Evaluation of velopharyngeal closure by 4D imaging using 320-detector-row computed tomography

Sakamoto, Yoshiaki; Soga, Shigeyoshi; Jinzaki, Masahiro; Yamada, Yoshitake; Ogata, Hisao; Kishi, Kazuo

doi:10.1016/j.bjps.2014.12.020

Cited by 15 publications

(17 citation statements)

References 16 publications

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“…In 2015, Sakamoto et al first reported the clinical application of 320-ADCT to estimate VPF in patients with cleft palate [8]. The authors evaluated five children (aged 4–10 years) with persistent VPI post-palatoplasty with 10-s imaging, during vowel phonation and swallowing.…”

Section: Introductionmentioning

confidence: 99%

“…The authors evaluated five children (aged 4–10 years) with persistent VPI post-palatoplasty with 10-s imaging, during vowel phonation and swallowing. They concluded that 320-ADCT provides detailed morphological and kinematic analysis of VPC and may offer advantages over conventional procedures [8]. However, the authors also advised that the high exposure dose during imaging (4.44 ± 1.64 mSv) could not be ignored in pediatric patients.…”

Section: Introductionmentioning

confidence: 99%

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Velopharyngeal closure analysis using four-dimensional computed tomography: a pilot study of healthy volunteers and adult patients with cleft palate

et al. 2019

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Background Nasopharyngoscopy is a common method to evaluate velopharyngeal closure in patients with cleft palate. However, insertion of a fiberoptic nasopharyngoscope causes discomfort in patients. The aim of this study was to estimate the reliability of short-time exposure images obtained using 320-row area detector computed tomography (320-ADCT) as a novel evaluation method for the assessment of velopharyngeal function. Methods We evaluated five healthy adult volunteers and five postoperative adult patients with cleft palate. During a 3.3-s imaging exposure, the participants were asked to perform two tasks: nasal inspiration and subsequent oral expiration through a catheter into a water-filled cup. The movement of the velopharyngeal structures was recorded during each examination, and the presence of velopharyngeal insufficiency (VPI) and velopharyngeal closure (VPC) patterns were estimated. If VPI was detected, the cross-sectional area was also calculated. Cohen’s kappa and weighted kappa coefficients were used to evaluate the concordance of nasopharyngoscopy and 320-ADCT evaluation. Results Speech pathology evaluation did not reveal hypernasality in any study participant. Micro-VPI was detected by nasopharyngoscopy in one healthy volunteer and two patients. 320-ADCT detected micro-VPI in two more patients. The cross-sectional area of the VPI in these subjects ranged from 2.53 to 16.28 mm 2 . Nasopharyngoscopy and 320-ADCT were concordant in detecting VPI in eight participants (κ = 0.6) and in assessing VPC patterns in nine (κ = 0.82). Moreover, images obtained using 320-ADCT allowed for reduced dead angle and, thus, easy detection of micro-VPI and Passavant’s ridges. Conclusion Although the radiation exposure cannot be ignored, our novel evaluation method using 320-ADCT enables more detailed evaluation of VPC than nasopharyngoscopy. Future studies should investigate the relationship between 320-ADCT findings and speech pathology evaluations. Electronic supplementary material The online version of this article (10.1186/s12880-019-0350-4) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Velopharyngeal closure analysis using four-dimensional computed tomography: a pilot study of healthy volunteers and adult patients with cleft palate

et al. 2019

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“…In their 2015 study, Sakamoto et al [3] reported the rst 4D assessment of VPF in a patient with cleft palate by using 320-ADCT. They evaluated VPF in ve pediatric patients during an exposure time of approximately 10 seconds and concluded that 4D-CT produces clear and detailed images with less stress and pain; it also had a shorter examination duration than that of other imaging modalities, and allows a quantitative VPC evaluation [3]. However, they reported that a major drawback of their procedure was an average radiation exposure of 4.44 mSv, which is larger than the level required in cephalometry, video uoroscopy, and conventional CT [3].…”

