scholarly journals The Reliability of Two- and Three-Dimensional Cephalometric Measurements: A CBCT Study

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2292
Author(s):  
Chenshuang Li ◽  
Hellen Teixeira ◽  
Nipul Tanna ◽  
Zhong Zheng ◽  
Stephanie Hsiang Yi Chen ◽  
...  

Cephalometry is a standard diagnostic tool in orthodontic and orthognathic surgery fields. However, built-in magnification from the cephalometric machine produces double images from left- and right-side craniofacial structures on the film, which poses difficulty for accurate cephalometric tracing and measurements. The cone-beam computed tomography (CBCT) images not only allow three-dimensional (3D) analysis, but also enable the extraction of two-dimensional (2D) images without magnification. To evaluate the most reliable cephalometric analysis method, we extracted 2D lateral cephalometric images with and without magnification from twenty full-cranium CBCT datasets; images were extracted with magnification to mimic traditional lateral cephalograms. Cephalometric tracings were performed on the two types of extracted 2D lateral cephalograms and on the reconstructed 3D full cranium images by two examiners. The intra- and inter-examiner intraclass correlation coefficients (ICC) were compared between linear and angular parameters, as well as between CBCT datasets of adults and children. Our results showed that overall, tracing on 2D cephalometric images without magnification increased intra- and inter-examiner reliability, while 3D tracing reduced inter-examiner reliability. Angular parameters and children’s images had the lowest inter- and intra-examiner ICCs compared with adult samples and linear parameters. In summary, using lateral cephalograms extracted from CBCT without magnification for tracing/analysis increased reliability. Special attention is needed when analyzing young patients’ images and measuring angular parameters.

2019 ◽  
Vol 56 (9) ◽  
pp. 1164-1170 ◽  
Author(s):  
Diana S. Jodeh ◽  
S. Alex Rottgers

Background: Anthropometry is a well-established means of measuring facial morphology. Although reliable, direct anthropometry can be time-consuming and not conducive to a busy clinical practice. The Vectra H1 handheld stereophotogrammetric system requires 3 stereophotographs taken from different perspectives to generate a three-dimensional (3D) surface. The time needed to take the 3 stereophotographs can increase the possibility of involuntary movements, precluding its use to assess young patients. To overcome this limitation, we evaluated if accurate linear facial measurements can be obtained from a single stereophotograph and compare these to the measurements taken by direct anthropometry. Methods: Twenty pediatric patients, aged 0 to 10 years, who were undergoing minor surgical procedures at Johns Hopkins All Children’s Hospital were recruited. Fourteen linear facial distances were obtained from each participant using direct anthropometry under general anesthesia. These same distances were measured using Mirror 3D analysis. Intraclass correlation was used to determine intrarater reliability on duplicate 3D images. Results: Correlation coefficients between 3D imaging in frontal view and direct anthropometric measurements were excellent for 13 measures taken, ranging from 0.8 (subnasale to columella and subnasale to stomion superius) to 0.98 (nasion to subnasale and subnasale to labiale superius). Correlation coefficients between submental view and direct anthropometric measurements were excellent for 13 measures as well, ranging from 0.77 (subnasale to columella) to 0.98 (nasion to subnasale). Conclusions: Linear anthropometric measurements taken from 3D surfaces generated from a single stereophotograph correlate closely with direct anthropometric measures. This improves workflow and applicability of anthropometric studies to our youngest patients.


2013 ◽  
Vol 83 (6) ◽  
pp. 1049-1058 ◽  
Author(s):  
Liliane de Carvalho Rosas Gomes ◽  
Karla Orfelina Carpio Horta ◽  
Luiz Gonzaga Gandini ◽  
Marcelo Gonçalves ◽  
João Roberto Gonçalves

ABSTRACT Objective: To investigate the relationship between craniofacial measurements obtained from cephalometric radiographs and analogous measurements from profile photographs. Materials and Methods: Lateral cephalograms and standardized facial profile photographs were obtained from a sample of 123 subjects (65 girls, 58 boys; age 7–12 years). Intraclass correlation coefficients (ICCs) were calculated from repeated photographic measurements to evaluate method reliability. Analogous cephalometric and photographic measurements were compared to assess Pearson correlation coefficients. Linear regression analyses were conducted between the measurements that achieved correlation coefficients greater than r  =  0.7. Results: The reliability of the photographic technique was satisfactory. Most measurements showed ICCs above 0.80 and highly significant correlations (P ≤ .001) with cephalometric variables. Among all measurements used, the A'N'B' angle was the most effective in explaining the variability of its analogous cephalometric, mainly for female subjects (r2  =  0.80). The FMA' angle showed the best results for vertical assessment (r2  =  0.65). Conclusions: The photographic method has proven to be a repeatable and reproducible tool provided that a standardized protocol is followed. Therefore, it may be considered a feasible and practical diagnostic alternative, particularly if there is a need for a low-cost and noninvasive method.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Pieter-Jan Verhelst ◽  
H. Matthews ◽  
L. Verstraete ◽  
F. Van der Cruyssen ◽  
D. Mulier ◽  
...  

