Imaging Science in Dentistry

Korean Academy of Oral and Maxillofacial Radiology (대한영상치의학회)
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A novel method for determining dose distribution on panoramic reconstruction computed tomography images from radiotherapy computed tomography

  • Hiroyuki Okamoto (Radiation Safety and Quality Assurance Division, National Cancer Center Hospital) ;
  • Madoka Sakuramachi (Department of Radiation Oncology, National Cancer Center Hospital) ;
  • Wakako Yatsuoka (Dental Division, National Cancer Center Hospital) ;
  • Takao Ueno (Dental Division, National Cancer Center Hospital) ;
  • Kouji Katsura (Department of Oral Radiology, Niigata University Medical and Dental Hospital) ;
  • Naoya Murakami (Department of Radiology, Juntendo University) ;
  • Satoshi Nakamura (Radiation Safety and Quality Assurance Division, National Cancer Center Hospital) ;
  • Kotaro Iijima (Department of Radiology, Juntendo University) ;
  • Takahito Chiba (Radiation Safety and Quality Assurance Division, National Cancer Center Hospital) ;
  • Hiroki Nakayama (Radiation Safety and Quality Assurance Division, National Cancer Center Hospital) ;
  • Yasunori Shuto (Radiation Safety and Quality Assurance Division, National Cancer Center Hospital) ;
  • Yuki Takano (Radiation Safety and Quality Assurance Division, National Cancer Center Hospital) ;
  • Yuta Kobayashi (Radiation Safety and Quality Assurance Division, National Cancer Center Hospital) ;
  • Hironori Kishida (Radiation Safety and Quality Assurance Division, National Cancer Center Hospital) ;
  • Yuka Urago (Radiation Safety and Quality Assurance Division, National Cancer Center Hospital) ;
  • Masato Nishitani (Radiation Safety and Quality Assurance Division, National Cancer Center Hospital) ;
  • Shuka Nishina (Radiation Safety and Quality Assurance Division, National Cancer Center Hospital) ;
  • Koushin Arai (Department of Radiological Technology, National Cancer Center Hospital) ;
  • Hiroshi Igaki (Department of Radiation Oncology, National Cancer Center Hospital)
  • Received : 2023.10.21
  • Accepted : 2024.02.28
  • Published : 2024.06.30
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Abstract

Purpose: Patients with head and neck cancer (HNC) who undergo dental procedures during radiotherapy (RT) face an increased risk of developing osteoradionecrosis (ORN). Accordingly, new tools must be developed to extract critical information regarding the dose delivered to the teeth and mandible. This article proposes a novel approach for visualizing 3-dimensional planned dose distributions on panoramic reconstruction computed tomography (pCT) images. Materials and Methods: Four patients with HNC who underwent volumetric modulated arc therapy were included. One patient experienced ORN and required the extraction of teeth after RT. In the study approach, the dental arch curve (DAC) was defined using an open-source platform. Subsequently, pCT images and dose distributions were generated based on the new coordinate system. All teeth and mandibles were delineated on both the original CT and pCT images. To evaluate the consistency of dose metrics, the Mann-Whitney U test and Student t-test were employed. Results: A total of 61 teeth and 4 mandibles were evaluated. The correlation coefficient between the 2 methods was 0.999, and no statistically significant difference was observed (P>0.05). This method facilitated a straightforward and intuitive understanding of the delivered dose. In 1 patient, ORN corresponded to the region of the root and the gum receiving a high dosage (approximately 70 Gy). Conclusion: The proposed method particularly benefits dentists involved in the management of patients with HNC. It enables the visualization of a 3-dimensional dose distribution in the teeth and mandible on pCT, enhancing the understanding of the dose delivered during RT.

Keywords

Acknowledgement

The authors wish to express their gratitude to all staff members involved in the radiation therapy treatments at their institution.

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