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PubMed2006

A review of dentists' use of digital radiography and caries diagnosis with digital systems.

OBJECTIVES: To investigate the evidence for (1) dentists' use of digital radiography and (2) the outcome of caries diagnosis with digital systems. METHODS: A literature search with the software search package PubMed was used to get internet-based access to Medline through the website www.ncbi.nlm.nih.gov/pubmed. The search was limited to the years 1999-2005 since most papers dealing with the diagnostic value of digital radiography systems published before 1999 will hold little interest for today's users due to changes in the systems. The search strategies resulted in 123 articles (Table 1, #4 and #5). Original research articles (not reviews) were selected by the following inclusion criteria: (1) questionnaire studies on the use of direct digital intraoral radiography systems (not digitized film), (2) studies which used human teeth and natural caries lesions, and further in laboratory studies, the sectioned tooth was the gold standard for validating the presence or depth of a lesion. RESULTS: The search resulted in 42 articles fulfilling the above criteria, which could be grouped into three types of studies: (a) questionnaire studies, (b) clinical (in vivo) studies, and (c) laboratory (in vitro) studies. Nine questionnaire studies, five clinical studies and 28 laboratory studies were found. These studies and their results are summarized in Tables 2-5. CONCLUSIONS: The number of studies was limited, and some of the digital systems were evaluated in only one or two studies. A conclusive judgment may therefore not be possible for the majority of the digital systems selected for this review. There is a continuous need for the evaluation of new digital intraoral radiography systems that appear on the market, first and foremost for their image quality and diagnostic accuracy, but certainly also for their performance in the clinic, a clear deficiency observed after the literature search for the present review.

Dental Caries↗
PubMed2004

Reliability of landmark identification in cephalometric radiography acquired by a storage phosphor imaging system.

OBJECTIVES: To compare the cephalometric landmark identification on softcopy and hardcopy of direct digital cephalography acquired by a storage-phosphor (SP) imaging system. METHODS: Ten digital cephalograms and their conventional counterpart, hardcopy on a transparent blue film, were obtained by a SP imaging system and a dye sublimation printer. Twelve orthodontic residents identified 19 cephalometric landmarks on monitor-displayed SP digital images with computer-aided method and on their hardcopies with conventional method. The x- and y-coordinates for each landmark, indicating the horizontal and vertical positions, were analysed to assess the reliability of landmark identification and evaluate the concordance of the landmark locations in softcopy and hardcopy of SP digital cephalometric radiography. RESULTS: For each of the 19 landmarks, the location differences as well as the horizontal and vertical components were statistically significant between SP digital cephalometric radiography and its hardcopy. Smaller interobserver errors on SP digital images than those on their hardcopies were noted for all the landmarks, except point Go in vertical direction. The scatter-plots demonstrate the characteristic distribution of the interobserver error in both horizontal and vertical directions. Generally, the dispersion of interobserver error on SP digital cephalometric radiography is less than that on its hardcopy with conventional method. CONCLUSIONS: The SP digital cephalometric radiography could yield better or comparable level of performance in landmark identification as its hardcopy, except point Go in vertical direction.

Cephalometry↗
PubMed2006

Evaluation of the flexion gap by axial radiography of the distal femur.

The shape of the flexion gap in 20 normal knees was evaluated by axial radiography of the distal femur, and the results compared with those obtained in a previous study by MRI. The observed asymmetry was reduced by 29% using radiography, with a mean value of 3.6 degrees (1.5 degrees to 6.3 degrees) compared with that obtained by MRI of 5.1 degrees (2.6 degrees to 9.5 degrees), a mean discrepancy of 1.49 degrees. The results obtained by radiography and MRI showed a strong correlation (r = 0.78). Axial radiography is acceptable for the evaluation of the flexion gap and is less expensive and more comfortable to perform than MRI. Additionally, no metallic artefact occurs when the radiological method is used for assessment after arthroplasty.

Adolescent↗
PubMed1986

Reduced radiation-absorbed dose to tissues with partial panoramic radiography for evaluation of third molars.

The radiation-absorbed doses from panoramic radiography, distal molar radiography, and a partial panoramic radiographic technique that exposes only the third molar region to radiation are compared. Doses of radiation to the submandibular salivary gland were comparable by all three techniques, but doses of radiation to the head and neck were reduced greatly by the partial panoramic radiographic technique. Partial panoramic radiography is a diagnostically satisfactory and a radiologically safer technique for evaluation of third molar pathosis than is panoramic or distal molar radiography.

