Pittayapat, Pisha
(OIC, OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven)
,
Jacobs, Reinhilde
(OIC, OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven)
,
Odri, Guillaume A.
(Service de Chirurgie Orthopedique et Traumatologique, Centre Hospitalier Regional d'Orleans)
,
Vasconcelos, Karla De Faria
(Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas)
,
Willems, Guy
(Orthodontics, Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven, University of Leuven)
,
Olszewski, Raphael
(Department of Oral and Maxillofacial Surgery, Cliniques Universitaires Saint Luc, Universite Catholique de Louvain)
Purpose: This study was performed to assess the reproducibility of identifying the sella turcica landmark in a three-dimensional (3D) model by using a new sella-specific landmark reference system. Materials and Methods: Thirty-two cone-beam computed tomographic scans (3D Accuitomo$^{(R)}$...
Purpose: This study was performed to assess the reproducibility of identifying the sella turcica landmark in a three-dimensional (3D) model by using a new sella-specific landmark reference system. Materials and Methods: Thirty-two cone-beam computed tomographic scans (3D Accuitomo$^{(R)}$ 170, J. Morita, Kyoto, Japan) were retrospectively collected. The 3D data were exported into the Digital Imaging and Communications in Medicine standard and then imported into the Maxilim$^{(R)}$ software (Medicim NV, Sint-Niklaas, Belgium) to create 3D surface models. Five observers identified four osseous landmarks in order to create the reference frame and then identified two sella landmarks. The x, y, and z coordinates of each landmark were exported. The observations were repeated after four weeks. Statistical analysis was performed using the multiple paired t-test with Bonferroni correction (intraobserver precision: p<0.005, interobserver precision: p<0.0011). Results: The intraobserver mean precision of all landmarks was <1 mm. Significant differences were found when comparing the intraobserver precision of each observer (p<0.005). For the sella landmarks, the intraobserver mean precision ranged from $0.43{\pm}0.34mm$ to $0.51{\pm}0.46mm$. The intraobserver reproducibility was generally good. The overall interobserver mean precision was <1 mm. Significant differences between each pair of observers for all anatomical landmarks were found (p50% precision in locating the landmark within 1 mm. Conclusion: A newly developed reference system offers high precision and reproducibility for sella turcica identification in a 3D model without being based on two-dimensional images derived from 3D data.
Purpose: This study was performed to assess the reproducibility of identifying the sella turcica landmark in a three-dimensional (3D) model by using a new sella-specific landmark reference system. Materials and Methods: Thirty-two cone-beam computed tomographic scans (3D Accuitomo$^{(R)}$ 170, J. Morita, Kyoto, Japan) were retrospectively collected. The 3D data were exported into the Digital Imaging and Communications in Medicine standard and then imported into the Maxilim$^{(R)}$ software (Medicim NV, Sint-Niklaas, Belgium) to create 3D surface models. Five observers identified four osseous landmarks in order to create the reference frame and then identified two sella landmarks. The x, y, and z coordinates of each landmark were exported. The observations were repeated after four weeks. Statistical analysis was performed using the multiple paired t-test with Bonferroni correction (intraobserver precision: p<0.005, interobserver precision: p<0.0011). Results: The intraobserver mean precision of all landmarks was <1 mm. Significant differences were found when comparing the intraobserver precision of each observer (p<0.005). For the sella landmarks, the intraobserver mean precision ranged from $0.43{\pm}0.34mm$ to $0.51{\pm}0.46mm$. The intraobserver reproducibility was generally good. The overall interobserver mean precision was <1 mm. Significant differences between each pair of observers for all anatomical landmarks were found (p50% precision in locating the landmark within 1 mm. Conclusion: A newly developed reference system offers high precision and reproducibility for sella turcica identification in a 3D model without being based on two-dimensional images derived from 3D data.
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문제 정의
No reliable method of identifying the sella point, which is a floating landmark in nature, on real 3D surface models has been published.20Therefore, the aim of this study was to assess the reproducibility of a new technique to identify the sella landmark in a 3D model by using a newly developed reference system.
제안 방법
Morita, Kyoto, Japan) into the Digital Imaging and Communications in Medicine format and then imported into the Maxilim® software (Medicim NV, Sint-Niklaas, Belgium). Three-dimensional surface models for all subjects were created using the full CBCT volume with 0.5-mm voxel subsampling. The threshold value was set between 276 and 476 in order to segment the hard tissues for the 3D models.
In this study, precision was defined for a given landmark as the mean distance of the coordinates of that landmark on all subjects as reported by all observers. Intraobserver precision was defined for a given landmark as the mean distance of all coordinates for that landmark on all subjects as reported by each observer.
