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Study on the hard tissue changes in osteomyelitis of the jaws using CT image (CT 영상을 이용한 악골 골수염의 경조직 변화에 관한 연구)

  • An, Chang-Hyeon;Choi, Bo-Ram;Huh, Kyung-Hoe;Lee, Won-Jin;Lee, Sam-Sun;Choi, Soon-Chul
    • Imaging Science in Dentistry
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    • v.39 no.3
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    • pp.163-168
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    • 2009
  • Purpose : To assess the clinical findings and hard tissue changes of osteomyelitis of the jaws using computed tomographic (CT) image analysis. Materials and Methods : We reviewed and interpreted the CT images of 163 patients (64 males and 99 females, age range from 10 to 87 years) who visited the Seoul National University Dental Hospital from April 23, 2006 to December 31, 2008 and were diagnosed as osteomyelitis of the jaws through clinical, radiologic, and histopathologic examination. Each CT findings was investigated for frequency, correlation with age and gender. Results : Of the 163 patients, 31 (19.0%) were affected on the maxilla, 135 (82.8%) were affected on the mandible, and 3 (1.8%) were affected on the both jaws simultaneously. The mean age of the patients who were affected on the maxilla was 61.0 years and that of the patients who were affected on the mandible was 56.2 years. On the maxilla, the most frequent site of disease was the posterior area (83.9%) and on the mandible, mandibular body (83.0%), followed by angle (48.1%), ramus (38.5%), condyle (13.3%), incisal area (9.6%), and coronoid process (3.0%). Among the 31 maxillary osteomyelitis, defect in the trabecular bone was observed in 28 (90.3%), osteosclerosis 20 (64.5%), defect in the cortical bone 27 (87.1%), sequestrum 17 (54.8%), and periosteal reaction 2 (6.5%). Among the 135 mandibular osteomyelitis, defect in the trabecular bone was observed in 100 (74.1%), osteosclerosis 104 (77.0%), defect in the cortical bone 116 (85.9%), sequestrum 36 (26.7%), and periosteal reaction 67 (49.6%). Conclusion : Of our cases, the maxillary osteomyelitis was visibly observed more frequently in females than males. The incidence is the highest in seventies (28.8%) and the lowest in teens (3.1%). The osteomyelitis of the jaws was observed more frequently in males than females before the age of 50, and observed more frequently in females after the age of 50. The most noticeable point was that the sequestrum was observed more often on maxillary osteomyelitis and the periosteal reaction was observed more often on mandibular osteomyelitis.

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Comparison of measurements from digital cephalometric radiographs and 3D MDCT-synthetized cephalometric radiographs and the effect of head position (디지털 측방두부규격방사선사진과 MDCT의 3차원 재구성 영상을 이용한 합성측방두부규격방사선사진의 계측치 비교 및 머리 위치가 미치는 효과)

  • Kim, Mi-Ja;Choi, Bo-Ram;Huh, Kyung-Hoe;Yi, Won-Jin;Heo, Min-SUk;Lee, Sam-Sun;Choi, Soon-Chul
    • Imaging Science in Dentistry
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    • v.39 no.3
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    • pp.133-147
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    • 2009
  • Purpose : To investigate the reproducibilities and compare the measurements in digital and MDCT-synthesized cephalometric radiograph, and to investigate the effect of head position on the measurement during imaging with MDCT. Materials and Methods : Twenty-two dry skulls (combined with mandible) were used in this study. Conventional digital cephalometric radiograph was taken in standard position, and MDCT was taken in standard position and two rotated position ($10^{\circ}$ left rotation and $10^{\circ}$ right tilting). MDCT data were imported in $OnDemand^{(R)}$ and lateral cephalometric radiograph were synthesized from 3D virtual models. Two types of rotated MDCT data were synthesized with default mode and with corrected mode using both ear rods. For all six images, sixteen angular and eleven linear measurements were made in V-$Ceph^{(R)}$ three times. Reproducibility of measurements was assessed using repeated measures ANOV A and ICC. Linear and angular measurements were compared between digital and five MDCT-synthesized images by Student t-test. Results : All measurements in six types of cephalometric radiograph were not statistically different under ICC examination. Measurements were not different between digital and MDCT-synthesized images (P>.05). Measurements in MDCT-synthesized image in $10^{\circ}$ left rotation or $10^{\circ}$ right tilting position showed possibility of difference from digital image in some measurements, and possibility of improvement via realignment of head position using both ear rods. Conclusion : MDCT-synthesized cephalometric radiograph can substitute conventional cephalometric radiograph. The error on head position during imaging with MDCT have possibility that can produce measurement errors with MDCT-synthesized image, and these position error can be corrected by realignment of the head position using both ear rods.

