title: MRI alone versus MRI-CBCT registered images to evaluate temporomandibular joint internal derangement.
abstract: OBJECTIVE
  To evaluate the effect of magnetic resonance imaging-cone beam computed tomography (MRI-CBCT) image registration on inter- and intraexaminer consistency when evaluating temporomandibular joint (TMJ) internal derangement compared to MRI alone.
  
  
  METHODS
  MRI and CBCT images of 25 patients (50 TMJs) were obtained and coregistered using mutual-information rigid image registration via Mirada XD software. Two experienced radiologists independently and blindly evaluated two types of images (MRI alone and MRI-CBCT registered images) at two different times (T1 and T2) for TMJ internal derangement, based on sagittal and coronal articular disc position in relation to the head of the condyle and the posterior slope of the articular eminence.
  
  
  RESULTS
  The intraexaminer consistency with MRI alone (examiner 1 = 0.85 [0.74-0.92]; examiner 2 = 0.91 [0.84-0.95]) was lower than for the MRI-CBCT registered images (examiner 1 = 0.95 [0.91-0.97]; examiner 2 = 0.97 [0.96-0.99]). The interexaminer consistency of evaluating internal derangement with MRI alone (0.52 [0.18-0.73] at T1; 0.71 [0.45-0.84] at T2) was lower than for the MRI-CBCT registered images (0.97 [0.95-0.98] at T1; 0.98 [0.96-0.99] at T2). When disc position classification was dichotomized to normal versus anteriorly displaced, intraexaminer agreement for the two examiners was 0.52 and 0.63 for MRI alone, but was 0.91 and 0.92 for MRI-CBCT registered images. Interexaminer agreement for MRI alone was 0.29 at T1 and 0.42 at T2, but was 0.96 at both examination times for MRI-CBCT registered images.
  
  
  CONCLUSIONS
  The MRI-CBCT registered images improved intra- and interexaminer consistency in the evaluation of internal derangement of TMJ.
authors.affiliation: School of Dentistry, University of Alberta, Edmonton, Alberta, Canada. Electronic address: m.alsaleh@ualberta.ca.
authors.forename: Mohammed A Q
authors.initials: MA
authors.lastname: Al-Saleh
authors.affiliation: School of Dentistry, University of Alberta, Edmonton, Alberta, Canada; Faculty of Dentistry, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Noura A
authors.initials: NA
authors.lastname: Alsufyani
authors.affiliation: School of Dentistry, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Manuel
authors.initials: M
authors.lastname: Lagravere
authors.affiliation: School of Dentistry, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Brian
authors.initials: B
authors.lastname: Nebbe
authors.affiliation: School of Dentistry, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Hollis
authors.initials: H
authors.lastname: Lai
authors.affiliation: Department of Radiology and Diagnostic Imaging, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Jacob L
authors.initials: JL
authors.lastname: Jaremko
authors.affiliation: School of Dentistry, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Paul W
authors.initials: PW
authors.lastname: Major
mesh_terms: D000328:Adult; D054893:Cone-Beam Computed Tomography; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D015203:Reproducibility of Results; D012984:Software; D013705:Temporomandibular Joint Disorders / Q000000981:diagnostic imaging*