Portable X-ray Device Research Articles

Comparison of the Operator and Surrounding Dose When Using Portable Intraoral X-ray Devices

This study aimed to investigate the scattered radiation dose using three portable dental radiographic units: iRay D3, EZRay Air, and Epix. The absorbed dose was measured at 0.5 and 1 m distances, every 15° in the horizontal plane, using an ionization chamber. The maximum number of radiographs per day using the portable units was calculated considering a dose limit of 50 mSv/year and 20 mSv/year. The doses were higher in the Epix unit compared to the other two devices. Anterior exposure was generally higher than the sides or posterior exposure. With a dose limit of 50 mSv/year, considering a distance of 0.5 m between the operator and the X-ray unit, a maximum of 961, 565, and 38 radiographs are permitted daily using iRay D3, EZRay Air, and Epix, respectively. Considering a dose limit of 20 mSv/year, with a distance of 0.5 m between the operator and the radiographic device, a maximum of 384, 226, and 15 radiographs are permitted daily using iRay D3, EZRay Air, and Epix portable units, respectively. It is highly unlikely that an operator would reach occupational dose limits when using iRay D3 and EZRay Air. The Epix radiographic device allows for fewer daily radiographs and should be avoided for daily use.

Is a Camera-Type Portable X-Ray Device Clinically Feasible in Chest Imaging?: Image Quality Comparison with Chest Radiographs Taken with Traditional Mobile Digital X-Ray Devices.

To evaluate whether the image quality of chest radiographs obtained using a camera-type portable X-ray device is appropriate for clinical practice by comparing them with traditional mobile digital X-ray devices. Eighty-six patients who visited our emergency department and underwent endotracheal intubation, central venous catheterization, or nasogastric tube insertion were included in the study. Two radiologists scored images captured with traditional mobile devices before insertion and those captured with camera-type devices after insertion. Identification of the inserted instruments was evaluated on a 5-point scale, and the overall image quality was evaluated on a total of 20 points scale. The identification score of the instruments was 4.67 ± 0.71. The overall image quality score was 19.70 ± 0.72 and 15.02 ± 3.31 (p < 0.001) for the mobile and camera-type devices, respectively. The scores of the camera-type device were significantly lower than those of the mobile device in terms of the detailed items of respiratory motion artifacts, trachea and bronchus, pulmonary vessels, posterior cardiac blood vessels, thoracic intervertebral disc space, subdiaphragmatic vessels, and diaphragm (p = 0.013 for the item of diaphragm, p < 0.001 for the other detailed items). Although caution is required for general diagnostic purposes as image quality degrades, a camera-type device can be used to evaluate the inserted instruments in chest radiographs.

Assessment of the Occupational Radiation Dose from a Handheld Portable X-ray Unit During Full-mouth Intraoral Dental Radiographs in the Dog and the Cat - A Pilot Study.

Occupational radiation protection is an important consideration in small animal clinics world-wide. With the increased use of portable handheld X-ray devices in veterinary dentistry, concerns related to occupational radiation protection are being raised. Annual occupational dose limits for dental workers are expressed as Total Dose Equivalent (TDE) or Effective Dose. The permitted TDE can vary depending on the anatomical region, ranging from 50 millisieverts (mSv) for the external whole body exposure dose to 500 mSv for external exposure of the skin or an extremity. Although several studies have been performed in human dentistry to establish the amount of backscatter radiation produced using portable handheld X-ray devices, no similar research has been conducted in veterinary dentistry. This study aimed to determine the TDE while acquiring a full mouth intraoral radiograph set in dogs and cats and to estimate the TDE for a handheld X-ray device's operator. For this, the backscatter radiation dose recorded by three sets of monitoring dosimeters located in strategic anatomical areas of the operator was assessed after taking one hundred intraoral radiographs in each group. The study concluded that the backscatter radiation levels were far below the permitted annual occupational doses in the three patient groups of this study. Even though the portable handheld X-ray unit was demonstrated to be a safe dental radiographic unit regarding backscattering radiation, the operator's eye, ovary, and breast regions were exposed to unnecessary radiation.

Use of a Compact, Lightweight X-ray Unit to Reduce the Risk of Five Invasive Procedures in the Emergency Room.