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Influence of kilovoltage- peak and the metal artifact reduction tool in cone-beam computed tomography on the detection of bone defects around titanium-zirconia and zirconia implants

  • Fontenele, Rocharles Cavalcante;Nascimento, Eduarda Helena Leandro;Imbelloni-Vasconcelos, Ana Catarina;Martins, Luciano Augusto Cano;Pontual, Andrea dos Anjos;Ramos-Perez, Flavia Maria Moraes;Freitas, Deborah Queiroz
    • Imaging Science in Dentistry
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    • v.52 no.3
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    • pp.267-273
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    • 2022
  • Purpose: The aim of this study was to assess the influence of kilovoltage- peak (kVp) and the metal artifact reduction (MAR) tool on the detection of buccal and lingual peri-implant dehiscence in the presence of titanium-zirconia (Ti-Zr) and zirconia (Zr) implants in cone-beam computed tomography (CBCT) images. Materials and Methods: Twenty implant sites were created in the posterior region of human mandibles, including control sites (without dehiscence) and experimental sites (with dehiscence). Individually, a Ti-Zr or Zr implant was placed in each implant site. CBCT scans were performed using a Picasso Trio device, with variation in the kVp setting (70 or 90 kVp) and whether the MAR tool was used. Three oral radiologists scored the detection of dehiscence using a 5-point scale. The area under the receiver operating characteristic (ROC) curve, sensitivity, and specificity were calculated and compared by multi-way analysis of variance (α=0.05). Results: The kVp, cortical plate involved (buccal or lingual cortices), and MAR did not influence any diagnostic values (P>0.05). The material of the implant did not influence the ROC curve values(P>0.05). In contrast, the sensitivity and specificity were statistically significantly influenced by the implant material (P<0.05) with Zr implants showing higher sensitivity values and lower specificity values than Ti-Zr implants. Conclusion: The detection of peri-implant dehiscence was not influenced by kVp, use of the MAR tool, or the cortical plate. Greater sensitivity and lower specificity were shown for the detection of peri-implant dehiscence in the presence of a Zr implant.

Examination Techniques and Imaging Findings of Hepatic Hemangioma (간혈관종의 검사기법과 영상소견)

  • Chang-Hoe Koo;Jong-Wan Keum;Ji-Eun Seok;Dong-Chul Choi;Yun-Ho Choi;Man-Seok Han;Min-Cheol Jeon
    • Journal of the Korean Society of Radiology
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    • v.17 no.3
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    • pp.375-384
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    • 2023
  • Most Hepatic hemangiomas are asymptomatic and small in size, making them difficult to find by pathological examination. Therefore, radiological diagnosis is essential for the early finding and diagnosis of Hepatic hemangioma. Three-phase method using contrast medium in computed tomography, T1, T2-weighted imaging in magnetic resonance imaging, dynamic magnetic resonance imaging using contrast medium, echo planar imaging method, diffusion-weighted imaging method, blood pool scan using 99mTc-labeled red blood cells in nuclear medicine, we looked at the color doppler method In ultrasound, and it is important to accurately understand the imaging findings of hepatic hemangioma and perform the examination in order to make an accurate diagnosis. most hepatic hemangioma are benign tumors, care should be taken not to confuse them with malignant tumors such as hepatocellular carcinoma to prevent unnecessary procedures. Therefore, in order to make an accurate diagnosis, it is important to accurately understand the imaging findings of hemangioma and perform the examination.