AbstractAutomatic craniomaxillofacial (CMF) three dimensional (3D) dense phenotyping promises quantification of the complete CMF shape compared to the limiting use of sparse landmarks in classical phenotyping. This study assesses the accuracy and reliability of this new approach on the human mandible. Classic and automatic phenotyping techniques were applied on 30 unaltered and 20 operated human mandibles. Seven observers indicated 26 anatomical landmarks on each mandible three times. All mandibles were subjected to three rounds of automatic phenotyping using Meshmonk. The toolbox performed non-rigid surface registration of a template mandibular mesh consisting of 17,415 quasi landmarks on each target mandible and the quasi landmarks corresponding to the 26 anatomical locations of interest were identified. Repeated-measures reliability was assessed using root mean square (RMS) distances of repeated landmark indications to their centroid. Automatic phenotyping showed very low RMS distances confirming excellent repeated-measures reliability. The average Euclidean distance between manual and corresponding automatic landmarks was 1.40 mm for the unaltered and 1.76 mm for the operated sample. Centroid sizes from the automatic and manual shape configurations were highly similar with intraclass correlation coefficients (ICC) of > 0.99. Reproducibility coefficients for centroid size were < 2 mm, accounting for < 1% of the total variability of the centroid size of the mandibles in this sample. ICC’s for the multivariate set of 325 interlandmark distances were all > 0.90 indicating again high similarity between shapes quantified by classic or automatic phenotyping. Combined, these findings established high accuracy and repeated-measures reliability of the automatic approach. 3D dense CMF phenotyping of the human mandible using the Meshmonk toolbox introduces a novel improvement in quantifying CMF shape.


2009 ◽  
Vol 46 (2) ◽  
pp. 147-153 ◽  
Author(s):  
E. M. Ongkosuwito ◽  
M. M. J. Dieleman ◽  
A. M. Kuijpers-Jagtman ◽  
P. G. H. Mulder ◽  
J. W. van Neck

Objective: To investigate the reliability of length measurements of the mandible by comparing orthopantomograms (OPTs) with lateral cephalograms. Design: Observational study. Setting: OPTs and lateral cephalograms were taken of 20 human dry skulls. Four orthodontists and four maxillofacial surgeons located landmarks on all radiographs using a computer program for cephalometric measurements. Intraobserver and interobserver variability in locating landmarks was assessed, as well as positioning of the skulls prior to radiography between the x-ray assistants. Magnification differences between the left and right side of the mandible on the OPT were determined for five skulls. Kappa statistics were used to calculate the intraclass correlation coefficient for intraobserver and interobserver differences. An F test was used to assess differences between methods and between type of observer. Results: No significant differences were found in the magnification factor of the left and right side of the mandible. Compared with a lateral cephalogram, the OPT had comparable reliability in measuring mandibular distances condylion-gonion, gonion-menton, and condylion-menton. No significant differences were observed between the x-ray assistants in taking the OPTs and lateral cephalograms or in repositioning the skulls. Significant differences were found between orthodontists and maxillofacial surgeons for landmark measurements. Conclusion: An OPT is as reliable as a lateral cephalogram for linear measurements of the mandible (condylion-gonion, gonion-menton, and condylion-menton).