Many invasive procedures performed in the emergency room (ER) have potential risks and complications. Because of their limitations, in particular size, portable X-ray devices are generally not used during such procedures. However, miniaturized units enable physicians to obtain X-ray images without assistance. We developed a safe, compact, and lightweight X-ray unit that was used during five invasive procedures in the ER. In all procedures, a chest X-ray image was obtained, to confirm the utility of the unit. Case 1 (central venous catheter placement): After needle and guidewire insertion and catheter placement, the location of the catheter could be confirmed. Case 2 (chest tube insertion): During insertion of a chest tube into the pleural space, the tip of the thoracic tube was confirmed to be at the correct location. Case 3 (percutaneous tracheostomy or cricothyroidotomy): After needle and guidewire insertion, the guidewire was visualized in the right main bronchus and was inserted into the trachea. Case 4 (resuscitative endovascular aortic balloon of the aorta): The captured image revealed that the catheter was located in zone I before balloon inflation. Case 5 (Sengstaken-Blakemore tube): The image revealed that the balloon was located in the stomach. The portable X-ray unit improved medical safety during invasive procedures frequently performed in the ER.

Portable X-ray devices: technique, image quality and regulations

Portable intraoral X-ray devices are marketed as an alternative for conventional wall mounted devices. On the basis of a recent clinical trial the diagnostic quality of portables appears to measure up to the conventional devices. When CE-certified portable devices are used with rectangular collimation and a backshatter radiation shield with adapted technique resulting in a beam parallel to the ground, operator exposure stays well within dose limits. However, the dose to the operator is higher than when using conventional devices. Therefore, in the Netherlands, guidelines restrict the use of portable devices to ambulant use outside the dental clinic while deploying additional radiation protection measures. If presumed advantages of increased control over the exposure due to proximity to the patient would be substantiated by research, this restricted use could be reconsidered. Dentists should be aware of online availability of non-CE-certified portable intra-oral X-ray devices that are potentially unsafe.

Association of Chest X- ray findings with SARS-CoV-2 severity

Background: The COVID-19 first surfaced when cluster of pneumonia patients arose in Wuhan, Hubei Province, China. Although the current gold standard for COVID-19 diagnosis is reverse transcriptase-polymerase chain reaction (RT-PCR), chest x-ray (CXR) and computed tomography (CT) play a vital role in sickness diagnosis due to their limited sensitivity and availability. Aim: To evaluate retrospectively the role of CXR, the main radiological findings in it and its diagnostic accuracy in COVID-19 pneumonia. Methods: This is a cross sectional study involving 264 PCR positive COVID-19 patients with their clinical–epidemiological findings admitted at Ziauddin Hospital from May-July 2020. CXRs were taken as digital radiographs in our emergency department's isolation wards using the same portable X-ray device, according to local norms. CXRs were taken in two directions: antero-posterior (AP) and postero-anterior (PA). The hospitals' database had all of the images. To determine the number of radiological findings, multiple radiologists on duty completed an independent and retrospective examination of each CXR. In the event of disagreement, a mutual agreement was reached. SPSS version 20 was used for statistical analysis. Results: We were able to find 264 patients who met our criteria. With a mean age of 56.4214.89, the majority of individuals were determined to be males 189(71.6%) and females 75(28.4%). (Range of 16 to 87 years). 127 patients (48.1%) had severe illness symptoms and were admitted to the ICU, while the remaining 102(38.6%) had mild to moderate disease 35(13.3%). Diffuse (29.2%) and middle and lower co-existing distribution (25.8%) whereas just lower lobe (13.3%) were the most common predominance in severity. Peripheral involvement was also seen in (8.7%) cases. Conclusion: Both lungs are equally affected with the disease having the consolidation and opacifications while the effusion is the major complication in the severe cases. Diffuse involvement of the lung lobes is seen in the study followed by the middle and lower lobe involvement. Keywords: X-ray, COVID-19, pneumonia, lungs, consolidation, opacification

APPLICATION OF THE MONTE CARLO METHOD FOR THE EVALUATION OF SCATTERED RADIATION DOSE DUE TO THE USE OF HANDHELD X-RAY IN DENTISTRY.

The object of this study was to evaluate the dose of scattered radiation in the organs of the operator and assistant located in different positions within a dental room when acquiring intraoral images with a portable handheld X-ray device, using Monte Carlo simulations for recommended and traditional techniques. A typical dental installation was modeled, where the operator and assistant were placed. The beam is represented by 60-kV spectrum. Ten scenarios were simulated, representing different positions and use of the lead apron. The results of the simulations were carried out with typical parameters of the annual workload, showing significant increases in dose in the organs of the operator due to the angulation. The minimum dose in the organs of the assistant occurred when he was located 2-m away and 45° from the direction of the beam. The dose received by the operator is significantly reduced with the use apron.