Deep Learning Algorithm for Simultaneous Noise Reduction and Edge Sharpening in Low-Dose CT Images: A Pilot Study Using Lumbar Spine CT

  • Hyunjung Yeoh;Sung Hwan Hong;Chulkyun Ahn;Ja-Young Choi;Hee-Dong Chae;Hye Jin Yoo;Jong Hyo Kim
    • Korean Journal of Radiology
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    • v.22 no.11
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    • pp.1850-1857
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    • 2021
  • Objective: The purpose of this study was to assess whether a deep learning (DL) algorithm could enable simultaneous noise reduction and edge sharpening in low-dose lumbar spine CT. Materials and Methods: This retrospective study included 52 patients (26 male and 26 female; median age, 60.5 years) who had undergone CT-guided lumbar bone biopsy between October 2015 and April 2020. Initial 100-mAs survey images and 50-mAs intraprocedural images were reconstructed by filtered back projection. Denoising was performed using a vendor-agnostic DL model (ClariCT.AITM, ClariPI) for the 50-mAS images, and the 50-mAs, denoised 50-mAs, and 100-mAs CT images were compared. Noise, signal-to-noise ratio (SNR), and edge rise distance (ERD) for image sharpness were measured. The data were summarized as the mean ± standard deviation for these parameters. Two musculoskeletal radiologists assessed the visibility of the normal anatomical structures. Results: Noise was lower in the denoised 50-mAs images (36.38 ± 7.03 Hounsfield unit [HU]) than the 50-mAs (93.33 ± 25.36 HU) and 100-mAs (63.33 ± 16.09 HU) images (p < 0.001). The SNRs for the images in descending order were as follows: denoised 50-mAs (1.46 ± 0.54), 100-mAs (0.99 ± 0.34), and 50-mAs (0.58 ± 0.18) images (p < 0.001). The denoised 50-mAs images had better edge sharpness than the 100-mAs images at the vertebral body (ERD; 0.94 ± 0.2 mm vs. 1.05 ± 0.24 mm, p = 0.036) and the psoas (ERD; 0.42 ± 0.09 mm vs. 0.50 ± 0.12 mm, p = 0.002). The denoised 50-mAs images significantly improved the visualization of the normal anatomical structures (p < 0.001). Conclusion: DL-based reconstruction may enable simultaneous noise reduction and improvement in image quality with the preservation of edge sharpness on low-dose lumbar spine CT. Investigations on further radiation dose reduction and the clinical applicability of this technique are warranted.

Imaging Findings of Peripheral Arterial Disease on Lower-Extremity CT Angiography Using a Virtual Monoenergetic Imaging Algorithm (가상의 단일 에너지 영상 재구성 기법을 이용한 하지 단층촬영 혈관조영술에서 말초 동맥 질환 영상 소견)

  • Jun Seong Kim;So Hyun Park;Suyoung Park;Jung Han Hwang;Jeong Ho Kim;Seong Yong Pak;Kihyun Lee;Bernhard Schmidt
    • Journal of the Korean Society of Radiology
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    • v.83 no.5
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    • pp.1032-1045
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    • 2022
  • Peripheral arterial disease (PAD) is common in elderly patients. Lower-extremity CT angiography (LE-CTA) can be useful for detecting PAD and planning its treatment. PAD can also be accurately evaluated on reconstructed monoenergetic images (MEIs) from low kiloelectron volt (keV) to high keV images using dual-energy CT. Low keV images generally provide higher contrast than high keV images but also feature more severe image noise. The noise-reduced virtual MEI reconstruction algorithm, called the Mono+ technique, was recently introduced to overcome such image noise. Therefore, this pictorial review aimed to present the imaging findings of PAD on LE-CTA and compare low and high keV images with those subjected to the Mono+ technique. We found that, in many cases, the overall and segmental image qualities were better and metal artifacts and venous contamination were decreased in the high keV images.

