Spatial resolution in CBCT machines for dental/maxillofacial applications-what do we know today?

Spatial resolution is one of the most important parameters objectively defining image quality, particularly in dental imaging, where fine details often have to be depicted. Here, we review the current status on assessment parameters for spatial resolution and on published data regarding spatial resolution in CBCT images. The current concepts of visual [line-pair (lp) measurements] and automated [modulation transfer function (MTF)] assessment of spatial resolution in CBCT images are summarized and reviewed. Published measurement data on spatial resolution in CBCT are evaluated and analysed. Effective (i.e. actual) spatial resolution available in CBCT images is being influenced by the two-dimensional detector, the three-dimensional reconstruction process, patient movement during the scan and various other parameters. In the literature, the values range between 0.6 and 2.8 lp mm(-1) (visual assessment; median, 1.7 lp mm(-1)) vs MTF (range, 0.5-2.3 cycles per mm; median, 2.1 lp mm(-1)). Spatial resolution of CBCT images is approximately one order of magnitude lower than that of intraoral radiographs. Considering movement, scatter effects and other influences in real-world scans of living patients, a realistic spatial resolution of just above 1 lp mm(-1) could be expected.