A disaster victim identification workshop focused on forensic odontology using embalmed human remains

A high number of victims of mass casualty incidences are identified through their teeth. While forensic odontologists need to have a complex skillset during a disaster victim identification (DVI) response, hands-on training opportunities are rare. In countries with very limited forensic casework, such as New Zealand, many forensic odontologists find it difficult to achieve the number of annual forensic dental identifications required to maintain their credentialling. This report details the development of a hands-on forensic odontology-focused DVI workshop using human Crosado-embalmed remains. Anonymous participant evaluations, including five-point Likert and open-ended items, were performed in both years the workshop was held. A total of 10 and 17 participants, predominantly dentists, attended the workshop in 2020 and 2021, respectively. Participant feedback was extremely positive. Likert items were statistically similar between participants in both years. Open-ended items revealed positive feedback regarding the use of cadaveric remains, the gained hands-on experience, or the teamwork aspect. Participants who attended the workshop in both years commented on the positive aspect of repetition to cement their skills. As areas of improvement, participants named (for example) time management and the number of portable X-ray devices, leading to changes that were implemented in 2021. Moreover, the participants expressed interest to further their skills on decomposed, burnt, and fragmented human remains, which for ethical reasons has yet to be implemented. The DVI workshop described here, using embalmed human remains, provides an opportunity to add dental identifications toward annual credentialling requirements for forensic odontologists. Participants rated the course to be excellent overall and highly relevant for their role. For future workshops, there is an interest to include further aspects of the DVI response such as fingerprinting or police work as well as remains, which are altered due to natural or physical reasons.

Correlation between serum dosage of Calcium, Phosphorus, Alkaline Phosphatase and epifisary closing age in foals of low genetic grouping / Correlação entre as dosagens séricas de Cálcio, Fósforo, fosfatase Alcalina e idade de fechamento epifisário em potros do grupamento genético baixadeiro

The subsided region of Maranhão is characterized by its peculiar ecosystem, flooded fields in rainy seasons and an arid environment in the dry season. In this region, there is a remarkable record of the presence of a genetic group called by the local population, of horse "baixadeiro". The study aimed to determine, through radiographic evaluation, the age of closure of the radio growth plate of these animals, correlating radiographic findings with gender and serum dosages of calcium, phosphorus and alkaline phosphatase. In the study, 60 horses were used, with ages ranging from 18 to 30 months, divided into two equal groups according to gender. A portable X-ray device was used to obtain the images. The radiographic technique used was 53 kVp and 5 mAs, with a film focus distance of 70 cm in craniocaudal projection. Blood samples were performed by puncture of the external jugular vein and stored in Ependorff tubes, frozen until processing. Biochemical analyses were performed using specific kits to measure calcium, phosphorus, and alkaline phosphatase. According to the results obtained, the average age of closure of the growth plate was 26.7 months for the male and 24.5 in females. As for serum dosages, we observed that the average values found in calcium were higher in males, while the average values found for both phosphorus and alkaline phosphatase were higher in females.

ASSESSMENT OF OCCUPATIONAL RADIATION DOSE FROM CAMERA MODEL INTRAORAL HANDHELD X-RAY DEVICE WITHOUT STRAY RADIATION PROTECTION SHIELD

The aim of this study was to assess the occupational exposure from portable X-ray device without stray radiation protection shield measured using thermoluminescent dosemeters (TLDs). A total of 108 intraoral periapical radiographies of six sextants were performed. The TLDs were located on right index finger and left palm, between the pupils of the eyes at the edges of the Nasion point, Manubrium of Sternum bone and genital area. The detected mean doses per procedure were 70, 99, 60, 51, 51 and 58 μSv in the right finger, left palm, level of the Nasion point, under left clavicle, above the sternum manubrium and at the gonad area, respectively. Maximum number of radiographic images that the operator is allowed to perform depends on eye exposure and in accordance with International Commission on Radiological Protection is 0.16 (0.12-0.23) per hour or 1.28 (0.96-1.84) per day.

