Usefulness of MRI-CBCT Image Registration to Evaluate Temporomandibular Joint Internal Derangement by Novice Examiners

• Published in: Oral surgery, oral medicine, oral pathology and oral radiology
• Main Authors: Al-Saleh, Mohammed A.Q., DDS, MSc, PhD, Alsufyani., Noura, Ph.D, FRCD(C), Lai., Hollis, PhD, Lagravere., Manuel, Ph.D., FRCD(C), Jaremko, Jacob L., MD. PhD, Major, Paul W., DDS, MSc, FRCD(C)
• Format: Journal Article
• Language: English
• Published: 2016
• Subjects: Surgery
• ISSN: 2212-4403
• DOI: 10.1016/j.oooo.2016.10.016

Abstract Purpose To assess whether novice examiners can more reliably determine temporomandibular joint (TMJ) disc derangements using fused magnetic resonance and coned-beam computed tomography (MRI-CBCT) images compared to MRI alone. Methods Thirty dental students with minimal exposure to TMJ imaging received a 30-minute calibration session explaining TMJ diagnostic imaging and normal anatomy of the TMJ internal derangement. The students evaluated the disc positions of 16 TMJs in two sets of images (MRI-alone and MRI-CBCT images) randomly and independently. The disc positions evaluated by two experienced radiologists were used for comparison. Results The internal consistency among all students improved from an unacceptable consistency (α = 0.40) with MRI alone to a good consistency (α = 0.84) with MRI-CBCT images. The agreement between students and the radiologists improved from a poor agreement with MRI alone (k mean=0.07±0.12) to a moderate agreement with MRI-CBCT images (k mean=0.55±0.25). This improvement in the agreement was significant (p<0.001). Conclusions Fusing MRI and CBCT images to visualize the TMJs in a single display significantly improved the examiners’ reliability and accuracy of assessment of disc positions. The improvement of the novice readers in assessing the disc positions highlights the potential use of MRI-CBCT image fusion as an educational tool.