Phantom for a dental panoramic X-ray apparatus

Abstract: A phantom for dental panoramic X-ray imaging is provided with an arrangement of X-ray transparent segment midpoints of which are registered along a standard jaw curve on an X-ray transparent holder. This holder is provided with locking means to ensure an exact positioning of the holder in the X-ray apparatus ensuring exact coincidence of the standard jaw curve thereof with the location of the dentition of patients to be examined.

Description: The invention relates to a test phantom for a dental panoramic X-ray apparatus. Test phantoms are used in dental panoramic X-ray radiography for an objective assesment of image quality. In conventional radiography this kind of phantoms has existed for many years. The kind of information supplied therewith refers mostly to the performances of the detector, viz film, screen and developing system. In fact manufacturers of such apparatus normally offer their own quality phantoms and criteria. In tomography and similar techniques, however, also the movement system and the generator are relevant for the overall image quality. The relevant test phantoms become more complex and expensive, also due to the increasing number of parameters determining image quality such as layer depth, positioning, movement artifacts, etc. In dental panoramic radiography some additional and particular requirements complicate the matter further. In order to be of practical advantage to a large number of potential users, including private dentists, for instance in the framework of a program for quality assurance in dental practice, a test phantom should be inexpensive and data revealed therewith should introduce an easy and unambiguous interpretation. Available test phantoms as disclosed for instance in document DE-U-8 009 106 and defined in the preamble of claim 1 are only suitable for certain subjective checks on particular models of equipment. Further, the subtle but fundamental question arises of what exactly is the radiological target here. Dental panoramic radiology exclusively depicts teeth and jaws; in order to acertain, by a technical test phantom, how closely the radiological projection modality conforms to the organ to be depicted, it is necessary to establish an objective, i.e. mathematical, model of the organ itself. From studies for such a model it can be concluded that: Sex, race and age play no substantial role in determining the average contour of the detal arch at roots level. Individual deviations from the average curve are well within the range of a minimum unsharpness layer as provided by most rotational panoramic systems. The average arrangement of roots in mandible and maxilla can be described by a simple even-terms polinomial equation. It can be concluded that, in spite of considerable individual variations, it is possible to establish a meaningful model of the dentition, also including the average position and orientation of the Temporo Mandibular Joint (TMJ) condyles, on the basis of experimental statistical data being available in literature. Such a special technical test phantom would be useful for objective assesment of image quality, and of its congruency during the time, in dental panoramic radiograms, obtained from different equipment, from different units of the same type, and in different operating conditions. Such a phantom should fulfill the following requirements: To be based upon objective statistical data about the morphology of the dento-maxillo-facial complex, and to be applicable irrespective of sex, race and age. To permit quantitave evaluation of the most important parameters affecting image quality and related to the dental panoramic equipment itself. To be of simple and repeatable construction, and affordable cost, for widespread use in everyday dental practice. Such a phantom should also be utilisable to check and optimaze the performances of a dental X-ray panoramic apparatus during the progress of the design and application process, by optimizing the projection movement as a function of image quality obtained.the software-driven system. To meet the above requirements a test phantom for a dental panoramic X-ray apparatus of the kind set forth in accordance with the invention is characterized by the features set out in the characterizing portion of claim 1. Such a phantom enables registration of the relevent parameters involved in image quality. Symmetry can easily be evaluated by comparing the two halves of an image formed, the halves must be specular. In principle the phantom may consist of an array of thin metallic segments, of the same length and equally spaced, whose midpoint are arranged along the a.m. standarad jaw curve. The segments are registered in planes locally perpendicular to the standard jaw curve, and are inclined at 45 deg with respect to the curve itself. The phantom is intended to be positioned horizontally within the panoramic rotational equipment to be tested, in the position where the patient dentition is to lay, with the standard curve laying in the occlusal plane and its frontmost point on a few mm, for instance 7 mm behind the incisors occlusion, to account for the distance of the midpoint of incisors roots. The angle of incidance of the X-ray beam with respect to the standard jaw curve can be simply derived from the angle between the (horizontal) projection of the midline curve itself and the segments. The horizontal magnification in any point is simply calculated by the ratio of the distance between two adjacent segments measured on the radiogram and the real distance on the test phantom. In a preferred embodiment the segments are registered on mutually equal distances along a standard jaw curve and preferably are of equal length, facilitating image interpretation. In a further embodiment the segments are inclined over about 45° with respect to the mid point jaw curve corresponding to the angle of incidence of the X-ray beam with respect to the standard jaw curve this is the angle between the projection of the mid-line curve itself and the segments. In a preferred embodiment the absorbing segments comprise a high atomic number element deposited on a flexible low X-ray absorbing support by any deposition technique such as vapour deposition, photo etching, printing or spraying. Preferably the support is a flexible strip being shaped enabling it to be fixed onto a mould of low X-ray absorbing material on which a jaw shaped surface is provided. To obtain information from beyond the terminals of the jaw curve additional segments can be introduced on the mould symmetrically with respect to both terminals of the jaw curve. Some embodiments in accordance with the invention will be described hereinafter with reference to the drawing showing in Figure 1 an example of an object to be examined, Figure 2 an arrangement of segments of a phantom according to the invention, Figure 3 a radiographic image of such a phantom and Figure 4 an example of a practical test phantom fixed on an adapted holder. Aim of an apparatus for dental panoramic radiography is to image a set of teeth 2 which are automatically arranged along a jaw curve 4 being relatively uniform for men. That is to say a good part of the jaw curves of adult persons show only realtively small deviations from a standard jaw curve. Such a standard jaw curve thus can be defined by measuring X- and Y-values of each element along indicated X- and Y-axis for a large number of dentitions. A standard jaw curve is specular with respect to the Y-axis and so are usually the jaw curves of men. In normal practise also the location of the teeth with respect to the TMJ condyle 6 should be determinable. Preferably a phantom has to be adapted to these data. A geometrical registration of phantom segments 10 of a phantom in accordance with the invention is given in Figure 2. Midpoints 12 of the sements 10 are orientated along a standard jaw curve 14 laying in an X-Y plane here. The segments are directed square to the standard jaw curve and are inclined over an angle of about. 45° with respect to the X-Y plane. The segments, for example 0.2 mm wide and about 10 mm long and are produced for example by a photolitographic etching process in a metal layer preferably of copper having a thickness of for example 10 µm. This metal layer is fixed on a surface 13 of an X-ray transparent support 15 for example a thickness up to for example 250 µm. In order to keep the arrangement readable the segments or slits are given as line segments. The absorption of a copper layer may be increased by deposition of tin, lead, tin-lead alloy or any other applicable high X-ray absorbing material thereupon. The embodiment shows 25 segments or slits for dentition control. No segments for TMJ imagingcontrol are indicated in the embodiment shown but easily can be added thereto. Figure 3 shows an image of a phantom as shown in Figure 2 formed by X-ray radiation on, an X-ray film sheet for example. Images 20 of the segments become registered along a straight line 22. A central segment image 24 corresponding to a central slit 16 in Figure 2 is directed square to the line 22 and the line system is specular with respect to this mid line segment image. From such a segment image arrangement all relevant parameters of the imaging system can be controlled by a very simple measuring of line deviations, mutual line distances, line sharpness etc., in the image. The image being registered on a transparent sheet, such as an X-ray film sheet, for example with dark lines for the segment images, is also very easy comparable with a standard, distortion-free, image so that discrepancies, due to system irregularities, can easily be determined and defined. It now can easily be checked whether -a equals b, for which also fixed phantom points 27 can be used, line 24 is perpendicular to line 22 within a given limitation, line 22 is staight and horizontal, the image pattern is well centered and the distances between segment images is mutually equal. Figure 4 shows an example of a practical phantom device comprising a holder 30 which is easily fixable in a radiographic apparatus with the aid of fixing elements 32, such as mutually passing pins and holes. These fixing elements are preferably dimensioned and located to ensure an exact positioning of the phantom device in the apparatus fixing the standard jaw curve thereof to coincidence with the jaw curve location of a dentition of a patient to be examined. The holder is preferably made of a synthetic material, plastics or any other applicable X-ray transparent material. The holder is provided with a plane 34 on which the segements 12 supporting sheet 15 can be fixed for which also positioning elements 36 are added coiciding with holes, in the sheet 15 for example. The sheet can be fixed on the holder in any known manner and preferably fixed on an inner surface thereof. For matter of clearness the bonding surface is located on the outside of the holder here. For examination of the condyles further sheets 38 with segments 10 are mounted on surfaces 40 of the holder, the position of which relative to the sheet 10 being accurately fixed, preferably on a 45° orientation thereof. The sheets of segments can similar to the sheet be fixed in any appropriate manner to the relevant bonding surface with the aid of locating elements 44. The bonding surfaces are preferably also mounted on inner surfaces of the holder.

