Imaging Science in Dentistry

Korean Academy of Oral and Maxillofacial Radiology (대한영상치의학회)
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Image quality-based dose optimization in pediatric cone-beam computed tomography: A pilot methodological study

  • Hak-Sun Kim (Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry) ;
  • Yoon Joo Choi (Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry) ;
  • Kug Jin Jeon (Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry) ;
  • Sang-Sun Han (Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry) ;
  • Chena Lee (Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry)
  • Received : 2024.02.19
  • Accepted : 2024.04.26
  • Published : 2024.09.30
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Abstract

Purpose: This study aimed to propose a methodological approach for reducing the radiation dose in pediatric cone-beam computed tomography (CBCT), focusing exclusively on balancing image quality with dose optimization. Materials and Methods: The dose-area product (DAP) for exposure was reduced using copper-plate attenuation of an X-ray source. The thickness of copper (Cu) was increased from 0 to 2.2 mm, and 10 different DAP levels were used. The QUART DVT_AP phantom and pediatric radiologic dentiform were scanned under the respective DAP levels. The contrast-to-noise ratio (CNR), image homogeneity, and modulation transfer function (MTF) were analyzed using the QUART DVT_AP phantom. An expert evaluation (overall image grade, appropriateness of field of view, artifacts, noise, and resolution) was conducted using pediatric dentiform images. The critical DAP level was determined based on phantom and dentiform analysis results. Results: CNR and image homogeneity decreased as the DAP was reduced; however, there was an inflection point of image homogeneity at Cu 1.6 mm (DAP=138.00 mGy·cm2), where the value started increasing. The MTF showed constant values as the DAP decreased. The expert evaluation of overall image grades showed "no diagnostic value" for dentiform images with Cu 1.9-2.2 mm (DAP=78.00-103.33 mGy·cm2). The images with Cu 0-1.6 mm (DAP=138.00-1697.67mGy·cm2) had a "good," "moderate," or "poor but interpretable" grade. Conclusion: Reducing DAP beyond a 1.6-mm Cu thickness degraded CBCT image quality. Image homogeneity and clinical image grades indicated crucial decision points for DAP reduction in pediatric CBCT scans.

Keywords

Acknowledgement

The authors would like to thank Hoyoung Seo, Yong Hyun Lee, Jiwoo An, and Youjin Jung for assisting with the experiment as part of a student research grant from the Yonsei University College of Dentistry.

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