Imaging software accuracy for 3-dimensional analysis of the upper airway

Area of Science:

• Medical Imaging
• Radiology
• Dental Imaging

Background:

• Accurate measurement of upper airway volumes is crucial for diagnosing conditions like sleep apnea.
• Cone-beam computed tomography (CBCT) is increasingly used for airway analysis.
• Evaluating the precision and accuracy of different imaging software is essential for reliable clinical application.

Purpose of the Study:

• To compare the precision and accuracy of six imaging software programs for measuring upper airway volumes from CBCT data.
• To identify the most reliable software for upper airway volume assessment.

Main Methods:

• Thirty-three growing patients and an oropharynx acrylic phantom underwent CBCT scans.
• Semi-automatic segmentation of the oropharynx was performed using Mimics, ITK-Snap, OsiriX, Dolphin3D, InVivo Dental, and Ondemand3D software with interactive and fixed threshold protocols.
• Intraclass correlation coefficient, repeated measurements ANOVA, and Bonferroni post-hoc tests were used for reliability and comparison.

Main Results:

• All software programs demonstrated high reliability.
• Using the interactive threshold protocol, Mimics, Dolphin3D, OsiriX, and ITK-Snap showed less than 2% volume error compared to the gold standard phantom.
• Ondemand3D and InVivo Dental exhibited over 5% error with the interactive protocol, and all programs showed similar errors (-11.1% to -11.7%) with the fixed threshold protocol.

Conclusions:

• While all six software programs are reliable, significant differences in accuracy exist for upper airway volume segmentation.
• Mimics, Dolphin3D, ITK-Snap, and OsiriX are more accurate for upper airway assessment than InVivo Dental and Ondemand3D.