Imaging Science in Dentistry

Korean Academy of Oral and Maxillofacial Radiology (대한영상치의학회)
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Correlation between gray values of cone-beam computed tomograms and Hounsfield units of computed tomograms: A systematic review and meta-analysis

  • Selvaraj, Abirami (Department of Orthodontics and Dentofacial Orthopaedics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University) ;
  • Jain, Ravindra Kumar (Department of Orthodontics and Dentofacial Orthopaedics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University) ;
  • Nagi, Ravleen (Department of Oral Medicine and Radiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University) ;
  • Balasubramaniam, Arthi (Department of Public Health Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University)
  • Received : 2021.11.11
  • Accepted : 2022.03.18
  • Published : 2022.06.30
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Abstract

Purpose: The aim of this review was to systematically analyze the available literature on the correlation between the gray values (GVs) of cone-beam computed tomography (CBCT) and the Hounsfield units (HUs) of computed tomography (CT) for assessing bone mineral density. Materials and Methods: A literature search was carried out in PubMed, Cochrane Library, Google Scholar, Scopus, and LILACS for studies published through September 2021. In vitro, in vivo, and animal studies that analyzed the correlations GVs of CBCT and HUs of CT were included in this review. The review was prepared according to the PRISMA checklist for systematic reviews, and the risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. A quantitative analysis was performed using a fixed-effects model. Results: The literature search identified a total of 5,955 studies, of which 14 studies were included for the qualitative analysis and 2 studies for the quantitative analysis. A positive correlation was observed between the GVs of CBCT and HUs of CT. Out of the 14 studies, 100% had low risks of bias for the domains of patient selection, index test, and reference standards, while 95% of studies had a low risk of bias for the domain of flow and timing. The fixed-effects meta-analysis performed for Pearson correlation coefficients between CBCT and CT showed a moderate positive correlation (r=0.669; 95% CI, 0.388 to 0.836; P<0.05). Conclusion: The available evidence showed a positive correlation between the GVs of CBCT and HUs of CT.

Keywords

Acknowledgement

AS and RKJ worked on conception, drafting, review design, and interpretation of data. The critical revision was done by RKJ and RN. The interpretation of data for the quantitative analysis was confirmed by AB.

