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Informationen aus Orthodontie & Kieferorthopädie 2020; 52(01): 17-28
DOI: 10.1055/a-0966-5829
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Pilotstudie: Vergleich der Artefakte von Brackets mittels Dual-Energy-CT

Pilot Study: Comparison of Artifacts of Brackets Using Dual-Energy CT
Manuel Kasslatter
1   Universitätsklinik für Kieferorthopädie, Medizinische Universität Innsbruck, Innsbruck, Österreich
,
Bernhard Glodny
2   Universitätsklinik für Radiologie und Neuroradiologie, Medizinische Universität Innsbruck, Innsbruck, Österreich
,
Astrid Grams
2   Universitätsklinik für Radiologie und Neuroradiologie, Medizinische Universität Innsbruck, Innsbruck, Österreich
,
Adriano Crismani
1   Universitätsklinik für Kieferorthopädie, Medizinische Universität Innsbruck, Innsbruck, Österreich
,
Lisa Schieffer
1   Universitätsklinik für Kieferorthopädie, Medizinische Universität Innsbruck, Innsbruck, Österreich
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Publikationsverlauf

Publikationsdatum:
25. März 2020 (online)

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Zusammenfassung

Untersuchungen zur Anwendung der monochromen (MC) Bildgebung nach Implantation metallischer Materialien an den Extremitäten oder der Wirbelsäule haben gezeigt, dass dadurch verursachte Artefakte deutlich reduziert werden können. Aufgrund der hohen Ordnungszahlen und der hohen Dichte der in der Kieferorthopädie, Kieferchirurgie und Zahnerhaltung verwendeten Materialien stellen Aufhärtungsartefakte ein großes Problem bei der Computertomografie-Bildgebung (CT) der Zähne und des Kiefers dar. Die verursachten Einschränkungen der Bildqualität bei der Darstellung der Kiefer und denkbare Verbesserungsmöglichkeiten sind bisher unzureichend untersucht. Das Ziel dieser Arbeit war, die oben genannten Artefakte zu untersuchen und diese durch Erzeugung von Monochromen im Zahn- und Kieferbereich zu reduzieren. Dual-Energy-Computertomografien (DECTs) wurden an 10 Leichenköpfen mit und ohne kieferorthopädische Apparatur durchgeführt. Anschließend wurden MC von 80 bis 160 kV generiert. Die Artefakte wurden mit etablierten Methoden qualitativ und quantitativ beurteilt. An anatomischen Strukturen wie dem Mundboden und dem weichen Gaumen, die sich nicht in der gleichen axialen Ebene mit stark artefaktproduzierenden Objekten mit hoher Ordnungszahl befinden, konnte mit zunehmender kV-Zahl der MC eine Zunahme der Hounsfieldeinheiten (HE) beobachtet werden. An Strukturen in der gleichen Ebene mit artefaktproduzierenden Objekten konnte mit zunehmender kV-Zahl der MC eine Abnahme der HE beobachtet werden. Diese Studie zeigt, dass es auch im Kieferbereich möglich ist mittels MC Artefaktreduktion zu betreiben. In allen Untersuchungen konnten keine signifikant erhöhten Artefakte im Setting mit KFO-Apparatur im Vergleich zum Setting ohne KFO-Apparatur festgestellt werden.

Abstract

Studies on the use of monochrome (MC) imaging after implantation of metallic materials on the extremities or spine have shown that artifacts can be significantly reduced. Due to the high atomic numbers and high density of materials used in orthodontics, maxillofacial surgery and tooth preservation, hardening artifacts present a major problem in computed tomography (CT) imaging of the teeth, and jaw. The limitations of the image quality caused by the visualization of the jaw, and conceivable possibilities for improvement have not been adequately investigated. The aim of this work was to investigate the above artifacts and reduce them by creating monochromes in the jaw area. Dual energy CTs (DECTs) were performed on 10 corpse heads with and without orthodontic appliances. Subsequently, MCs of 80 to 160 kV were produced. The artifacts were assessed qualitatively and quantitatively using established methods. On anatomical structures such as the floor of the mouth and the soft palate, which are not in the same axial plane with high artefact producing objects of high atomic number, an increase of the Hunsfield units (HU) could be observed with increasing kV number of MC. On structures in the same plane with artifact-producing objects, a decrease of the HU could be observed with increasing kV number of MC. This study shows that it is also possible to reduce artifacts in the jaw area using MC. In all investigations no significantly increased artifacts were found in the setting with orthodontic appliances compared to the setting without orthodontic appliances.

