macq B, Mahy P, Reychler H. 3D CT-based cephalometric analysis: 3D cephalometric theoretical concept and software. Neuroradiology 2006; 48 : 853-62. https://doi.org/10.1007/s00234-006-0140-x
  13. Park SH, Yu HS, Kim KD, Lee KJ, Baik HS. A proposal for a new analysis of craniofacial morphology by 3-dimensional computed tomography. Am J Orthod Dentofacial Orthop 2006; 129 : 600.e23-34. https://doi.org/10.1016/j.ajodo.2005.11.032
  14. Maeda M, Katsumata A, Ariji Y, Muramatsu A, Yoshida K, Goto S, et al. 3D-CT evaluation of facial asymmetry in patients with maxillofacial deformities. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 102 : 382-90. https://doi.org/10.1016/j.tripleo.2005.10.057
  15. Hwang HS, Hwang CH, Lee KH, Kang BC. Maxillofacial 3-dimensional image analysis for the diagnosis of facial asymmetry. Am J of Orthod Dentofac Orthop 2006; 130 : 779-85. https://doi.org/10.1016/j.ajodo.2005.02.021
  16. Yoon SJ, Lim HJ, Kang BC, Hwang HS. Three dimensional CT analysis of facial asymmetry. Korean J Oral Maxillofac Radiol 2007; 37 : 45-51.
  17. Cevidanes LH, Styner MA, Proffit WR. Image analysis and superimposition of 3-dimensional cone-beam computed tomography models. Am J Orthod Dentofacial Orthop 2006; 129 : 611-8. https://doi.org/10.1016/j.ajodo.2005.12.008
  18. Cevidanes LH, Bailey LJ, Tucker GR Jr, Styner MA, Mol A, Phillips CL, et al. Superimposition of 3D cone-beam CT models of orthognathic surgery patients. Dentomaxillofac Radiol 2005; 34 : 369-75. https://doi.org/10.1259/dmfr/17102411
  19. Ongkosuwito EM, Katsaros C, van't Hof MA, Bodegom JC, Kuijpers- Jagtman AM. The reproducibility of cephalometric measurements: a comparison of analogue and digital methods. Eur J Orthod 2002; 24 : 655-65. https://doi.org/10.1093/ejo/24.6.655
  20. Baumrind S, Frantz RC. The reliability of head film measurements. 1. Landmark identification. Am J Orthod 1971; 60 : 111-27. https://doi.org/10.1016/0002-9416(71)90028-5
  21. Baumrind S, Frantz RC. The reliability of head film measurements. 2. Conventional angular and linear measures. Am J Orthod 1971; 60 : 505-17. https://doi.org/10.1016/0002-9416(71)90116-3
  22. Huston WJ. The analysis of errors in orthodontic measurements. Am J Orthod 1983; 83 : 382-90. https://doi.org/10.1016/0002-9416(83)90322-6
  23. Houston WJ, Maher RE, McElroy D, Sherriff M. Sources of error in measurements from cephalometric radiographs. Eur J Orthod 1986; 8 : 149-51. https://doi.org/10.1093/ejo/8.3.149
  24. Franklin JB. Certain factors of aberration to be considered in clinical reontgenographic cephalometry. Am J Orthod 1952; 38 : 351-68. https://doi.org/10.1016/0002-9416(52)90049-3
  25. Ahlqvist J, Eliasson S, Welander U. The effect of projection errors on cephalometric length measurements. Eur J Orthod 1986; 8 : 141-8. https://doi.org/10.1093/ejo/8.3.141
  26. Major PW, Johnson DE, Hesse KL, Glover KE. Landmark identification error in posterior anterior cephalometrics. Angle Orthod 1994; 64 : 447-54.
  27. Major PW, Johnson DE, Hesse KL, Glover KE. Effect of head orientation on posterior anterior cephalometric landmark identification. Angle Orthod 1996; 66 : 51-60.
  28. Ahlqvist J, Eliasson S, Welander U. The effect of projection errors on angular measurements in cephalometry. Eur J Orthod 1988; 10 : 353- 61.
  29. Midtgard J, Bjork G, linder-Aronsson S. Reproducibility of cephalometric landmarks and errors of measurements of cephalometric cranial distances. Angle Orthod 1974; 44 : 56-62
  30. Hatton ME, Grainger RM. Reliability of measurements from cephalograms at the Burlington orthodontic research centre. J Dent Res 1958; 37 : 853-9. https://doi.org/10.1177/00220345580370051301
  31. Cooke MS, Wei SH. Cephalometric errors: a comparison between repeat measurements and retaken radiographs. Aust Dent J 1991; 36 : 38-43. https://doi.org/10.1111/j.1834-7819.1991.tb00806.x
  32. Shaw WC. Problems of accuracy and reliability in cephalometric studies with implants in infants with cleft lip & palate. Br J Orthod 1977; 4 : 93-100.
  33. Gron P. A geometrical evaluation of image size in dental radiograph. J Dent Res 1960; 39 : 289-301. https://doi.org/10.1177/00220345600390021101
  34. Eliasson S, Welander U, Ahlqvist J. The cephalometric projection. I: general considerations. Dentomaxillofac Radiol 1982; 11 : 117-22.
  35. Ahlqvist J, Eliasson S, Welander U. The cephalometric projection. II: principles of image distortion in cephalography. Dentomaxillofac Radiol 1983; 12 : 101-8.