# Improve the diagnostic accuracy of CBCT for oral lesions

> **NIH NIH R56** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2021 · $512,301

## Abstract

ABSTRACT
 Oral cancer accounts for 2.5% of all cancers in the United States. It has one of the lowest five-year survival
rates among the major cancer types. Early diagnosis and treatment are critical to improve the prognosis of oral
cancer patients. Contrast enhanced computed tomography (CT) and magnetic resonance imaging (MRI) are
currently the most widely accepted imaging modalities for diagnosis and staging of oral cancer. However,
because of their high cost, high patient radiation exposure (CT), and large footprint, CT and MRI are not the
standard imaging modalities used in dental clinics. In addition, oral lesions in the CT images are frequently
obscured by metal artifacts caused by dental prostheses, reducing the sensitivity and increasing false diagnosis.
CT is known to have a high specificity but low sensitivity for detection of oral cancers.
 Cone beam CT (CBCT) reduces the radiation exposure to the patient, the cost to purchase and to operate,
as well as the footprint, compared to CT. It has found wide applications in dentistry. However, CBCT’s role in
oral cancer imaging and staging is currently limited, despite its wide availability. This is primarily due to its poor
soft tissue contrast resolution, which makes it difficult to visualize the tumor mass, and neoplastic processes are
frequently overlooked. The role of CBCT in preoperative assessment of bone invasion from oral cancer has
been evaluated in only a few studies with inconsistent results. The presence of strong metal artifacts also
degrades the quality of the CBCT images, as in the case of CT.
 We propose a multisource spectral volumetric CT (mSCT) technology to 1) increase the soft tissue contrast
of dental CBCT; 2) reduce the image metal artifacts; and 3) improve the tumor delineation in contrasted CT
imaging. These will be achieved by 1) retrofitting the conventional CBCT with a unique carbon nanotube (CNT)
x-ray source array invented by our team; and 2) incorporating dual energy CT (DECT) and virtual monoenergetic
image (VMI) capabilities at low cost. The device maintains all the clinical functionality and utility of CBCT and
its desirable attributes. The technology has the potential to not only enable precision imaging of oral lesions
using the widely available CBCT after modification, reducing the cost and patient radiation exposure compared
to the current clinical practice, but also improve earlier detection of oral cancer through either screening or/and
opportunistic imaging.
 The Specific Aims are: 1) Optimizing mSCT to achieve high soft tissue contrast resolution; 2) Reducing metal
artifacts and improving tumor delineation by incorporating spectral filter based dual-energy and virtual
monoenergetic imaging; 3) Constructing a prototype mSCT scanner and characterizing its system performance;
and 4) Demonstrating increased soft tissue contrast, reduced metal artifact and improved oral lesion delineation
in mSCT compared to CBCT.

## Key facts

- **NIH application ID:** 10427072
- **Project number:** 1R56DE030962-01
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** OTTO Z ZHOU
- **Activity code:** R56 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $512,301
- **Award type:** 1
- **Project period:** 2021-07-02 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10427072

## Citation

> US National Institutes of Health, RePORTER application 10427072, Improve the diagnostic accuracy of CBCT for oral lesions (1R56DE030962-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10427072. Licensed CC0.

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