Schlüsselwörter

Brackets - Dual-Energy-CT - Artefaktreduktion - monochromatische Rekonstruktionen

Key words

brackets - dual-energy CT - artifact reduction - monochromatic reconstruction
 

  • Literatur

  • 1 Kalender WA. Computertomografie. 2. Auflage. Erlangen: Publicis; 2006
    Suche in Google Scholar
  • 2 Pessis E, Campagna R, Sverzut JM. et al. Virtual monochromatic spectral imaging with fast kilovoltage switching: reduction of metal artifacts at CT. Radiographics 2013; 33: 573-583
    CrossrefPubMedSuche in Google Scholar
  • 3 Chiro GD, Brooks RA, Kessler RM. et al. Tissue signatures with dual-energy computed tomography. Radiology 1979; 131: 521-523
    CrossrefPubMedSuche in Google Scholar
  • 4 Millner MR, McDavid WD, Waggener RG. Extraction of information from CT scans at different energies. Med Phys 1979; 6: 70-71
    CrossrefPubMedSuche in Google Scholar
  • 5 Genant HK, Boyd D. Quantitative bone mineral analysis using dual energy computed tomography. Invest Radiol 1977; 12: 545-551
    CrossrefPubMedSuche in Google Scholar
  • 6 Robinson E, Babb J, Chandarana H. et al. Dual source dual energy MDCT: comparison of 80 kVp and weighted average 120 kVp data for conspicuity of hypo-vascular liver metastases. Invest Radiol 2010; 45: 413-418
    CrossrefPubMedSuche in Google Scholar
  • 7 Thomas C, Krauss B, Ketelsen D. et al. Differentiation of urinary calculi with dual energy CT: effect of spectral shaping by high energy tin filtration. Invest Radiol 2010; 45: 393-398
    CrossrefPubMedSuche in Google Scholar
  • 8 Johnson TR. Dual-energy CT: general principles. AJR Am J Roentgenol 2012; 199: 3-8
    CrossrefPubMedSuche in Google Scholar
  • 9 Zhang LJ, Peng J, Wu SY. et al. Dual source dual-energy computed tomography of acute myocardial infarction: correlation with histopathologic findings in a canine model. Invest Radiol 2010; 45: 290-297
    CrossrefPubMedSuche in Google Scholar
  • 10 Chae EJ, Seo JB, Lee J. et al. Xenon ventilation imaging using dual-energy computed tomography in asthmatics: initial experience. Invest Radiol 2010; 45: 354-361
    CrossrefPubMedSuche in Google Scholar
  • 11 Krasnicki T, Podgorski P, Guzinski M. et al. Novel clinical applications of dual energy computed tomography. Adv Clin Exp Med 2012; 21: 831-841
    PubMedSuche in Google Scholar
  • 12 Karcaaltincaba M, Aktas A. Dual-energy CT revisited with multidetector CT: review of principles and clinical applications. Diagn Interv Radiol 2011; 17: 181-194
    PubMedSuche in Google Scholar
  • 13 De Cecco CN, Darnell A, Rengo M. et al. Dual-energy CT: oncologic applications. AJR Am J Roentgenol 2012; 199: 98-105
    CrossrefPubMedSuche in Google Scholar
  • 14 Nicolaou S, Liang T, Murphy DT. et al. Dual-energy CT: a promising new technique for assessment of the musculoskeletal system. AJR Am J Roentgenol 2012; 199: 78-86
    CrossrefPubMedSuche in Google Scholar
  • 15 Phan CM, Yoo AJ, Hirsch JA. et al. Differentiation of hemorrhage from iodinated contrast in different intracranial compartments using dual-energy head CT. AJNR Am J Neuroradiol 2012; 33: 1088-1094
    CrossrefPubMedSuche in Google Scholar
  • 16 Kim SJ, Lim HK, Lee HY. et al. Dual-energy CT in the evaluation of intracerebral hemorrhage of unknown origin: differentiation between tumor bleeding and pure hemorrhage. AJNR Am J Neuroradiol 2012; 33: 865-872
    CrossrefPubMedSuche in Google Scholar
  • 17 Brockmann C, Scharf J, Nolte IS. et al. Dual-energy CT after peri-interventional subarachnoid haemorrhage: a feasibility study. Clin Neuroradiol 2010; 20: 231-235
    CrossrefPubMedSuche in Google Scholar
  • 18 Gupta R, Phan CM, Leidecker C. et al. Evaluation of dual-energy CT for differentiating intracerebral hemorrhage from iodinated contrast material staining. Radiology 2010; 257: 205-211
    CrossrefPubMedSuche in Google Scholar
  • 19 Postma AA, Hofman PA, Stadler AA. et al. Dual-energy CT of the brain and intracranial vessels. AJR Am J Roentgenol 2012; 199: 26-33
