The cadmium telluride photon counting sensor in panoramic radiology: gray value separation and its potential application for bone density evaluation

ObjectiveTo investigate whether bone mineral density can be evaluated more accurately using a panoramic device with a new cadmium telluride photon-counting sensor and software than 2 panoramic devices with a conventional semiconductor sensor.Study DesignA fiduciary test object with several known levels of hydroxy apatite mineral concentration was placed in a phantom on the mandibular occlusal plane. Panoramic images were acquired by changing the position of the test object within the dental arch. The gray value, the spectrum deformation index (SDI), and the relative attenuation index (RAI) of the test object were evaluated. The SDI and RAI represent unique energy information as acquired by the QR-Master panoramic machine and the corresponding special QR-MC analysis software. In order to compare the values expressed in the different units (gray, SDI, and RAI values), the percentage discrepancy was calculated.ResultsThe cadmium telluride photon-counting fitted machine more consistently separated each of the hydroxy apatite concentrations in all of the different positioning configurations and locations. The SDI function of the QR Master machine produced more stable values than the RAI value and the gray values of the 2 conventional panoramic machines.ConclusionsThe methodologies as developed for this study can be used to test more sophisticated analyses for the determination of bone density.