• Journal of the Korean Society of Radiology
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• v.7 no.2
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• pp.131-136
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• 2013

Panorama of dental radiation generators can observe the wide anatomical structures of oral and maxillofacial areas but there can be distortion of lengths, angles, or shapes. CBCT can diagnose 3D images and get the ones whose errors by superposition and interference are remarkably smaller between anatomical structures. But the quality of the images by movement of subjects can be lowered as it takes long to diagnose them. And if there are impermeable radiation objects like metal in mouths, impermeable radiation lines can radially appear with the objects as center. This study tries to analyze accuracy of panorama and CBCT and get useful anatomical information in dental treatment by comparing the length of wisdom teeth which were measured by Panorama and CBCT with the teeth which were actually extracted and analyzing distortion of the teeth. The test result could be found that Panorama is expanded by average 7.3% as the errors of Panorama and Digital Vernier Caliper range from 110.7% to 103.9%. The length of wisdom teeth which were measured in CBCT and Digital Vernier Caliper could be found that the error range is 1.3%. And the length of wisdom teeth which were measured in Panorama and Digital Vernier Caliper has found that the error range shows 7.3%. So it could be found that the images of CBCT is about 6% more exact than those of Panorama. It could be found that CBCT shows the more exact images than those of Panorama. But because the examination expenses of CBCT are higher than those of Panorama and exposure dose of CBCT is much more than that of Panorama, it is thought to find proper ways in examination.

• Progress in Medical Physics
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• v.25 no.1
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• pp.37-45
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• 2014

The accuracy and uniformity of CT numbers are the main causes of radiation dose calculation error. Especially, for the dose calculation based on kV-Cone Beam Computed Tomography (CBCT) image, the scatter affecting the CT number is known to be quite different by the object sizes, densities, exposure conditions, and so on. In this study, the scatter impact on the CBCT based dose calculation was evaluated to provide the optimal condition minimizing the error. The CBCT images was acquired under three scatter conditions ("Under-scatter", "Over-scatter", and "Full-scatter") by adjusting amount of scatter materials around a electron density phantom (CIRS062, Tissue Simulation Technology, Norfolk, VA, USA). The CT number uniformities of CBCT images for water-equivalent materials of the phantom were assessed, and the location dependency, either "inner" or "outer" parts of the phantom, was also evaluated. The electron density correction curves were derived from CBCT images of the electron density phantom in each scatter condition. The electron density correction curves were applied to calculate the CBCT based doses, which were compared with the dose based on Fan Beam Computed Tomography (FBCT). Also, 5 prostate IMRT cases were enrolled to assess the accuracy of dose based on CBCT images using gamma index analysis and relative dose differences. As the CT number histogram of phantom CBCT images for water equivalent materials was fitted with a gaussian function, the FHWM (146 HU) for "Full-scatter" condition was the smallest among the FHWM for the three conditions (685 HU for "under scatter" and 264 HU for "over scatter"). Also, the variance of CT numbers was the smallest for the same ingredients located in the center and periphery of the phantom in the "Full-scatter" condition. The dose distributions calculated with FBCT and CBCT images compared in a gamma index evaluation of 1%/3 mm criteria and in the dose difference. With the electron density correction acquired in the same scatter condition, the CBCT based dose calculations tended to be the most accurate. In 5 prostate cases in which the mean equivalent diameter was 27.2 cm, the averaged gamma pass rate was 98% and the dose difference confirmed to be less than 2% (average 0.2%, ranged from -1.3% to 1.6%) with the electron density correction of the "Full-scatter" condition. The accuracy of CBCT based dose calculation could be confirmed that closely related to the CT number uniformity and to the similarity of the scatter conditions for the electron density correction curve and CBCT image. In pelvic cases, the most accurate dose calculation was achievable in the application of the electron density curves of the "Full-scatter" condition.

