• Journal of Trauma and Injury
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• 제35권1호
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• pp.12-18
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• 2022

Purpose: Pedicle screw fixation provides 3-column stabilization, multidimensional control, and a higher rate of interbody fusion. Although computed tomography (CT) is recommended for the postoperative assessment of pedicle screw fixation, its use is limited due to the radiation exposure dose. The purpose of this preliminary retrospective study was to assess the clinical usefulness of low-dose mobile cone-beam CT (CBCT) for the postoperative evaluation of pedicle screw fixation. Methods: The author retrospectively reviewed postoperative mobile CBCT images of 15 patients who underwent posterior pedicle screw fixation for spinal disease from November 2019 to April 2020. Pedicle screw placement was assessed for breaches of the bony structures. The breaches were graded based on the Heary classification. Results: The patients included 11 men and four women, and their mean age was 66±12 years. Of the 122 pedicle screws, 34 (27.9%) were inserted in the thoracic segment (from T7 to T12), 82 (67.2%) in the lumbar segment (from L1 to L5), and six (4.9%) in the first sacral segment. Although there were metal-related artifacts, the image of the screw position (according to Heary classification) after surgery could be assessed using mobile CBCT at all levels (T7-S1). Conclusions: Mobile CBCT was accurate in determining the location and integrity of the pedicle screw and identifying the surrounding bony structures. In the postoperative setting, mobile CBCT can be used as a primary modality for assessing the accuracy of pedicle screw fixation and detecting postoperative complications.

• Imaging Science in Dentistry
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• 제45권3호
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• pp.153-158
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• 2015

Purpose: The purpose of this study was to evaluate and compare the efficacy of cone-beam computed tomography (CBCT) and digital intraoral radiography in diagnosing simulated small external root resorption cavities. Materials and Methods: Cavities were drilled in 159 roots using a small spherical bur at different root levels and on all surfaces. The teeth were imaged both with intraoral digital radiography using image plates and with CBCT. Two sets of intraoral images were acquired per tooth: orthogonal (PA) which was the conventional periapical radiograph and mesioangulated (SET). Four readers were asked to rate their confidence level in detecting and locating the lesions. Receiver operating characteristic (ROC) analysis was performed to assess the accuracy of each modality in detecting the presence of lesions, the affected surface, and the affected level. Analysis of variation was used to compare the results and kappa analysis was used to evaluate interobserver agreement. Results: A significant difference in the area under the ROC curves was found among the three modalities (P=0.0002), with CBCT (0.81) having a significantly higher value than PA (0.71) or SET (0.71). PA was slightly more accurate than SET, but the difference was not statistically significant. CBCT was also superior in locating the affected surface and level. Conclusion: CBCT has already proven its superiority in detecting multiple dental conditions, and this study shows it to likewise be superior in detecting and locating incipient external root resorption.

• Imaging Science in Dentistry
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• 제45권1호
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• pp.23-29
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• 2015

Purpose: This study aimed to assess the reliability of measurements performed on three-dimensional (3D) virtual models of maxillary defects obtained using cone-beam computed tomography (CBCT) and 3D optical scanning. Materials and Methods: Mechanical cavities simulating maxillary defects were prepared on the hard palate of nine cadavers. Images were obtained using a CBCT unit at three different fields-of-views (FOVs) and voxel sizes: 1) $60{\times}60mm$ FOV, $0.125mm^3$ ($FOV_{60}$); 2) $80{\times}80mm$ FOV, $0.160mm^3$ ($FOV_{80}$); and 3) $100{\times}100mm$ FOV, $0.250mm^3$ ($FOV_{100}$). Superimposition of the images was performed using software called VRMesh Design. Automated volume measurements were conducted, and differences between surfaces were demonstrated. Silicon impressions obtained from the defects were also scanned with a 3D optical scanner. Virtual models obtained using VRMesh Design were compared with impressions obtained by scanning silicon models. Gold standard volumes of the impression models were then compared with CBCT and 3D scanner measurements. Further, the general linear model was used, and the significance was set to p=0.05. Results: A comparison of the results obtained by the observers and methods revealed the p values to be smaller than 0.05, suggesting that the measurement variations were caused by both methods and observers along with the different cadaver specimens used. Further, the 3D scanner measurements were closer to the gold standard measurements when compared to the CBCT measurements. Conclusion: In the assessment of artificially created maxillary defects, the 3D scanner measurements were more accurate than the CBCT measurements.