Appendiceal Visualization on 2-mSv CT vs. Conventional-Dose CT in Adolescents and Young Adults with Suspected Appendicitis: An Analysis of Large Pragmatic Randomized Trial Data

  • Jungheum Cho;Youngjune Kim;Seungjae Lee;Hooney Daniel Min;Yousun Ko;Choong Guen Chee;Hae Young Kim;Ji Hoon Park;Kyoung Ho Lee;LOCAT Group
    • Korean Journal of Radiology
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    • v.23 no.4
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    • pp.413-425
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    • 2022
  • Objective: We compared appendiceal visualization on 2-mSv CT vs. conventional-dose CT (median 7 mSv) in adolescents and young adults and analyzed the undesirable clinical and diagnostic outcomes that followed appendiceal nonvisualization. Materials and Methods: A total of 3074 patients aged 15-44 years (mean ± standard deviation, 28 ± 9 years; 1672 female) from 20 hospitals were randomized to the 2-mSv CT or conventional-dose CT group (1535 vs. 1539) from December 2013 through August 2016. A total of 161 radiologists from 20 institutions prospectively rated appendiceal visualization (grade 0, not identified; grade 1, unsure or partly visualized; and grade 2, clearly and entirely visualized) and the presence of appendicitis in these patients. The final diagnosis was based on CT imaging and surgical, pathologic, and clinical findings. We analyzed undesirable clinical or diagnostic outcomes, such as negative appendectomy, perforated appendicitis, more extensive than simple appendectomy, delay in patient management, or incorrect CT diagnosis, which followed appendiceal nonvisualization (defined as grade 0 or 1) and compared the outcomes between the two groups. Results: In the 2-mSv CT and conventional-dose CT groups, appendiceal visualization was rated as grade 0 in 41 (2.7%) and 18 (1.2%) patients, respectively; grade 1 in 181 (11.8%) and 81 (5.3%) patients, respectively; and grade 2 in 1304 (85.0%) and 1421 (92.3%) patients, respectively (p < 0.001). Overall, undesirable outcomes were rare in both groups. Compared to the conventional-dose CT group, the 2-mSv CT group had slightly higher rates of perforated appendicitis (1.1% [17] vs. 0.5% [7], p = 0.06) and false-negative diagnoses (0.4% [6] vs. 0.0% [0], p = 0.01) following appendiceal nonvisualization. Otherwise, these two groups were comparable. Conclusion: The use of 2-mSv CT instead of conventional-dose CT impairs appendiceal visualization in more patients. However, appendiceal nonvisualization on 2-mSv CT rarely leads to undesirable clinical or diagnostic outcomes.

Serum Oncofetal Fibronectin (onfFN) mRNA in Differentiated Thyroid Carcinoma (DTC): Large Overlap between Disease-Free and Metastatic Patients

  • Sritara, Chanika;Charoenphun, Putthiporn;Ponglikitmongkol, Mathurose;Musikarat, Suchawadee;Utamakul, Chirawat;Chokesuwattanasakul, Payap;Thakkinstian, Ammarin
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.4203-4208
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    • 2012
  • Aim: This study assessed if onfFN mRNA in the peripheral blood of patients with DTC can identify individuals with metastatic disease. Methods: Comparison of onfFN mRNA was made among 3 groups: disease-free, lymph node metastasis, and distant metastasis using real-time RT-PCR on 5 ml blood samples from each DTC patient. Results: Fifty-one patients were included: 30 (59%) were disease-free; 7 (13.7%) had lymph node metastasis; and 14 (27.5%) had distant metastasis. OnfFN mRNA levels in the 3 groups were significantly different (P=0.001) but with a large overlap and the expression being highest in the disease-free group. Subgroup analysis of the metastatic groups did not show any effect of age, cell type, and serum TSH, Tg, and antiTg on onfFN mRNA. The within-run and between-run root mean square coefficients of variations were <2%. Conclusion: OnfFN mRNA in patients with DTC cannot identify those with metastatic disease.

