Dental radiology is being extensively used especially after the consolidation of the dental implant technique. Although dental radiology has always been regarded as a low-dose technique, this scenario has changed with the introduction of volumetric techniques and consequent changes that have resulted from the use of the new technique. To compare dose values related to the use of different technologies used in the acquisition of dental panoramic images, the effective dose associated with this image technique was calculated using two different conversion factors for kerma-area product, P(KA), in the effective dose. Twenty-four pieces of equipment were evaluated and distributed into three categories: (1) 19 units of conventional equipment, (2) 3-cone beam computed tomography equipment (CBCT) which has a specific sensor to obtain panoramic images and (3) 2 items of CBCT equipment which only have sensors for volumetric acquisition, and the obtainment of panoramic images is through software reconstruction. The results show values of PKA and effective dose are higher for devices using digital image receptors. It is concluded that optimisation procedures and critical analysis should always be applied when adopting new technologies.
Radiation Risks and the Importance of Radiological Protection in Interventional Cardiology: A Systematic ReviewWe discuss some aspects related to the legal framework, international recommendations and training programs on radiological protection; image quality and equipment; the biological effects and risks of ionizing radiation; lesions in patients and operators; patient's reference levels; occupational dose limit and preventive actions. The use of ionizing radiation involves risks that are justified in diagnostic and therapeu tic procedures. The awareness and knowledge of these risks minimizes the damage, optimizing the quality of images and safe use of ionizing radiation. There is evidence of radiationin duced cataracts in individuals who work in catheterization laboratories. Several studies suggest there may be a significant risk of lens opacity, if radiological protection devices are not properly used. Additionally, these interventional procedures are performed in Latin America, usually by medical specialists in collaboration with nurses, technologists and technicians, who often do not have adequate training in radiological protection.
Basically, all modalities of diagnostic radiology require phantoms suitable for dosimetric evaluations. New technologies frequently arise unaccompanied of tools for dosimetric evaluations and quality control. In this study, a low-cost phantom and a consequent proposed methodology for dosimetric evaluations in cone beam computed tomography (CBCT) were presented. The developed phantom has typical dimensions of the human face, was built in polymethyl methacrylate and filled with water. Three devices with different technological concepts were evaluated and a proposed index, kerma index-height product (PKIH), was defined as an option to the use of air kerma-area product. The results of this study show relatively uniform kerma profiles for scanners with field of views (FOVs) of large diameters and non-uniform for FOVs of small diameters. With regard to the values obtained for the kerma indexes, much higher values were found for the equipment FOVs with small diameter compared with the values of the two other equipment that have larger diameters. The results indicate that (1) there is a need for special phantoms for use in CBCT, (2) the use of P(KA) in the evaluation of protocols on different equipment can lead to false interpretations and (3) the new index is a suitable alternative for the use of P(KA) in CBCT.
A phantom for quality control in cone beam computed tomography (CBCT) scanners was designed and constructed, and a methodology for testing was developed. The phantom had a polymethyl methacrylate structure filled with water and plastic objects that allowed the assessment of parameters related to quality control. The phantom allowed the evaluation of essential parameters in CBCT as well as the evaluation of linear and angular dimensions. The plastics used in the phantom were chosen so that their density and linear attenuation coefficient were similar to those of human facial structures. Three types of CBCT equipment, with two different technological concepts, were evaluated. The results of the assessment of the accuracy of linear and angular dimensions agreed with the existing standards. However, other parameters such as computed tomography number accuracy, uniformity and high-contrast detail did not meet the tolerances established in current regulations or the manufacturer's specifications. The results demonstrate the importance of establishing specific protocols and phantoms, which meet the specificities of CBCT. The practicality of implementation, the quality control test results for the proposed phantom and the consistency of the results using different equipment demonstrate its adequacy.
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