Dental imaging using an ultra-high resolution photon-counting CT system.

Area of Science:

• Dentistry
• Radiology
• Medical Imaging

Background:

• Clinical photon-counting CT (PCCT) offers high spatial resolution (approx. 200 µm).
• PCCT may enable acquisitions comparable to dental cone-beam CT (CBCT).

Purpose of the Study:

• To evaluate the capabilities of PCCT compared to dental CBCT.
• To assess PCCT's accuracy in identifying dental diagnostic entities and structures.

Main Methods:

• Acquisitions were performed on cadaveric heads using an experimental ultra-high resolution PCCT system and a dental CBCT scanner.
• PCCT scans were conducted at varying dose levels (8.5, 38.0, 66.5 mGy), while CBCT used 8.94 mGy.
• Image quality, delineation of hard tissues, root canals, periodontal space, and apical osteolysis were assessed by two readers.

Main Results:

• All 8 apical osteolyses identified in CBCT were also detected by both readers across all PCCT protocols.
• PCCT at medium and high doses showed statistically significant improvements in visibility scores for root canals, periodontal space, cortical, and spongious bone compared to CBCT.
• Both PCCT and CBCT demonstrated excellent image quality and high interrater agreement for all assessed structures.

Conclusions:

• Ultra-high resolution PCCT reliably identifies diagnostic entities and structures in dental imaging, similar to conventional dental CBCT.
• PCCT demonstrates comparable diagnostic performance to CBCT, even at similar radiation doses.
• PCCT shows significant potential for advanced dental diagnostics.