Accuracy in positioning of dental X-ray images – A comparative study of a portable X-ray device and a wall-mounted device

IntroductionThe benefits of portable dental X-ray devices remain controversially debated. This study aimed to compare the accuracy in positioning dental X-ray images using handheld (Nomad Pro 2) and wall-mounted (Heliodent Plus) X-ray devices. Materials and methodsRadiographical imaging was exercised on a maxillofacial phantom using the handheld dental X-ray device Nomad Pro 2 (Kavo Kerr, Biberach, Germany) and the wall-mounted dental X-ray device Heliodent Plus (Sirona Dental Systems, Bensheim, Germany). Accuracy of device positioning (i.e., centeredness and perpendicularity) was measured as horizontal and vertical deviation (pixels and millimeters) from a centrally positioned crosshair. The reproducibility of the results was tested for 80 images per device and operator. IBM SPSS (SPSS Inc., Chicago, IL) was used for statistical analyses. ResultsCenteredness of produced dental X-rays was significantly better for the wall-mounted device than for the handheld device in both deviation from the x-axis (p = 0.042) and y-axis (p = 0.020). The perpendicularity of the produced dental X-rays was significantly better for the handheld device than for the wall-mounted device for both horizontal (p < 0.001) and vertical (p < 0.001) plains. ConclusionsHandheld dental X-ray devices appear to provide a high degree of accuracy in image positioning, especially in regard to proper perpendicular image angulation.

Data augmentation approaches using cycle-consistent adversarial networks for improving COVID-19 screening in portable chest X-ray images

The current COVID-19 pandemic, that has caused more than 100 million cases as well as more than two million deaths worldwide, demands the development of fast and accurate diagnostic methods despite the lack of available samples. This disease mainly affects the respiratory system of the patients and can lead to pneumonia and to severe cases of acute respiratory syndrome that result in the formation of several pathological structures in the lungs. These pathological structures can be explored taking advantage of chest X-ray imaging. As a recommendation for the health services, portable chest X-ray devices should be used instead of conventional fixed machinery, in order to prevent the spread of the pathogen. However, portable devices present several problems (specially those related with capture quality). Moreover, the subjectivity and the fatigue of the clinicians lead to a very difficult diagnostic process. To overcome that, computer-aided methodologies can be very useful even taking into account the lack of available samples that the COVID-19 affectation shows. In this work, we propose an improvement in the performance of COVID-19 screening, taking advantage of several cycle generative adversarial networks to generate useful and relevant synthetic images to solve the lack of COVID-19 samples, in the context of poor quality and low detail datasets obtained from portable devices. For validating this proposal for improved COVID-19 screening, several experiments were conducted. The results demonstrate that this data augmentation strategy improves the performance of a previous COVID-19 screening proposal, achieving an accuracy of 98.61% when distinguishing among NON-COVID-19 (i.e. normal control samples and samples with pathologies others than COVID-19) and genuine COVID-19 samples. It is remarkable that this methodology can be extrapolated to other pulmonary pathologies and even other medical imaging domains to overcome the data scarcity.

Update on Hand-Held X-Ray Devices in Dentistry: a Literature Review

In the last two decades, the use of portable intraoral X-ray devices, stabilized by the operator, has increased. While all radiographic devices present an inherent risk from ionizing radiation, improper use of portable devices can increase operator exposure. Use of portable devices on a tripod or powered from a protected area is recommended. However, in highly justified cases, for using without these accessories, recommendations should be followed to reduce operator exposure. Because radioprotection is essential when using X-rays, fixed dental radiographic devices should be favored over portable equipment since the first provides a lower radiation dose to the operator.

Multi-stage transfer learning for lung segmentation using portable X-ray devices for patients with COVID-19

One of the main challenges in times of sanitary emergency is to quickly develop computer aided diagnosis systems with a limited number of available samples due to the novelty, complexity of the case and the urgency of its implementation. This is the case during the current pandemic of COVID-19. This pathogen primarily infects the respiratory system of the afflicted, resulting in pneumonia and in a severe case of acute respiratory distress syndrome. This results in the formation of different pathological structures in the lungs that can be detected by the use of chest X-rays. Due to the overload of the health services, portable X-ray devices are recommended during the pandemic, preventing the spread of the disease. However, these devices entail different complications (such as capture quality) that, together with the subjectivity of the clinician, make the diagnostic process more difficult and suggest the necessity for computer-aided diagnosis methodologies despite the scarcity of samples available to do so. To solve this problem, we propose a methodology that allows to adapt the knowledge from a well-known domain with a high number of samples to a new domain with a significantly reduced number and greater complexity. We took advantage of a pre-trained segmentation model from brain magnetic resonance imaging of a unrelated pathology and performed two stages of knowledge transfer to obtain a robust system able to segment lung regions from portable X-ray devices despite the scarcity of samples and lesser quality. This way, our methodology obtained a satisfactory accuracy of 0.9761±0.0100 for patients with COVID-19, 0.9801±0.0104 for normal patients and 0.9769±0.0111 for patients with pulmonary diseases with similar characteristics as COVID-19 (such as pneumonia) but not genuine COVID-19.

