Advantages of using CBCT for diagnostic purposes

Uvod: CBCT je novejša diagnostična modalnost slikanja, ki nam omogoča prikaz volumna telesa v 3D pogledu (aksialnem, koronalnem, transverzalnem preseku), na interesnem področju kjer je največje prekrivanje delov telesa. CT s stožčastim snopom je preiskovalna metoda, kjer izvor in detektor rentgenskih žarkov krožno zajameta in posnameta več zaporednih slik pacienta. CBCT temelji na volumetrični tomografiji, glavna razlika v primerjavi s tradicionalnim CT je oblika uporabljenega snopa. Ta ima pri CT obliko pahljače, medtem ko imajo žarki pri CBCT obliko stožca ali piramide. Zaradi potrebnih prilagoditev na drugačno obliko snopa žarkov in detektorja je rekonstrukcija slike pri CBCT zahtevnejša, vendar je v vseh smereh enakomerna in natančnejša. Najnovejše naprave lahko 3D rekonstrukcijo posameznega zajemanja slike opravijo že v 15 sekundah. Slikanje s CBCT sistemom se največkrat uporablja za diagnostiko v področju stomatologije. Namen: Namen diplomske naloge je, raziskati sistem CBCT in ugotoviti njegove prednosti oz. pomanjkljivosti pred tradicionalnim CT, predvsem v področju diagnostike. Zanima me, v katerem medicinskem področju je sistem CBCT najpogosteje v uporabi in kje je njegova uporaba omejena. CBCT je slikovna metoda, ki je zraven ustne in maksilofacialne regije vedno bolj nepogrešljiva tudi v področjih interventne radiologije, ortopedije, mamografije, otolaringologije, onkologije in še kje se odpirajo nove možnosti v razna področjih medicine. Metode dela: Podatke sem zbirala in preučila. Za pregled literature sem uporabila novejše in aktualne medicinske strokovne elektronske in tiskane članke javnih objav, večinoma pridobljene na mednarodnem internetnem omrežju in nekaj knjižne literature, strokovne publikacije po predlogu mentorjev. Različne dobljene informacije z ugotovitvami sem analizirala, primerjala in podala v tekstu. Rezultati: Ker smo s CBCT tehnologijo omejeni pri volumskem zajemu območja telesa (FOV), je primerna predvsem za prikaz dobre prostorske ločljivosti kosti, sklepov in interesnega področja, kjer ne potrebujemo velikega preiskovanega slikovnega volumna. V primerjavi s klasičnim CT je prikaz mehkih tkiv slabši, a je z novim tehnološkim sistemom CBCT z lokom C diagnostika napredovala in se še izpopolnjuje. Omogoča fuzijo fluoroskopskih posnetkov s predhodnimi 2D ali 3D opravljenimi preiskavami iz zajema slik CBCT, CT ali MR. Razprava in zaključek: Slikovna tehnika CBCT je zelo primerna za diagnostiko, kjer nas zanima majhno interesno področje prekrivanja telesa. Ima majhen voksel in dobro prostorsko ločljivost, zato nam odpira nove možnosti diagnostike in načrtovanje interventnega kirurškega zdravljenja. Največ se še zmeraj uporablja v ustni in maksilofacialni regijikirurgiji, implantologiji, endodontiji, parodontologiji, načrtovanju ortodontskega zdravljenja, torej v področju stomatologije, kamor segajo njeni začetki.Introduction: CBCT is a newer diagnostic imaging modality that allows us to display body volume in 3D view (axial, coronal, transverse section) in the area of interest where there is the greatest overlap of body parts. Cone beam CT is an investigative method where the source and X-ray detector capture in circular motion several consecutive images of a patient. CBCT is based on volumetric tomography. The main difference compared to traditional CT is the shape of the used beam. This has a fan shape in CT, while the rays in CBCT have the shape of a cone or pyramid. Due to the necessary adjustments to a different beam and detector shape the reconstruction of the image at CBCT is more demanding, but it is uniform and more accurate in all directions. The latest devices can perform a 3D reconstruction of an individual image capture in as little as 15 seconds. Imaging with the CBCT system is most often used for diagnostics in the field of dentistry. Purpose: The purpose of the diploma thesis is to research the CBCT system and determine its advantages or disadvantages compared to traditional CT, especially in the field of diagnostics. I am interested in which medical field the CBCT system is most commonly used and where its use is restricted. CBCT is an imaging method that in addition to the oral and maxillofacial region, is increasingly indispensable in the fields of interventional radiology, orthopaedics, mammography, otolaryngology, oncology, and where new possibilities are opening up in various fields of medicine. Methods: I collected and studied the data. For reviewing the literature I used newer and current medical professional electronic and printed articles of public publications, mostly obtained on the international internet network and some books, professional publications at the suggestion of mentors. I analysed, compared and presented various obtained information with findings in the text. Results: Because we are limited by CBCT technology in volume capture of the body area (FOV), it is especially suitable for displaying good spatial resolution of bones, joints and areas of interest where we do not need a large investigated image volume. Compared to classical CT the soft tissue display is poorer, but with the new CBCT technological system with the C arc, diagnostics has advanced and is still being improved. It allows the fusion of fluoroscopic images with previous 2D or 3D examinations performed from the capture of CBCT, CT or MR images. Discussion and conclusion: The CBCT imaging technique is very suitable for diagnostics where we are interested in a small area of interest of body overlap. It has a small voxel and good spatial resolution, so it opens up new possibilities for diagnosis and planning of interventional surgical treatment. The beginnings of CBCT are in the field of dentistry where it is still mostly used in the oral and maxillofacial regionsurgery, implantology, endodontics, periodontology and orthodontic treatment planning