Section: Discussionmentioning

confidence: 99%

“…In 2019, we reported a four-dimensional (4D) evaluation method that appends the time phase image to threedimensional (3D) images for the assessment of velopharyngeal closure (VPC) by using 320-row area detector computed tomography (320-ADCT) images acquired from adult volunteers; this method was named "virtual nasopharyngoscopy" [2]. When using this method, the time and dose of exposure were reduced, compared to those of a previously reported method [3]. In this study, we report the application of our method to pediatric patients and estimate the organ-absorbed doses in these patients by using Monte Carlo (MC) simulation.…”

Section: Introductionmentioning

confidence: 99%

Early experience with four-dimensional computed tomography for observing velopharyngeal closure function in pediatric patients and the evaluation of the exposure dose

Kobayashi

Kanamori

et al. 2020

Preprint

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Background The aims of this study were to perform a four-dimensional assessment of velopharyngeal closure function in pediatric patients with cleft palate using 320-row area detector computed tomography (CT), and to estimate the organ-absorbed doses using Monte Carlo simulation. Methods We evaluated CT image data obtained between July 2018 and August 2019 from five pediatric patients with cleft palate (four boys and one girl; age range, 4–7 years) at Fujita Health University Hospital. The presence of velopharyngeal insufficiency (VPI), patterns of velopharyngeal closure (VPC), and cross-sectional area of VPI were evaluated. In addition, organ-absorbed doses were assumed in the Monte Carlo simulation. However, we did not perform statistical analysis because of the insufficient number of patients enrolled in this study. Results The existence of VPI and hypernasality were completely concordant. The VPC patterns were circular (two patients), circular with Passavant’s ridge (one patient), and unevaluable (two patients). The organ-absorbed doses were relatively lower than those in past reports. Conclusions Our method could be an alternative for patients who refuse the conventional nasopharyngoscopic evaluation.

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“…Furthermore, a 320 detector CT device was developed in 2007, enabling a longitudinal coverage of 16 cm in one rotation (Rybicki et al 2008). Repetitive acquisitions at the same position using a wider range of acquisition during one rotation has enabled four dimensional (4D) imaging (Fujiwara et al 2013;Sakamoto et al 2015) .4 Improvement of CT image quality using iterative reconstruction techniques Left: An image obtained using 0.12 mSv, which is almost equal or less than the dose associated with a simple chest X-ray examination. The image quality is very low Right: An image reconstructed from the 0.12 mSv image using an iterative reconstruction technique.…”

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confidence: 99%

Development of Upright CT and Its Initial Evaluation: Effect of Gravity on Human Body and Potential Clinical Application

Jinzaki

2019

Make Life Visible

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The first images of the human body's interior date back to 1895, when Roentgen discovered X-rays (Röntgen 1896). An X-ray of his wife's hand provided the first image of a human internal structure. Unfortunately, the contrast produced by X-rays was not sufficient to visualize internal organs, such as the liver, spleen, kidney, or urinary bladder (Fig. 27.1). To compensate for the weakness of low-contrast X-rays, a contrast material was developed in 1896, 1 year after the discovery of X-rays (Haschek 1896). Thereafter, iodinated contrast material (CM) was developed and has been widely used ever since (Brooks 1924; Wallingford 1953). CM enables the visualization of the vascular system, urinary tract system, biliary tract system and alimentary tract system during projection imaging using X-rays (Fig. 27.2). 27.2 Cross-Sectional Imaging of Human Body In 1972, Hounsfield developed a technology called computed tomography (CT) that enabled cross-sectional imaging in humans (Hounsfield 1973). Since then, the scanning time has improved with the development of single-helical scans in 1990 (Kalender et al. 1990) and a four-row detector CT in 1999 (Hu 1999), and the scanning time was drastically improved by the development of a 64-detector CT in 2004. This development also enabled thinner slice images with a slice thickness of less

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Evaluation of velopharyngeal closure by 4D imaging using 320-detector-row computed tomography

Cited by 15 publications

References 16 publications

Velopharyngeal closure analysis using four-dimensional computed tomography: a pilot study of healthy volunteers and adult patients with cleft palate

Velopharyngeal closure analysis using four-dimensional computed tomography: a pilot study of healthy volunteers and adult patients with cleft palate

Early experience with four-dimensional computed tomography for observing velopharyngeal closure function in pediatric patients and the evaluation of the exposure dose

Development of Upright CT and Its Initial Evaluation: Effect of Gravity on Human Body and Potential Clinical Application

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