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Digital Imaging in Dentistry Applications and Challenges S. Brent Dove, DDS, MS University of Texas Health Science Center “A picture is worth a thousand words” “Knowledge is valuable” “Don’t waste it” Digital Dental Radiology Intra-oral Panoramic Cephalometric Sinus and Skull Tomography CT MRI Advantages of Digital Radiology No Darkroom No Chemical Processing Lower Cost Per Image Instant Viewing of Images Less Radiation to Patient Image Processing and Analysis Transmission of Images for Consultation CCD/CMOS-based Sensor X-ray Beam Scintillator Fiber Optics CCD High Resolution = 22.5 Standard & High Resolution #2 High #1 Standard = 45 Standard #0 CCD/CMOS - 45 CCD/CMOS - 22 Storage Phosphor X-ray Beam Imaging Plate Storage Phosphor Helium-Neon Laser Photoreceptor Imaging Plate Storage Phosphor Storage Phosphor Diagnostic Accuracy Primary Dental Caries Recurrent Dental Caries Periodontal Periapical Disease Lesions Endodontic File Length Determination CCD Extra-oral Radiograpy Tomography Panoramic Radiography Cephalometric Radiography The Next Generation Three Dimensional Imaging TACT Small Volume CT TACT™ Methodology Series of images taken from different angles Slices of a maxillary molar Small Volume CT Small Volume CT Small Volume CT The Future is Full of Possibilities Optical Laser 3D Biopsy Computed Tomography Ultrasound Laser Fluorescence Computer-based FOTI Computer Aided Diagnosis (CAD) Observational Errors Misinterpretation Integration Most Errors of Data Errors Beneficial in Observational Errors “CAD systems do not necessarily have to be better than the clinician, just help him not miss obvious lesions.” Computer Aided Diagnosis (CAD) PAP Cytology & Oral Brush Biopsy Mammography Chest X-ray Screening Periodontal Dental Disease Caries Digital Subtraction Radiography - Neural Network Detection Digital Dental Imaging Intra-oral Radiography Panoramic Radiography Cephalometric Radiography Tomography Intra-oral Photography Extra-oral Photography Histology & Surgical Microscopy Interoperability ???????? The DICOM Standard The Digital Imaging and Communications in Medicine (DICOM) Standard is a detailed specification that describes semantics and syntax for exchanging images and associated information. The standard applies to the operation of the interface which is used to transfer data in and out of an imaging device. DICOM Workflow DICOM Display Workstation LiteBox Storage, Query/Retrieve, Study Component Query/Retrieve Results Management Media Exchange DICOM Acquisition Print Management DICOM Archive Query/Retrieve, Patient & Study What is DICOM Digital Imaging and Communication in Medicine Standard for communication of images and image related information between devices International All in scope biomedical imaging Voluntary standard DICOM is Biomedcial Informatics “the storage, retrieval, sharing, and optimal use of biomedical information, data, and knowledge for problem solving and decision making.” Edward Shortliffe “model formation, implementation of the model, application of implementaion to the real world, evaluation of the implementation” Titus Schleyer DICOM, Informatics, Research Digital X-ray Visible Light Clinical Trials Structured Reporting The Future is Full of Possibilities