Determination of size-specific exposure settings in dental cone-beam CT

Pauwels, Ruben; Jacobs, Reinhilde; Bogaerts, Ria; Bosmans, Hilde; Panmekiate, Soontra

doi:10.1007/s00330-016-4353-z

Cited by 27 publications

(19 citation statements)

References 20 publications

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“…From those data, 6 protocols applicable for the study itself were defined including the utmost protocols (higher and lower dose) as well as four intermediates protocols, at a lower level of mAs (Table 1). This selection was based on image quality overview, ED provided by MC simulation and in accordance with previous studies showing optimal results - dose reduction and acceptable image quality - at lower mAs 7,8 .…”

Section: Methodsmentioning

confidence: 86%

“…It is a small polymethyl-methacrylate (PMMA) cylinder, approximately 3.45 cm in diameter and 2.0 cm in height, and contains a central air-filled cylinder of 1.0 cm diameter. It was placed centrally in the SEDENTEXCT IQ phantom; the rest of the phantom was half filled up with PMMA inserts in order to represent the attenuation of a child, according to a previous study 8 .…”

Section: Methodsmentioning

confidence: 99%

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Halve the dose while maintaining image quality in paediatric Cone Beam CT

Oenning

Pauwels

Stratis

et al. 2019

Sci Rep

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Cone beam CT (CBCT) for dentomaxillofacial paediatric assessment has been widely used despite the uncertainties of the risks of the low-dose radiation exposures. The aim of this work was to investigate the clinical performance of different CBCT acquisition protocols towards the optimization of paediatric exposures. Custom-made anthropomorphic phantoms were scanned using a CBCT unit in six protocols. CT slices were blinded, randomized and presented to three observers, who scored the image quality using a 4-point scale along with their level of confidence. Sharpness level was also measured using a test object containing an air/PMMA e,dge. The effective dose was calculated by means of a customized Monte Carlo (MC) framework using previously validated paediatric voxels models. The results have shown that the protocols set with smaller voxel size (180 µm), even when decreasing exposure parameters (kVp and mAs), showed high image quality scores and increased sharpness. The MC analysis showed a gradual decrease in effective dose when exposures parameters were reduced, with an emphasis on an average reduction of 45% for the protocol that combined 70 kVp, 16 mAs and 180 µm voxel size. In contrast, both “ultra-low dose” protocols that combined a larger voxel size (400 µm) with lower mAs (7.4 mAs) demonstrated the lowest scores with high levels of confidence unsuitable for an anatomical approach. In conclusion, a significant decrease in the effective dose can be achieved while maintaining the image quality required for paediatric CBCT.

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Section: Methodsmentioning

confidence: 86%

Section: Methodsmentioning

confidence: 99%

Halve the dose while maintaining image quality in paediatric Cone Beam CT

Oenning

Pauwels

Stratis

et al. 2019

Sci Rep

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“…The aforementioned inserts were placed in the central column, and three of the six peripheral columns were kept empty, whereas the other columns were filled up with PMMA inserts. As a result, the phantom was similar to a small patient in terms of X-ray absorption and scatter 7 (Figure 1). Phantoms were scanned using a large and a medium field of view (FOV) and exposure parameters displayed in Table 1.…”

Section: Cbct Unit and Phantomsmentioning

confidence: 85%

Image quality optimization of narrow detector dental computed tomography for paediatric patients

Brasil

Pauwels

Coucke

et al. 2019

Dentomaxillofacial Radiology

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Objectives: Dental CBCT exposure parameters should be optimized according to patient-specific indications, mainly for children that are most vulnerable to harmful effects of ionizing radiation. The aim of this study was to determine optimized kV settings for paediatric acquisitions for a dental CBCT device. Methods: Clinical and quantitative evaluations of image quality were performed using 5 and 10 years old (y/o) anthropomorphic phantoms. Technical evaluation was performed with the SEDENTEXCT-IQ phantom. Images were obtained using a PaX-i3D Green CBCT (Vatech, Korea) device, combining tube voltages ranging from 85 to 110 kV and 2 fields of view (FOVs: 21 × 19 and 12 × 9 cm), while maintaining the radiation dose fixed by adjusting the mA accordingly. Clinically, observers assessed images based on overall quality, sharpness, contrast, artefacts, and noise. For quantitative evaluation, mean grey value shift, % increase standard deviation, % beam-hardening and contrast-to-noise ratio were calculated. For technical evaluation, segmentation accuracy, contrast-to-noise ratio and full width at half maximum were measured. Biplot graphs were used to choose representative parameters, from which the best kV was selected for each protocol and evaluation. kV values that had no statistical differences (p > 0.05) with the best kV chosen were considered as having the same quality. Results: Clinically, 95 kV was found as a cut-off value. From the quantitative aspect, 85 kV (p < 0.05) showed the worst quality, except in 12 × 9 cm 5 y/o. Technically, 85 and 110 kV in the large FOV showed significantly worse quality for the large FOV. Conclusion: For paediatric indications, 95 kV or higher (and correspondingly low mA values) was found as optimal.

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“…In addition, reducing the scan time, number of projections, and the mAs (Milliampere-seconds) has an additional role in reducing the dose as well [30,31]. In fact, small and strategic adjustments in exposure parameters can result in significant reduction in the effective dose without significantly compromising the image quality [32,33]. However, significant modifications of these parameters aimed at significant reduction of the effective dose can reduce the image quality [28,34].…”

Section: Radiation Dosage Of Cbct In Orthodonticsmentioning

confidence: 99%

Cone-Beam Computed Tomography in Orthodontics

Abdelkarim

2019

Dentistry Journal

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Unlike patients receiving implants or endodontic treatment, most orthodontic patients are children who are particularly sensitive to ionizing radiation. Cone-beam computed tomography (CBCT) carries risks and benefits in orthodontics. The principal risks and limitations include ionizing radiation, the presence of artifacts, higher cost, limited accessibility, and the need for additional training. However, this imaging modality has several recognized indications in orthodontics, such as the assessment of impacted and ectopic teeth, assessment of pharyngeal airway, assessment of mini-implant sites, evaluation of craniofacial abnormalities, evaluation of sinus anatomy or pathology, evaluation of root resorption, evaluation of the cortical bone plate, and orthognathic surgery planning and evaluation. CBCT is particularly justified when it brings a benefit to the patient or changes the outcome of the treatment when compared with conventional imaging techniques. Therefore, CBCT should be considered for clinical orthodontics for selected patients. Prescription of CBCT requires judicious and sound clinical judgment. The central question of this narrative review article is: when does CBCT add value to the practice of orthodontics? To answer this question, this article presents discussion on radiation dosage of CBCT and other imaging techniques used in orthodontics, limitations of CBCT in orthodontics, justifying the use of CBCT in orthodontics, and the benefits and evidence-based indications of CBCT in orthodontics. This review summarizes the central themes and topics in the literature regarding CBCT in orthodontics and presents ten orthodontic cases in which CBCT proved to be valuable.

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Determination of size-specific exposure settings in dental cone-beam CT

Cited by 27 publications

References 20 publications

Halve the dose while maintaining image quality in paediatric Cone Beam CT

Halve the dose while maintaining image quality in paediatric Cone Beam CT

Image quality optimization of narrow detector dental computed tomography for paediatric patients

Cone-Beam Computed Tomography in Orthodontics

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