Optimization strategies in CBCT thought development of institutional diagnostic reference levels of radiation dose and assessment of the influence of a narrow off-axis geometry computed tomography unit in image quality and radiation dose
Although cone beam computed tomography (CBCT) exams offer a relatively low radiation dose to the patient, substantial evidence regarding ionizing radiation's stochastic effects indicates that even small doses may induce effects such as carcinogenesis. Therefore, exposure parameters should be adjusted, keeping the radiation dose as low as diagnostically acceptable. Increasingly, CBCT systems have shown improvements in the detector, beam collimation, acquisition geometry, and reconstruction algorithms, acquiring images of a large region of interest to optimize the acquisition of exams reducing the radiation dose. Low-dose protocols have been recommended for specific imaging and patient indication. Besides, the implementation of national diagnostic reference levels for radiographic exams has been assumed valuable for dose optimization. This study aims to investigate the dose-area product (DAP) level of CBCT exams performed at KU Leuven using CBCT scanners capable of applying low-dose protocols and their association with different age groups, gender, type of CBCT scanner, FOV, voxel size, and imaging indication, as well as to study the influence of using a narrow vertical detector in image quality and radiation dose. Patient-related (age, gender, and indication for image taking) and imaging-related (type of CBCT scanner, FOV, voxel size, use of the pre-programmed low-dose protocol, and DAP value) data will be recorded for each patient imaging procedure for CBCT exams performed in the University Hospital St. Raphael of the KU Leuven. Moreover, a polymethyl methacrylate geometric phantom (SedentexCT-IQ) will be scanned using the PaX-i3D Green Premium system to measure noise in basis images and compare to Accuitomo 3D 170 and OP300 Maxio systems regarding the influence of using a narrow vertical detector.
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