• Imaging Science in Dentistry
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• v.54 no.1
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• pp.33-41
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• 2024

Purpose: The aims of this study were to create a deep learning model to distinguish between nasopalatine duct cysts (NDCs), radicular cysts, and no-lesions (normal) in the midline region of the anterior maxilla on panoramic radiographs and to compare its performance with that of dental residents. Materials and Methods: One hundred patients with a confirmed diagnosis of NDC (53 men, 47 women; average age, 44.6±16.5 years), 100 with radicular cysts (49 men, 51 women; average age, 47.5±16.4 years), and 100 with normal groups (56 men, 44 women; average age, 34.4±14.6 years) were enrolled in this study. Cases were randomly assigned to the training datasets (80%) and the test dataset (20%). Then, 20% of the training data were randomly assigned as validation data. A learning model was created using a customized DetectNet built in Digits version 5.0 (NVIDIA, Santa Clara, USA). The performance of the deep learning system was assessed and compared with that of two dental residents. Results: The performance of the deep learning system was superior to that of the dental residents except for the recall of radicular cysts. The areas under the curve (AUCs) for NDCs and radicular cysts in the deep learning system were significantly higher than those of the dental residents. The results for the dental residents revealed a significant difference in AUC between NDCs and normal groups. Conclusion: This study showed superior performance in detecting NDCs and radicular cysts and in distinguishing between these lesions and normal groups.

• Journal of the Korean Society of Radiology
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• v.85 no.5
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• pp.960-964
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• 2024

Distant metastasis to the spleen is extremely rare. To the best of our knowledge, metastasis to the accessory spleen based on pathological findings has only been reported in four patients in the English literature, including one each of ovarian cancer, transitional cell carcinoma, breast cancer, and uterine carcinosarcoma after surgery. Furthermore, among these reported cases, only two reports (one each of transitional cell carcinoma and uterine carcinosarcoma) presented imaging findings. In this study, we report a case of colon cancer metastasis to the accessory spleen without involvement of the spleen in a 58-year-old male patient, providing imaging findings. This case emphasized the importance of considering the possibility of metastasis to the accessory spleen in patients with malignancy.

• Imaging Science in Dentistry
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• v.41 no.3
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• pp.95-100
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• 2011

Purpose : The purpose of this study was to compare asymmetric mandibular prognathism individuals with symmetric mandibular prognathism individuals using a new alternate spherical coordinate system. Materials and Methods : This study consisted of 47 computed tomographic images of patients with mandibular prognathism. The patients were classified into symmetric and asymmetric groups. Mandibular and ramal lines were analyzed using an alternate spherical coordinate system. The length as well as midsagittal and coronal inclination angle of the lines was obtained. The bilateral differences of the spherical coordinates of the facial lines were statistically analyzed in the groups. Results : There were significant differences between the groups in bilateral difference of the length and midsagittal inclination angle of the lines (p<0.05). The bilateral difference of the length and midsagittal inclination angle of the lines has significant correlation with chin deviation (p<0.05). Conclusion : The new alternate spherical coordinate system was able to effectively evaluate facial lines. The bilateral difference of lengths and midsagittal inclination of the facial lines might contribute to the facial asymmetry in mandibular prognathism individuals.

• Korean Journal of Radiology
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• v.25 no.4
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• pp.384-394
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• 2024

Objective: To evaluate the image quality of novel dark-blood computed tomography angiography (CTA) imaging combined with deep learning reconstruction (DLR) compared to delayed-phase CTA images with hybrid iterative reconstruction (HIR), to visualize the cervical artery wall in patients with Takayasu arteritis (TAK). Materials and Methods: This prospective study continuously recruited 53 patients with TAK (mean age: 33.8 ± 10.2 years; 49 females) between January and July 2022 who underwent head-neck CTA scans. The arterial- and delayed-phase images were reconstructed using HIR and DLR. Subtracted images of the arterial-phase from the delayed-phase were then added to the original delayed-phase using a denoising filter to generate the final-dark-blood images. Qualitative image quality scores and quantitative parameters were obtained and compared among the three groups of images: Delayed-HIR, Dark-blood-HIR, and Dark-blood-DLR. Results: Compared to Delayed-HIR, Dark-blood-HIR images demonstrated higher qualitative scores in terms of vascular wall visualization and diagnostic confidence index (all P < 0.001). These qualitative scores further improved after applying DLR (Dark-blood-DLR compared to Dark-blood-HIR, all P < 0.001). Dark-blood DLR also showed higher scores for overall image noise than Dark-blood-HIR (P < 0.001). In the quantitative analysis, the contrast-to-noise ratio (CNR) values between the vessel wall and lumen for the bilateral common carotid arteries and brachiocephalic trunk were significantly higher on Dark-blood-HIR images than on Delayed-HIR images (all P < 0.05). The CNR values were significantly higher for Dark-blood-DLR than for Dark-blood-HIR in all cervical arteries (all P < 0.001). Conclusion: Compared with Delayed-HIR CTA, the dark-blood method combined with DLR improved CTA image quality and enhanced visualization of the cervical artery wall in patients with TAK.

