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. 2018 Jul;47(6):20180021.
doi: 10.1259/dmfr.20180021. Epub 2018 May 10.

Magnitude of cone beam CT image artifacts related to zirconium and titanium implants: impact on image quality

Rocharles C Fontenele  1 , Eduarda Hl Nascimento  1 , Taruska V Vasconcelos  1 , Marcel Noujeim  2 , Deborah Q Freitas  1
Affiliations

Magnitude of cone beam CT image artifacts related to zirconium and titanium implants: impact on image quality

Rocharles C Fontenele et al. Dentomaxillofac Radiol. 2018 Jul.

Abstract

Objectives: To evaluate the magnitude of artifacts related to titanium and zirconium implants at different distances and angulations and their impact on cone beam CT(CBCT) image quality.

Methods: CBCT images were obtained before and after the insertion of titanium and zirconium implants in a mandible on different CBCT units: Picasso Trio, ProMax 3D and 3D Accuitomo 80. Artifact was assessed by measuring the standard deviation (SD) of gray values and contrast-to-noise ratio (CNR) of 11 regions of interest (ROIs) at different distances (1.5 cm, 2.5 cm and 3.5 cm) and angulations (65°, 90°, 115° and 140°) from implant region.

Results: For titanium images, SD values did not differ from those of images without implant in all ROIs; however, some effect occurred in Picasso images as higher values were observed in ROIs closer to the implant (p < 0.05). Zirconium images showed higher SD values than the others in some ROIs for Picasso and ProMax (p < 0.05). In ProMax, the difference was observed even in the farthest ROIs from the implant. CNR values were not influenced by the ROI in Picasso, but presented lower values in ROIs closer to the zirconium implant for ProMax and Accuitomo.

Conclusions: The quantity and magnitude of artifacts in CBCT are influenced by the type of implant and CBCT unit. Although they are more pronounced in regions closer to the implant and located at 90° in relation to the mandibular long axis, they can reach as far as 3.5 cm from the artifact-generator object.

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Figures

Figure 1.
Figure 1.
Examples of cropped axial views of “without implant”, “titanium” and “zirconium” groups acquired in units studied.
Figure 2.
Figure 2.
Determination of the ROIs to evaluate the magnitude of artifacts. (a) One line was determined in the center of implant image following the long axis of the mandible body. Four additional lines at angles of 65°, 90°, 115° and 140° in relation to the first were drawn passing through the central region of the implant. From this centered point, three semi-circles were drawn with radii of 1.5, 2.5 and 3.5 cm. (b) On the intersection of circles and lines, 11 square ROIs of 2.8 × 2.8 mm were established over three distance levels and four angles in relation to the implant region. (c) Final location of the ROIs and the additional CR were placed on the ERBS block. CR, control ROI; ERBS, resin-based tissue substitute; ROIs, regions of interest.
See this image and copyright information in PMC

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