Establishing national Diagnostic Reference Levels for dental radiography applications

Congress:

ECR 2020

Poster Number:

C-00205

Type:

Scientific Exhibit

Keywords:

Not applicable, Retrospective, Quality assurance, Dosimetric comparison, Radiation safety, Dosimetry, Audit and standards, Digital radiography, Radioprotection / Radiation dose, Professional issues, Management, Physics in Medical Imaging

Authors:

T. De Bondt¹, O. Demat², A. Jacobs³, B. Manche², H. Bosmans³; ¹Antwerp/BE, ²Vilvoorde/BE, ³Leuven/BE

DOI:

10.26044/ecr2020/C-00205

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-00205

Fig. 1: Histogram showing the dose distribution of the maxilliary molar programs for...

Fig. 2: Histogram showing the dose distribution of panoramic imaging systems.

Fig. 3: Histogram showing the dose distribution of cephalometric imaging systems.

Purpose

The Euratom 2013/59 Directive urges member states to use, and update, Diagnostic Reference Levels (DRLs) for radiodiagnostic procedures. Unlike in general radiology departments, the use of DRLs in dental applications is less adopted. Preferably, DRLs should be based on recent measurements in a wide range of establishments. Large scale dental dose surveys however, are scarce. In this work we propose DRLs based on data from the largest national company in medical physics QC for dental practices.

Methods and materials

Data was automatically collected from QC reports using a python script. After cleanup, data of 1764 intraoral, 914 panoramic and 151 cephalometric devices were included for analysis. Incident air kerma (IAK) for intraoral maxillary molar acquisitions and dose area product (DAP) of standard adult protocols for panoramic and cephalometric imaging were assessed. For intraoral equipment, differences between digital and film were accounted for. For panoramic and cephalometric acquisitions this was not possible due to lack of standardization in the QC reports.

Results

As can be appreciated in Figure 1, IAK for intraoral radiography was significantly lower for digital imaging than for film. The median dose resp. P75 for the maxillary molar was 1.0 mGy, resp. 1.4 mGy for digital systems and 1.6 mGy resp. 2.1 mGy for film systems. For panoramic systems, depicted in Figure 2, the median DAP was 6.9 cGy.cm², and the P75 was 9.6 cGy.cm².A small second peak in the distribution can be noted around 9 cGy.cm². This can be caused by either or...

Conclusion

Based on dose measurements of clinically used settings we propose as DRL 1.4mGy for intraoral maxillary molar, 9.6 cGy.cm2 for panoramic and 3.3 cGy.cm2 for cephalometric imaging. These results are in line with recent literature values1,2. The DRL values could be stratified for digital/film imaging, and can be used as a tool for optimization.

Personal information and conflict of interest

T. de Bondt; Antwerp/BE - Employee at TechniTest - Consultant at GE Healthcare A. Jacobs; Leuven/BE - nothing to disclose O. Demat; Vilvoorde/BE - Employee at TechniTest B. Manche; Vilvoorde/BE - CEO at TechniTest H. Bosmans; Leuven/BE - nothing to disclose

References

1. Christofides et al. Diagnostic reference levels of intraoral dental radiography in the public hospitals of cyprus. Physica Medica.Volume 32, Supplement 3, September 2016, Page 212 2. Hodolli et al. Diagnostic reference levels at intraoral and dental panoramic examinations. International Journal of Radiation Research, January 2019. Volume 17, No 1