• Imaging Science in Dentistry
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• v.54 no.1
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• pp.81-91
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• 2024

Purpose: The objective of this study was to propose a deep-learning model for the detection of the mandibular canal on dental panoramic radiographs. Materials and Methods: A total of 2,100 panoramic radiographs (PANs) were collected from 3 different machines: RAYSCAN Alpha (n=700, PAN A), OP-100 (n=700, PAN B), and CS8100 (n=700, PAN C). Initially, an oral and maxillofacial radiologist coarsely annotated the mandibular canals. For deep learning analysis, convolutional neural networks (CNNs) utilizing U-Net architecture were employed for automated canal segmentation. Seven independent networks were trained using training sets representing all possible combinations of the 3 groups. These networks were then assessed using a hold-out test dataset. Results: Among the 7 networks evaluated, the network trained with all 3 available groups achieved an average precision of 90.6%, a recall of 87.4%, and a Dice similarity coefficient (DSC) of 88.9%. The 3 networks trained using each of the 3 possible 2-group combinations also demonstrated reliable performance for mandibular canal segmentation, as follows: 1) PAN A and B exhibited a mean DSC of 87.9%, 2) PAN A and C displayed a mean DSC of 87.8%, and 3) PAN B and C demonstrated a mean DSC of 88.4%. Conclusion: This multi-device study indicated that the examined CNN-based deep learning approach can achieve excellent canal segmentation performance, with a DSC exceeding 88%. Furthermore, the study highlighted the importance of considering the characteristics of panoramic radiographs when developing a robust deep-learning network, rather than depending solely on the size of the dataset.

• Imaging Science in Dentistry
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• v.39 no.1
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• pp.27-33
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• 2009

Purpose: The purpose of this study was to evaluate the clinical usefulness of the recently developed multi-detector computed tomography and cone beam computed tomography in pre-operative implant evaluation, by comparing them with the single detector computed tomography, already confirmed for accuracy in this area. Materials and Methods: Five partially edentulous dry human mandibles, with $1{\times}1mm$ gutta percha cones, placed in 5mm intervals posterior to the mental foramen on each side of the buccal part of the mandible, were used in this study. They were scanned as follows: 1) Single detector computed tomography: slice thickness 1mm, 200mA, 120kV 2) Multi-detector computed tomography: slice thickness 0.75mm, 250mA, 120kV 3) Cone beam computed tomography: 15mAs, 120kV Axial images acquired from three computed tomographies were transferred to personal computer, and then reformatted cross-sectional images were generated using V-Implant $2.0^{(R)}$ (CyberMed Inc., Seoul, Korea) software. Among the cross-sectional images of the gutta perch a cone, placed in the buccal body of the mandible, the most precise cross section was selected as the measuring point and the distance from the most superior border of the mandibular canal to the alveolar crest was measured and analyzed 10 times by a dentist. Results: There were no significant intraobserver differences in the distance from the most superior border of the mandibular canal to the alveolar crest (p>0.05). There were no significant differences among single detector computed tomography, multi-detector computed tomography and cone beam computed tomography in the distance from the most superior border of the mandibular canal to the alveolar crest (p>0.05). Conclusion: Multi-detector computed tomography and cone beam computed tomography are clinically useful in the evaluation of pre-operative site for mandibular dental implants, with consideration for radiation exposure dose and scanning time.

