CBCT Basics Part II Flashcards
What filter is on this image?
bone window filter
What is better than saying “Cone Beam Imaging is 3D”
Cone beam imaging is multiplanar imaging
Can a basis image be read?
No- not until reconstructed into a volumetric data set
If you want other people (offices etc.) to be able to read the images from a CBCT scan, they need to be in the form of:
Volumetric data set
The ____ is the primary reconstruction when volumetric data is first accessed by a viewing software program
multiplanar reconstruction
The number and types of of reconstructions (images) are dependent on the power of the ____ as specified by the ___
program; software manufacturers
The ____ data (___ data) forms the volumetric data set
original scan data (projection data)
What forms the volumetric data set?
original scan data (projection data)
Scanner software can either store the volumetric data in either the:
- proprietary form (unique to vendor)
- universal format (DICOM)
DICOM:
Digital imaging and communications in medicine
If the volumetric is in the proprietary format, it is:
unique to vendor (only readable if you have that exact software)
Allows for volumetric data to be universally read by different practices with different CBCT programs:
DICOM
The proprietary format that is unique to the vendor may also be called:
InVivo format
What type of format is the Eggviewer format?
Universal (DICOM) format
Standard information transfer method (file format) for transferring images and associated information between devices manufactured by various vendors:
DICOM
T/F: Any proprietary volumetric data set can be converted to DICOM
True
HIPPA:
Health Insurance Portability and Accountability Act
T/F: Due to DICOM and sharing information between offices, you don’t need to get patient consent to share CBCT with another dental specialist
False- Due to HIPPA you must get patient consent to share any info
.dcm signifies:
That the file is converted into DICOM format
Multiple ____ software available for imaging DICOM compatible CBCT volumetric data
third-party software
Multiple third-party software available for imaging DICOM compatible CBCT volumetric data, these include:
- Anatomage InVivo 3D
- CareStream 3D
- Cybermed 3D
- Dophin 3D
- (Infinitt) Xelis Dental, Xelis 3D
- Keystone EasyGuide 3D
- NobelClinician
- OnDemand 3D
- OsiriX DICOM Viewer
Which third party software available for imaging DICOM CBCT volumetric data is free to download?
OsiriX DICOM Viewer
Multiple third-party software available for imaging DICOM compatible CBCT volumetric data list the ones we use at UMKC and star the ones used most often here:
- Anatomage InVivo 3D *
- CareStream 3D
- Dophin 3D (ortho)
- NobelClinician
- OsiriX DICOM Viewer
Oldest third-party software that is available for imaging DICOM Compatible CBCT volumetric data and lacks many of the newer feature but has the ability to give you multiplanar reconstructions:
OsiriX DICOM Viewer
Most widely used DICOM viewer because of global recognition and longevity:
OsiriX DICOM Viewer
One for he first to fully support the DICOM standard for easy integration (3rd party software)
OsiriX DICOM Viewer
- Materialise SurgiCase CMF
- Simplant (Materialise)
- Sirona- SICAT
- Morita- I-Dixel
These are all examples of:
Non-DICOM compatible 3D software
T/F: Only DICOM Projection data files are transferred to and stored in the UMKC-SoD MiPACS server
True
At UMKC, where are proprietary (native) files stored?
Stored in the capture CPU or its serve
At UMKC, what type of files are stored in the MiPACS server?
Only DICOM projection data files
Why are multiple forms of data sets a problem?
It inhibits the access to health care by:
1) limiting the access to the patients info
2) increasing cost of treatment
3) delaying time of treatment
T/F: Image transfer is as simple as transferring one or a series of intraoral images
False- one transfers an entire data set so the users may access the image files to construct the selected images needed (the images needed will vary between different practitioner)
_____ dwarfs the ranges of intraoral, panoramic, and skull images
CBCT image reconstruction capacity
T/F: 2D image reconstructions are not typically stored and transferred
True
Entire volumetric data sets are transferred so that practitioners:
- are not limited to a limited number of reconstructions
- can determine their own preferred range of images needed for their diagnostic and treatment needs
What are the two inherent artifacts that we see most often with CBCTs?
- beam hardening
- streaking
Beam hardening and streaking are due to:
software
What occurs with beam hardening?
dark areas adjacent to metal
This occurs when software does a reconstruction and it notices an area with no signal (due to metal) so the program compensates by increasing the signal next to the metal (an overcorrection); it is a reconstruction artifact:
Beam hardening
What inherent artifact is indicated by the red arrows?
Beam hardening
A sunburst like pattern reconstruction artifact seen when there is metal:
Streaking
What inherent artifact is indicated by the green arrows?
Streaking
What needs to be present in order to have either streaking or beam hardening or both?
metal
Beam hardeningg creates ___ that is really not there
pathology
A reconstruction artifact in CT due to the total absorption of low energy photons by metal objects:
Beam hardening
When metal is detected in a CT, beam hardening may occurs because _____ in the heterogenous x-ray bean will create a single in tissues adjacent to the metal structure in the back projection algorithm and these areas will be “_____” thus creating ____
high energy photons; “burned out”; dark areas
What is the effects of beam hardening in the cross-sectional and parasagittal reconstructions?
simulates peri-implantitis and alveolar bone defects
In addition to metal, beam hardening may occur with:
GP (root canal filling materials) (Leaves a void that’s not really there)
Creates the outline of a “ghost implant” as well as other radiopaque outlines in the cross-sectional reconstruction
streak artifact
Beam hardening =
Streaking =
radiolucent
radiopaque
The streak artifact makes it more difficult to:
discern the validity of the cortisol bone outlines
Streak artifact:
x-rays are heavily attenuated after passing through metal objects which results in:
very weak signals reaching the detector
Streak artifact:
Metal shadows in the raw projection data will then introduce street artifact in the back projection algorithm reconstructions which introduces the metal streak artifact in:
low density structures (soft tissues)
What can be seen in the following image?
streak artifact
What error can be seen in the following image>
streak artifact
CBCT Streak artifact is minimized with:
distance from metals
Why does slice two show much more extreme streaking compared to slice one?
Slice 1 is further away from the metal
CBCT Image reconstruction applications:
- MPR
- Panoramic
- Volume rendering (3D)
- TMJ
- Implant planning
List the CBCT Image capture and data management (3)
- Basis Image(s)
- Projection data- total set of basis images
- Volumetric data set- image files managed by image software
MPR:
Multi-planar reconstruction
In the following multi-planar reconstruction (MPR) the red line is the level of:
axial reconstruction
Imaging software packages can reconstruct ____ images from the CBCT storage data
panoramic
T/F: CBCT scan is indicated solely for panoramic imaging in certain situations
False- CBCT scan is NOT indicated SOLELY for panoramic imaging
The following image is from:
2D panoramic reconstruction from CBCT
What can be seen in the following image?
Volume rendering- 3D implant planning reconstruction
What can be seen in the following image?
Volume rendering
A type of data visualization technique which creates a 3D representation of data:
Volume rendering
The following images are examples of:
Volume rendering
What tool is being utilized in the following image? What type of reconstruction is seen?
Airway measurement tooth; sagittal reconstruction
What components are measured with the airway measurement tool from InVivoDental 5.2 imaging software?
Total volume & minimum area
T/F: Program wizard computes the volume of the airway space. Threshold values for compromised airway volumes have been determined.
First statement true; Second statement false
What can be seen in the following image?
Volume rendering
What is indicated in the boxed areas in the below image?
Bilateral TMJ
Implant planning may utilize CBCT for a:
2D reconstruction (virtual implant placement) and tracings of nerves