    CrossrefPubMedSuche in Google Scholar
  • 20 McCollough CH, Leng S, Yu L. et al. Dual- and Multi-Energy CT: Principles, Technical Approaches, and Clinical Applications. Radiology 2015; 276: 637-653 Figure 16: Axial CT images. By using custom software that takes advantage of the increased in-spectral separation provided by a tin filter on the high-energy beam of a dual-source CT system, uric acid stones (red) can be distinguished from three groups of non–uric acid stones: cystine (yellow), calcium oxalate/brushite/struvite (green), and apatite (blue). (a) Uric acid stone in a 71-year-old man. (b) Cystine stone in a 63-year-old man. (c) Calcium oxalate stone in a 21-year-old woman. (d) Apatite stone in a 34-year-old woman.S. 648
    CrossrefPubMedSuche in Google Scholar
  • 21 Yu L, Christner JA, Leng S. et al. Virtual monochromatic imaging in dual-source dual-energy CT: radiation dose and image quality. Med Phys 2011; 38: 6371-6379
    CrossrefPubMedSuche in Google Scholar
  • 22 Sudarski S, Apfaltrer P, Nance JW. et al. Optimization of keV-settings in abdominal and lower extremity dual-source dual-energy CT angiography determined with virtual monoenergetic imaging. Eur J Radiol 2013; 82: 574-581
    CrossrefPubMedSuche in Google Scholar
  • 23 Lin CH, Chen YY, Chiu LA. et al. Dual energy computed tomography angiography for the rapid diagnosis of reversible cerebral vasoconstriction syndromes: report of a case. Acta Neurol Taiwan 2013; 22: 36-42
    PubMedSuche in Google Scholar
  • 24 Morhard D, Fink C, Graser A. et al. Cervical and cranial computed tomographic angiography with automated bone removal: dual energy computed tomography versus standard computed tomography. Invest Radiol 2009; 44: 293-297
    CrossrefPubMedSuche in Google Scholar
  • 25 Schneider D, Apfaltrer P, Sudarski S. et al. Optimization of Kiloelectron Volt Settings in Cerebral and Cervical Dual-energy CT Angiography Determined with Virtual Monoenergetic Imaging. Acad Radiol 2014; 21: 431-436
    CrossrefPubMedSuche in Google Scholar
  • 26 Vock P, Szucs-Farkas Z. Dual energy subtraction: principles and clinical applications. Eur J Radiol 2009; 72: 231-237
    CrossrefPubMedSuche in Google Scholar
  • 27 Grams AE, Sender J, Moritz R. et al. Dual Energy CT Myelography after Lumbar Osteosynthesis. Rofo 2014; 186: 670-674
    Thieme ConnectPubMedSuche in Google Scholar
  • 28 McCollough CH, Leng S, Yu L. et al. Dual- and Multi-Energy CT: Principles, Technical Approaches, and Clinical Applications. Radiology 2015; 276: 637-653. Figure 10: Coronal CT angiogram in a 62-year-old woman. With dual-energy techniques, bone anatomy can be auto-matically separated from the vascular anatomy and highly enhancing kidneys. S 645
    CrossrefPubMedSuche in Google Scholar
  • 29 Khan AN, Khosa F, Shuaib W. et al. Effect of Tube Voltage (100 vs. 120 kVp) on Radiation Dose and Image Quality using Prospective Gating 320 Row Multi-detector Computed Tomography Angiography. J Clin Imaging Sci 2013; 3: 62 . doi: 10.4103/2156-7514.124092 [eCollection 2013]
    CrossrefPubMedSuche in Google Scholar
  • 30 Lewis M, Reid K, Toms AP. Reducing the effects of metal artefact using high keV monoenergetic reconstruction of dual energy CT (DECT) in hip replacements. Skeletal Radiol 2013; 42: 275-282
    CrossrefPubMedSuche in Google Scholar
  • 31 Meinel FG, Bischoff B, Zhang Q. et al. Metal artifact reduction by dual-energy computed tomography using energetic extrapolation: a systematically optimized protocol. Invest Radiol 2012; 47: 406-414
    CrossrefPubMedSuche in Google Scholar
  • 32 Zhou C, Zhao YE, Luo S. et al. Monoenergetic imaging of dual-energy CT reduces artifacts from implanted metal orthopedic devices in patients with factures. Acad Radiol 2011; 18: 1252-1257
    CrossrefPubMedSuche in Google Scholar