• 대한치과교정학회지
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• 제43권6호
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• pp.271-278
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• 2013

Objective: The purposes of this study were to determine the accuracy of crown and root length measurements of premolars using cone-beam computed tomography (CBCT) and to generate reference CBCT-based data on incisor, canine, and premolar lengths in patients with malocclusions. Methods: Imaging was performed using a CBCT scanner with a 0.292-mm voxel size and 12-bit grayscale. The CBCT-based length measurements were compared with direct measurements of 94 subsequently extracted premolars without metal restorations using the paired t-test. Furthermore, the crown and root lengths of incisors, canines, and premolars in 62 Korean patients with malocclusions were measured using CBCT, and Pearson's correlation coefficients were calculated to examine the relationship between the crown and root length measurements of each tooth type. Results: The differences between the CBCT-based and direct measurements of the extracted premolars were not significant, with 95% limits of agreement of -0.90 to 0.90 mm for crown length and -1.23 to 1.18 mm for root length. Weak positive correlations between the crown and root length measurements were observed for the mandibular canine and premolars. Conclusions: The CBCT-based measurements showed a wider range of limits of agreements for root length than for crown length. The CBCT-based data can be used as a reference for evaluating root length and resorption of teeth without metal restorations in patients with malocclusions.

• 대한방사선치료학회지
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• 제21권2호
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• pp.83-88
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• 2009

목 적: 온 보드영상(OBI)장치를 이용한 콘빔CT는 환자 치료 중 실시간으로 전산화모의치료 영상과 비교하여 환자의 자세 및 표적용적의 움직임과 셋업오차를 확인 할 수 있다. IMRT 시 콘빔CT를 이용해 환자의 자세 및 표적용적의 변화와 움직임을 확인하여 치료계획과의 오차정도를 산출하고, Automatic Match System을 이용하여 위치 보정을 한 후 전자포털영상 장치를 통하여 위치보정의 정확성을 검증하고, IMRT에서 콘빔CT의 유용성과 Automatic Match System의 정확성에 대하여 알아보고 자 한다. 대상 및 방법: 본원에서 치료받은 IMRT 환자 중 두 경부 치료환자 3명, 골반부 치료환자 1명을 대상으로 치료 자세의 변동과 그에 따른 조사용적의 위치변동을 알아보기 위해 선형가속기에 장착된 온 보드 영상 장치를 이용해 콘빔 CT를 촬영하였다. IMRT 전 매 치료 시 마다 콘빔CT를 촬영하여 전산화단층모의치료 영상과 비교하여 좌표별로 치료계획과의 오차값을 확인하고 3D/3D Match의 Automatic Match System을 통하여 치료계획과 일치하도록 이동 보정한 후 전자포털영상 장치를 이용하여 검증, 평가하였다. 결 과: 치료 전 콘빔 CT와 전산화단층모의치료 영상 비교 시 두 경부에서 좌표별 평균오차는 Vertical 0.99 mm, Longitudinal 1.14 mm, Lateral 0.84 mm, Rotation $0.49^o$이고, 골반부의 평균오차는 Vertical 2.78 mm, Longitudinal 2.04 mm, Lateral 4.91 mm, Rotation $1.07^o$로 부위별로 다소 근소한 차이를 보였다. 보정 후 검증에서는 전자포털영상 장치에 의한 영상과 DRR 영상 비교 결과 0.5 mm 이내의 오차로 정확한 보정이 이루어졌음을 알 수 있었다. 결 론: 치료 전 콘빔CT 영상은 환자의 셋업오차와 장기 및 표적의 위치변화를 2차원적 영상의 비교와 달리 하나의 체적으로 재구성된 3차원적 영상으로 비교함으로써 보다 정확하게 위치변화와 표적용적의 변동 등을 측정, 보정하여 정확한 치료를 할 수 있으며, 그 오차 값을 산출하여 비교할 수 있다. 이상의 연구로 보아 콘빔CT는 치료계획과 일치하는 정확한 치료전달과 반복적인 치료재현성에 유용하였으며, 만족스러운 결과를 얻을 수 있었다. 콘빔CT에 의해 향상된 정확도는 복잡한 모양의 표적용적과 급격한 선량분포의 변화가 나타나는 IMRT에서 더욱 필요하며 각 치료 부위별, 치료 목적별로 Match focus에 대한 기준을 연구해야 될 것으로 사료된다.

