The Effect of Exposure Factors on Reliability of Voxel Values from Cone-Beam Computed Tomography on Density Evaluation

Several factors affect the success rate of dental implants, including the quality of bone. Schwartz for the first time described the use of computed tomography (CT) to classify bone density. Cone-beam CT (CBCT) has replaced CT in various fields due to lower dose and cost. This study aimed to evaluate the effect of exposure factors on reliability of CBCT in determining density.
In this study, CT dose index phantoms including nine different concentrations of 76% meglumine with active ingredient of iodine were subjected to CBCT imaging with Planmecca 3D Mid under different exposure conditions. To obtain Hounsfield unit from CT, CT imaging from the phantoms was performed under standard conditions. Hounsfield unit and voxel values from CBCT and CT were recorded under all conditions, then, the difference and correlation between them was evaluated using paired-samples t-test and linear regression.
The results of this study showed excellent correlation between voxel values from CBCT and Hounsfield unit from CT (R=0.847). With changing the kVp conditions and mA this correlation remained high (R>0.8). There was no significant difference between the voxel values from CBCT and Hounsfield unit from CT under standard exposure conditions (P=0.6). However, variation in the amount of radiation exposure factors caused a significant change in CT and CBCT values, which could affect reliability of voxel values from CBCT (P=0.049).
Our findings exhibited no significant difference between voxel values from CBCT and Hounsfield unit from CT. Furthermore, changes in exposure factors can affect the reliability of voxel values.