A visual odometry base-tracking system for intraoperative C-arm guidance.

C-arms are portable X-ray devices used to generate radiographic images in orthopedic surgical procedures. Evidence suggests that scouting images, which are used to aid in C-arm positioning, result in increased operation time and excess radiation exposure. C-arms are also primarily used qualitatively to view images, with limited quantitative functionality. Various techniques have been proposed to improve positioning, reduce radiation exposure, and provide quantitative measuring tools, all of which require accurate C-arm position tracking. While external stereo camera systems can be used for this purpose, they are typically considered too obtrusive. This paper therefore presents the development and verification of a low-profile, real-time C-arm base-tracking system using computer vision techniques. The proposed tracking system, called OPTIX (On-board Position Tracking for Intraoperative X-rays), uses a single downward-facing camera mounted to the base of a C-arm. Relative motion tracking and absolute position recovery algorithms were implemented to track motion using the visual texture in operating room floors. The accuracy of the system was evaluated in a simulated operating room mounted on a real C-arm. The relative tracking algorithm measured relative translation position changes with errors of less than 0.75% of the total distance travelled, and orientation with errors below 5% of the cumulative rotation. With an error-correction step incorporated, OPTIX achieved C-arm repositioning with translation errors of less than [Formula: see text] mm and rotation errors of less than [Formula: see text]. A display based on the OPTIX measurements enabled consistent C-arm repositioning within 5mm of a previously stored reference position. The system achieved clinically relevant accuracies and could result in a reduced need for scout images when re-acquiring a previous position. We believe that, if implemented in an operating room, OPTIX has the potential to reduce both operating time and harmful radiation exposure to patients and surgical staff.

Image quality of a portable X-ray device (Nomad Pro 2) compared to a wall-mounted device in intraoral radiography

ObjectivesThe aim of this study was to determine whether a handheld (HH) X-ray device (Nomad Pro 2) is capable of producing equivalent or even superior X-ray image quality in comparison to a wall-mounted (WM) dental X-ray unit (Heliodent Plus) on the basis of objectifiable image quality parameters.MethodsAnatomical, radiological and biological dental X-ray image quality parameters of a handheld dental X-ray device (Nomad Pro 2, Kavo Kerr, Biberach, Germany) were compared to a standard wall-mounted dental X-ray unit (Heliodent Plus, Sirona Dental Systems, Bensheim, Germany) using a maxillofacial phantom. In addition, the effect of different operators (dentists, dental students, dental assistants) on the dental X-ray image quality was measured.ResultsHH and WM devices showed comparable image quality for anterior teeth, premolars, molars and bitewing images. During the two-month investigational period, the radiation exposure level for the operator of the Nomad Pro 2 was 0.1 mSv for 203 images. Dentists as the highest trained personnel enrolled in the study achieved better image quality with the Nomad Pro 2 as compared to dental students and dental assistants, especially in the molar region.ConclusionsA HH device delivers a comparable image quality to a WM device. In addition, there seem to be short learning curves with regard to image acquisition when using a handheld device, which is further minimised by the previous training of the operating personnel. HH dental X-ray devices, such as the Nomad Pro 2 are a promising adjunct for dental radiology in cases where WM units are of limited practicability.

Dosimetry of a portable in vivo x-ray fluorescence system using EBT3 radiochromic film

Purpose. In vivo x-ray fluorescence is a non-invasive analytical technique for determining trace and toxic element exposures. In this work we measure the dose for a portable handheld x-ray system (pXRF). Materials and Methods. We used EBT3 radiochromic film calibrated with a clinical orthovoltage unit for absolute dose measurement. Films were placed on a human phantom and irradiated with the Tracer III-SD pXRF at tube potentials of 40 and 45 kVp with various levels of filtration. Results. Using settings that result in the best detection limits, the highest absorbed point dose to the skin was 0.3 Gy, the equivalent dose to a 1 cm2 area was 54 mSv, and the whole-body effective dose was less than 1 μSv for a standard 3-min in vivo measurement of strontium or lead. Recent work has demonstrated that 1 s and 30 s measurements are feasible for bone strontium measurements, which would lead to significantly lower doses. Conclusions. Our results are in agreement with a previous dosimetry study of another portable x-ray device and indicate that it is safe for in vivo measurements of elements such as strontium and lead, only after appropriate dose validation and with appropriate beam filtration in place.