The reference system created in this study was comprised of four operator-indicated landmarks, two softwarecalculated landmarks, and two sella landmarks on two different vertical planes (Table 1). The landmarks used in the system were carefully selected to facilitate the precise identification of the center of the pituitary fossa.
The reference system created in this study was comprised of four operator-indicated landmarks, two softwarecalculated landmarks, and two sella landmarks on two different vertical planes (Table 1). The landmarks used in the system were carefully selected to facilitate the precise identification of the center of the pituitary fossa. The landmarks forming the vertical planes were chosen because they are located adjacent to the sella turcica.
This led to a visible difference in the results. There were significant differences in intraobserver precision among observers for some landmarks (ACPR, ACP-L, APT-R, and APT-L), and it was found that two observers (observers 1 and 2) were able to identify the landmarks more precisely. Moreover, significant differences between each pair of observers were found for all anatomical landmarks, implying that interobserver precision was observer-dependent.
Cephalometric analysis is an essential part of orthodontic treatment planning. Each analysis involves assessing several cephalometric landmarks. Superimposing structures onto a lateral cephalogram is a technique used to perform an individual’s longitudinal growth evaluation and to assess the outcome of orthodontic treatment.
대상 데이터
Thirty-two patients (11 males and 21 females, age range 8.8-76.7 years, mean age 26.0±21.6 years) were retrospectively selected from the hospital database.
software in order to identify the geometric center or midpoint of the sella turcica. The reference frame was composed of six landmarks (four operator-indicated landmarks and two software-calculated landmarks) and two sella landmarks, which were indicated on two distinct vertical planes created from the reference system (Table 1) (Fig. 1).
During each observation session, an observer identified six landmarks (Table 1). The x, y, and z coordinates of each landmark were exported to Microsoft Excel files.
데이터처리
Analysis of variation (ANOVA) with Tukey’s post-hoc test was used to compare the mean values of intraobserver precision across landmarks for each observer.
ANOVA with Tukey’s post-hoc test was calculated to compare the precision values among landmarks corresponding to the values obtained by each pair of observers.
The multiple paired t-test with Bonferroni correction was performed on the transformed variable to assess the variation of intraobserver precision for each landmark across observers. Analysis of variation (ANOVA) with Tukey’s post-hoc test was used to compare the mean values of intraobserver precision across landmarks for each observer.
For each pair of observers, ANOVA with Tukey’s posthoc test was also performed to compare the mean precision values across landmarks.
23 to evaluate 3D landmark identification. The results showed a high intraclass correlation coefficient for both intraobserver and interobserver assessments. The authors concluded that 3D landmark identification using CBCT could offer reproducible data, if a protocol for operator training and calibration was followed.
Statistically significant differences were found for the APT-R and APT-L when analyzing the intraobserver precision results for each observer across all landmarks (ANOVA with Tukey’s post-hoc test, p < 0.05).
The mean precision values for each landmark as assessed by each pair of observers were evaluated by the multiple paired t-test with Bonferroni correction. ANOVA with Tukey’s post-hoc test was calculated to compare the precision values among landmarks corresponding to the values obtained by each pair of observers.
성능/효과
Comparing the intraobserver precisions of each observer, using the multiple paired t-test with Bonferroni correction on the transformed variable, showed significant differences (p < 0.005) for ACP-R, ACP-L, and APT-L.
The reproducibility of the two sella turcica landmarks, Sella 1 and Sella 2, was shown to be good (7.8%-37.5% of mean precision values > 1 mm).
For most pairs of observers, Sella 1 and Sella 2 were observed with better precision than the APT-R and APT-L, and precision values for Sella 1 and Sella 2 were sometimes as good as those of the ACP-R and ACP-L (p < 0.05).
It was found that for all pairs of observers, the ACP-R and ACP-L were observed with significantly better precision than other landmarks (p < 0.05).
Bony resorption of the posterior part of the sella turcica may occur, potentially making it difficult to identify the border of the sella. The results of this study showed that for some landmarks (APT-L, APT-R, Sella 1, and Stella 2), the precision was subject-sensitive. One potential reason for this is of the possibility that the landmarks and bony structures were more difficult to visualize in the CBCT scans of some patients, and moreover, that image noise was more of a problem in some CBCTs.
The results of this study showed that both the intraobserver and interobserver precision of all landmarks were moderate to very good. However, the precision was poorer for some landmarks (APT-R and APT-L), an effect that was most clearly seen in the interobserver precision results.
후속연구
, comparing the sella-nasionpoint A angle or the sella-nasion-point B angle). Further studies should be conducted in order to integrate this sella reference system into 3D cephalometric analysis and to assess how this system may influence the angular measurements and the results of multiple 3D cephalometric analyses.
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