DOI QR코드

DOI QR Code

Cone-beam computed tomography: Time to move from ALARA to ALADA

  • Jaju, Prashant P. (Department of Oral Medicine and Radiology, Rishiraj College of Dental Sciences and Research Centre) ;
  • Jaju, Sushma P. (Department of Conservative Dentistry and Endodontics, Rishiraj College of Dental Sciences and Research Centre)
  • Received : 2015.06.11
  • Accepted : 2015.07.18
  • Published : 2015.12.31

Abstract

Cone-beam computed tomography (CBCT) is routinely recommended for dental diagnosis and treatment planning. CBCT exposes patients to less radiation than does conventional CT. Still, lack of proper education among dentists and specialists is resulting in improper referral for CBCT. In addition, aiming to generate high-quality images, operators may increase the radiation dose, which can expose the patient to unnecessary risk. This letter advocates appropriate radiation dosing during CBCT to the benefit of both patients and dentists, and supports moving from the concept of "as low as reasonably achievable" (ALARA) to "as low as diagnostically acceptable" (ALADA).

Keywords

References

  1. Ludlow JB, Timothy R, Walker C, Hunter R, Benavides E, Samuelson DB, et al. Effective dose of dental CBCT-a meta analysis of published data and additional data for nine CBCT units. Dentomaxillofac Radiol 2014; 44: 20140197.
  2. De Vos W, Casselman J, Swennen GR. Cone-beam computerized tomography (CBCT) imaging of the oral and maxillofacial region: a systematic review of the literature. Int J Oral Maxillofac Surg 2009; 38: 609-25. https://doi.org/10.1016/j.ijom.2009.02.028
  3. Choi E, Ford NL. Measuring absorbed dose for i-CAT CBCT examinations in child, adolescent and adult phantoms. Dentomaxillofac Radiol 2015; 44: 20150018. https://doi.org/10.1259/dmfr.20150018
  4. Carter L, Farman AG, Geist J, Scarfe WC, Angelopoulos C, Nair MK, et al. American Academy of Oral and Maxillofacial Radiology executive opinion statement on performing and interpreting diagnostic cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 106: 561-2. https://doi.org/10.1016/j.tripleo.2008.07.007
  5. Ludlow JB, Ivanovic M. Comparative dosimetry of dental CBCT devices and 64-slice CT for oral and maxillofacial radiology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 106: 106-14. https://doi.org/10.1016/j.tripleo.2008.03.018
  6. Brenner DJ, Hall EJ. Computed tomography-an increasing source of radiation exposure. N Engl J Med 2007; 357: 2277-84. https://doi.org/10.1056/NEJMra072149
  7. Ludlow JB, Davies-Ludlow LE, Brooks SL, Howerton WB. Dosimetry of 3 CBCT devices for oral and maxillofacial radiology: CB Mercuray, NewTom 3G and i-CAT. Dentomaxillofac Radiol 2006; 35: 219-26. https://doi.org/10.1259/dmfr/14340323
  8. Brown J, Jacobs R, Levring Jaghagen E, Lindh C, Baksi G, Schulze D, et al. Basic training requirements for the use of dental CBCT by dentists: a position paper prepared by the European Academy of DentoMaxilloFacial Radiology. Dentomaxillofac Radiol 2014; 43: 20130291. https://doi.org/10.1259/dmfr.20130291
  9. Horner K, O'Malley L, Taylor K, Glenny AM. Guidelines for clinical use of CBCT: a review. Dentomaxillofac Radiol 2015; 44: 20140225. https://doi.org/10.1259/dmfr.20140225
  10. National Council on Radiation Protection and Measurements. NCRP: achievements of the past 50 years and addressing the needs of the future. Fiftieth annual meeting program. Bethesda: NCRP; 2014 [cited 2015 June 8]. Available from: http://www.ncrponline.org/Annual_Mtgs/2014_Ann_Mtg/PROGRAM_2-10.pdf.