• Korean Journal of Radiology
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• v.22 no.11
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• pp.1909-1917
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• 2021

Objective: Muscle quantity and quality can be measured with an automated system on CT. However, the effects of contrast phases on the muscle measurements have not been established, which we aimed to investigate in this study. Materials and Methods: Muscle quantity was measured according to the skeletal muscle area (SMA) measured by a convolutional neural network-based automated system at the L3 level in 89 subjects undergoing multiphasic abdominal CT comprising unenhanced phase, arterial phase, portal venous phase (PVP), or delayed phase imaging. Muscle quality was analyzed using the mean muscle density and the muscle quality map, which comprises normal and low-attenuation muscle areas (NAMA and LAMA, respectively) based on the muscle attenuation threshold. The SMA, mean muscle density, NAMA, and LAMA were compared between PVP and other phases using paired t tests. Bland-Altman analysis was used to evaluate the inter-phase variability between PVP and other phases. Based on the cutoffs for low muscle quantity and quality, the counts of individuals who scored lower than the cutoff values were compared between PVP and other phases. Results: All indices showed significant differences between PVP and other phases (p < 0.001 for all). The SMA, mean muscle density, and NAMA increased during the later phases, whereas LAMA decreased during the later phases. Bland-Altman analysis showed that the mean differences between PVP and other phases ranged -2.1 to 0.3 cm² for SMA, -12.0 to 2.6 cm² for NAMA, and -2.2 to 9.9 cm² for LAMA.The number of patients who were categorized as low muscle quantity did not significant differ between PVP and other phases (p ≥ 0.5), whereas the number of patients with low muscle quality significantly differed (p ≤ 0.002). Conclusion: SMA was less affected by the contrast phases. However, the muscle quality measurements changed with the contrast phases to greater extents and would require a standardization of the contrast phase for reliable measurement.

• Imaging Science in Dentistry
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• v.30 no.2
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• pp.149-154
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• 2000

Fibrous dysplasia is believed to be a hamartomatous developmental lesion of unknown origin. This disease is divided into monostotic and polyostotic fibrous dysplasia. Polyostotic type can be divided into craniofacial type, Lichtenstein-Jaffe type, and McCune-Albright syndrome. In this case, a 31-year-old female presented spontaneous loss of right mandibular teeth before 5 years and has shown continuous expansion of right mandibular alveolus. Through the radiographic view, the coarse pattern of the mixed radiopaque-lucent lesion was seen on the right mandibular body, and there was diffuse pattern of the mixed radiopaque-lucent lesion with ill-defined margin in the left mandibular body. In the right calvarium, the lesion had cotton-wool appearance. Partial excision for contouring, multiple extraction, and alveoloplasty were accomplished under general anesthesia for supportive treatment. Finally we could conclude this case was polyostotic fibrous dysplasia of cranio-maxillofacial area based on the clinical, radiologic finding, and histopathologic examination.

• Imaging Science in Dentistry
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• v.30 no.4
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• pp.249-254
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• 2000

Purpose: To clarify the clinical and radiologic parameters that can be used to differentiate odontogenic keratocyst and ameloblastoma Materials and Methods: The records of 46 patients of ameloblastoma and 48 patients of odontogenic keratocyst at the Yonsei University Dental Hospital during the period of 1979 to 1995 were retrospectively reviewed. As a possible means for differentiating between the odontogenic keratocyst and ameloblastoma, the clinical parameters and the radiologic parameters were evaluated. Results: In the clinical parameters, there was no significant difference in age, sex, and sign and symptoms (p>0.05). In the radiologic parameters, there was significant difference in site, shape of the lesion, and external root resorption of adjacent teeth (p<0.05). Conclusion: The site, shape of the lesion, and external root resorption of adjacent teeth can be the parameters to differentiate odontogenic keratocyst and ameloblastoma, but a definite differentiation of these two lesions needs a more specialized imaging modality.

• Imaging Science in Dentistry
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• v.32 no.2
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• pp.119-122
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• 2002

Two cases of Eagle's syndrome are reported. The first case involved a 31-year-old man who complained of pain in his throat and pain at preauricular area on turning his head. Panoramic and computed tomography (CT) views showed bilateral stylohyoid ligament ossification. The symptoms were relieved after surgical removal. The second case involved a 56-year-old female whose chief complaints were a continuous dull pain and occasional 'shooting' pain on lower left molar area. During the physical examination, an ossified stylohyoid ligament was palpated at the left submandibular area. Panoramic and CT images showed prominent bilateral stylohyoid ligament ossification. CT scans also showed hypertrophy of left medial and lateral pterygoid muscles. The symptoms were relieved after medication. CT is a useful tool for the examination of ossified stylohyoid ligaments and studying the relationship between Eagle's syndrome and adjacent soft tissue.