Head↗
PubMed1990

Brain and salivary gland tumors related to prior dental radiography: implications for current practice.

Five epidemiological studies of brain, cranial meninge, and salivary gland tumor sites reviewed implicate prior dental radiography with increased risk of subtentorial intracranial meningiomas and tumors of the parotid gland. Diagnostic radiography (medical and dental) was the most important risk factor identified for parotid gland cancers; among Los Angeles County residents, about 85% of the cumulative parotid dose from diagnostic radiography came from dental examinations. Irradiation of patients during dental radiography declined substantially from 1920 to 1988; it is uncertain whether current low doses increase risk. Recommendations for exposure reduction are made.

Adolescent↗
PubMed2002

Comparisons of physical imaging properties among three kinds of imaging plates used in photostimulable phosphor systems for dental radiography.

The purpose of this study was to compare the physical imaging properties of three kinds of imaging plates (IPs) used with two photostimulable phosphor systems for dental radiography: HR-V, used with the Digora, BAS-SR, and ST-V, used with the DenOptix for intraoral radiography and panoramic radiography, respectively. Sensitivity to X-ray, gradient, modulation transfer function (MTF), noise power spectrum (NPS), noise-equivalent quanta (NEQ), and detective quantum efficiency (DQE) were compared. All imaging plates were read using the DenOptix scanner with inactive automatic range control (ARC). The scanning resolution was set at 300 dpi. Decay of image information by room light was also compared at inactive and active ARC settings. BAS-SR showed the lowest sensitivity, the lowest gradient, the highest MTF, and the highest NPS. ST-V showed the highest sensitivity, the highest gradient, the lowest MTF, and the lowest NPS. HR-V was the second best for all imaging properties examined in this study. NEQ and DQE of BAS-SR were lowest, and those of ST-V were highest at low spatial frequencies. However, BAS-SR showed relatively constant NEQ and DQE while those of ST-V decreased remarkably at high spatial frequencies. NEQ and DQE of HR-V were the second best at low spatial frequencies and the best at high spatial frequencies. Therefore, we concluded that HR-V has the best imaging properties for dental radiography among three kinds of IPs evaluated in this study. However, the light decay speed of image information with HR-V was remarkably faster than with BAS-SR. To adopt HR-V for a system with which IPs are treated in an ordinary room, the light decay should be taken into account.

Artifacts↗
PubMed2006

Specimen radiography in confirmation of MRI-guided needle localization and surgical excision of breast lesions.

OBJECTIVE: Confirmation of lesion retrieval after MRI-guided needle localization and surgical excision of breast lesions are difficult because the targeted lesion is not enhanced ex vivo. The aim of this study was to determine the feasibility of using specimen radiography to verify lesion removal after MRI-guided needle localization and surgical excision. CONCLUSION: To our knowledge, our study was the first to examine the use of specimen radiography in the localization and excision of breast lesions. Specimen radiography is a reliable, cost-effective alternative to repeated dynamic contrast-enhanced MRI for confirming lesion removal after surgery. Specimen radiography has the additional advantage of facilitating immediate assessment of surgical margins.

Biopsy, Needle↗
PubMed1988

Plain chest radiograph with computed radiography: improved sensitivity for the detection of coronary artery calcification.

The ability of computed radiography (CR) with photostimulable phosphor to detect coronary artery calcification (CAC) was compared with conventional radiography with the film-screen method. Posteroanterior and lateral chest radiographs were reviewed that had been obtained with both methods in 77 patients with a variety of heart diseases. Cineangiography confirmed that 31 patients had CAC (left CAC in 31 patients, right CAC in 11) and that 46 patients had no CAC. For left CAC, the sensitivity of CR was 71%, significantly higher than that of conventional radiography (32%, p less than .01). For right CAC, the sensitivity of CR was only 27%, but that of conventional radiography was 0%. The specificities in detecting CAC were similar for both methods (CR, 96%; conventional method, 100%). Fine anatomic details of calcified foci were seen more clearly on CR. Chest imaging with the CR system is a promising method for detecting CAC.

Adolescent↗
PubMed1992

Digital skeletal radiography.

Skeletal radiography accounts for a large proportion of the plain film images generated in most radiology departments, yet it has been underemphasized in the investigation of digital imaging technologies. Unique features of skeletal radiography provide a challenge in the evaluation and investigation of digital skeletal imaging. This review summarizes the results of ongoing research in digital skeletal radiography. Elementary concepts of digital imaging are reviewed to provide a foundation for discussion of nominal contrast and resolution requirements for clinically useful digital skeletal radiography. Methods of acquiring digital skeletal images are reviewed, and digital image display, image compression, and basic image processing techniques are discussed with emphasis on specific skeletal applications.