Cited by

  1. The Use of Cone-Beam Computed Tomography in Management of Patients Requiring Dental Implants: An American Academy of Periodontology Best Evidence Review vol.88, pp.10, 2015, https://doi.org/10.1902/jop.2017.160548
  2. Dosimetry in CBCT with Different Protocols: Emphasis on Small FOVs Including Exams for TMJ vol.28, pp.4, 2015, https://doi.org/10.1590/0103-6440201701525
  3. Diagnosis of alveolar and root fractures in macerated canine maxillae: a comparison between two different CBCT protocols vol.46, pp.6, 2015, https://doi.org/10.1259/dmfr.20170037
  4. Diagnostic accuracy of phosphor plate systems and conventional radiography in the detection of simulated internal root resorption vol.75, pp.8, 2015, https://doi.org/10.1080/00016357.2017.1359331
  5. The effect of different exposure parameters on proximal caries detection using the Kodak 9000 3D CBCT system vol.65, pp.4, 2017, https://doi.org/10.1590/1981-863720170002000053256
  6. Cone-beam CT in paediatric dentistry: DIMITRA project position statement vol.48, pp.3, 2015, https://doi.org/10.1007/s00247-017-4012-9
  7. The Appearance of The Infraorbital Canal and Infraorbital Ethmoid (Haller's) Cells on Panoramic Radiography of Edentulous Patients vol.2018, pp.None, 2015, https://doi.org/10.1155/2018/1293124
  8. Absorbed doses in salivary and thyroid glands from panoramic radiography and cone beam computed tomography vol.34, pp.1, 2018, https://doi.org/10.1590/2446-4740.03717
  9. Clinical guidelines for dental cone-beam computed tomography vol.34, pp.2, 2015, https://doi.org/10.1007/s11282-018-0314-3
  10. Effect of Milliamperage Reduction on Pre-surgical Implant Planning Using Cone Beam Computed Tomography by Surgeons of Varying Experience vol.17, pp.4, 2015, https://doi.org/10.1007/s12663-017-1075-y
  11. Three‐dimensional prediction of roots position through cone‐beam computed tomography scans‐digital model superimposition: A novel method vol.22, pp.1, 2019, https://doi.org/10.1111/ocr.12252
  12. Comparison of manual and dose reduction modes of a MORITA R100 CBCT vol.48, pp.2, 2015, https://doi.org/10.1259/dmfr.20180009
  13. Dentists’ use of digital radiographic techniques: Part II - extraoral radiography: a questionnaire study of Swedish dentists vol.77, pp.2, 2015, https://doi.org/10.1080/00016357.2018.1525763
  14. A reject analysis of cone-beam CTs in under-aged patients vol.48, pp.3, 2019, https://doi.org/10.1259/dmfr.20180138
  15. TMJ Arthritis Imaging: Conventional Radiograph vs. CT Scan - Is CT Actually Needed? vol.15, pp.2, 2019, https://doi.org/10.2174/1573397114666180927101637
  16. Comparison of linear and volumetric measurements obtained from periodontal defects by using cone beam-CT and micro-CT: an in vitro study vol.23, pp.5, 2015, https://doi.org/10.1007/s00784-018-2665-x
  17. Ex Vivo Detection of Apical Delta in Premolars: A Comparative Study Using Periapical Radiography, Cone-beam Computed Tomography, and Micro–computed Tomography vol.45, pp.5, 2015, https://doi.org/10.1016/j.joen.2019.02.022
  18. Influence of scan mode (partial/full rotations) and FOV size in the formation of artefacts in cone beam CT vol.48, pp.4, 2015, https://doi.org/10.1259/dmfr.20180340
  19. Cone-beam computed tomography and three-dimensional orthodontics. Where we are and future perspectives vol.46, pp.1, 2015, https://doi.org/10.1177/1465312519840029
  20. Image quality optimization of narrow detector dental computed tomography for paediatric patients vol.48, pp.5, 2015, https://doi.org/10.1259/dmfr.20190032
  21. Can adaptive post-processing of storage phosphor plate panoramic radiographs provide better image quality? A comparison of anatomical image quality of panoramic radiographs before and after adaptive p vol.77, pp.5, 2015, https://doi.org/10.1080/00016357.2018.1556801
  22. Influence of the incorporation of a lead foil to intraoral digital receptors on the image quality and root fracture diagnosis vol.48, pp.6, 2015, https://doi.org/10.1259/dmfr.20180369
  23. Dental students' ability to detect maxillary sinus abnormalities: A comparison between panoramic radiography and cone-beam computed tomography vol.49, pp.3, 2019, https://doi.org/10.5624/isd.2019.49.3.191
  24. Changes to the consent process for mandibular third molar surgery vol.10, pp.4, 2015, https://doi.org/10.1308/rcsfdj.2019.126
  25. Visibility, location, and morphology of the primary maxillary sinus ostium and presence of accessory ostia: a retrospective analysis using cone beam computed tomography (CBCT) vol.23, pp.11, 2015, https://doi.org/10.1007/s00784-019-02829-9
  26. A comparison of perceived diagnostic image quality in direct digital panoramic images between standard and advanced external GOP image processing vol.77, pp.8, 2015, https://doi.org/10.1080/00016357.2019.1618912
  27. Three-dimensional evaluation of the root resorption of maxillary incisors after the orthodontic traction of bicortically impacted canines: case reports vol.20, pp.1, 2015, https://doi.org/10.1186/s40510-019-0267-z
