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Dentomaxillofacial Radiology (2008) 37, 375-379
© 2008 British Institute of Radiology
doi: 10.1259/dmfr/29966973

RESEARCH

Selecting regions of interest on intraoral radiographs for the prediction of bone mineral density

W G M Geraets1,*, J G C Verheij1, P F van der Stelt1, K Horner2, C Lindh3, K Nicopoulou-Karayianni4, R Jacobs5, E J Marjanovic6, J E Adams6 and H Devlin2

1Department of Oral and Maxillofacial Radiology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands; 2School of Dentistry, Department of Radiology, University of Manchester, UK; 3Faculty of Odontology, Malmö University, Sweden; 4Department of Oral Diagnosis and Radiology, University of Athens, Greece; 5Oral Imaging Center, University of Leuven, Belgium; 6Department of Imaging Science and Biomedical Engineering, University of Manchester, UK

*Correspondence to: Dr Wl GM Geraets, MSc, PhD, Department of Oral and Maxillofacial Radiology, Academic Centre for Dentistry Amsterdam, Louwesweg 1, 1066 EA Amsterdam, The Netherlands. E-mail: W.Geraets{at}acta.nl

Received 17 October 2007; revised 10 December 2007; accepted 11 December 2007

Objectives: A previous study showed that the trabecular pattern on dental radiographs correlates with femoral and spinal bone mineral density (BMD). The objective of this study was to determine if the correlation is affected by the size and location of the region of interest (ROI).

Methods: In a European research project on osteoporosis, BMD was measured at the left hip and the lumbar spine of 525 women. From all subjects, intraoral radiographs were made of the premolar region in the upper and lower jaws. Two ROIs were indicated manually on each scanned image. The smallest region involved only trabecular bone and the largest also included parts of the neighbouring teeth. The ROIs were subjected to automatic image analysis, yielding 26 measurements per ROI. Stepwise linear regression was used to predict femoral and spinal BMD.

Results: Inner and outer regions predicted BMD equally well. The radiographs of lower and upper jaw also predicted BMD equally well. Combining inner and outer regions did not improve the prediction of femoral and spinal BMD, but combining lower and upper jaws did.

Conclusions: This study shows that it is possible to include parts of neighbouring teeth in the ROI used to assess the trabecular pattern and predict BMD. This simplifies the process of selecting the ROIs because no efforts have to be made to exclude neighbouring teeth. Combining ROIs of lower and upper jaws significantly improves the prediction of BMD.

Keywords: dental radiographs, region of interest, image processing, bone mineral density






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