Bone and Bones↗
PubMed1995

Digital chest imaging with a selenium detector: comparison with conventional radiography for visualization of specific anatomic regions of the chest.

OBJECTIVE: The purpose of this study was to compare a new digital chest radiography system that uses amorphous selenium as the X-ray detector with conventional radiography for the visualization of various anatomic regions of the chest as a first phase of testing image quality. MATERIALS AND METHODS: Six observers analyzed pairs of posteroanterior chest radiographs of 40 patients. One radiograph in each pair was obtained with a conventional chest film changer, and the other was obtained with the digital selenium chest radiography system. Each observer rated the visibility and the radiographic quality of 12 different anatomic regions. RESULTS: The observers rated visualization obtained with the digital system as better than that obtained with the conventional system in four regions (right lower lobe, upper lobes, ribs, and soft tissue), as better than or equal to that obtained with the conventional system in four regions (retrocardiac, retrodiaphragmatic, hilum, and upper mediastinum), and as equal to that obtained with the conventional system in four regions (horizontal fissure, carina, azygoesophageal recess, and thoracic spine). Some observers had a strong preference for the digital images, whereas others showed no preference. The conventional system was not ranked high for any region (2880 observations, p < .01, sign test). CONCLUSION: The digital selenium chest radiography system performs well in a clinical setting, providing visualization of anatomic structures that is better than or at least equal to that provided by standard screen-film images.

Humans↗
PubMed1996

Detection and differential diagnosis of pulmonary infections and tumors in patients with AIDS: value of chest radiography versus CT.

OBJECTIVE: The purpose of this study was to compare the sensitivity and specificity of chest radiography with those of CT in the detection of pulmonary infections and tumors in patients with AIDS. MATERIALS AND METHODS: The study was retrospective and included the radiographs and CT scans of 139 patients. Eighty-nine had one proven thoracic complication, 17 had two proven thoracic complications, and 33 had no active intrathoracic disease at the time of the examinations. The radiographs and CT scans were interpreted blindly by two independent observers from different institutions. The observers assessed for the presence or absence of intrathoracic disease and recorded the most likely diagnosis and the degree of confidence in that diagnosis. RESULTS: The patients were more commonly correctly identified as having or not having intrathoracic disease on the basis of CT findings than on the basis of radiographic findings ( p < .01, chi-square test). Of the 106 patients with intrathoracic complications, 90% (191 of 212 interpretations) were correctly identified by the two observers on the radiograph and 96% (204 of 212 interpretations) at CT. Of 33 patients without intrathoracic disease, 73% (48 of 66 interpretations) were correctly identified at radiography and 86% (57 of 66 interpretations) at CT. Of 89 patients with one proved thoracic complication, the observers confident in their first-choice diagnosis in 34% of the cases (61 of 178 interpretations) at chest radiography and in 47% (83 of 178 interpretations) at CT. This diagnosis was correct in 67% (41 of 61) of confident radiographic interpretations as compared with 87% (72 of 83) of interpretations at CT (p < .01, chi-square test). CONCLUSION: CT is superior to chest radiography in allowing identification of patients with and without thoracic disease and in the differential diagnosis of pulmonary complications of patients with AIDS. However, the improvement in differential diagnosis is modest. Because in most cases the radiographs and CT scans were obtained as part of the clinical evaluation, the study is probably biased toward problematic clinical cases. In the majority of patients, the chest radiograph provides adequate information and CT is not warranted.

AIDS-Related Opportunistic Infections↗
PubMed1998

Detection of ankle effusions: comparison study in cadavers using radiography, sonography, and MR imaging.

OBJECTIVE: The purpose of this study was to compare radiography, sonography, and MR imaging in revealing ankle effusions in cadaveric specimens. MATERIALS AND METHODS: Known quantities of saline solution were instilled in increments into the ankle joints of three cadaveric specimens. Imaging was completed after each injection with the ankle in dorsiflexion, plantar flexion, and a neutral position. Imaging included radiography, sonography, and MR imaging. Three observers who were aware of possible joint fluid evaluated the images by consensus and determined the presence or absence of joint effusion. RESULTS: MR imaging revealed 1 ml of fluid within the anterior recess of the ankle in a neutral position and in plantar flexion and within the posterior recess in dorsiflexion. Sonography revealed 2 ml of fluid within the anterior recess in a neutral position and in plantar flexion. Radiography revealed 5 ml of fluid within the anterior recess in a neutral position. CONCLUSION: MR imaging, sonography, and lateral radiography, in order of decreasing sensitivity, revealed ankle effusion. The power to reveal with each technique is influenced by the precise position of the ankle.