Claims: A test phantom for dental panoranic X-ray apparatus comprising X-ray absorbing indicating means (10) for indicating location of teeth (2) characterised in that the indicating means (10) comprise a plurality of elongate indicating elements (10) extending along a standard jaw curve (4) in a series corresponding to locations of the teeth (2) and carried on a strip (15) of reduced X-ray absorbing material, the elements (10) each being inclined with respect to a plane containing the jaw curve (4) and being arranged so that a central transverse axis is contained in said plane. A test phantom as claimed in Claim 1 characterised in that the elements (10) are spaced one from another symmetrically of an axis contained in a plane of the jaw curve and bisecting the curve. A test phantom as claimed in Claim 1 or Claim 2 characterised in that the elements (10) are of substantially equal length one to another. A test phantom as claimed in any one of the preceding Claims characterised in that each plane containing a corresponding element (10) extends at an angle substantially 45° with respect to the Claim containing the jaw curve (4). A test phantom as claimed in any one of the preceding claims characterised in that the elements (10) comprise a rectilinear grid. A test phantom as claimed in any one of the preceding Claims characterised in that the strip (15) is flexible. A test phantom as claimed in any one of the preceding Claims characterised in that the strip (15) is carried on a carrier (30) of reduced X-ray absorbing material. A test phantom as claimed in Claim 7 characterised in that the strip (15) is located on a jaw-shaped portion of the carrier (30). A test phantom as claimed in any one of the preceding Claims characterised in that the indicating elements (10) are arranged in two series.

Inventors: DI PIERRO VINCENZO, MOLTENI ROBERTO, DI PIERRO, VINCENZO, MOLTENI, ROBERTO
Applicants: GENDEX CORP, GENDEX CORPORATION
Application year: 1989
Main classification: A61B6
IPC codes: A61B6, H05G1