Assessment of endodontically treated teeth by using different radiographic methods: an ex vivo comparison between CBCT and other radiographic techniques

  • Demiralp, Kemal Ozgur;Kamburoglu, Kivanc;Gungor, Kahraman;Yuksel, Selcen;Demiralp, Gokcen;Ucok, Ozlem
    • Imaging Science in Dentistry
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    • v.42 no.3
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    • pp.129-137
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    • 2012
  • Purpose: To compare different radiographic methods for assessing endodontically treated teeth. Materials and Methods: Root canal treatments were applied in 120 extracted mandibular teeth, which were divided into four groups: (1) ideal root canal treatment (60 teeth), (2) insufficient lateral condensation (20 teeth), (3) root canals filled short of the apex (20 teeth), (4) overfilled root canal treatment (20 teeth). The teeth were imaged using intraoral film, panoramic film, digital intraoral systems (CCD and PSP), CCD obtained with portable X-ray source, digital panoramic, and CBCT images obtained at 0.3 $mm^3$ and 0.2 $mm^3$ voxel size. Images were evaluated separately by three observers, twice. Kappa coefficients were calculated. The percentage of correct readings obtained from each modality was calculated and compared using a t-test (p<0.05). Results: The intra-observer kappa for each observer ranged between 0.327 and 0.849. The inter-observer kappa for each observer for both readings ranged between 0.312 and 0.749. For the ideal root canal treatment group, CBCT with 0.2 $mm^3$ voxel images revealed the best results. For insufficient lateral condensation, the best readings were found with periapical film followed by CCD and PSP. The assessment of teeth with root canals filled short of the apex showed the highest percentage of correct readings by CBCT and CCD. For the overfilled canal treatment group, PSP images and conventional periapical film radiographs had the best scores. Conclusion: CBCT was found to be successful in the assessment of teeth with ideal root canal treatment and teeth with canals filled short of the apex.

Accuracy of various imaging methods for detecting misfit at the tooth-restoration interface in posterior teeth

  • Francio, Luciano Andrei;Silva, Fernanda Evangelista;Valerio, Claudia Scigliano;Cardoso, Claudia Assuncao e Alves;Jansen, Wellington Correa;Manzi, Flavio Ricardo
    • Imaging Science in Dentistry
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    • v.48 no.2
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    • pp.87-96
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    • 2018
  • Purpose: The present study aimed to evaluate which of the following imaging methods best assessed misfit at the tooth-restoration interface: (1) bitewing radiographs, both conventional and digital, performed using a photostimulable phosphor plate (PSP) and a charge-coupled device (CCD) system; (2) panoramic radiographs, both conventional and digital; and (3) cone-beam computed tomography (CBCT). Materials and Methods: Forty healthy human molars with class I cavities were selected and divided into 4 groups according to the restoration that was applied: composite resin, composite resin with liner material to simulate misfit, dental amalgam, and dental amalgam with liner material to simulate misfit. Radiography and tomography were performed using the various imaging methods, and the resulting images were analyzed by 2 calibrated radiologists. The true presence or absence of misfit corresponding to an area of radiolucency in regions subjacent to the esthetic and metal restorations was validated with microscopy. The data were analyzed using a receiver operating characteristic (ROC) curve, and the scores were compared using the Cohen kappa coefficient. Results: For bitewing images, the digital systems (CCD and PSP) showed a higher area under the ROC curve (AUROC) for the evaluation of resin restorations, while the conventional images exhibited a larger AUROC for the evaluation of amalgam restorations. Conventional and digital panoramic radiographs did not yield good results for the evaluation of resin and amalgam restorations (P<.05). CBCT images exhibited good results for resin restorations(P>.05), but showed no discriminatory ability for amalgam restorations(P<.05). Conclusion: Bitewing radiographs (conventional or digital) should be the method of choice when assessing dental restoration misfit.