An optimized imaging protocol for orofacial cleft patients.

Dries De Mulder,Maria Cadenas De Llano‐Pérula,Anna Verdonck,Reinhilde Jacobs,Guy Willems,Jakob Titiaan Dormaar

doi:10.1002/cre2.123

Dries De Mulder, Maria Cadenas De Llano‐Pérula + Show 4 more

Open Access

https://doi.org/10.1002/cre2.123

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Abstract

The objective was to present an optimized imaging protocol for orofacial cleft (OFC) patients, which might be used as an international recommendation for OFC care programs. The present radiological protocol has been structured by the OFC team of the University Hospitals Leuven based on a combined approach of clinical experience and scientific evidence. The development was based on careful monitoring of the existing needs for radiological diagnosis by the involved disciplines. Needs were revised by expert consensus and radiological optimization. Effective doses were converted to panoramic equivalents (professional conversion) and background radiation (patient conversion). At the age of 6, a panoramic radiograph is taken for the evaluation of dental anomalies. For the preoperative planning of secondary alveolar bone, grafting a low‐resolution cone beam computer tomography (CBCT) of a limited field of the maxilla is taken at the age of 7 to 9. At the age of 10, 15, and 20, a low‐resolution CBCT of both jaws with the smallest possible field is taken serving as conventional, presurgical, and end of treatment records, respectively. Two‐dimensional images are reconstructed out of 3D ones. There are currently no international guidelines concerning the imaging protocol for OFC patients. It is clear that a multidisciplinary approach plays a key role in radiation hygiene. In this article, we presented an optimized imaging protocol for OFC patients based on European guidelines to accomplish the concepts of justification and optimization, which might be used as an international recommendation for OFC care programs.

Highlights

Orofacial clefts (OFC) are common congenital malformations of the lip and/or palate, caused by a complex interaction of genetic and environmental factors (Wehby & Murray, 2010)
The aim of this article is to present an optimized imaging protocol for OFC patients, which might be used as an international recommendation for OFC care programs
The present imaging protocol has been structured by the OFC team of the University Hospitals Leuven, based on a combined approach of clinical experience and scientific evidence

Summary

| INTRODUCTION

Orofacial clefts (OFC) are common congenital malformations of the lip and/or palate, caused by a complex interaction of genetic and environmental factors (Wehby & Murray, 2010). Different radiological projections may be required for diagnostic, presurgical, and postoperative assessment by different specialties throughout the lifespan of an OFC patient. The latter may lead to cumulative radiation throughout childhood and adolescence that means an increased radiation risk (Jacobs et al, 2017; Pauwels et al, 2014a). OFC protocols should strive for optimized imaging during the various treatment phases up until adulthood. The aim of this article is to present an optimized imaging protocol for OFC patients, which might be used as an international recommendation for OFC care programs. Subobjectives include justification of the required imaging steps and optimization of the related radiation doses versus required image quality at various time points throughout the entire treatment of the OFC patient

| MATERIALS AND METHODS

Evaluation of dental anomalies

| DISCUSSION

| CONCLUSIONS