Effect of voxel size on the accuracy of 3D reconstructions with cone beam CT

Objectives: The various types of cone beam CT (CBCT) differ in several technical characteristics, notably their spatial resolution, which is defined by the acquisition voxel size. However, data are still lacking on the effects of voxel size on the metric accuracy of three-dimensional (3D) reconstructions. This study was designed to assess the effect of isotropic voxel size on the 3D reconstruction accuracy and reproducibility of CBCT data. Methods: The study sample comprised 70 teeth (from the Institut d'Anatomie Normale, Strasbourg, France). The teeth were scanned with a KODAK 9500 3D (R) CBCT (Carestream Health, Inc., Marne-la-Vallee, France), which has two voxel sizes: 200 mu m (CBCT 200 mu m group) and 300 mu m (CBCT 300 mu m group). These teeth had also been scanned with the KODAK 9000 3D (R) CBCT (Carestream Health, Inc.) (CBCT 76 mu m group) and the SCANCO Medical micro-CT XtremeCT (SCANCO Medical, Bruttisellen, Switzerland) (micro-CT 41 mu m group) considered as references. After semi-automatic segmentation with AMIRA (R) software (Visualization Sciences Group, Burlington, MA), tooth volumetric measurements were obtained. Results: The Bland-Altman method showed no difference in tooth volumes despite a slight underestimation for the CBCT 200 mu m and 300 mu m groups compared with the two reference groups. The underestimation was statistically significant for the volumetric measurements of the CBCT 300 mu m group relative to the two reference groups (Passing-Bablok method). Conclusions: CBCT is not only a tool that helps in diagnosis and detection but it has the complementary advantage of being a measuring instrument, the accuracy of which appears connected to the size of the voxels. Future applications of such measurements with CBCT are discussed. Dentomaxillofacial Radiology (2012) 41, 649-655. doi: 10.1259/dmf/81804525