Expression of beam hardening artifacts on horizontally stitched cone-beam computed tomography images.

Purpose: This study was performed to evaluate the expression of beam hardening artifacts generated by high atomic number materials in stitched cone-beam computed tomography (CBCT) images, compared to the traditional acquisition mode.

Materials and methods: CBCT volumes were acquired using an acrylic resin phantom embedded with pairs of cylinders made from amalgam dental alloy, cobalt-chromium alloy, gutta-percha, titanium, and zirconium. These cylinders were placed within the overlapping zones of the stitching reconstruction area. For each material, 3 acquisitions were conducted: 1 utilizing the automatic stitching process with a FOV of 80×37 mm, and 2 with smaller FOVs of 50×37 mm. For the smaller FOVs, 1 scan targeted the anterior region, while the other focused on the left posterior region. Thus, 3 groups were formed: stitched FOV, anterior FOV, and posterior FOV. Artifact expression was assessed by calculating the means and standard deviations (SDs) of the gray values in 4 regions of interest located anteriorly, posteriorly, medially, and laterally to the cylinders. Analysis of variance was used to compare the data, with an alpha level of 5%.

Results: The stitched FOV exhibited lower SD values than the posterior and anterior FOVs (P<0.05). Regarding the materials evaluated, amalgam, cobalt-chromium, and zirconium generally demonstrated higher SDs of the gray values than gutta-percha and titanium (P<0.05).

Conclusion: Horizontally stitched CBCT images demonstrated lower artifact expression compared to the traditional mode of acquisition.