2020 ◽  
Author(s):  
Jiangang Sun ◽  
Yang Liu

BACKGROUND An increasing number of wrist-worn wearables are being examined in the context of health care. However, studies of their use during physical education (PE) lessons remain scarce. OBJECTIVE We aim to examine the reliability and validity of the Fizzo Smart Bracelet (Fizzo) in measuring heart rate (HR) in the laboratory and during PE lessons. METHODS In Study 1, 11 healthy subjects (median age 22.0 years, IQR 3.75 years) twice completed a test that involved running on a treadmill at 6 km/h for 12 minutes and 12 km/h for 5 minutes. During the test, participants wore two Fizzo devices, one each on their left and right wrists, to measure their HR. At the same time, the Polar Team2 Pro (Polar), which is worn on the chest, was used as the standard. In Study 2, we went to 10 schools and measured the HR of 24 students (median age 14.0 years, IQR 2.0 years) during PE lessons. During the PE lessons, each student wore a Polar device on their chest and a Fizzo on their right wrist to measure HR data. At the end of the PE lessons, the students and their teachers completed a questionnaire where they assessed the feasibility of Fizzo. The measurements taken by the left wrist Fizzo and the right wrist Fizzo were compared to estimate reliability, while the Fizzo measurements were compared to the Polar measurements to estimate validity. To measure reliability, intraclass correlation coefficients (ICC), mean difference (MD), standard error of measurement (SEM), and mean absolute percentage errors (MAPE) were used. To measure validity, ICC, limits of agreement (LOA), and MAPE were calculated and Bland-Altman plots were constructed. Percentage values were used to estimate the feasibility of Fizzo. RESULTS The Fizzo showed excellent reliability and validity in the laboratory and moderate validity in a PE lesson setting. In Study 1, reliability was excellent (ICC&gt;0.97; MD&lt;0.7; SEM&lt;0.56; MAPE&lt;1.45%). The validity as determined by comparing the left wrist Fizzo and right wrist Fizzo was excellent (ICC&gt;0.98; MAPE&lt;1.85%). Bland-Altman plots showed a strong correlation between left wrist Fizzo measurements (bias=0.48, LOA=–3.94 to 4.89 beats per minute) and right wrist Fizzo measurements (bias=0.56, LOA=–4.60 to 5.72 beats per minute). In Study 2, the validity of the Fizzo was lower compared to that found in Study 1 but still moderate (ICC&gt;0.70; MAPE&lt;9.0%). The Fizzo showed broader LOA in the Bland-Altman plots during the PE lessons (bias=–2.60, LOA=–38.89 to 33.69 beats per minute). Most participants considered the Fizzo very comfortable and easy to put on. All teachers thought the Fizzo was helpful. CONCLUSIONS When participants ran on a treadmill in the laboratory, both left and right wrist Fizzo measurements were accurate. The validity of the Fizzo was lower in PE lessons but still reached a moderate level. The Fizzo is feasible for use during PE lessons.


2019 ◽  
Vol 90 (3) ◽  
pp. 397-404 ◽  
Author(s):  
Zhuoxing Xiao ◽  
Zijin Liu ◽  
Yan Gu

ABSTRACT Objective To evaluate three-dimensional (3D) accuracy and reliability of nonradiographic dentofacial images integrated with a two-step method. Methods 3D facial images, cone-beam computed tomography (CBCT) images and digital maxillary dental casts were obtained from 20 pre-orthodontic subjects. Digital dental casts were integrated into 3D facial images using a two-step method based on the anterior tooth area. 3D coordinate values of five dental landmarks were identified in both dentofacial images and CBCT images. The accuracy of the integration method was assessed with paired t-tests between dentofacial images and CBCT-based reference standards. Intraclass correlation coefficients (ICCs) were assessed for the reliability of dentofacial images and CBCT-based images. Analysis of variance and Kruskal-Wallis tests evaluated the accuracy of the method in different dimensions. Results There was no statistical difference between dentofacial images and CBCT reference standards in both translational and rotational dimensions (P &gt; .05). Translational mean absolute errors for full dentitions were within 0.42 mm and ICCs were over 0.998 in x, y, and z directions. Rotational mean absolute errors for full dentitions were within 0.92° and ICCs over 0.734 in pitch, yaw, and roll orientations. Integration errors were significantly greater in the first molar, z-translation, and pitch rotation (P &lt; .05). Conclusions Integrating 3D dentofacial images with the two-step method is precise and acceptable for clinical diagnostics and scientific purposes. Errors were greater in the molar region, z-translation, and pitch rotation.


2001 ◽  
Vol 21 (10) ◽  
pp. 1146-1150 ◽  
Author(s):  
Jussi Hirvonen ◽  
Kjell Någren ◽  
Jaana Kajander ◽  
Jarmo Hietala

[11C]SCH 23390 is a standard ligand for positron emission tomography (PET) studies on striatal dopamine D1 receptors. Its usefulness for cortical D1 receptor quantification in human PET studies has been questioned but has not been addressed previously. The authors tested the reproducibility of [11C]SCH 23390 binding potential (BP) in cortical areas in five healthy volunteers using three-dimensional PET. Measurement of D1 receptor BP was reproducible in basal ganglia, as well as in all cortical areas studied (intraclass correlation coefficients between 0.81 and 0.92). The absolute variability in cortical areas was 9.21% ± 0.07%. The reproducibility of cortical D1 receptor BP measurement with [11C]SCH 23390 is equal to that observed with a more recent D1 -ligand, [11C]NNC 112. [11C]NNC 112 produces slightly higher specific-to-nonspecific binding ratios but has markedly slower kinetics resulting in a need for a longer scan time. These aspects should be considered when designing studies on the cortical D1 -like receptors.