• 대한치과의사협회지
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• 제50권4호
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• pp.196-202
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• 2012

Radiographic diagnosis of periapical lesions is based on many factors, including anatomical limitations such as thickness of the cortical bone; positioning of the apical abscess to the cortical bone; and is complicated by proximity to other anatomical structures and neighboring teeth. With conventional radiographs, these structures are often superimposed. Dental CBCT with its associated geometric accuracy offers accurate visualizations of the complex relationships and boundaries between teeth, related anatomical features, and their associated pathology. Its images also provide us internal tooth morphology, periodontal ligament space, the presence or absence of periapicl lesions in association wi th critical anatomical structures and maxillary sinus involement. Using 3 D imaging makes it easier for clinicians to detect, diagnosis, and develop highly effective treatment plans. Now, 4 cases of periapical and periodontal pathosis with CBCT images are to be presented including periapical abscess, furcation involvement, periapical pathosis involving maxillary sinus, and osteomyelitis. CBCT analyze specific area of interest and provides the highly detailed anatomical information. It also facilitates earlier and more accurate diagnosis, and treatment planning decisions and more predictable outcome.

• Imaging Science in Dentistry
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• 제49권3호
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• pp.191-199
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• 2019

Purpose: To compare the diagnostic ability of undergraduate dental students to detect maxillary sinus abnormalities in panoramic radiographs(PR) and cone-beam computed tomography (CBCT). Materials and Methods: This was a retrospective study based on the evaluation of PR and CBCT images. A pilot study was conducted to determine the number of students eligible to participate in the study. The images were evaluated by 2 students, and 280 maxillary sinuses were assessed using the following categories: normal, mucosal thickening, sinus polyp, antral pseudocyst, nonspecific opacification, periostitis, antrolith, and antrolith associated with mucosal thickening. The reference standard was established by the consensus of 2 oral radiologists based on the CBCT images. The kappa test, receiver operating characteristic curves, and 1-way analysis of variance with the Tukey-Kramer post-hoc test were employed. Results: Intraobserver and interobserver reliability showed agreement ranging from substantial (0.809) to almost perfect (0.922). The agreement between the students' evaluations and the reference standard was reasonable (0.258) for PR and substantial(0.692) for CBCT. Comparisons of values of sensitivity, specificity, and accuracy showed that CBCT was significantly better(P<0.05). Conclusion: CBCT was better than PR for the detection of maxillary sinus abnormalities by dental students. However, CBCT should only be requested after a careful analysis of PR by students and more experienced professionals.