  • 33 Wang Y, Qian B, Li B. et al. Metal artifacts reduction using monochromatic images from spectral CT: evaluation of pedicle screws in patients with scoliosis. Eur J Radiol 2013; 82: 360-366
    CrossrefPubMedSuche in Google Scholar
  • 34 Guggenberger R, Winklhofer S, Osterhoff G. et al. Metallic artefact reduction with monoenergetic dual-energy CT: systematic ex vivo evaluation of posterior spinal fusion implants from various vendors and different spine levels. Eur Radiol 2012; 22: 2357-2364
    CrossrefPubMedSuche in Google Scholar
  • 35 Bamberg F, Dierks A, Nikolaou K. et al. Metal artifact reduction by dual energy computed tomography using monoenergetic extrapolation. Eur Radiol 2011; 21: 1424-1429
    CrossrefPubMedSuche in Google Scholar
  • 36 Park HH, Shin JY, Lee J. et al. A study on the artifacts generated by dental materials in PET/CT image. Conf Proc IEEE Eng Med Biol Soc 2013; 2013: 2465-2468
    PubMedSuche in Google Scholar
  • 37 Grams AE, Gempt J, Forschler A. Comparison of spinal anatomy between 3-Tesla MRI and CT-myelography under healthy and pathological conditions. Surg Radiol Anat 2010; 32: 581-585
    CrossrefPubMedSuche in Google Scholar
  • 38 Glodny B, Helmel B, Trieb T. et al. A method for calcium quantification by means of CT coronary angiography using 64-multidetector CT: very high correlation with Agatston and volume scores. Eur Radiol 2009; 19: 1661-1668
    CrossrefPubMedSuche in Google Scholar
  • 39 Glodny B, Nasseri P, Plaikner M. et al. Prediction of the presence of renal artery stenosis by calcium scoring of the abdominal aorta. Eur J Radiol 2012; 81: 1393-1399
    CrossrefPubMedSuche in Google Scholar
  • 40 Glodny B, Rapf K, Unterholzner V. et al. Accessory or additional renal arteries show no relevant effects on the width of the upper urinary tract: a 64-slice multidetector CT study in 1072 patients with 2132 kidneys. Br J Radiol 2011; 84: 145-152
    CrossrefPubMedSuche in Google Scholar
  • 41 Glodny B, Nasseri P, Crismani A. et al. The occurrence of dental caries is associated with atherosclerosis. Clinics (Sao Paulo) 2013; 68: 946-953
    CrossrefPubMedSuche in Google Scholar
  • 42 McHanwell S, Brenner E, Chirculescu AR. et al. The legal and ethical framework governing Body Donation in Europe – A review of current practice and recommendations for good practice. Eur. J Anat 2008; 12: 1-24
    PubMedSuche in Google Scholar
  • 43 Platzer W, Putz R, Poisel S. Ein neues Konservierungs- und Aufbewahrungssystem für anatomisches Material. Acta Anat 1978; 102: 60-67
    CrossrefPubMedSuche in Google Scholar
  • 44 Riederer BM, Bolt S, Brenner E. et al. The legal and ethical framework governing Body Donation in Europe – 1st update on current practice. Eur. J Anat 2012; 16: 1-21
    PubMedSuche in Google Scholar
  • 45 Oloomi S, Noori Eskandari H, Zakavi SR. et al. A New Approach for Scatter Removal and Attenuation Compensation from SPECT/CT Images. Iran J Basic Med Sci 2013; 16: 1181-1189
    PubMedSuche in Google Scholar
  • 46 Stolzmann P, Winklhofer S, Schwendener N. et al. Monoenergetic computed tomography reconstructions reduce beam hardening artifacts from dental restorations. Forensic Sci Med Pathol 2013; 9: 327-332
    CrossrefPubMedSuche in Google Scholar
  • 47 Tanaka R, Hayashi T, Ike M. et al. Reduction of dark-band-like metal artifacts caused by dental implant bodies using hypothetical monoenergetic imaging after dual-energy computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115: 833-838
    CrossrefPubMedSuche in Google Scholar
  • 48 Hegazy MA, Eldib ME, Hernandez D. et al. Dual-energy-based metal segmentation for metal artifact reduction in dental computed tomography. Med Phys 2018; 45: 714-724
    CrossrefPubMedSuche in Google Scholar
  • 49 Große Hokamp N, Laukamp K, Lennartz S. et al. Artifact reduction from dental implants using virtual monoenergetic reconstructions from novel spectral detector CT. Eur J Radiol 2018; 104: 136-142
    CrossrefPubMedSuche in Google Scholar