Optimization of orofacial cleft imaging protocols using device-specific low-dose cone-beam computed tomography

Area of Science:

• Dentistry
• Radiology
• Medical Imaging

Background:

• Cone-beam computed tomography (CBCT) is crucial for pre-surgical planning in cleft defects.
• Optimizing CBCT protocols can reduce radiation dose while maintaining diagnostic image quality.

Purpose of the Study:

• To evaluate device-specific low-dose CBCT protocols for pre-surgical diagnostics and 3D modeling of cleft defects.
• To compare image quality and diagnostic accuracy across various low-dose CBCT settings.

Main Methods:

• Six pediatric skulls with artificial clefts were scanned using a high-resolution CBCT as a reference.
• Eight low-dose CBCT protocols on a Newtom VGi-evo device were tested with varying fields of view (FOVs).
• Image quality was assessed for lamina dura, cementoenamel junction (CEJ), trabecular bone, and bony bridges, alongside 3D defect modeling.

Main Results:

• Low-dose protocols reduced radiation dose by up to eight times compared to the reference standard.
• Trabecular bone and CEJ showed adequate image quality across all tested low-dose protocols.
• Regular small FOV protocols offered superior image quality for lamina dura and bony bridge delineation compared to Eco FOV counterparts.

Conclusions:

• Low-dose CBCT protocols can achieve substantial radiation dose reduction without compromising diagnostic image quality for cleft defect assessment.
• Optimized low-dose CBCT is suitable for pre-surgical diagnostics and 3D modeling in pediatric cleft cases.
• Specific low-dose settings, particularly Regular small FOV, enhance visualization of critical anatomical structures.