Hypermobility Frequency in School Children: Relationship With Idiopathic Scoliosis, Age, Sex and Musculoskeletal Problems.

This study aims to assess the prevalence of generalized joint hypermobility (GJH) in school children in relation to scoliosis and to identify musculoskeletal problems. This cross-sectional study included 822 school children (413 males, 409 females; mean age 12.2±1.3 years; range, 10 and 15 years). Demographic characteristics of all children were recorded. The presence of GJH was assessed by the Beighton score (≥4 was considered joint hypermobility). Scoliosis screening consisted of forward bend test (FBT) and measurement of angle of trunk rotation (ATR). Positive FBT or ATR ≥5° was referred to a portable X-ray device. The presence of musculoskeletal complaints was determined by a questionnaire. Children's Body Mass Index (BMI) was 19.6±4.1. GJH was diagnosed in 151 subjects (18.4%). No significant association was detected between sex and hypermobility. Joint hypermobility was inversely correlated with age and BMI. Scoliosis was found in 43 subjects (5.2%) and all of them except one girl had mild scoliosis. The most common scoliosis pattern was a single left thoracolumbar curve. Seventy-three subjects (8.9%) had Cobb angle under 10°, with a potential for progression. Among subjects having GJH, the most common clinical finding was pes planus (34.3%) and the most common clinical symptom was ankle sprain (31.3%). Similar to that found in children from many countries, GJH is a common clinical condition in Turkish children. GJH should be assessed in the differential diagnosis of adolescents with musculoskeletal complaints for effective treatment and reducing morbidity. GJH should be considered in adolescents with scoliosis, which may be an important aspect in treatment.

New-Age Pyroelectric Radiographic X-Ray Generators

Medical imaging history has begun with the discovery of X-rays. X-rays that are widely used since&#x0D; their invention in different areas from projectional radiography to computed tomography. Year by&#x0D; year their technology is improved in many aspects especially for their generation of which tubes&#x0D; are changed to get the most efficient rays. Nowadays different mechanisms are studied to obtain&#x0D; X-rays; one of them is pyroelectricity phenomena. Pyroelectricity is a material’s electricity&#x0D; generation from temperature changes. The output spectra of the pyroelectric X-ray generator is&#x0D; quite similar to traditional X-ray tubes, which gives a chance for replacing low-voltage pyroelectric&#x0D; X-ray generators instead of high-voltage conventional X-ray tubes. The results of conducted&#x0D; experiments and continued studies show us that the use of pyroelectricity for X-ray generation has&#x0D; great advantages. More portable X-ray devices may be available in the near future, and these new&#x0D; designs offer safer and easier to operate since they use only 12 Volts instead of kiloVolts. In&#x0D; conclusion, healthcare technologies require high budges in general, this low-cost alternative might&#x0D; make the radiological imaging available for low-income countries. In this paper, the fundamentals&#x0D; of X-ray generation from pyroelectric material is reviewed, a device on the market, COOL-X, is&#x0D; investigated, and both conventional method and pyroelectricity methods are compared.

Precision of aiming with a portable X-ray device (Nomad Pro 2) compared to a wall-mounted device in intraoral radiography.

20 operators obtained intraoral radiographs of four regions (bitewing, upper molar, lower molar and upper anterior) in five mannequins, using HH and WM devices. Beam-aiming devices were fitted with metal cross-wires to project on image sensors. Deviation from ideal perpendicular incidence of beam was calculated, based on positions of cross-wires relative to gold-standard positions (i.e. average of 10-fold precise aiming by authors via WM system). Analytic models relied on Wilcoxon signed-rank test and mixed model analyses. Mean deviations from perfect aim were 2.88˚ (± 1.80˚) for WM and 3.06˚ (± 1.90˚) for HH methods. The difference among all operators (HH vs WM) was 0.17˚ (± 2.48˚), which was not significant. Seven operators showed better aim by HH device (13 by WM system); and in one instance, this difference was significant. Aiming precision proved similar for HH and WM methods of intraoral radiography, although individual operators may perform better using one of these modalities. Aim is not an expected limiting factor for image quality in HH (vs WM) diagnostics.