Assessing the reliability of MRI-CBCT image registration to visualize temporomandibular joints

Abstract

Objectives: To evaluate image quality of two methods of registering MRI and CBCT images of the temporomandibular joint (TMJ), particularly regarding TMJ articular disc-condyle relationship and osseous abnormality. Methods: MR and CBCT images for 10 patients (20 TMJs) were obtained and co-registered using two methods (non-guided and marker guided) using Mirada XD software (Mirada Medical Ltd, Oxford, UK). Three radiologists independently and blindly evaluated three types of images (MRI, CBCT and registered MRI-CBCT) at two times (T 1 and T 2 ) on two criteria: (1) quality of MRI-CBCT registrations (excellent, fair or poor) and (2) TMJ disc-condylar position and articular osseous abnormalities (osteophytes, erosions and subcortical cyst, surface flattening, sclerosis). Results: 75% of the non-guided registered images showed excellent quality, and 95% of the marker-guided registered images showed poor quality. Significant difference was found between the non-guided and marker-guided registration (x 2 5 108.5; p , 0.01). The interexaminer variability of the disc position in MRI [intraclass correlation coefficient (ICC) 5 0.50 at T 1 , 0.56 at T 2 ] was lower than that in MRI-CBCT registered images [ICC 5 0.80 (0.52-0.92) at T 1 , 0.84 (0.62-0.93) at T 2 ]. Erosions and subcortical cysts were noticed less frequently in the MRI-CBCT images than in CBCT images. Conclusions: Non-guided registration proved superior to marker-guided registration. Although MRI-CBCT fused images were slightly more limited than CBCT alone to detect osseous abnormalities, use of the fused images improved the consistency among examiners in detecting disc position in relation to the condyle.

Three-Dimensional Assessment of Temporomandibular Joint Using MRI-CBCT Image Registration

“…Only minute deformities may be missed in these images. Registering multiple MRI sequences to CBCT image with unified x,y, and z coordinates improves disc morphology visualization,[16] and potentially improves the disc segmentation accuracy and reduce the operator error. The accuracy of the mutual-information-based MRI-CBCT registration protocol was measured in a previous study by the same authors of the present study.…”

“…The registration process to generate MRI-CBCT images has been shown to be accurate and reliable in TMJ internal derangement assessment. [16,17]…”

Relación entre la presencia de cambios óseos de osteoartrosis del cóndilo mandibular e inclinación de la eminencia articular en pacientes clase II esquelética evaluados mediante tomografía computarizada de haz cónico

“…La inclinación de la eminencia articular puede variar entre los individuos y determina la trayectoria de movimiento condíleo, así como el grado de rotación del disco sobre el cóndilo ( [1][2][3][4][5][6][7][8][9][10] ). La profundidad de la cavidad glenoidea varía y el desarrollo de la eminencia articular depende de los estímulos funcionales que tenga el cóndilo ( [11][12][13][14][15][16][17][18][19][20]. Estudios sugieren que la formación ósea de compensación de la cavidad glenoidea podría ayudar a soportar el aumento de las sobrecargas en la ATM que acompañan los cambios óseos degenerativos condilares ( 2,(11)(12)(13)(14)(15) ).…”

“…Una opinión que Rev Cient Odontol (Lima). 2019; 7 (1): [34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52] Víctor Pardo Juárez se respalda por estos estudios es que el desarrollo de la eminencia articular y el cóndilo mandibular se ve más afectado por la función que por las características de la base del cráneo ( [15][16][17][18][19] ).…”

MRI and CBCT image registration of temporomandibular joint: A systematic review

“…Virtual 3D surface models have been developed to quantify tissue displacement between two time points using a color-coded scale [ 12 , 13 ]. Registration of CBCT images has evolved into automatic superimposition of 2 CBCT images using the mutual information registration concept and has recently been introduced as a new tool to evaluate the craniofacial changes and TMJ assessment [ 14 , 15 ].…”