CBCT Om Seminar
CBCT Om Seminar
CBCT Om Seminar
Cone-Beam
Computed
Tomography
Krystell Lau 181323047 Law Phui Wai 181323048 Visvam Rathinam 181323049
Learning Objectives
1. Describe the principles of CBCT. (C2)
2. Explain image formation in CBCT. (C2)
3. List the uses of CBCT in dentistry. (C1)
4. Search the recent concepts. (LL1)
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Principles of CBCT
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● Imaging performed using a
rotating platform/gantry
○ X-ray source (divergent
cone-shaped/pyramidal)
○ Detector
● X-ray directed through region
of interest (ROI)
● Attenuated beam projected
onto detector
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● Moves 180 to 360°- multiple sequential planar projection
images
● Individual images = basis, frame or raw images
○ constitute the raw primary data
● Projection data = the complete series of images
● Software programs generate a volumetric data set
○ provide primary reconstruction images (axial, sagittal
& coronal planes)
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Image Formation in CBCT
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Components of cbct image production
● X-ray generation
● X-ray detection
● Image reconstruction
Image Reconstruction
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1. X-ray Generation
Parameters in X-ray Generation
Patient X-ray
Stabilization Generator
Scan Scan
Factors Volume
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A) Patient Stabilization
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A) Patient Stabilization
A. Supine Unit B. Standing Unit C. Sitting Unit
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A) Patient Stabilization
● Immobilization of the patient’s head is more important than patient
positioning .
● This can be achieved by using some combination of
➔ Chin cup
➔ Bite fork
➔ Other head-restraint mechanism
X-ray Generator
Continuous Pulsed
- Preferable.
- Actual exposure time is up to
50% less than scanning time .
- Reduces patient radiation
dose considerably.
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B) X-ray Generator
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C) Scan Volume/ Field of View (FOV)
● Dimensions of the FOV or scan volume primarily depend on
- Detector size and shape
- Beam projection geometry
- Ability to collimate the beam
Spherical
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C) Scan Volume/ Field of View (FOV)
● Reduction of FOV
- Reduces unnecessary exposure to the patient.
- Produces the best images by minimizing scattered radiation, which
degrades image quality.
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C) Scan Volume/ Field of View (FOV)
Methods enabling scanning of ROI greater than the
FOV of the detector
Method 1
- Obtaining data from two or more separate scans
Method 2
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D) Scan Factors
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2. Image Detectors
Image Detector
● CBCT units provide voxel resolutions that are isotropic (equal in all 3
dimension).
● The principal determinant of nominal voxel size in the CBCT image are the
matrix and pixel size of the detector.
● Detectors with smaller pixels capture fewer x- ray photons per voxel and
result in more image noise.
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➢ Spatial Resolution
● The spatial resolution (detail of a CBCT image) is determined by the
dimensions of individual voxels.
● Both the focal spot size and the geometric configuration of the x-ray source
are important to determine the degree of geometric unsharpness, a limiting
factor in spatial resolution.
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➢ Spatial Resolution
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➢ Gray Scale
● This parameter is called the bit depth of the system and determines the
number of shades of gray available to display attenuation.
● All current CBCT units have 12-bit detectors that provides 4096 shades of
gray.
● A 16-bit detector can provide 65,536 shades of grey but with increased file
sizes and image processing time.
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3. Image Reconstruction
Image Reconstruction
Preprocessing Reconstruction
Stage Stage
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Preprocessing Stage
● Multiple planar projection images are must be corrected for inherent pixel
imperfections, variations in sensitivity across the detector and uneven
exposure.
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Reconstruction Stage
● Corrected images are converted into sinogram, composite image developed from multiple
projection images (Radon transformation).
● Final image is reconstructed from the sinogram with a filtered back- projection algorithm
(Feldkamp algorithm) for volumetric data acquired by CBCT imaging.
(Inverse Radon transformation)
● When all slices have been reconstructed, they are combined into a single volume for visualization.
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➢ Reconstruction Time
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Radiation Dose in CBCT
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Depends on:
● The exposure factors (kV, mA and
time of exposure)
● The volume size – field of view
● The type of equipment used
● The part of the jaw/maxillofacial
skeleton being imaged.