References

  1. Nackaerts O, Maes F, Yan H, Couto Souza P, Pauwels R, Jacobs R. Analysis of intensity variability in multislice and cone beam computed tomography. Clin Oral Implants Res 2011; 8: 873-9.
  2. Dula K, Mini R, Lambrecht JT, van der Stelt PF, Schneeberger P, Clemens G, et al. Hypothetical mortality risk associated with spiral tomography of the maxilla and mandible prior to endosseous implant treatment. Eur J Oral Sci 1997; 105: 123-9. https://doi.org/10.1111/j.1600-0722.1997.tb00190.x
  3. Frederiksen NL, Benson BW, Sokolowski TW. Effective dose and risk assessment from computed tomography of the maxillofacial complex. Dentomaxillofac Radiol 1995; 24: 55-8. https://doi.org/10.1016/0250-832X(95)90642-C
  4. Shroff B. Biology of orthodontic tooth movement: current concepts and applications in orthodontic practice. Switzerland: Springer; 2016.
  5. Aranyarachkul P, Caruso J, Gantes B, Schulz E, Riggs M, Dus I, et al. Bone density assessments of dental implant sites: 2. Quantitative cone-beam computerized tomography. Int J Oral Maxillofac Implants 2005; 20: 416-24.
  6. Marquezan M, Lau TC, Mattos CT, Cunha AC, Nojima LI, Sant'Anna EF, et al. Bone mineral density. Angle Orthod 2012; 82: 62-6. https://doi.org/10.2319/031811-192.1
  7. Silva IM, Freitas DQ, Ambrosano GM, Boscolo FN, Almeida SM. Bone density: comparative evaluation of Hounsfield units in multislice and cone-beam computed tomography. Braz Oral Res 2012; 26: 550-6. https://doi.org/10.1590/S1806-83242012000600011
  8. Miles DA, Danforth RA. A clinician's guide to understanding cone beam volumetric imaging (CBVI). Santa Monica, CA: Academy of Dental Therapeutics and Stomatology; 2008.
  9. Hua Y, Nackaerts O, Duyck J, Maes F, Jacobs R. Bone quality assessment based on cone beam computed tomography imaging. Clin Oral Implants Res 2009; 20: 767-71. https://doi.org/10.1111/j.1600-0501.2008.01677.x
  10. Parsa A, Ibrahim N, Hassan B, van der Stelt P, Wismeijer D. Bone quality evaluation at dental implant site using multislice CT, micro-CT, and cone beam CT. Clin Oral Implants Res 2015; 26: e1-7.
  11. Pauwels R, Nackaerts O, Bellaiche N, Stamatakis H, Tsiklakis K, Walker A, et al. Variability of dental cone beam CT grey values for density estimations. Br J Radiol 2013; 86: 20120135. https://doi.org/10.1259/bjr.20120135
  12. Azeredo F, de Menezes LM, Enciso R, Weissheimer A, de Oliveira RB. Computed gray levels in multislice and cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2013; 144: 147-55. https://doi.org/10.1016/j.ajodo.2013.03.013
  13. Gonzalez-Garcia R, Monje F. The reliability of cone-beam computed tomography to assess bone density at dental implant recipient sites: a histomorphometric analysis by micro-CT. Clin Oral Implants Res 2013; 24: 871-9. https://doi.org/10.1111/j.1600-0501.2011.02390.x
  14. Sarkis A, Noujeim M, Nummikoski P. Bone density measurements in cone-beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 103: e53.
  15. Scarfe WC, Angelopoulos C. Maxillofacial cone beam computed tomography: principles, techniques and clinical applications. Cham: Springer; 2018.
  16. Shahlaie M, Gantes B, Schulz E, Riggs M, Crigger M. Bone density assessments of dental implant sites: 1. Quantitative computed tomography. Int J Oral Maxillofac Implants 2003; 18: 224-31.
  17. Eguren M, Holguin A, Diaz K, Vidalon J, Linan C, Pacheco-Pereira C, et al. Can gray values be converted to Hounsfield units? A systematic review. Dentomaxillofac Radiol 2022; 51: 20210140. https://doi.org/10.1259/dmfr.20210140
  18. DeGhett VJ. Effective use of Pearson's product-moment correlation coefficient: an additional point. Animal Behaviour 2014; 98: e1-2. https://doi.org/10.1016/j.anbehav.2014.10.006
  19. Naitoh M, Hirukawa A, Katsumata A, Ariji E. Evaluation of voxel values in mandibular cancellous bone: relationship between cone-beam computed tomography and multislice helical computed tomography. Clin Oral Implants Res 2009; 20: 503-6. https://doi.org/10.1111/j.1600-0501.2008.01672.x
  20. Mah P, Reeves TE, McDavid WD. Deriving Hounsfield units using grey levels in cone beam computed tomography. Dentomaxillofac Radiol 2010; 39: 323-35. https://doi.org/10.1259/dmfr/19603304
  21. Razi T, Niknami M, Alavi Ghazani F. Relationship between Hounsfield unit in CT scan and gray scale in CBCT. J Dent Res Dent Clin Dent Prospects 2014; 8: 107-10.
  22. Parsa A, Ibrahim N, Hassan B, Motroni A, van der Stelt P, Wismeijer D. Reliability of voxel gray values in cone beam computed tomography for preoperative implant planning assessment. Int J Oral Maxillofac Implants 2012; 27: 1438-42.
  23. Bujtar P, Simonovics J, Zombori G, Fejer Z, Szucs A, Bojtos A, et al. Internal or in-scan validation: a method to assess CBCT and MSCT gray scales using a human cadaver. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117: 768-79. https://doi.org/10.1016/j.oooo.2014.02.012
  24. Nomura Y, Watanabe H, Shirotsu K, Honda E, Sumi Y, Kurabayshi T. Stability of voxel values from cone-beam computed tomography for dental use in evaluating bone mineral content. Clin Oral Implants Res 2013; 24: 543-8. https://doi.org/10.1111/j.1600-0501.2012.02420.x
  25. Nomura Y, Watanabe H, Honda E, Kurabayashi T. Reliability of voxel values from cone-beam computed tomography for dental use in evaluating bone mineral density. Clin Oral Implants Res 2010; 21: 558-62. https://doi.org/10.1111/j.1600-0501.2009.01896.x
  26. Cassetta M, Stefanelli LV, Pacifici A, Pacifici L, Barbato E. How accurate is CBCT in measuring bone density? A comparative CBCT-CT in vitro study. Clin Implant Dent Relat Res 2014; 16: 471-8. https://doi.org/10.1111/cid.12027
  27. Chindasombatjaroen J, Kakimoto N, Shimamoto H, Murakami S, Furukawa S. Correlation between pixel values in a cone-beam computed tomographic scanner and the computed tomographic values in a multidetector row computed tomographic scanner. J Comput Assist Tomogr 2011; 35: 662-5. https://doi.org/10.1097/RCT.0b013e31822d9725
  28. Varshowsaz M, Goorang S, Ehsani S, Azizi Z, Rahimian S. Comparison of tissue density in Hounsfield units in computed tomography and cone beam computed tomography. J Dent (Tehran) 2016; 13: 108-15.
  29. Patrick S, Birur NP, Gurushanth K, Raghavan AS, Gurudath S. Comparison of gray values of cone-beam computed tomography with Hounsfield units of multislice computed tomography: an in vitro study. Indian J Dent Res 2017; 28: 66-70. https://doi.org/10.4103/ijdr.IJDR_415_16
  30. Razi T, Emamverdizadeh P, Nilavar N, Razi S. Comparison of the Hounsfield unit in CT scan with the gray level in cone-beam CT. J Dent Res Dent Clin Dent Prospects 2019; 13: 177-82. https://doi.org/10.15171/joddd.2019.028
  31. Katsumata A, Hirukawa A, Okumura S, Naitoh M, Fujishita M, Ariji E, et al. Relationship between density variability and imaging volume size in cone-beam computerized tomographic scanning of the maxillofacial region: an in vitro study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107: 420-5. https://doi.org/10.1016/j.tripleo.2008.05.049
  32. Endo M, Tsunoo T, Nakamori N, Yoshida K. Effect of scattered radiation on image noise in cone beam CT. Med Phys 2001; 28: 469-74. https://doi.org/10.1118/1.1357457
  33. Pauwels R, Araki K, Siewerdsen JH, Thongvigitmanee SS. Technical aspects of dental CBCT: state of the art. Dentomaxillofac Radiol 2015; 44: 20140224. https://doi.org/10.1259/dmfr.20140224
  34. Molen AD. Considerations in the use of cone-beam computed tomography for buccal bone measurements. Am J Orthod Dentofacial Orthop 2010; 137(4 Suppl): S130-5. https://doi.org/10.1016/j.ajodo.2010.01.015