• Anatomy and Cell Biology
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• v.56 no.2
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• pp.185-190
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• 2023

The root canal morphology undergoes aging-related changes, and relevant quantitative analyses have not yet been reported. We compared the cone beam computed tomography (CBCT) and micro-computed tomography (microCT) scans of extracted mandibular incisors to check the accuracy of morphological measurements. Thereafter, the root canal morphology and aging-related changes in the mandibular incisors of Japanese individuals were assessed using CBCT. Six extracted teeth were fixed in a phantom head and imaged using CBCT and micro-CT. The correlation between the findings of the two imaging modalities was examined. Further, CBCT reconstructed images of the mandibular incisors of 81 individuals were observed. Age-related changes of the root canals were compared between participants aged <30 years and those aged ≥30 years. The CBCT and micro-CT findings regarding the root canals of the extracted teeth coincided in 94.4% of the cases. Mandibular incisors exhibiting two root canals in either cross-section accounted for 9.9% of central incisors and 12.4% of lateral incisors. Mandibular central incisors with two root canals were observed in two (6.3%) individuals aged <30 years and six (12.2%) aged ≥30 years. Mandibular lateral incisors with two root canals were observed in one (3.1%) individual aged <30 years and nine (18.4%) aged ≥30 years. CBCT allows accurate evaluation of complex root canal morphologies and is useful for endodontic preoperative assessment. Mandibular incisors have more frequent occurrence of two root canals with aging.

• Progress in Medical Physics
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• v.22 no.1
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• pp.28-34
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• 2011

To perform the Adaptive Radiation Therapy (ART), a high degree of deformable registration accuracy is essential. The purpose of this study is to identify whether the change of MV CBCT intensity can improve registration accuracy using predefined modification level and filtering process. To obtain modification level, the cheese phantom images was acquired from both kilovoltage CT (kV CT), megavoltage cone-beam CT (MV CBCT). From the cheese phantom images, the modification level of MV CBCT was defined from the relationship between Hounsfield Units (HUs) of kV CT and MV CBCT images. 'Gaussian smoothing filter' was added to reduce the noise of the MV CBCT images. The intensity of MV CBCT image was changed to the intensity of the kV CT image to make the two images have the same intensity range as if they were obtained from the same modality. The demon deformable registration which was efficient and easy to perform the deformable registration was applied. The deformable lung phantom which was intentionally created in the laboratory to imitate the changes of the breathing period was acquired from kV CT and MV CBCT. And then the deformable lung phantom images were applied to the proposed method. As a result of deformable image registration, the similarity of the correlation coefficient was used for a quantitative evaluation of the result was increased by 6.07% in the cheese phantom, and 18% in the deformable lung phantom. For the additional evaluation of the registration of the deformable lung phantom, the centric coordinates of the mark which was inserted into the inner part of the phantom were measured to calculate the vector difference. The vector differences from the result were 2.23, 1.39 mm with/without modification of intensity of MV CBCT images, respectively. In summary, our method has quantitatively improved the accuracy of deformable registration and could be a useful solution to improve the image registration accuracy. A further study was also suggested in this paper.

• Proceedings of the Korea Contents Association Conference
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• 2009.05a
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• pp.1159-1166
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• 2009

The use of cone-beam computed tomography(CBCT) has been proposed for guiding the delivery of radiation therapy. A kilovoltage imaging system capable of radiography, fluoroscopy, and cone-beam computed tomography(CT) has been integrated with a medical linear accelerator. A standard clinical linear accelerator, operating in arc therapy mode, and an amorphous-silicon (a-Si) with an on-board electronic portal imager can be used to treat palliative patient and verify the patient's position prior to treatment. On-board CBCT images are used to generate patient geometric models to assist patient setup. The image data can also, potentially, be used for dose reconstruction in combination with the fluence maps from treatment plan. In this study, the accuracy of Hounsfield Units of CBCT images as well as the accuracy of dose calculations based on CBCT images of a phantom and compared the results with those of using CT simulator images. Phantom and patient studies were carried out to evaluate the achievable accuracy in using CBCT and CT stimulator for dose calculation. Relative electron density as a function of HU was obtained for both planning CT stimulator and CBCT using a Catphan-600 (The Phantom Laboratory, USA) calibration phantom. A clinical treatment planning system was employed for CT stimulator and CBCT based dose calculations and subsequent comparisons. The dosimetric consequence as the result of HU variation in CBCT was evaluated by comparing MU/cCy. The differences were about 2.7% (3-4MU/100cGy) in phantom and 2.5% (1-3MU/100cGy) in patients. The difference in HU values in Catphan was small. However, the magnitude of scatter and artifacts in CBCT images are affected by limitation of detector's FOV and patient's involuntary motions. CBCT images included scatters and artifacts due to In addition to guide the patient setup process, CBCT data acquired prior to the treatment be used to recalculate or verify the treatment plan based on the patient anatomy of the treatment area. And the CBCT has potential to become a very useful tool for on-line ART.)

