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Practice Solutions: Lower Radiation Dose by Chris Martin

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by Chris Martin

Over the past 20 years, the use of ionizing radiation in diagnostic medical examinations has nearly doubled the average American adult's annual dose.1 This is no insignificant risk; computed-tomography (CT) studies alone may be implicated in an estimated 1.5 percent to two percent of all U.S. cancers.2

However, a new study performed by J.B. Ludlow and J. Koivisto, entitled, "Dosimetry of Orthodontic Diagnostic FOVs Using Low Dose CBCT Protocol," has found that dentists can reduce the amount of radiation from the Planmeca ProMax 3D family of imaging units without losing diagnostic quality of images. The research is published in the April issue of Journal of the International Association of Dental Research.

Researchers from the University of North Carolina School of Dentistry tested the imaging units to determine if reduced radiation exposure would result in a reduction of the diagnostic quality of CBCT images taken.

Dose values were noted using various combinations of field size and exposure parameters necessary for children and adult settings for typical orthodontic diagnostic practices on the Planmeca ProMax 3D family of CBCT imaging units. According to Planmeca, its ProMax units were designed around the "As Low As Reasonably Achievable" (ALARA) principle of radiation exposure.

The study examined images taken using the ProMax's 3D ultra-low dose (ULD) protocol with standard exposures. Images were taken at 24 locations in a 10-year-old child phantom and an adult phantom, with multiple exposures made for each imaging location.

Dosimeters were read three times, and dose values were adjusted for sensitivity of dosimeters to effective kV of X-ray source. To obtain dose per scan, doses were divided by the number of exposures.

The study found that using the ULD protocol resulted in a 77 percent reduction in radiation exposure when compared with standard imaging protocols. The researchers also found that while the imaging methods reduced exposure, they found "no statistical reduction in image quality between ULD and standard protocols," suggesting that lower-dose images can be effectively utilized for dental and orthodontic patients without compromising diagnostic quality.

Because radiation dosage has become a significant health risk in a large percentage of the population as more diagnostic imaging is performed, these findings may have profound implications for reducing that risk.

"In my opinion, the ULD images acquired by the Planmeca ProMax in this study meet the standards of the ALARA radiation safety principle," said Dr. Jack Fisher, a professor of dentistry and orthodontics at Vanderbilt University School of Dentistry. "Why would anyone take a 2D image with this amount of exposure when they can get a 3D image with excellent diagnostic quality at an ultra-low dose of radiation?"

The study was supported, in part, by a grant from the National Institute of Dental and Craniofacial Research.

References
  1. National Council on Radiation Protection and Measurements. Ionizing Radiation Exposure of the Population of the United States (Report No. 160), Bethesda, MD. 2009, The Council
  2. Brenner DJ, Hall EJ. Computed tomography-an increasing source of radiation exposure. N Engl J Med. 2007;357:2277-84


Most of Chris Martin's 20 years of experience in communications and public relations has been with health-care organizations, including the American Osteopathic Association, American Dental Association, Blue Cross and Blue Shield Association, and Rush University Medical Center. In 2005, Martin graduated from the University of Illinois at Chicago School of Public Health with a master's in public health. Martin has helped many health-care industry clients grow their businesses, including the Illinois Nurses Association, the Illinois Podiatric Medical Association, Planmeca USA, La Rabida Children's Hospital, The International Society of Hair Restoration Surgery, and The Hearing Doctors.


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