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Diagnostic efficacy of CBCT, MRI, and CBCT-MRI fused images in distinguishing articular disc calcification from loose body of temporomandibular joint

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Abstract

Objectives

To evaluate the diagnostic efficacy of CBCT-MRI fused images for articular disc calcification of temporomandibular joint (TMJ).

Materials and methods

Twenty patients (24 TMJs) whose image examinations showed dense bodies in the TMJ space were included in the study. The locations of dense bodies evaluated by the three experts were used as a reference standard. Three oral and maxillofacial radiology residents evaluated whether the dense bodies were disc calcification or not, with a five-point scale for four sets of images (CBCT alone, MRI alone, both CBCT and MRI observed at a time, and CBCT-MRI fused images) randomly and independently. Each set of images was observed at least 1 week apart. A second evaluation was performed after 4 weeks. Intraclass correlation coefficients were calculated to assess the intra- and inter-observer agreement. The areas under the ROC curves (AUCs) were compared between the four image sets using Z test.

Results

Ten cases were determined as articular disc calcifications, and fourteen cases were recognized as loose bodies in the TMJ spaces. The average AUC index for the CBCT-MRI fused images was 0.95 and significantly higher than the other sets (p < 0.01). The intra- and inter-observer agreement in the CBCT-MRI fused images (0.90–0.91, 0.93) was excellent and higher than those in the other images.

Conclusions

CBCT-MRI fused images can significantly improve the observers’ reliability and accuracy in determining articular disc calcification of the TMJ.

Clinical relevance

The multimodality image fusion is feasible in detecting articular disc calcification of the TMJ which are hard to define by CBCT or MRI alone. It can be utilized especially for inexperienced residents to shorten the learning curve and improve diagnostic accuracy.

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Funding

The study was supported by the National Natural Science Foundation of China (No. 81671034) and National Key R&D Program of China (No. 2018YFC0807303)

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Correspondence to Gang Li.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the study involving human participants were in accordance with the ethical standards of Institutional Review Board of Peking University School and Hospital of Stomatology and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Institutional Review Board of Peking University School and Hospital of Stomatology (PKUSSIRB-202054057).

Informed consent

Written informed consent was not required for this study because all the included patients in the present investigation were collected retrospectively. Exemption of informed consent will not affect the rights and health of included patients. The application for free informed consent has been approved by the Institutional Review Board.

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Wang, Yh., Li, G., Ma, Rh. et al. Diagnostic efficacy of CBCT, MRI, and CBCT-MRI fused images in distinguishing articular disc calcification from loose body of temporomandibular joint. Clin Oral Invest 25, 1907–1914 (2021). https://doi.org/10.1007/s00784-020-03497-w

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  • DOI: https://doi.org/10.1007/s00784-020-03497-w

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