title: Movement characteristics in young patients and the impact on CBCT image quality.
abstract: OBJECTIVE
  To assess patient movement characteristics in children and young adults and the impact on CBCT image quality.
  
  
  METHODS
  During 33 CBCT examinations, the patients (age: average, 14 years; range, 9-25 years) who had moved were identified by video observation [movement group (MG)]. The CBCT data sets were matched with those of 33 non-moving patients according to age, diagnostic task, examined region, field of view and voxel resolution [non-movement group (N-MG)]. Three observers scored the videos of MG, regarding motional state second by second (moving/non-moving), and movement characteristics: duration (in seconds), complexity (uniplanar or multiplanar) and distance (<3/≥3 ≤ 10/>10 mm). The observers blindly assessed axial sections of the 66 examinations individually, categorizing the image quality (appropriate/acceptable/inappropriate). Next, the observers blindly assessed axial sections of the matched-pairs images simultaneously, deciding which image in the pair had the highest image quality or if it was impossible to decide. The relationship between image quality and movement/movement characteristics was evaluated.
  
  
  RESULTS
  When the 66 CBCT images were evaluated individually, no relationship between image quality and movement was found. However, based on the matched-pairs assessment, accumulated number (≤2 vs ≥3, p = 0.039), duration (≤5 s vs ≥6 s, p = 0.024) and complexity (uniplanar vs multiplanar, p = 0.046) of movements had an impact on image quality; the more severe the movement, the more often the image quality was assessed lower in the MG.
  
  
  CONCLUSIONS
  Axial CBCT images of young patients who moved during examination did not always present lower quality than images originating from non-moving patients. Image quality was, however, significantly lower in the moving patients when movement occurred several times, had a long duration or was multiplanar.
authors.affiliation: Oral Radiology, Department of Dentistry, Aarhus University, Aarhus, Denmark.
authors.forename: Rubens
authors.initials: R
authors.lastname: Spin-Neto
authors.affiliation: Oral Radiology, Department of Dentistry, Aarhus University, Aarhus, Denmark.
authors.forename: Louise H
authors.initials: LH
authors.lastname: Matzen
authors.affiliation: Oral Radiology, Department of Dentistry, Aarhus University, Aarhus, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Schropp
authors.affiliation: Oral Radiology, Department of Dentistry, Aarhus University, Aarhus, Denmark.
authors.forename: Erik
authors.initials: E
authors.lastname: Gotfredsen
authors.affiliation: Oral Radiology, Department of Dentistry, Aarhus University, Aarhus, Denmark.
authors.forename: Ann
authors.initials: A
authors.lastname: Wenzel
mesh_terms: D000293:Adolescent; D000328:Adult; D016477:Artifacts; D016022:Case-Control Studies; D002648:Child; D054893:Cone-Beam Computed Tomography / Q000592:standards*; D003481:Cuspid / Q000000981:diagnostic imaging; D005260:Female; D006257:Head / Q000000981:diagnostic imaging* / Q000502:physiology; D006801:Humans; D008297:Male; D008964:Molar, Third / Q000000981:diagnostic imaging; D009068:Movement / Q000502:physiology; D015588:Observer Variation; D011856:Radiographic Image Enhancement / Q000592:standards*; D011861:Radiography, Dental / Q000592:standards*; D013997:Time Factors; D014095:Tooth, Impacted / Q000000981:diagnostic imaging; D014741:Video Recording; D055815:Young Adult
keywords: cone beam CT; image quality; motion artefacts; patient movement