Exploring Dental Anatomy: An Ex Vivo Comparative Study Between Photon-Counting Detector CT and Cone-Beam CT

Area of Science:

• Radiology
• Medical Imaging
• Dental Anatomy

Background:

• Cone-beam computed tomography (CBCT) is widely used for dentomaxillofacial imaging.
• Assessing advanced imaging techniques like photon-counting detector computed tomography (PCD-CT) is crucial for improving diagnostic accuracy.
• Optimizing radiation dose while maintaining image quality is a key challenge in medical imaging.

Purpose of the Study:

• To compare the performance of PCD-CT and CBCT for imaging mandibular and dental structures.
• To evaluate image quality, artifact susceptibility, and diagnostic interpretability at equivalent radiation doses.
• To determine the effectiveness of PCD-CT as an alternative to CBCT in dentomaxillofacial imaging.

Main Methods:

• An ex vivo study using six porcine cadaver heads.
• Acquisition of 12 CBCT and 18 PCD-CT volumes across high, standard, and low radiation dose levels.
• Assessment of image quality, artifacts, and diagnostic interpretability by two blinded observers using a Likert scale and interobserver reliability analysis.

Main Results:

• PCD-CT demonstrated superior anatomy coverage, density, contrast, and reduced artifact susceptibility compared to CBCT at standard and low doses.
• Both high and standard dose PCD-CT protocols achieved perfect scores, while low-dose PCD-CT still outperformed CBCT.
• PCD-CT exhibited higher inter- and intra-reader reliability across all dose levels, particularly at low doses.

Conclusions:

• PCD-CT significantly outperforms CBCT in diagnostic interpretability and artifact reduction for dentomaxillofacial imaging.
• PCD-CT offers a promising alternative for imaging, aligning with the ALADAIP principle of minimizing radiation exposure.
• The findings support the adoption of PCD-CT for enhanced diagnostic capabilities in dental and maxillofacial radiology.