Evaluation of condylar osseous changes using a wireless detector with proton density-weighted imaging sequences

Xing Ming; Xinge Cheng; Chong Tian; Wuchao Li; Rongpin Wang; Chunqi Qian; Xianchun Zeng

doi:10.21037/qims-22-424

Evaluation of condylar osseous changes using a wireless detector with proton density-weighted imaging sequences

Quant Imaging Med Surg. 2023 Jan 1;13(1):17-26. doi: 10.21037/qims-22-424. Epub 2022 Oct 27.

Authors

Xing Ming^#¹, Xinge Cheng^#¹, Chong Tian¹, Wuchao Li¹, Rongpin Wang¹, Chunqi Qian^{2

3}, Xianchun Zeng¹

Affiliations

¹ Department of Radiology, Guizhou Provincial People's Hospital, Key Laboratory of Intelligent Medical Imaging Analysis and Accurate Diagnosis of Guizhou Province, International Exemplary Cooperation Base of Precision Imaging for Diagnosis and Treatment, Guiyang, China.
² Department of Electrical and Computer Engineering, Michigan State University, East Lansing, MI, USA.
³ Department of Radiology, Michigan State University, East Lansing, MI, USA.

^# Contributed equally.

Abstract

Background: Cone-beam computed tomography (CBCT) is the gold standard for evaluating condylar osseous changes. However, the radiation risk and low soft-tissue resolution of CBCT make it unsuitable for evaluating soft tissue such as the articular disc and lateral pterygoid muscle. This study aimed to qualitatively and quantitatively evaluate the feasibility and advantages of using wireless detectors (WD) with proton density-weighted imaging (PDWI) sequences to image condyle changes in patients with temporomandibular disorders (TMD).

Methods: This study involved 20 patients (male =8, female =12; mean age 31.65 years, SD 12.68 years) with TMD. All participants underwent a closed oblique sagittal PDWI scan with head/neck coupling coiling (HNCC) and wireless detector-HNCC (WD-HNCC) on a 3.0 T magnetic resonance imaging (MRI) scanner. Subsequently, the changes in the condyle bones in the scanned images for the 2 image types were scored subjectively and compared qualitatively. The contrast-to-noise ratio (CNR) of the 2 types of scanned images was compared quantitatively. The comparison of CNR differences between the 2 types of images was performed using the paired t-test. The kappa statistic was used to test the consistency of quantitative analyses of MRI images between observers. The subjective scores of condylar osseous changes in the 2 types of images were compared by paired rank-sum test. A P value <0.05 was considered statistically significant.

Results: A total of 40 condyles from 20 patients were scanned. Among them, 8 condyles showed no bone changes, and the other 32 condyles demonstrated condylar osseous changes of varying degrees and nature. These 32 condyles were used in the subsequent analysis. As compared to images acquired by HNCC in the PDWI sequence, the WD-HNCC images more clearly showed mandibular osteophyte, bone cortical erosion, subcortical cystic focus, and bone cortical hyperplasia and thickening. In addition, the WD-HNCC was demonstrated to improve image CNR by 158.9% compared to HNCC (28.17±16.01 vs. 10.88±6.53; t=8.63; P=0.001).

Conclusions: WD-HNCC in PDWI sequences is suitable for imaging the condylar bone changes of patients with TMD and significantly improves the image quality.

Keywords: Wireless detector (WD); magnetic resonance imaging (MRI); temporomandibular disorders (TMD); temporomandibular joint (TMJ).