Adipose Tissue↗
PubMed2000

Radiography of cervical spine injury in children: are flexion-extension radiographs useful for acute trauma?

OBJECTIVE: We assessed the role of cervical spine flexion-extension radiographs in the acute evaluation of pediatric trauma patients. MATERIAL AND METHODS: We performed a retrospective review of all pediatric trauma patients who underwent static cervical spine radiography followed by flexion-extension radiography during a 22-month period. We reviewed the mechanism of injury, physical examination findings, and patient age, and tabulated the results of initial and follow-up imaging studies. RESULTS: Two hundred forty seven children (age range, 1.6-18 years; mean age, 11.5 years) with a history of trauma underwent cervical spine radiography followed by flexion-extension radiography. Static cervical spine radiographs revealed normal findings in 224 patients (91%). Flexion-extension radiographs revealed normal findings for all patients with normal findings on cervical spine radiographs. Of 23 children (9%) with abnormal findings on static cervical spine radiographs, seven (30%) had congenital abnormalities visible on flexion-extension radiographs; 10 (43%) had traumatic injuries including fracture, subluxation, or soft-tissue swelling; two (9%) had instability; and six (26%) had questionable abnormalities that were noted on static cervical spine radiographs. In four patients (66%) with abnormal findings on static cervical spine radiographs, flexion-extension radiographs were helpful in ruling out abnormality. CONCLUSION: In children with a history of trauma and normal findings on static cervical spine radiographs, additional flexion-extension radiographs are of questionable use.

Adolescent↗
PubMed2003

Evaluation of chest radiography versus chest computed tomography in screening for pulmonary malignancy in advanced head and neck cancer.

OBJECTIVE: To evaluate the role of chest radiography versus chest computed tomography (CT) in screening for pulmonary malignancy in advanced head and neck squamous cell carcinoma (HNSCC). DESIGN: Retrospective review of imaging. SETTING: Head and neck cancer unit. METHOD: Over a period of 1 year, 26 patients with advanced HNSCC (T3/T4) were screened for pulmonary malignancy with both chest radiography and chest CT prior to definitive therapy. OUTCOME MEASURES: Radiologic evidence of malignancy. RESULTS: Twenty patients had a normal chest radiograph and a normal CT scan. Four patients had a normal chest radiograph but an abnormal CT scan. Three of these patients had a pulmonary malignancy and one had a suspicious lesion that resolved following surgery to the index tumour. Two patients had both an abnormal chest radiograph and CT scan. One of these had a pulmonary malignancy and one had a CT-guided biopsy of the chest lesion 4 weeks postoperatively, which was normal. Chest CT scanning therefore identified three chest malignancies that would have been missed by chest radiography alone. CONCLUSIONS: Chest CT is an effective tool in screening for malignant pulmonary disease in patients with advanced head and neck cancer and should be used instead of chest radiography to avoid false-negative results.

Carcinoma, Squamous Cell↗
PubMed1992

Sensitometric comparison of direct- and indirect-exposure films used in intraoral radiography.

In Japan, some dentists use indirect-exposure (screen) films for intraoral radiography, without the use of intensifying screens. The purpose of the present investigation was to determine whether film speed, inherent contrast, and latitude of Japanese indirect-exposure films used without intensifying screens were comparable to those of direct-exposure (non-screen) films used for intraoral radiography. The characteristic curves of Kodak Ektaspeed ("E" speed) and Ultra-speed ("D" speed) films were used as standards for comparison. Indirect-exposure films without intensifying screens were extremely slow compared with direct-exposure "E" and "D" speed films. Therefore, they should not be used for intraoral radiography because they needlessly expose the patient to excessive X-ray radiation. The direct-exposure films Hanshin Hi-Fi and Hanshin New Silver were equivalent in speed, higher in contrast, and narrower in latitude than Kodak Ektaspeed film. In general, the indirect-exposure films had lower speed, lower contrast and wider latitude than the direct-exposure films. Their speed and contrast would have been increased if intensifying screens had been used. Therefore, indirect-exposure films without intensifying screens should not be used for intraoral radiography.

