Jadhav Aniket, Desai Neha G, Tadinada Aditya
Oral and Maxillofacial Radiology, Virginia Commonwealth University School of Dentistry, Richmond, USA.
Dentistry and Public Health, Jefferson Dental Care (JDC) Healthcare, Houston, USA.
Cureus. 2023 Sep 5;15(9):e44723. doi: 10.7759/cureus.44723. eCollection 2023 Sep.
Two-dimensional (2D) radiographs are the standard of care for diagnosis and treatment planning in the day-to-day practice of dentistry. With the growing popularity of cone beam computed tomography (CBCT), it is now becoming the standard of care in many areas of general dentistry due to its ability to create non-linear projections from volumetric data. The CBCT-generated non-orthogonal radiographs can serve as easy-to-use 2D and three-dimensional (3D) diagnostic tools and offer a similar experience for diagnosis as conventional 2D images. The aim of this study is to compare the accuracy of conventional radiographs and CBCT-generated projections to identify relevant anatomic landmarks and their associated variants.
Thirty-two patients referred to the University of Connecticut School of Dental Medicine's Advanced Imaging Center were selected for this retrospective analysis. Nineteen anatomical landmarks were retrospectively assessed on conventional panoramic and CBCT scans generated panoramic radiographs using two different digital imaging and communications in medicine viewers. A total of 1,216 anatomical landmarks were evaluated by two oral and maxillofacial radiologists to assess the accuracy and consistency of the depiction of radiographic anatomy.
There was a very good agreement between the two evaluators with a Cohen's kappa value of 0.934. McNemar change test concluded that the anatomical assessment values compared between conventional panoramic and CBCT-generated panoramic radiographs are similar.
This study showed that CBCT-generated panoramic images are comparable to conventional panoramic radiographs in identifying anatomical landmarks typically evaluated using a conventional panoramic projection. In addition, they have the added advantage of having 3D information in the acquired volume to better evaluate the area of interest. In clinical situations where a mid- to large-volume CBCT scan is available, a simulated panoramic image can be generated using the CBCT volume, leaving exposure of the patient to the additional radiation of a panoramic image unnecessary.
在日常牙科实践中，二维（2D）X线片是诊断和治疗计划的标准。随着锥形束计算机断层扫描（CBCT）的日益普及，由于其能够从容积数据创建非线性投影，它现在正成为普通牙科许多领域的标准。CBCT生成的非正交X线片可作为易于使用的二维和三维（3D）诊断工具，并提供与传统二维图像相似的诊断体验。本研究的目的是比较传统X线片和CBCT生成的投影在识别相关解剖标志及其相关变异方面的准确性。
选取32例转诊至康涅狄格大学牙医学院高级影像中心的患者进行这项回顾性分析。使用两种不同的医学数字成像和通信（DICOM）阅读器，在传统全景和CBCT扫描生成的全景X线片上回顾性评估19个解剖标志。两名口腔颌面放射科医生共评估了1216个解剖标志，以评估放射解剖结构描绘的准确性和一致性。
两位评估者之间的一致性非常好，科恩kappa值为0.934。McNemar变化检验得出结论，传统全景X线片和CBCT生成的全景X线片之间比较的解剖评估值相似。
本研究表明，CBCT生成的全景图像在识别通常使用传统全景投影评估的解剖标志方面与传统全景X线片相当。此外，它们的额外优势在于在采集的容积中具有三维信息，以便更好地评估感兴趣区域。在有中到大容积CBCT扫描的临床情况下，可以使用CBCT容积生成模拟全景图像，无需让患者额外接受全景图像的辐射。
