Deriving Hounsfield units using grey levels in cone beam CT: A clinical application

T. E. Reeves, Peter Mah, W. D. McDavid

Research output: Contribution to journalArticlepeer-review

66 Scopus citations


Objective: To present a clinical study demonstrating a method to derive Hounsfield units from grey levels in cone beam CT (CBCT). Methods: An acrylic intraoral reference object with aluminium, outer bone equivalent material (cortical bone), inner bone equivalent material (trabecular bone), polymethlymethacrylate and water equivalent material was used. Patients were asked if they would be willing to have an acrylic bite plate with the reference object placed in their mouth during a routine CBCT scan. There were 31 scans taken on the Asahi Alphard 3030 (Belmont Takara, Kyoto, Japan) and 30 scans taken on the Planmeca ProMax 3D (Planmeca, Helsinki, Finland) CBCT. Linear regression between the grey levels of the reference materials and their linear attenuation coefficients was performed for various photon energies. The energy with the highest regression coefficient was chosen as the effective energy. The attenuation coefficients for the five materials at the effective energy were scaled as Hounsfield units using the standard Hounsfield units equation and compared to those derived from the measured grey levels of the materials using the regression equation. Results: In general, there was a satisfactory linear relation between the grey levels and the attenuation coefficients. This made it possible to calculate Hounsfield units from the measured grey levels. Uncertainty in determining effective energies resulted in unrealistic effective energies and significant variability of calculated CT numbers. Linear regression from grey levels directly to Hounsfield units at specified energies resulted in greater consistency. Conclusions: The clinical application of a method for deriving Hounsfield units from grey levels in CBCT was demonstrated.

Original languageEnglish (US)
Pages (from-to)500-508
Number of pages9
JournalDentomaxillofacial Radiology
Issue number6
StatePublished - Sep 1 2012
Externally publishedYes


  • Bone density
  • Cone beam computed tomography
  • Grey levels
  • Hounsfield units
  • Linear attenuation coefficient

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Radiology Nuclear Medicine and imaging
  • Dentistry(all)


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