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Artefacts in CBCT
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A) INHERENT ARTEFACTS
● Scatter
Cone-beam related
● Partial volume effect artefacts
● Cone-beam effect
IMAGE
ARTEFACTS B) PROCEDURE-RELATED ARTEFACTS
● Aliasing artefact
● Circular or ring artefact
● Double contour artefact
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C) INTRODUCED ARTEFACTS
-Beam hardening phenomenon:
● Cupping artefact
● Extinction / Missing value artefacts
IMAGE
ARTEFACTS D) PATIENT MOTION ARTEFACTS
● Double contour artefact
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A) Inherent Artefacts
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A) INHERENT ARTEFACTS - Partial volume effect continued…
● In the top row, the 3 × 5 pixels in size object “projected” just on the reconstructed pixels, so the real gray
scale values of the object are displayed on the reconstructed image. On the bottom row, the object is also
3 × 5 pixels in size but is not “projected” on the reconstructed pixels, so not the actual grayscale values are
displayed on the reconstructed image.
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A) INHERENT ARTEFACTS
● Cone-Beam artefact
● Peripheral “V” artefact of increased noise and reduced contrast
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B) PROCEDURE-RELATED ARTEFACTS
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Uses in dentistry
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Orthodontics
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Recent updates
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Recent updates
Incorporation of AI system in
CBCT has significantly improved
the diagnostic capabilities of
dentists.
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TYPES OF CBCT SCANNERS
AVAILABLE IN
MALAYSIA
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CBCT Special feature Price
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Planmeca Viso G7
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Largev
Smart3D-x
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Take home messages
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● All computed tomographic (CT) scanner consist of an X-ray source and detector mounted
on a rotating gantry, including CBCT imaging.
● Practitioners and operators using CBCT must have a thorough understanding of the
operational parameters and the effects of these parameters on image quality and
radiation safety.
● There should be justification of the exposure to the patient so that the total potential
diagnostic benefits are greater than the individual detriment radiation exposure might
cause.
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Quiz!
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“
1. CBCT is an imaging technique consisting of a
rotating gantry with an X-ray source and
detector.
True or False?
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“
1. CBCT is an imaging technique consisting of a
rotating gantry with an X-ray source and
detector.
True or False
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“
2. Raw primary data in CBCT imaging consist of
frame images.
True or False?
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“
2. Raw primary data in CBCT imaging consist of
frame images.
True or False
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“
3. CBCT has a slower examination speed than CT
scan
True or False?
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“
3. CBCT has a slower examination speed than CT
scan
True or False
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“
4. Dimension of FOV depends on ……..
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“
4. Dimension of FOV depends on ……..
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“
5. Which of the following factor(s) can influence
reconstruction time ?
A. Voxel size
B. Processing speed
C. Reconstruction algorithms
D. All of the above
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“
5. Which of the following factor(s) can influence
reconstruction time ?
A. Voxel size
B. Processing speed
C. Reconstruction algorithms
D. All of the above
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“
6. Moiré patterns are seen in
introduced artefacts.
True or False?
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“
6. Moiré patterns are seen in
introduced artefacts.
True or False
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“
5.
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References
● White, S.C. & Pharoah, M.J. (2009). Oral Radiology Principles and Interpretation (8th ed.). Mosby, St. Louis:
Elsevier
● Alhummayani, F. M., & Mustafa, Z. A. (2021). A new guide using CBCT to identify the severity of maxillary
canine impaction and predict the best method of intervention. Journal of orthodontic science, 10, 3.
https://doi.org/10.4103/jos.JOS_41_20
● Ezhov, M., Gusarev, M., Golitsyna, M., Yates, J. M., Kushnerev, E., Tamimi, D., Aksoy, S., Shumilov, E., Sanders, A., &
Orhan, K. (2021). Clinically applicable artificial intelligence system for dental diagnosis with CBCT. Scientific
reports, 11(1), 15006. https://doi.org/10.1038/s41598-021-94093
● Liu, S., Wang, S., Du, Y., Zhang, W., Cui, X., Xing, J., & Zang, Y. (2021). The clinical study of CBCT imaging
technology in the restoration of upper anterior teeth of the elderly. American journal of translational
research, 13(6), 7022–7028.
● Walsh, T., Macey, R., Riley, P., Glenny, A. M., Schwendicke, F., Worthington, H. V., Clarkson, J. E., Ricketts, D., Su, T. L.,
& Sengupta, A. (2021). Imaging modalities to inform the detection and diagnosis of early caries. The
Cochrane database of systematic reviews, 3(3), CD014545. https://doi.org/10.1002/14651858.CD014545
● Tamás Szabó, B., Dobai, A., & Dobo-Nagy, C. (2020). Cone-Beam Computed Tomography in Dentomaxillofacial
Radiology. Novel Imaging and Spectroscopy. https://doi.org/10.5772/intechopen.90932
● Guides/2014-planmeca-pricing_retail_0911814_low.pdf
● https://frontiermedicalstore.com/products/Planmeca-Viso-G7.html
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