• Imaging Science in Dentistry
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• v.48 no.1
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• pp.11-19
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• 2018

Purpose: This study compared the diagnostic accuracy of cone-beam computed tomography (CBCT) scans obtained with 2 CBCT systems with high- and low-resolution modes for the detection of root perforations in endodontically treated mandibular molars. Materials and Methods: The root canals of 72 mandibular molars were cleaned and shaped. Perforations measuring 0.2, 0.3, and 0.4 mm in diameter were created at the furcation area of 48 roots, simulating strip perforations, or on the external surfaces of 48 roots, simulating root perforations. Forty-eight roots remained intact(control group). The roots were filled using gutta-percha (Gapadent, Tianjin, China) and AH26 sealer (Dentsply Maillefer, Ballaigues, Switzerland). The CBCT scans were obtained using the NewTom 3G (QR srl, Verona, Italy) and Cranex 3D (Soredex, Helsinki, Finland) CBCT systems in high- and low-resolution modes, and were evaluated by 2 observers. The chi-square test was used to assess the nominal variables. Results: In strip perforations, the accuracies of low- and high-resolution modes were 75% and 83% for NewTom 3G and 67% and 69% for Cranex 3D. In root perforations, the accuracies of low- and high-resolution modes were 79% and 83% for NewTom 3G and was 56% and 73% for Cranex 3D. Conclusion: The accuracy of the 2 CBCT systems was different for the detection of strip and root perforations. The Cranex 3D had non-significantly higher accuracy than the NewTom 3G. In both scanners, the high-resolution mode yielded significantly higher accuracy than the low-resolution mode. The diagnostic accuracy of CBCT scans was not affected by the perforation diameter.

• The Journal of the Korea Contents Association
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• v.9 no.12
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• pp.742-749
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• 2009

The use of cone-beam computed tomography(CBCT) has been proposed for guiding the delivery of radiation therapy. A kilovoltage imaging system capable of radiography, fluoroscopy, and cone-beam computed tomography(CT) has been integrated with a medical linear accelerator. A standard clinical linear accelerator, operating in arc therapy mode, and an amorphous-silicon (a-Si) with an on-board electronic portal imager can be used to treat palliative patient and verify the patient's position prior to treatment. On-board CBCT images are used to generate patient geometric models to assist patient setup. The image data can also, potentially, be used for dose reconstruction in combination with the fluence maps from treatment plan. In this study, the accuracy of Hounsfield Units of CBCT images as well as the accuracy of dose calculations based on CBCT images of a phantom and compared the results with those of using CT simulator images. Phantom and patient studies were carried out to evaluate the achievable accuracy in using CBCT and CT stimulator for dose calculation. Relative electron density as a function of HU was obtained for both planning CT stimulator and CBCT using a Catphan-600 (The Phantom Laboratory, USA) calibration phantom. A clinical treatment planning system was employed for CT stimulator and CBCT based dose calculations and subsequent comparisons. The dosimetric consequence as the result of HU variation in CBCT was evaluated by comparing MU/cCy. The differences were about 2.7% (3-4MU/100cGy) in phantom and 2.5% (1-3MU/100cGy) in patients. The difference in HU values in Catphan was small. However, the magnitude of scatter and artifacts in CBCT images are affected by limitation of detector's FOV and patient's involuntary motions. CBCT images included scatters and artifacts due to In addition to guide the patient setup process, CBCT data acquired prior to the treatment be used to recalculate or verify the treatment plan based on the patient anatomy of the treatment area. And the CBCT has potential to become a very useful tool for on-line ART.)

