Analysis of linear measurement accuracy obtained by cone beam computed tomography (CBCT-NewTom VG)

Background: One of the major uses of cone beam computed tomography (CBCT) is presurgical implant planning. Linear measurement is used for the determination of the quantity of alveolar bone (height and width). Linear measurements are used in orthodontic analysis and definition of jaw tumor size. The objective of this study is to evaluate the accuracy of the linear measurement of CBCT (Newtom VG) in the axial and coronal planes, with two different voxel sizes.

Materials and methods: In this accuracy diagnostic study, 22 anatomic landmarks in four dry human skulls were marked by gutta-percha. Fifteen linear measurements were obtained using a digital caliper. These were considered to be the gold standard (real measurement). The skulls were scanned by CBCT (Newtom VG) at two settings: (a) Voxel size 0.3 mm (b) voxel size 0.15 mm High Resolution (HR). The radiographic distance measurements were made in the axial and coronal sections by three observers. The radiographic measurements were repeated two weeks later for evaluation of intraobserver reliability. SPSS software version 17 was used for data analysis. The level of significance was considered to be 5% (P ≤ 0.05).

Results: The mean differences of real and radiographic measurements were -0.10±0.99 mm in the axial sections, -0.27±1.07 mm in the coronal sections, +0.14±1.44 mm in the axial (HR) sections, and 0.02±1.4 mm in the coronal (HR) sections. The intraclass correlation (ICC) for CBCT measurements in the axial sections was 0.9944, coronal sections 0.9941, axial (HR) sections 0.9935, and coronal (HR) sections 0.9937. The statistical analysis showed high interobserver and intraobserver reliability (P ≤ 0.05).

Conclusion: CBCT (Newtom VG) is highly accurate and reproducible in linear measurements in the axial and coronal image planes and in different areas of the maxillofacial region. According to the findings of the present study, a CBCT scan with a larger voxel size (0.3 mm in comparison to 0.15 mm) is recommended when the purpose of the CBCT scan is to measure linear distances. This will result in lower patient radiation dose and faster scan time.