Evaluation of cephalometric landmark identification on CBCT multiplanar and 3D reconstructions.
OBJECTIVE
To evaluate the reliability of three-dimensional (3D) landmark identification in cone-beam computed tomography (CBCT) using two different visualization techniques.


METHODS
Twelve CBCT images were randomly selected. Three observers independently repeated three times the identification of 30 landmarks using 3D reconstructions and 28 landmarks using multiplanar views. The values of the coordinates X, Y, and Z of each point were obtained and the intraclass correlation coefficient (ICC) was calculated.


RESULTS
The ICC of the 3D visualization was rated >0.90 in 67.76% and 45.56%, and ≤0.45 in 13.33% and 14.46% of the intraobserver and interobserver assessments, respectively. The ICC of the multiplanar visualization was rated >0.90 in 82.16% and 78.56% and ≤0.45 in only 16.7% and 8.33% of the intraobserver and interobserver assessments, respectively. An individual landmark classification was done according to ICC values.


CONCLUSIONS
The frequency of highly reliable values was greater for multiplanar than 3D reconstructions. Overall, lower reliability was found for points on the condyle and higher reliability for those on the midsagittal plane. Depending on the anatomic region, the observer must choose the most reliable type of image visualization.
a  Former Graduate Student, Department of Orthodontics, Universidade Federal Fluminense, Niterói, RJ, Brazil.
Marcelo Baião da
MB
Neiva
Álvaro Cavalheiro
ÁC
Soares
Cinthia de Oliveira
Cde O
Lisboa
Oswaldo de Vasconcellos
Ode V
Vilella
Alexandre Trindade
AT
Motta
D000328:Adult; D059925:Anatomic Landmarks / Q000000981:diagnostic imaging*; D002508:Cephalometry / Q000706:statistics & numerical data*; D002680:Chin / Q000000981:diagnostic imaging; D054893:Cone-Beam Computed Tomography / Q000379:methods / Q000706:statistics & numerical data*; D005147:Facial Bones / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods / Q000706:statistics & numerical data; D021621:Imaging, Three-Dimensional / Q000379:methods / Q000706:statistics & numerical data*; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging; D008335:Mandibular Condyle / Q000000981:diagnostic imaging; D008437:Maxilla / Q000000981:diagnostic imaging; D009295:Nasal Bone / Q000000981:diagnostic imaging; D015588:Observer Variation; D015203:Reproducibility of Results; D014584:User-Computer Interface; D055815:Young Adult
Anatomic reference points; Cone-beam computed tomography; Orthodontics; Three-dimensional images