Measurement Accuracy in Cone Beam Computed Tomography in the Presence of Metal Artifact

Ahmed Ismail; Flavia Lakschevitz; David MacDonald; Nancy L. Ford

doi:10.11607/jomi.9079

Measurement Accuracy in Cone Beam Computed Tomography in the Presence of Metal Artifact

Ahmed Ismail, Flavia Lakschevitz, David MacDonald, Nancy L. Ford

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Purpose: Cone beam computed tomography (CBCT) image quality is known to be affected by artifacts produced by metal restorations, causing image deterioration via bright streaks and loss of gray values in the vicinity of the metallic structure. The aim of the study was to determine the impact of progressively increasing metal artifacts on the measurement accuracy of commonly evaluated points in implant treatment planning. Materials and Methods: Holes were drilled into porcine mandibles at known distances from the alveolar crest on the buccal and lingual surfaces and ﬁlled with gutta-percha. Repeated CBCT images were taken, with progressively increasing amalgam restorations and stainless steel crowns (up to a total of eight restorations per jaw). The imaging ﬁeld of view (FOV) was of a single site (5 × 5 cm ) in two different locations in the mandible, as well as a full-arch FOV (10 × 5 cm ). Images were taken using clinical settings, and with increased kVp and exposure time, without metal artifact reduction (MAR) corrections. Measurements between the buccal and lingual gutta-percha points on the mandible were performed using a digital caliper and compared to the same measurements taken digitally on the CBCT images. Measurements were obtained with no restorations (baseline) and compared with increasing number of restorations. Results: Comparison between caliper measurements and baseline CBCT with no metal artifact demonstrated differences ranging from 0 to 1.7 mm, with no clear detectable pattern of change related to the restorations. Compared to baseline measurements, scans with amalgam and stainless steel restorations showed a maximum difference of 0.54 ± 0.64 mm and 0.62 ± 0.64 mm, respectively, with no signiﬁcant differences with increasing metal restorations. Conclusion: There may be a variation of up to 1.7 mm between measured anatomical points and CBCT imaging under commonly used settings. While this result may be clinically important, it does not appear to be affected by increasing metal artifact due to amalgam restorations or stainless steel crowns. The ﬁndings of this study support current clinical practices accounting for a safety margin of up to 2 mm with any CBCT image, and not limiting CBCT scans for patients with multiple metal restorations

Original language	English (US)
Pages (from-to)	143-152
Number of pages	10
Journal	International Journal of Oral and Maxillofacial Implants
Volume	37
Issue number	1
DOIs	https://doi.org/10.11607/jomi.9079
State	Published - 2022
Externally published	Yes

Bibliographical note

Funding Information:
The authors acknowledge funding from the Faculty of Dentistry Graduate Student Research fund, University of British Columbia, and Dr Andrea Esteves for making the CBCT suite in the Nobel Biocare Oral Health Centre available for the authors' use. They have no conﬂicts of interest. This work was presented at the MSc thesis defense for Ahmed Is mail at the University of British Columbia, Vancouver, BC, on June 30, 2020. The abstract was also presented as a poster at the annual general meeting of the American Association of Physicists in Medi cine (2020) and at the Faculty of Dentistry Research Day 2020 at the University of British Columbia

Funding Information:
The authors acknowledge funding from the Faculty of Dentistry Graduate Student Research fund, University of British Columbia, and Dr Andrea Esteves for making the CBCT suite in the Nobel Biocare Oral Health Centre available for the authors' use. They have no conflicts of interest. This work was presented at the MSc thesis defense for Ahmed Is-mail at the University of British Columbia, Vancouver, BC, on June 30, 2020. The abstract was also presented as a poster at the annual general meeting of the American Association of Physicists in Medicine (2020) and at the Faculty of Dentistry Research Day 2020 at the University of British Columbia.

