Large scan field, high spatial resolution flat-panel detector based volumetric CT of the whole human skull base and for maxillofacial imaging.
OBJECTIVE
To assess the feasibility of flat-panel detector based volumetric CT (fpVCT) scanning of the whole human skull base and maxillofacial region, which has thus far only been demonstrated on small, excised specimens. Flat-panel detectors offer more favourable imaging properties than image intensifiers. It is therefore likely that they will replace them in cone-beam CT scanners that are currently used to scan parts of the skull base and maxillofacial region. Furthermore, the resolution of current CT imaging limits diagnosis, surgical planning and intraoperative navigation within these regions. fpVCT might overcome these limitations because it offers higher resolution of high contrast structures than current CT.


METHODS
Three embalmed cadaver heads were scanned in two scanners: an experimental fpVCT that offers a scan field large enough for a whole human head, and in a current multislice CT (MSCT). 28 structures were compared.


RESULTS
Both scanners produced bone images of diagnostic quality. Small high contrast structures such as parts of the ossicular chain and thin bony laminas were better delineated in fpVCT than in MSCT. fpVCT of maxillofacial region and skull base was rated superior to MSCT (P=0.002) as found in this limited, experimental study.


CONCLUSIONS
High spatial resolution fpVCT scanning of both regions in a whole human head is feasible and might be slightly superior to MSCT. fpVCT could improve diagnostic accuracy in selected cases, as well as surgical planning and intraoperative navigation accuracy.
Bartling
S H
SH
Department of Neuroradiology, OE 8210, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. soenkebartling@gmx.de
Majdani
O
O
Gupta
R
R
Rodt
T
T
Dullin
C
C
Fitzgerald
P F
PF
Becker
H
H
D000368:Aged; D002102:Cadaver; D007758:Ear, Inner / Q000000981:diagnostic imaging; D004867:Equipment Design; D005147:Facial Bones / Q000000981:diagnostic imaging*; D005240:Feasibility Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D008340:Mandibular Nerve / Q000000981:diagnostic imaging; D008442:Maxillary Nerve / Q000000981:diagnostic imaging; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000295:instrumentation / Q000379:methods; D019291:Skull Base / Q000000981:diagnostic imaging*; D013701:Temporal Bone / Q000000981:diagnostic imaging; D015898:Tomography Scanners, X-Ray Computed; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*; D014070:Tooth / Q000000981:diagnostic imaging