• 정보과학회 논문지
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• 제43권3호
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• pp.353-361
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• 2016

폐암 환자의 영상유도 방사선 치료의 경우 환자의 호흡 및 심장박동에 따라 종양의 움직임이 변화할 수 있으므로 치료 시 종양의 움직임을 추적하는 것이 필요하다. 본 논문에서는 치료계획용 4D MDCT 영상과 치료 시 획득한 4D CBCT 영상의 3차원 영상 정보를 기반으로 종양 움직임을 추적하는 방법을 제안한다. 첫째, 효율적으로 치료 시 종양의 움직임을 추적하기 위해 치료계획용 4D MDCT 영상에서 획득한 종양 움직임 모델을 통해 종양의 전역적 움직임을 예측한다. 둘째, 종양 움직임 추적의 정확성을 높이기 위해 4D CBCT 영상에서 종양 주변의 구조적 정보를 이용해 세부적 움직임을 보정하여 종양의 지역적 움직임을 예측한다. 제안방법의 성능 평가를 위해 디지털 팬텀을 이용해 실험한 결과, 지역적 움직임을 고려했을 때 전역적 움직임만 보정한 경우보다 종양 위치화 오류가 45% 감소하였다.

• Imaging Science in Dentistry
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• 제44권1호
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• pp.37-41
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• 2014

Purpose: The aim of this study was to investigate the accuracy of cone-beam computed tomography (CBCT) in the diagnosis of vertical root fractures in a tooth with gutta-percha and prefabricated posts. Materials and Methods: This study selected 96 extracted molar and premolar teeth of the mandible. These teeth were divided into six groups as follows: Groups A, B, and C consisted of teeth with vertical root fractures, and groups D, E, and F had teeth without vertical root fractures; groups A and D had teeth with gutta-percha and prefabricated posts; groups B and E had teeth with gutta-percha but without prefabricated posts, and groups C and F had teeth without gutta-percha or prefabricated posts. Then, the CBCT scans were obtained and examined by three oral and maxillofacial radiologists in order to determine the presence of vertical root fractures. The data were analyzed using IBM SPSS 20.0 (IBM Corp., Armonk, NY, USA). Results: The kappa coefficient was $0.875{\pm}0.049$. Groups A and D showed a sensitivity of 81% and a specificity of 100%; groups E and B, a sensitivity of 94% and a specificity of 100%; and groups C and F, a sensitivity of 88% and a specificity of 100%. Conclusion: The CBCT scans revealed a high accuracy in the diagnosis of vertical root fractures; the accuracy did not decrease in the presence of gutta-percha. The presence of prefabricated posts also had little effect on the accuracy of the system, which was, of course, not statistically significant.

• Imaging Science in Dentistry
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• 제37권3호
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• pp.165-170
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• 2007

Purpose: To estimate the shape of root and pulp canal using a dental cone beam computed tomography (CBCT) and to evaluate the accuracy of imaging reformation. Materials and Methods: CBCT images were obtained with incisors, premolars, and molars as the destination by using PSR $9000N^{TM}$ Dental CT system (Asahi Roentgen Ind. Co., Ltd, Kyoto, Japan) and i-CAT (Imaging Sciences International, Inc, USA) cone beam CT unit that have different kind of detector and field of view, and compared these with the shape and the size of actual root and root canal. Results: When the measuring value of cone beam computed tomography concerning to each root's bucco-lingual diameter and mesio-distal diameter was compared with the value of the actual root, it reveals an error range $-0.49{\sim}+0.63$ mm at PSR900N and $-0.97{\sim}+1.14$ mm at i-CAT (P>0.05). It was possible to identify and measure PSR$9000N^{TM}$ Dental CT system to the limit $0.48{\pm}0.06mm$ (P>0.05) and i-CAT CBCT to the limit $0.86{\pm}0.09mm$ (P<0.05) on estimating the size and the shape of root canal. Two kinds of CBCT images revealed the useful reproducibility to estimate the shape of root, but there was the difference to estimate the shape of root according to apparatus. The reproducibility of root shape in the image of three-dimensions at PSR 900N is low such as 0.65 mm in a case of minute root canal. Conclusions: CBCT images revealed higher accuracy of the imaging reformation for root and pulp and clinically CBCT is a useful diagnostic tool for the assessment of root and canal. However, there are different qualities of imaging reformation according to CBCT apparatus and limitation of reproducibility for minute root canals.