Publisher Copyright:
© 2022 by Quintessence Publishing Co Inc

Keywords

Dental cone beam computed tomography
Measurement accuracy
Metal artifact
Artifacts
Animals
Swine
Humans
Mandible/diagnostic imaging
Cone-Beam Computed Tomography

PubMed: MeSH publication types

Journal Article

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10.11607/jomi.9079

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title = "Measurement Accuracy in Cone Beam Computed Tomography in the Presence of Metal Artifact",

abstract = "Purpose: Cone beam computed tomography (CBCT) image quality is known to be affected by artifacts produced by metal restorations, causing image deterioration via bright streaks and loss of gray values in the vicinity of the metallic structure. The aim of the study was to determine the impact of progressively increasing metal artifacts on the measurement accuracy of commonly evaluated points in implant treatment planning. Materials and Methods: Holes were drilled into porcine mandibles at known distances from the alveolar crest on the buccal and lingual surfaces and ﬁlled with gutta-percha. Repeated CBCT images were taken, with progressively increasing amalgam restorations and stainless steel crowns (up to a total of eight restorations per jaw). The imaging ﬁeld of view (FOV) was of a single site (5 × 5 cm ) in two different locations in the mandible, as well as a full-arch FOV (10 × 5 cm ). Images were taken using clinical settings, and with increased kVp and exposure time, without metal artifact reduction (MAR) corrections. Measurements between the buccal and lingual gutta-percha points on the mandible were performed using a digital caliper and compared to the same measurements taken digitally on the CBCT images. Measurements were obtained with no restorations (baseline) and compared with increasing number of restorations. Results: Comparison between caliper measurements and baseline CBCT with no metal artifact demonstrated differences ranging from 0 to 1.7 mm, with no clear detectable pattern of change related to the restorations. Compared to baseline measurements, scans with amalgam and stainless steel restorations showed a maximum difference of 0.54 ± 0.64 mm and 0.62 ± 0.64 mm, respectively, with no signiﬁcant differences with increasing metal restorations. Conclusion: There may be a variation of up to 1.7 mm between measured anatomical points and CBCT imaging under commonly used settings. While this result may be clinically important, it does not appear to be affected by increasing metal artifact due to amalgam restorations or stainless steel crowns. The ﬁndings of this study support current clinical practices accounting for a safety margin of up to 2 mm with any CBCT image, and not limiting CBCT scans for patients with multiple metal restorations",

keywords = "Dental cone beam computed tomography, Measurement accuracy, Metal artifact, Artifacts, Animals, Swine, Humans, Mandible/diagnostic imaging, Cone-Beam Computed Tomography",

author = "Ahmed Ismail and Flavia Lakschevitz and David MacDonald and Ford, {Nancy L.}",

note = "Funding Information: The authors acknowledge funding from the Faculty of Dentistry Graduate Student Research fund, University of British Columbia, and Dr Andrea Esteves for making the CBCT suite in the Nobel Biocare Oral Health Centre available for the authors' use. They have no conﬂicts of interest. This work was presented at the MSc thesis defense for Ahmed Is mail at the University of British Columbia, Vancouver, BC, on June 30, 2020. The abstract was also presented as a poster at the annual general meeting of the American Association of Physicists in Medi cine (2020) and at the Faculty of Dentistry Research Day 2020 at the University of British Columbia Funding Information: The authors acknowledge funding from the Faculty of Dentistry Graduate Student Research fund, University of British Columbia, and Dr Andrea Esteves for making the CBCT suite in the Nobel Biocare Oral Health Centre available for the authors' use. They have no conflicts of interest. This work was presented at the MSc thesis defense for Ahmed Is-mail at the University of British Columbia, Vancouver, BC, on June 30, 2020. The abstract was also presented as a poster at the annual general meeting of the American Association of Physicists in Medicine (2020) and at the Faculty of Dentistry Research Day 2020 at the University of British Columbia. Publisher Copyright: {\textcopyright} 2022 by Quintessence Publishing Co Inc",

year = "2022",

doi = "10.11607/jomi.9079",

language = "English (US)",

volume = "37",

pages = "143--152",

journal = "International Journal of Oral and Maxillofacial Implants",

issn = "0882-2786",

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number = "1",

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T1 - Measurement Accuracy in Cone Beam Computed Tomography in the Presence of Metal Artifact

AU - Ismail, Ahmed

AU - Lakschevitz, Flavia

AU - MacDonald, David

AU - Ford, Nancy L.

