Photon-Counting Detector CT-Based Virtual Monoenergetic Imaging With Metal Artifact Reduction for Endodontic...

Area of Science:

• Dental Imaging
• Radiology
• Photon-Counting Detector Computed Tomography

Background:

• Assessing endodontic challenges requires high-quality imaging.
• Photon-counting detector computed tomography (PCD-CT) offers advanced imaging capabilities.
• Virtual monoenergetic imaging (VMI) and iterative metal artifact reduction (iMAR) are potential tools for improving endodontic diagnostics.

Purpose of the Study:

• Determine optimal VMI energy levels for PCD-CT in endodontic imaging.
• Evaluate the effectiveness of iMAR in reducing artifacts and improving diagnostic accuracy for simulated endodontic complications.

Main Methods:

• Ex vivo study using 16 extracted third molars with simulated endodontic challenges.
• PCD-CT imaging with VMI reconstruction (70-190 keV) and iMAR application.
• Diagnostic accuracy, image quality, and artifact severity assessed by two observers using a visual analogue scale.

Main Results:

• VMI achieved excellent diagnostic accuracy (97%) and visualization of endodontic challenges across the energy spectrum.
• Optimal visualization of caries at 70-80 keV and fractured files at 70-100 keV.
• iMAR did not improve image quality and reduced diagnostic performance; minimal artifacts observed at VMI energies ≥ 110 keV.

Conclusions:

• VMI from PCD-CT provides high-quality, low-artifact imaging suitable for endodontic diagnostics.
• PCD-CT enables novel, indication-specific workflows for enhanced endodontic diagnostic precision.
• VMI at specific energy levels can optimize visualization of different endodontic pathologies.