Usefulness of MRI-CBCT image registration in the evaluation of temporomandibular joint internal derangement by novice examiners

• Published in: Oral surgery, oral medicine, oral pathology and oral radiology oral medicine, oral pathology and oral radiology, 2017-02, Vol.123 (2), p.249-256
• Main Authors: Al-Saleh, Mohammed A.Q., Alsufyani, Noura, Lai, Hollis, Lagravere, Manuel, Jaremko, Jacob L., Major, Paul W.
• Format: Article
• Language: English
• Subjects: Clinical Competence; Cone-Beam Computed Tomography - methods; Dentistry; Education, Dental; Female; Humans; Image Interpretation, Computer-Assisted; Magnetic Resonance Imaging - methods; Male; Reproducibility of Results; Temporomandibular Joint Disorders - diagnostic imaging
• ISSN: 2212-4403; 2212-4411
• DOI: 10.1016/j.oooo.2016.10.016

To assess whether novice examiners can more reliably determine temporomandibular joint (TMJ) disk derangements with the use of fused images of magnetic resonance imaging and cone beam computed tomography (MRI-CBCT) compared with MRI images alone. Thirty dental students with minimal exposure to TMJ imaging received a 30-minute calibration session in which TMJ diagnostic imaging and the normal anatomy of the TMJ internal derangement were explained. The students evaluated the disk positions of 16 TMJs in two sets of images (MRI images alone and MRI-CBCT images) randomly and independently. The disk positions evaluated by two experienced radiologists were used for comparison. The internal consistency among all students improved from an unacceptable consistency (α = 0.40) with MRI images alone to a good consistency (α = 0.84) with MRI-CBCT images. The agreement in evaluation between the students and the radiologists improved from a poor agreement with MRI images 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