N1 - Funding Information: The authors acknowledge funding from the Faculty of Dentistry Graduate Student Research fund, University of British Columbia, and Dr Andrea Esteves for making the CBCT suite in the Nobel Biocare Oral Health Centre available for the authors' use. They have no conﬂicts of interest. This work was presented at the MSc thesis defense for Ahmed Is mail at the University of British Columbia, Vancouver, BC, on June 30, 2020. The abstract was also presented as a poster at the annual general meeting of the American Association of Physicists in Medi cine (2020) and at the Faculty of Dentistry Research Day 2020 at the University of British Columbia Funding Information: The authors acknowledge funding from the Faculty of Dentistry Graduate Student Research fund, University of British Columbia, and Dr Andrea Esteves for making the CBCT suite in the Nobel Biocare Oral Health Centre available for the authors' use. They have no conflicts of interest. This work was presented at the MSc thesis defense for Ahmed Is-mail at the University of British Columbia, Vancouver, BC, on June 30, 2020. The abstract was also presented as a poster at the annual general meeting of the American Association of Physicists in Medicine (2020) and at the Faculty of Dentistry Research Day 2020 at the University of British Columbia. Publisher Copyright: © 2022 by Quintessence Publishing Co Inc

PY - 2022

Y1 - 2022

N2 - Purpose: Cone beam computed tomography (CBCT) image quality is known to be affected by artifacts produced by metal restorations, causing image deterioration via bright streaks and loss of gray values in the vicinity of the metallic structure. The aim of the study was to determine the impact of progressively increasing metal artifacts on the measurement accuracy of commonly evaluated points in implant treatment planning. Materials and Methods: Holes were drilled into porcine mandibles at known distances from the alveolar crest on the buccal and lingual surfaces and ﬁlled with gutta-percha. Repeated CBCT images were taken, with progressively increasing amalgam restorations and stainless steel crowns (up to a total of eight restorations per jaw). The imaging ﬁeld of view (FOV) was of a single site (5 × 5 cm ) in two different locations in the mandible, as well as a full-arch FOV (10 × 5 cm ). Images were taken using clinical settings, and with increased kVp and exposure time, without metal artifact reduction (MAR) corrections. Measurements between the buccal and lingual gutta-percha points on the mandible were performed using a digital caliper and compared to the same measurements taken digitally on the CBCT images. Measurements were obtained with no restorations (baseline) and compared with increasing number of restorations. Results: Comparison between caliper measurements and baseline CBCT with no metal artifact demonstrated differences ranging from 0 to 1.7 mm, with no clear detectable pattern of change related to the restorations. Compared to baseline measurements, scans with amalgam and stainless steel restorations showed a maximum difference of 0.54 ± 0.64 mm and 0.62 ± 0.64 mm, respectively, with no signiﬁcant differences with increasing metal restorations. Conclusion: There may be a variation of up to 1.7 mm between measured anatomical points and CBCT imaging under commonly used settings. While this result may be clinically important, it does not appear to be affected by increasing metal artifact due to amalgam restorations or stainless steel crowns. The ﬁndings of this study support current clinical practices accounting for a safety margin of up to 2 mm with any CBCT image, and not limiting CBCT scans for patients with multiple metal restorations

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KW - Animals

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Measurement Accuracy in Cone Beam Computed Tomography in the Presence of Metal Artifact

Abstract

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