Radiation Dosage↗
PubMed2006

Comparison of results of computed tomography and radiography with histopathologic findings in tracheobronchial lymph nodes in dogs with primary lung tumors: 14 cases (1999-2002).

OBJECTIVE: To compare results of computed tomography (CT) and radiography with histopathologic findings in tracheobronchial lymph nodes (TBLNs) in dogs with primary lung tumors. DESIGN: Retrospective case series. ANIMALS: 14 client-owned dogs. PROCEDURES: Criteria for inclusion were diagnosis of primary lung tumor, use of thoracic radiography and CT, and histologic confirmation of TBLN status. Medical records were reviewed for signalment; history; and physical examination, clinicopathologic, radiographic, CT, surgical, and histopathologic findings. RESULTS: Tracheobronchial lymphadenopathy was not identified via radiography in any dogs. Tracheobronchial lymphadenopathy was diagnosed in 5 dogs via CT. Six dogs had histologic confirmation of metastasis to TBLNs. Radiographic diagnosis yielded 6 false-negative and no false-positive results for tracheobronchial lymphadenopathy. Computed tomography yielded 1 false-negative and no false-positive results. Sensitivity of CT for correctly assessing TBLN status was 83%, and specificity was 100%. Positive predictive value was 100%, and negative predictive value was 89%. Dogs with lymphadenopathy via CT, histologic confirmation of TBLN metastasis, or primary tumors with a histologic grade > 1 had significantly shorter survival times than their counterparts. CONCLUSIONS AND CLINICAL RELEVANCE: Results of CT evaluation of TBLN status were in agreement with histopathologic findings and more accurate than use of thoracic radiography for evaluating TBLNs in dogs with primary lung tumors. Computed tomography imaging should be considered as part of the staging process to more accurately assess the TBLNs in dogs with primary lung tumors.

Animals↗
PubMed2006

A technique for pelvic radiography in the standing horse.

REASONS FOR PERFORMING STUDY: An alternative technique of radiographing the pelvis in the standing horse is required, to avoid the risks associated with general anaesthesia. HYPOTHESIS: That lateral oblique radiography in the standing horse would be a useful technique in the investigation of pelvic injury. OBJECTIVES: To describe the technique of lateral oblique pelvic radiography in the standing horse and demonstrate the feasibility and usefulness of this technique. METHODS: A technique for lateral oblique radiography in the standing horse was devised and retrospective review made of radiographic findings in 18 clinical cases. RESULTS: The caudal iliac shaft, greater trochanter of the femur, femoral head, acetabulum and coxofemoral articulation on the side under investigation were visualised consistently using this technique. Of the 18 cases, 3 iliac shaft fractures, 1 acetabular fracture, 2 coxofemoral luxations and 4 horses with new bone formation around the coxofemoral joint and/or proximal femur were identified. CONCLUSIONS: Lateral oblique radiography in the standing, conscious horse can be used to investigate conditions affecting the caudal iliac shaft, coxofemoral articulation and proximal femur in the horse. POTENTIAL RELEVANCE: The technique is straightforward, noninvasive and useful in the investigation of horses with suspected pelvic injury. However, not all pelvic injuries would be identified, and normal radiographic findings do not rule out injury or fractures elsewhere in the pelvis.

Animals↗
PubMed1995

Bone scintigraphy in evaluation of heel pain in Reiter's disease: compared with radiography and clinical examination.

Tc-99m MDP bone scans were used to evaluate the heel pain (talalgia) in 38 patients with Reiter's disease, and compared with clinical examination and radiologic findings. In our work, 58% (22/38) patients presented talalgia with a total of 35 lesions. Only two lesions of clinical talalgia were missed by the bone scan. The diagnostic sensitivity was as high as 94% (33/35). However, the diagnostic sensitivity of radiography was only 69% (11/16) when the disease duration was more than one year; furthermore, it declined to 33% (4/12) when the disease duration was less than one year. Based on the bone scans, the correlation between positive scintigraphic findings and clinical talalgia was extremely good. Clinical talalgia occurred in all the 33 lesions demonstrated by bone scan. However, three lesions demonstrated by radiography were not consistent with clinical talalgia and not visualized by radioscintigraphy. Our data show that the radionuclide scan is a more sensitive indicator and has better correlation with clinical talalgia than radiography. We consider that bone scintigraphy is superior to radiography in the evaluation of heel pain in Reiter's disease.

Adolescent↗