2006 ◽  
Vol 43 (2) ◽  
pp. 129-137 ◽  
Author(s):  
Emeka Nkenke ◽  
Bernhard Lehner ◽  
Manuel Kramer ◽  
Gerd Haeusler ◽  
Stefanie Benz ◽  
...  

Objective To assess measurement errors of a novel technique for the three-dimensional determination of the degree of facial symmetry in patients suffering from unilateral cleft lip and palate malformations. Design Technical report, reliability study. Setting Cleft Lip and Palate Center of the University of Erlangen-Nuremberg, Erlangen, Germany. Patients The three-dimensional facial surface data of five 10-year-old unilateral cleft lip and palate patients were subjected to the analysis. Distances, angles, surface areas, and volumes were assessed twice. Main Outcome Measures Calculations were made for method error, intraclass correlation coefficient, and repeatability of the measurements of distances, angles, surface areas, and volumes. Results The method errors were less than 1 mm for distances and less than 1.5° for angles. The intraclass correlation coefficients showed values greater than .90 for all parameters. The repeatability values were comparable for cleft and noncleft sides. Conclusion The small method errors, high intraclass correlation coefficients, and comparable repeatability values for cleft and noncleft sides reveal that the new technique is appropriate for clinical use.


2016 ◽  
Vol 86 (6) ◽  
pp. 1004-1009 ◽  
Author(s):  
Asli Baysal ◽  
Ahmet Oguz Sahan ◽  
Mehmet Ali Ozturk ◽  
Tancan Uysal

ABSTRACT Objective: To evaluate the intraexaminer repeatability and interexaminer reproducibility of soft tissue landmarks on three-dimensional (3-D) stereophogrammetric images. Materials and Methods: Thirty-four stereophotogrammetric images were taken and 19 soft tissue points were identified. The images were obtained using the 3-DMD Face (3-DMD TM Ltd, Atlanta, Ga) system. Two examiners marked 34 images manually with a mouse-driven cursor 4 weeks apart. Intraexaminer marking differences were calculated and classified as &lt;0.5 mm, 0.5–1 mm, and &gt;1 mm. Intraclass correlation coefficients were calculated for intraexaminer reliability. A paired-samples t-test was used to evaluate the difference between the examiners. Interexaminer reproducibility was evaluated by kappa analysis. Statistical significance was set at P &lt; .05. Results: Only one landmark (labiale superior) had an intraexaminer marking difference less than 0.5 mm. Existing landmarks had an intraexaminer difference less than 1 mm, but higher than 0.5 mm. The intraclass correlation coefficients (ICCs) indicated good intraexaminer repeatability for both observers. The ICC range for examiners 1 and 2 was 0.986–1.000 and 0.990–1.000, respectively. Kappa scores showed good interexaminer agreement, especially on the z-axis. Conclusions: Except labiale superior, the soft tissue landmarks used in this study were shown to have moderate reproducibility, but the difference between the landmarks was less than 1 mm, and they had clinically acceptable reproducibility.


2020 ◽  
pp. 193229682097465
Author(s):  
Joel Willem Johan Lasschuit ◽  
Jill Featherston ◽  
Katherine Thuy Trang Tonks

Background: In an era of increasing technology and telehealth utilization, three-dimensional (3D) wound cameras promise reliable, rapid, and touch-free ulceration measurements. However, reliability data for commercially available devices in the diabetes foot service setting is lacking. We aimed to evaluate the reliability of diabetes-related foot ulceration measurement using a 3D wound camera in comparison to the routinely used ruler and probe. Method: Participants were prospectively recruited from a tertiary interdisciplinary diabetes foot service. Ulcerations were measured at each visit by two blinded observers, first by ruler and probe, and then using a 3D wound camera twice. Reliability was evaluated using intraclass correlation coefficients (ICC). Measurement methods were compared by Pearson correlation. Results: Sixty-three ulcerations affecting 38 participants were measured over 122 visits. Interobserver reliability of ruler measurement was excellent for estimated area (ICC 0.98, 95% CI 0.97-0.98) and depth (ICC 0.93, 95% CI 0.90-0.95). Intraobserver and interobserver reliability of the 3D wound camera area was excellent (ICC 0.96, 95%CI 0.95-0.97 and 0.97 95% CI 0.96-0.98, respectively). Depth was unrecordable in over half of 3D wound camera measurements, and reliability was inferior to probe measurement. Area correlation between methods was good ( R = 0.88 and 0.94 per observer); however, depth correlation was poor ( R = 0.49 and 0.65). Conclusions: 3D wound cameras offer practical advantages over ruler-based measurement. In diabetes-related foot ulceration, the reliability and comparability of area measurement was excellent across both methods, although depth was more reliably obtained by the probe. These limitations, together with cost, are important considerations if implementing this technology in diabetes foot care.


Sign in / Sign up

Export Citation Format

Share Document