Overview of cone beam CT patient radiation dose levels in a dental institution regarding patient age, clinical indications, and CBCT scanners

Abstract

<h3>Objective</h3> To present an overview of typical cone beam CT patient radiation dose levels in a dental institution for different age groups, clinical indications, and CBCT scanners. <h3>Study Design</h3> The patient dose database for CBCT exams performed in 2019, using the 3D Accuitomo 170 (Morita, Kyoto, Japan) and NewTom VGi evo (QR, Verona, Italy) CBCT systems in a dental education institution was assessed and extracted through an automated dose quality management system DOSE (Qaelum NV, Leuven, Belgium). Data regarding age, gender, and clinical indications related to patients, and the type of CBCT scanner, FOV size (small, medium, and large), and dose-area product (DAP) value related to imaging were recorded for each CBCT imaging procedure. A descriptive data analysis was performed, and the average DAP, an average of effective dose, and frequency of examinations were calculated. <h3>Results</h3> A total of 5,166 CBCT examinations were screened. Surgical planning and follow-up were the most frequent clinical indication being the majority indication in medium (35.7%) and large (27.6%) FOVs. In general, DAP and effective dose increased with FOV size. The effective dose ranged from 42.9 to 188.1 µSv for Accuitomo 170 to 46.7 to 140.1 µSv for NewTom VGi evo. <h3>Conclusion</h3> DAP values and effective doses were heterogeneously distributed amongst age groups and mostly influenced by clinical indications of the related FOV size selection. While patient-specific imaging remains advocated, the fact that two-thirds of the indications are surgically oriented makes the medium and large field of views predominant. Developers of CBCT systems could be advised to move towards patient-specific collimation and dynamic field-of-view selection, preferably via an automated algorithm to facilitate clinical implementation of the optimal patient-specific and indication-oriented dose (ALADAIP). <b>Statement of Ethical Review</b> Ethical review was sought and study was exempted from ethical review