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.2
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• pp.78-86
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• 2010

Introduction: Cone beam computed tomography (CBCT) has various advantages and is used favorably in many fields in dentistry. Especially, CBCT is being used as basic diagnostic tool for 3-dimensional analysis in orthognathic patient. Two-dimensional cephalograms can be synthesized from CBCT digital imaging and communications in medicine (DICOM) data. In this study, conventional cephalograms and CBCT were taken simultaneously, and representative landmarks were located and analyzed in its accuracy and reproducibility. Materials and Methods: Ten patients who had orthognathic surgery in Wonkwang University Daejeon Dental Hospital participated in this study. For each patient, CBCT and conventional cephalogram was taken. By using Ondemand (Cybermad, Korea), 2-dimensional cephalograms was established on CBCT. In addition, 19 landmarks were designated and measured by 3 orthodontists twice a week. After these landmarks were transferred to a coordinate, distance of landmark and axis, standard error, distribution degree were measured, compared and analyzed. Results: Comparing the CT ceph group and conventional cephalogram group, CT ceph group had shown shorter distance of landmark and axis in S, Hinge axis, Bpt, Ba, Or, Corpus left. Standard error of the mean shows that CT ceph group has better reproducibility in Or, Corpus left, Hinge axis at X axis and Na, U1R, U1T, Bpt, PNS, Ba Corpus left, Hinge axis at Y axis. In both groups, mean error was less than 1.00 mm, no significant difference were found between CT ceph group and conventional cephalogram group in all measurements. Furthermore, comparing two groups, each 17 landmarks out of 19 had its characteristic in distribution degree. Conclusion: No significant difference were found between CBCT composed cephalographic radiograph and conventional cephalograghic radiograph, clinical application may be possible if improved.

• The Journal of Advanced Prosthodontics
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• v.10 no.4
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• pp.279-285
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• 2018

PURPOSE. The aim of this clinical study was to assess the accuracy of the implants placed using a universal digital surgical guide. MATERIALS AND METHODS. Among 17 patients, 28 posterior implants were included in this study. The digital image of the soft tissue acquired from cast scan and hard tissue from CBCT have been superimposed and planned the location, length, diameter of the implant fixture. Then digital surgical guides were created using 3D printer. Each of angle deviations, coronal, apical, depth deviations of planned and actually placed implants were calculated using CBCT scans and casts. To compare implant positioning errors by CBCT scans and plaster casts, data were analyzed with independent samples t-test. RESULTS. The results of the implant positioning errors calculated by CBCT and casts were as follows. The means for CBCT analyses were: angle deviation: $4.74{\pm}2.06^{\circ}$, coronal deviation: $1.37{\pm}0.80mm$, and apical deviation: $1.77{\pm}0.86mm$. The means for cast analyses were: angle deviation: $2.43{\pm}1.13^{\circ}$, coronal deviation: $0.82{\pm}0.44mm$, apical deviation: $1.19{\pm}0.46mm$, and depth deviation: $0.03{\pm}0.65mm$. There were statistically significant differences between the deviations of CBCT scans and cast. CONCLUSION. The model analysis showed lower deviation value comparing the CBCT analysis. The angle and length deviation value of the universal digital guide stent were accepted clinically.

• Imaging Science in Dentistry
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• v.51 no.4
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• pp.407-412
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• 2021

Purpose: The purpose of this study was to evaluate the accuracy of virtual 3-dimensional (3D) cephalograms constructed using the principle of biplanar radiography by comparing them with cone-beam computed tomography (CBCT) images. Materials and Methods: Thirty orthodontic patients were enrolled in this study. Frontal and lateral cephalograms were obtained with the use of a head posture aligner and reconstructed into 3D cephalograms using biplanar radiography software. Thirty-four measurements representing the height, width, depth, and oblique distance were computed in 3 dimensions, and compared with the measurements from the 3D images obtained by CBCT, using the paired t-test and Bland-Altman analysis. Results: Comparison of height, width, depth, and oblique measurements showed no statistically significant differences between the measurements obtained from 3D cephalograms and those from CBCT images (P>0.05). Bland-Altman plots also showed high agreement between the 3D cephalograms and CBCT images. Conclusion: Accurate 3D cephalograms can be constructed using the principle of biplanar radiography if frontal and lateral cephalograms can be obtained with a head posture aligner. Three-dimensional cephalograms generated using biplanar radiography can replace CBCT images taken for diagnostic purposes.