  28. Generative Noise Reduction in Dental Cone-Beam CT by a Selective Anatomy Analytic Iteration Reconstruction Algorithm vol.8, pp.12, 2019, https://doi.org/10.3390/electronics8121381
  29. CBCT in Advanced Dental Education: A Survey of U.S. Postdoctoral Periodontics Programs vol.84, pp.3, 2015, https://doi.org/10.21815/jde.019.179
  30. Does the addition of a lead foil to digital radiographic receptors influence image contrast and approximal caries lesions diagnosis? vol.49, pp.4, 2015, https://doi.org/10.1259/dmfr.20190384
  31. 2D vs. 3D Radiological Methods for Dental Age Determination around 18 Years: A Systematic Review vol.10, pp.9, 2015, https://doi.org/10.3390/app10093094
  32. Cone-beam computed tomography imaging of dentoalveolar and mandibular fractures vol.36, pp.3, 2015, https://doi.org/10.1007/s11282-019-00390-5
  33. Detectability of Osseous Lesions with a Pre-Programmed Low-Dose Protocol for Cone-Beam Computed Tomography vol.10, pp.14, 2020, https://doi.org/10.3390/app10144961
  34. Can modifying shielding, field of view, and exposure settings make the effective dose of a cone-beam computed tomography comparable to traditional radiographs used for orthodontic diagnosis? vol.90, pp.5, 2015, https://doi.org/10.2319/072819-496.1
  35. Image retake rates of cone beam computed tomography in a dental institution vol.24, pp.12, 2015, https://doi.org/10.1007/s00784-020-03315-3
  36. Contour changes of peri-implant tissues are minimal and similar for a one- and a two-piece implant system over 12 years vol.25, pp.2, 2015, https://doi.org/10.1007/s00784-020-03638-1
  37. Quantitative bone imaging biomarkers to diagnose temporomandibular joint osteoarthritis vol.50, pp.2, 2015, https://doi.org/10.1016/j.ijom.2020.04.018
  38. Buccal bone defects and transversal tooth movement of mandibular lateral segments in patients after orthodontic treatment with and without piezocision: A case-control retrospective study vol.159, pp.3, 2015, https://doi.org/10.1016/j.ajodo.2020.08.017
  39. Development of a model of soft tissue simulation using ballistic gelatin for CBCT acquisitions related to dentomaxillofacial radiology research vol.50, pp.3, 2015, https://doi.org/10.1259/dmfr.20200191
  40. Head motion and perception of discomfort by young children during simulated CBCT examinations vol.50, pp.3, 2015, https://doi.org/10.1259/dmfr.20200445
  41. New Materials for Orthodontic Interceptive Treatment in Primary to Late Mixed Dentition. A Retrospective Study Using Elastodontic Devices vol.14, pp.7, 2015, https://doi.org/10.3390/ma14071695
  42. Effect of section thickness on cone beam computed tomography‐based measurements of intrabony defects compared with clinical measurements vol.92, pp.5, 2015, https://doi.org/10.1002/jper.20-0338
  43. A phantom study on dose efficiency for orthopedic applications: Comparing slot‐scanning radiography using ultra‐small‐angle tomosynthesis to conventional radiography vol.48, pp.5, 2015, https://doi.org/10.1002/mp.14680
  44. Skeletal and dentoalveolar effects using tooth-borne and tooth-bone-borne RME appliances: a randomized controlled trial with 1-year follow-up vol.43, pp.3, 2015, https://doi.org/10.1093/ejo/cjaa040
  45. New image quality and dose reduction technique for pediatric digital radiography vol.102, pp.7, 2015, https://doi.org/10.1016/j.diii.2021.01.009
  46. Low-dose Multidetector Computed Tomographic and Cone-beam Computed Tomographic Protocols for Volumetric Measurement of Simulated Periapical Lesions vol.47, pp.7, 2015, https://doi.org/10.1016/j.joen.2021.04.019
  47. Reject Rates of Radiographic Images in Dentomaxillofacial Radiology: A Literature Review vol.18, pp.15, 2021, https://doi.org/10.3390/ijerph18158076
  48. Radiographic interpretation using high-resolution Cbct to diagnose degenerative temporomandibular joint disease vol.16, pp.8, 2015, https://doi.org/10.1371/journal.pone.0255937
  49. ALADA Dose Optimization in the Computed Tomography of the Temporal Bone: The Diagnostic Potential of Different Low-Dose CT Protocols vol.11, pp.10, 2015, https://doi.org/10.3390/diagnostics11101894
  50. Craniofacial and airway morphology of individuals with oculoauriculovertebral spectrum vol.24, pp.4, 2021, https://doi.org/10.1111/ocr.12483
  51. Diagnostic Accuracy of Cystic Lesions Using a Pre-Programmed Low-Dose and Standard-Dose Dental Cone-Beam Computed Tomography Protocol: An Ex Vivo Comparison Study vol.21, pp.21, 2015, https://doi.org/10.3390/s21217402
  52. Dosimetric evaluation for temporomandibular joint cone beam computed tomography exams using different field of view vol.7, pp.6, 2015, https://doi.org/10.1088/2057-1976/ac240a
  53. Three-dimensional assessment of the spheno-occipital synchondrosis and clivus after tooth-borne and bone-borne rapid maxillary expansion: vol.91, pp.6, 2021, https://doi.org/10.2319/013021-86.1
  54. CBCT influences endodontic therapeutic decision-making in immature traumatized teeth with suspected pulp necrosis: a before-after study vol.50, pp.8, 2015, https://doi.org/10.1259/dmfr.20200594