Accuracy of anatomical landmark identification using different CBCT- and MSCT-based 3D images

ObjectiveThe aim of this study was to evaluate the reproducibility of anatomical landmarks and the accuracy of different cone-beam CTs (CBCTs/DVTs) and a multislice spiral CT (MSCT) scanner.MethodsA human, fresh-frozen cadaver head was scanned with four CBCTs (Accuitomo 3D, 3D eXam, Pax Reve 3D, Pax Zenith 3D) and one MSCT (SOMATOM Sensation 64) scanner. The three-dimensional (3D) reconstruction of the volume data sets and location of the anthropometric landmarks (n=11), together with linear (n=5) and angular (n=1) measurements were carried out by three examiners using the program VoXim® 6.1. The measurements were taken twice at a 14-day interval. Descriptive analyses were made and the standard deviations were used to compare differences in the accuracy of landmark identification.ResultsThe descriptive statistics showed distinct differences in the reference points in the three axes of the coordinate system. Because of anatomical and morphological factors, the pogonion and gnathion reference points displayed higher standard deviations when set on the transverse plane (SDCBCT Pog: 0.66–1.57 mm; SDMSCT Pog: 0.14–1.09 mm; SDCBCT Gn: 1.05–1.77 mm; SDMSCT Gn: 0.20–0.85 mm), thus showing less accuracy. However, standard deviations on the sagittal and vertical planes were smaller. Genion, anterior nasal spine and infradentale had very low standard deviations on all three planes. The distance (Mfl-Mfr) and angle (Krl-Krr-Ge) revealed significantly smaller standard deviations in the MSCT (SDCBCT Krl-Krr-Ge: 0.51–0.75 mm; SDMSCT Krl-Krr-Ge: 0.22 mm).ConclusionThe CBCT devices evaluated in this study are suitable for taking exact 3D measurements of anatomical structures and meet all requirements for 3D cephalometric analysis.ZusammenfassungHintergrundZiel dieser Studie war der Vergleich der Reproduzierbarkeit anatomischer Messpunkte und somit auch der Genauigkeit verschiedener dentaler Volumentomographen (DVT) und eines Mehrschicht-Spiral-Computertomographen (MSCT).Material und MethodikVon einem gefrorenem Leichenkopf wurden mit vier DVT-Geräten (Accuitomo 3D, 3D eXam, Pax Reve 3D, Pax Zenith 3D) und einem MSCT (SOMATOM Sensation 64) Volumenaufnahmen erstellt. Die dreidimensionale Rekonstruktion dieser Volumendatensätze und das Setzen der anthropometrischen Messpunkte (n=11) sowie lineare (n=5) und Winkelmessungen (n=1) wurden im Programm VoXim® 6.1 von drei Untersuchern zweimal im Abstand von 14 Tagen durchgeführt. Mittels deskriptiver Analyse wurde die Standardabweichung für die gesetzten Messpunkte ermittelt und diese innerhalb der unterschiedlichen Datensätze verglichen.ErgebnisseDie deskriptive Statistik zeigte deutliche Unterschiede für die einzelnen Punkte in den drei Achsen des Koordinatensystems. Aufgrund anatomisch-morphologischer Kriterien wiesen die Punkte Pogonion und Gnathion eine höhere Standardabweichung (SDDVT Pog: 0,66–1,57 mm; SDMSCT Pog: 0,14–1,09 mm; SDDVT Gn: 1,05–1,77 mm; SDMSCT Gn: 0,20–0,85 mm) und eine dementsprechend niedrigere Präzision in der Transversalen, aber eine niedrigere Standardabweichung in der Sagittalen und in der Vertikalen auf. Genion, Spina nasalis anterior und Infradentale zeigten eine sehr geringe Standardabweichung in allen drei Ebenen. Für die Strecke (Mfl – Mfr) und den Winkel (Krl – Krr – Ge) stellte sich die Standardabweichung für das MSCT signifikant geringer dar als für die untersuchten DVTs (SDDVT Krl – Krr – Ge: 0,51–0,75 mm; SDMSCT Krl – Krr – Ge: 0,22 mm).SchlussfolgerungDie untersuchten DVT-Geräte eignen sich für die exakte dreidimensionale Vermessung anatomischer Strukturen und erfüllen alle Voraussetzungen für die 3D Kephalometrie.

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