Introduction
Initially developed for dentistry, cone beam computed tomography (CBCT) is becoming essential in radiology departments. With less radiation exposure than traditional CT, CBCT uses a conical X-ray beam and rotating equipment to produce finely detailed 3D pictures of musculoskeletal systems. To compare the diagnostic efficacy of CBCT with conventional radiography, Multidetector Computed Tomography (MDCT), and Magnetic Resonance Imaging (MRI), this research examines the clinical uses of CBCT in musculoskeletal illnesses.
What Are the Advantages and Disadvantages of Musculoskeletal CBCT?
Advantages:
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High Spatial Resolution: Offers finely detailed views of the surface of articular cartilage and the microarchitecture of bones.
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Low Radiation Dose: Much lower dose than MDCT, which keeps patients safer.
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Customized Exposure: Dosage reduction depending on patient anatomy and size is possible with Safe Beam technology and angle tube current modulation.
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Economic Viability: It is more affordable overall than MDCT and can be used in various healthcare environments.
Disadvantages:
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Restricted Field of View (FOV): Because of its limited FOV, this imaging technique is inappropriate for large joint imaging.
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Limitations in Soft Tissue: Insufficient contrast resolution makes it difficult to evaluate soft tissue pathologies accurately.
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Motion Artifacts: The likelihood of motion artifacts increases with a somewhat longer acquisition duration (18 to 36 seconds).
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Radiation Exposure: Compared to Conventional Radiography (CR), the radiation exposure is higher, albeit lower than that of MDCT.
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Not Perfect for Every Soft Tissue: Limited pathology analysis affecting soft tissues.
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Patient Placement: This method takes slightly longer than CR but is equivalent in examination time to MDCT.
How Does Cone Beam Computed Tomography Enhance Fracture Detection Compared to Regular X-Rays?
A standard X-ray (CR) is typically the first test medical professionals perform when they suspect a bone fracture. X-rays are the first option, although they may not always be able to display minor fractures or those in intricate locations like the foot or wrist.
Cone Beam Computed Tomography (CBCT), a more detailed imaging method, can be applied in certain circumstances. CBCT is particularly effective at spotting tiny fractures that an ordinary X-ray could overlook. It is especially helpful in evaluating intricate regions like the wrist with many overlapping bones. Doctors may suggest a CBCT scan if a standard X-ray is negative, but there is still a high suspicion of a fracture. This is frequently the case while treating injuries to the feet or wrists.
In certain cases, such as suspected hand bone fractures, physicians may recommend an MRI if the results of a routine X-ray are negative. MRI is more sensitive than CBCT in these situations, but it is only sometimes readily available or appropriate for every patient.
When a standard X-ray cannot produce a clear image, particularly in regions with complicated bone structures, CBCT becomes the second-best alternative. It facilitates prompt and precise evaluations, potentially preventing the subsequent need for an MRI. Furthermore, CBCT can help track the healing of bones, particularly in cases when casts or splints are worn.
A weight-bearing CBCT can offer information about joint alignment for suspected joint instability, but special equipment is needed. CBCT is helpful in postoperative follow-ups to assess bone healing and callus formation and identify metallic hardware problems.
Despite all of CBCT's great qualities, traditional X-rays are still the way to go in some situations, such as diagnosing hardware fractures, because CBCT scans may exhibit artifacts from metal items.
What Are the Main Advantages and Limitations of Cone Beam Computed Tomography (CBCT) In Assessing Jaw Bone Tumors?
Compared to standard panoramic views, CBCT offers more specific information regarding the location, shape, and extent within the bone and the impacts on surrounding tissues and the roots of teeth. Nevertheless, CBCT is limited in its ability to assess soft tissue aspects of lesions. The use of CBCT for bone cancers in the extremities is less widespread. Although CBCT helps identify bone abnormalities, it is not recommended for evaluating soft tissue elements.
MRI is the ideal method for early diagnosis and staging, whereas conventional radiography (CR) serves as the baseline. In chronic osteomyelitis (bone infection), CT is the most effective modality for evaluating a sequestrum or a segment of dead bone. CBCT is as helpful as MDCT in the skeletal system of the jaws and appendices. The literature also mentions that, particularly in cases where metallic hardware is present, CBCT can offer a thorough view of bone alterations brought on by infection. Examples of these medical problems and the imaging methods used to diagnose them are shown in the accompanying images.
What Is the Optimal Method for Detecting Bone Infections and Evaluating Degenerative Joint Changes in Small Joints?
Physicians typically utilize MRI to detect bone infections early on and X-rays (CR) for a preliminary examination when monitoring for bone infections (osteomyelitis). However, CT scans are the most effective way to evaluate a chronic osteomyelitis disease called a sequestrum. A different kind of CT scan called a CBCT is just as good as a standard CT scan for limb and jaw bones. While CBCT can reveal fine-grained alterations brought on by infection, particularly when metal is in the body, MRI is not excellent at differentiating between a sequestrum and healthy bone.
To screen for degenerative joint disease, a specific kind of X-ray called computed tomography (CBCT) is superior to a standard X-ray (CR). It provides a more accurate image of the degree of joint damage, particularly in small joints where standard X-rays might not be able to reveal enough. While MRI is more effective in identifying indications of progressive joint disease, it is less helpful in displaying minor joint injury.
Why Is CBCT Arthrography Preferred for Detailed Information, Especially With Orthopedic Implants?
Arthroscopy is a common treatment used by doctors to examine the smooth tissue covering joints for issues related to cartilage. This entails inserting a tiny camera into the joint in order to identify and address problems. However, imaging studies should be used before surgery to fully evaluate cartilage issues, as arthroscopy carries some risks and can be intrusive. Unlike a more sophisticated MRI, MR-arthrography (MRA) is a frequently used imaging technique. Another technique is CBCT arthrography, which provides more precise images and is helpful, particularly if metal implants nearby could interfere with an MRI. This technique provides precise visuals to help guide treatment options and is especially useful for seeing things like loose bodies or certain disorders affecting the joint.
How Does the Integration of Fluoroscopy and CBCT Imaging Provide Improved Guidance in Musculoskeletal and Spinal Interventions?
Certain sophisticated medical imaging devices combine fluoroscopy and CBCT imaging to guide different treatments. These devices are frequently utilized for spine-related procedures such as vertebroplasty, nucleoplasty, and bone biopsies. Under imaging supervision, they also support processes such as ablation or palliative therapy. In addition to limiting fluoroscopy time, CBCT aids with accurate biopsy needle placement, tracking, and error detection during surgery, lowering total radiation exposure to patients and medical personnel.
These devices can also be integrated with MRI technology to target lesions precisely. Procedures employing CBCT guidance take about the same time as those using typical MDCT guidance, but the radiation exposure to the patient and the healthcare provider is less. This is particularly crucial for younger individuals. Certain systems are intended for examining the limbs that bear weight, enabling the assessment of joint stability. The choice to acquire CBCT equipment should be based on the unique requirements of every department, considering elements like the gantry's size and the availability of guide lights for needle placement.
Conclusion
After an accident, CBCT is a useful technique to examine tiny joints and bones, particularly in cases when traditional X-rays are ambiguous. CBCT offers detailed images of joint cartilage when paired with arthrography, which is helpful for assessing specific joint problems, such as those in the ankle. For those who are claustrophobic or otherwise unable to undergo an MRI, it may also serve as a substitute test. Treatments with CBCT may be more appropriate and quicker as a result. Although MDCT is often the preferred method, CBCT may be useful as a supplemental modality in large hospitals or in private offices that handle a high volume of musculoskeletal cases. To use CBCT efficiently, one must know its advantages and disadvantages.
