As a follow-up to RadSite’s August blog addressing Point of Care Imaging, RadSite recently hosted a complimentary webinar building on this theme last November, featuring several national experts in the dental, ENT, and orthopedic fields.
Roundtable participants discussed the clinical advantages of using Cone Beam CT (CBCT) 3D imaging in comparison to traditional 2D imaging. The expert panel discussion identified several advantages associated with Cone Beam CT scans including:
- Integrating diagnostic imaging with treatment planning
- Enhancing therapeutic interventions
- Improving the patient experience and satisfaction levels
- Tracking and reporting clinical outcomes
- Using AI and scan volumes to replicate body functions
- Providing high quality images at a reduced radiation level
- Supporting new clinical pathways of care.
Experts from each clinical practice provided examples of the advantages of CBCT 3D imaging from their perspective during the webinar.
For Dentistry Practices
According to Steve Carstensen, DDS, Premier Sleep Associates, highlights several advantages of CBCT 3D imaging for dentists: “In traditional restorative dentistry we are placing implants into the jaw to replace a missing tooth. While there are nerves and other structures that have to be considered, the only way to really visualize that is through 3D images to facilitate treatment planning and placement. Using traditional 2D imaging for dentistry has certain limitations. For example, individual images of the tooth do not show the root structure which are helpful for endodontists for root canals and other procedures. Cone Beam CT images empower endodontists to visualize a tooth in three dimensions, so they can map out their treatments and understand where their problems are coming from more specifically.”
He also addressed the advantages of using Cone Beam CT scans for orthodontics to better identify a pathway to change the alignment of the patient’s teeth and breathing disorders to ensure open airways at nighttime.
For ENT Practices
Mike Luick, COPM-C, Business Development Manager, Tungsten Medical Network, explains several ways the 3D scans make a difference: “Two popular issues for Cone Beam CT imaging in ENT practices are the sinuses and the temporal bone. Three-dimensional imaging does an excellent job for those field of views at a tenth of a dose of a standard full body CT scanner. Certainly, this is one of the reasons why we encourage ownership and use of CBCT scanners versus the full body CT that you typically see at traditional imaging centers or big hospitals.”
Luick also addressed the enhanced diagnostic functionality associated with using CBCT scanners when addressing medical issues associated with the interconnected head, nose, and throat systems.
For Orthopedic Practices
Jenna Roller, PA-C, Director of Clinical Applications, CurveBeam AI, identifies several improvements offered by CBCT 3D imaging related to the bones, joints and muscles: “In Orthopedics there are a number of clinical scenarios where you have bones that are overlapping, and when you have a 2D picture there is anatomy in the middle that can get missed and be overlooked. Sometimes this is fracture detection or can be a number of cystic changes. But when you have overlapping anatomy, you can’t see it unless you have a 3D image and you can really scroll through bone by bone to evaluate where the problem might be.”
Roller also makes clear the clinical difference with a point-of-care imaging system: “The biggest advantage on the orthopedic side is that we can do a weight-bearing scan, where previously we were limited to doing a 2D weight-bearing x-ray and then trying to superimpose weight-bearing alignment onto a supine 3D image that was done when the patient was lying down. And now you can get weight-bearing functional alignment information as part of your surgical planning, along with 3D, and that is really helping to optimize implant conditioning, especially for total joint replacement.”
The expert panel also addressed several challenges associated with Cone Beam CT imaging. These include:
- Improving insurance reimbursement pathways—instead of charging the patients directly
- Covering the capital expense for specialty providers to buy and operate the equipment
- Meeting all of the requirements of operating in-office advanced diagnostic imaging (ADI) system
- Finding ways to participate in value-based purchasing models
- Promoting the use of new diagnostic and treatment pathways in other specialties.
The importance of accreditation requirements to promote standardized practice was also discussed. This includes professional requirements for the imaging technologist and interpreting provider and imaging system performance such as through physics testing, and more. The importance of accreditation requirements to promote standardized practice was also discussed. This includes professional requirements for the imaging technologist and interpreting provider and ensuring imaging system performance such as through physics testing, and more.
Panelists also addressed the differences in the adoption curve between dental and medical Cone Beam CT scanning. While dental 3D imaging is used broadly in the U.S., the medical side has been a bit slower in the uptake. The reasons for this difference include more stringent requirements on the medical side for meeting regulations such as certificate of need (CON) licensure and prior authorization protocols on the medical insurance side.
Finally, participants described the differences in the functionality and capability of Cone Beam CT images. This topic will be addressed fully in RadSite’s featured January 2023 webinar “Selecting the Right Cone Beam CT Imaging System for Your Practice: A Buyers Checklist.” Click here for more information. You can also view our previous webinars that cover recent trends and provide practical information on RadSite’s YouTube channel.
Garry Carneal
President & CEO
RadSite