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MRI vs. CT for orthodontic applications: comparison of two MRI protocols and three CT (multislice, cone-beam, industrial) technologies

MRT vs. CT für kieferorthopädische Anwendungen: Vergleich von zwei MRT-Protokollen und drei CT-Verfahren (Mehrschicht-CT, CBCT/DVT, industrielle µCT)

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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Abstract

Objectives

To examine the relative usefulness and suitability of magnetic resonance imaging (MRI) in daily clinical practice as compared to various technologies of computed tomography (CT) in addressing questions of orthodontic interest.

Methods

Three blinded raters evaluated 2D slices and 3D reconstructions created from scans of two pig heads. Five imaging modalities were used, including three CT technologies—multislice (MSCT), cone-beam CT (CBCT), and industrial (µCT)—and two MRI protocols with different scan durations. Defined orthodontic parameters were rated one by one on the 2D slices and the 3D reconstructions, followed by final overall ratings for each modality. A mixed linear model was used for statistical analysis.

Results

Based on the 2D slices, the parameter of visualizing tooth-germ topography did not yield any significantly different ratings for MRI versus any of the CT scans. While some ratings for the other parameters did involve significant differences, how these should be interpreted depends greatly on the relevance of each parameter. Based on the 3D reconstructions, the only significant difference between technologies was noted for the parameter of visualizing root-surface morphology. Based on the final overall ratings, the imaging performance of the standard MRI protocol was noninferior to the performance of the three CT technologies.

Conclusions

On comparing the imaging performance of MRI and CT scans, it becomes clear that MRI has a huge potential for applications in daily clinical practice. Given its additional benefits of a good contrast ratio and complete absence of ionizing radiation, further studies are needed to explore this clinical potential in greater detail.

Zusammenfassung

Ziel

Ziel dieser Arbeit ist die Einordnung der Magnetresonanztomographie (MRT) in die Bewertung unterschiedlicher dreidimensionaler Bildgebungsverfahren im Hinblick auf kieferorthopädische Fragestellungen und deren Eignung im klinischen Alltag.

Material und Methodik

Drei verblindete Untersucher bewerteten jeweils Schichtbilder und 3-D-Rekonstruktionen einer MSCT-CT (Mehrschicht-Computertomographie), einer CBCT/DVT („cone-beam CT“/dentale digitale Volumentomographie), einer industriellen µCT und zweier MRT-Aufnahmen unterschiedlicher Aufnahmedauer von 2 Schweineköpfen. In den Schichtbildern und den 3-D-Rekonstruktionen wurden mehrere kieferorthopädische Parameter beurteilt. Abschließend wurden zudem alle Datensätze bewertet. Die statistische Analyse erfolgte mittels eines gemischt linearen Modells.

Ergebnisse

In den Schichtbildern unterschied sich die MRT hinsichtlich der Lagebeurteilung der Zahnkeime nicht signifikant von den anderen Methoden. Allerdings ergaben sich mehrere signifikante Unterschiede in den weiteren untersuchten Parametern, die hinsichtlich der Relevanz der einzelnen Parameter interpretiert und bewertet werden müssen. In der 3-D-Rekonstruktion zeigte sich kein signifikanter Unterschied zwischen den einzelnen Verfahren, außer in der Oberflächendarstellung der Wurzel. In einer Abschlussbeurteilung wurde die MRT-Aufnahme mit Standardparametern qualitativ ebenbürtig beurteilt.

Schlussfolgerung

Vergleicht man die Ergebnisse der konventionellen bildgebenden Verfahren mit denen der MRT-Aufnahmen, kann ein erhebliches Potenzial bei der möglichen Integrierung der MRT-Bildgebung in den klinischen Alltag festgestellt werden. Aufgrund dieser Ergebnisse, dem guten Kontrastverhältnis und der völligen Abwesenheit ionisierender Strahlung muss das klinische Potenzial in weiterführenden Studien weiter untersucht werden.

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Notes

  1. More specifically, the IIS "Project Group NanoCT Systems" (Würzburg, Germany) and the IIS "Application Center for Computed Tomography Measurement Technology" (Deggendorf, Germany).

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Acknowledgments

The authors wish to thank the German Orthodontic Society for financially supporting this study. They are indebted to Ksenija Belaja, Katrin Schütz, and Theodor Klinker for conducting the ratings.

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    Authors and Affiliations

    1. Department of Orthodontics and Orofacial Orthopedics, University of Erlangen Medical School, Erlangen, Germany

      Andreas Detterbeck, Michael Hofmeister, Elisabeth Hofmann & Ursula Hirschfelder

    2. Fraunhofer Institute for Integrated Circuits (IIS), Project Group NanoCT Systems, Würzburg, Germany

      Astrid Hölzing, Simon Zabler & Jens Engel

    3. Research Center for Magnetic Resonance Bavaria (MRB), Würzburg, Germany

      Daniel Haddad, Daniel Weber, Karl-Heinz Hiller & Peter Jakob

    4. Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), University of Bonn, Bonn, Germany

      Matthias Schmid

    5. Fraunhofer Institute for Integrated Circuits (IIS), Application Center for Computed Tomography in Metrology, Deggendorf, Germany

      Jochen Hiller

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    Correspondence to Andreas Detterbeck.

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    Andreas Detterbeck, Michael Hofmeister, Elisabeth Hofmann, Daniel Haddad, Daniel Weber, Astrid Hölzing, Simon Zabler, Matthias Schmid, Karl-Heinz Hiller, Peter Jakob, Jens Engel, Jochen Hiller, and Ursula Hirschfelder state that there are no conflicts of interest.

    The accompanying manuscript does not include studies on humans or living animals.

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    Dr. Andreas Detterbeck.

    A. Detterbeck and M. Hofmeister contributed equally to this study.

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    Detterbeck, A., Hofmeister, M., Hofmann, E. et al. MRI vs. CT for orthodontic applications: comparison of two MRI protocols and three CT (multislice, cone-beam, industrial) technologies. J Orofac Orthop 77, 251–261 (2016). https://doi.org/10.1007/s00056-016-0028-2

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