Sun Jui-Sheng, Lin Shih-Ying, Hsieh Chi-Yeh, Hung Min-Chih, Tai Han-Cheng, Chang Jenny Zwei-Chieng
Department of Orthopedic Surgery, En Chu Kong Hospital, New Taipei City, Taiwan.
Department of Orthopedic Surgery, National Taiwan University Hospital, Taipei, Taiwan.
J Dent Sci. 2024 Oct;19(4):1961-1971. doi: 10.1016/j.jds.2024.07.033. Epub 2024 Aug 7.
BACKGROUND/PURPOSE: The use of computed tomography (CT) for craniofacial measurements is common in medical imaging, but concerns about accuracy and reliability persist, especially with different CT technologies. This study assessed the accuracy of twenty-six common measurements on consecutive CT images from the same patients, using multidetector CT (MDCT) and cone-beam CT (CBCT) with two software programs (Amira and Dolphin).
Ten adult subjects with consecutive CBCT scans within one year were randomly selected. Another ten subjects with consecutive MDCT scans were paired with the CBCT group based on age, gender, race, occlusion, and craniofacial pattern. All digital imaging and communications in medicine (DICOM) files were randomly coded and analyzed using the two software programs. Intra-examiner reliability was assessed using the intraclass correlation coefficient. Successive measurement errors from consecutive scans for both imaging modalities and software programs were compared.
For most skeletal linear and angular measurements, Dolphin showed greater successive measurement errors compared to Amira. Eight of the 26 common measurements had errors greater than one unit (millimeter or degree). Despite almost perfect intra-examiner reliability for upper airway analysis, average successive measurement errors were notably high, particularly for intraoral and oropharyngeal airway volumes. The successive Dolphin measurement error for oropharyngeal airway volume on CBCT images was over three times that on MDCT images.
Given the substantial successive measurement errors observed during consecutive CT scanning for the upper airway, this study does not support the quantitative use of CT for analyzing changes in airway dimensions for research purposes.
背景/目的：在医学成像中，使用计算机断层扫描（CT）进行颅面测量很常见，但对于准确性和可靠性的担忧仍然存在，尤其是在不同的CT技术方面。本研究使用多排螺旋CT（MDCT）和锥形束CT（CBCT）以及两个软件程序（Amira和Dolphin），评估了同一患者连续CT图像上26项常见测量的准确性。
随机选择10名在一年内进行连续CBCT扫描的成年受试者。另外10名进行连续MDCT扫描的受试者根据年龄、性别、种族、咬合情况和颅面模式与CBCT组配对。所有医学数字成像和通信（DICOM）文件均被随机编码，并使用这两个软件程序进行分析。使用组内相关系数评估检查者内可靠性。比较了两种成像方式和软件程序连续扫描的连续测量误差。
对于大多数骨骼线性和角度测量，与Amira相比，Dolphin显示出更大的连续测量误差。26项常见测量中有8项的误差大于一个单位（毫米或度）。尽管在上气道分析中检查者内可靠性几乎完美，但平均连续测量误差仍然很高，特别是对于口腔内和口咽气道容积。CBCT图像上Dolphin对口咽气道容积的连续测量误差是MDCT图像上的三倍多。
鉴于在上气道连续CT扫描过程中观察到大量连续测量误差，本研究不支持将CT定量用于分析气道尺寸变化以进行研究目的。
