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@ARTICLE{Ruetters:303446,
      author       = {M. Ruetters and C. Mertens and H. Gehrig and S. Sen and
                      T.-S. Kim and H.-P. Schlemmer$^*$ and S. Schoenberg and M.
                      Froelich and M. Kachelrieß$^*$ and S. Sawall$^*$},
      title        = {{D}ental photon-counting computed tomography for the
                      assessment of {P}eri-{I}mplant structures.},
      journal      = {International journal of implant dentistry},
      volume       = {11},
      number       = {1},
      issn         = {2198-4034},
      address      = {Heidelberg},
      publisher    = {Springer},
      reportid     = {DKFZ-2025-01659},
      pages        = {51},
      year         = {2025},
      note         = {#LA:E025#},
      abstract     = {To assess the diagnostic performance of photon-counting
                      computed tomography (PCCT) in the imaging of peri-implant
                      bone structures and to compare it quantitatively and
                      qualitatively to cone-beam computed tomography (CBCT).Thirty
                      titanium implants were placed in ten porcine mandibles. CBCT
                      and PCCT scans were acquired and compared quantitatively
                      regarding image noise and CT-values. Additionally bone
                      thickness was compared to a gold standard at 60 standardized
                      locations by one calibrated investigator in both modalities.
                      Measurement accuracy was assessed by Bland-Altman analysis.
                      Two experienced raters performed qualitative assessments of
                      anatomic structures around the implant using a 5-point
                      visibility scale. These included the bone-implant interface
                      around the implant surface, the bone at the implant shoulder
                      as well as the oral and vestibular bone lamella. Inter-rater
                      agreement was assessed using ICC.Across all evaluated
                      implants, CT-values in a soft-tissue region of interest
                      adjacent to the implant increased by 11.7 ± $3.9\%$ for
                      CBCT acquisitions, whereas they decreased by 5.3 ± $1.3\%$
                      for PCCT acquisitions. Similarly, image noise in the
                      respective ROIs is increased by a factor of 63 ± $13\%$ in
                      case of CBCT acquisitions and only by 23 ± $5\%$ in case of
                      PCCT acquisitions. Bone thickness deviations were smaller
                      for PCCT (mean ± SD: 0.06 ± 0.08 mm) than for CBCT (0.39
                      ± 0.34 mm). Qualitative assessments consistently favored
                      PCCT (p < 0.05) with excellent inter-rater reliability (ICC
                      > 0.75 ) in almost all categories.PCCT enables superior
                      visualization of peri-implant bone structures with fewer
                      artifacts and improved diagnostic accuracy.},
      keywords     = {Animals / Swine / Cone-Beam Computed Tomography: methods /
                      Dental Implants / Mandible: diagnostic imaging / Mandible:
                      surgery / Tomography, X-Ray Computed: methods / Photons / 3D
                      dental imaging (Other) / CBCT (Other) / Image quality
                      (Other) / Implant diagnostics (Other) / Metal artifacts
                      (Other) / Peri-implant bone (Other) / Photon-counting CT
                      (Other) / Dental Implants (NLM Chemicals)},
      cin          = {E010 / E025},
      ddc          = {610},
      cid          = {I:(DE-He78)E010-20160331 / I:(DE-He78)E025-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40782315},
      doi          = {10.1186/s40729-025-00640-8},
      url          = {https://inrepo02.dkfz.de/record/303446},
}