Congress:
EuroSafe Imaging 2020
Keywords:
Action 2 - Clinical diagnostic reference levels (DRLs), Ear / Nose / Throat, Radioprotection / Radiation dose, Digital radiography, Diagnostic procedure, Dosimetric comparison, Prospective, Cross-sectional study, Performed at one institution
Authors:
S. Ebad, P. Kala, M. Gangadharappa
DOI:
10.26044/esi2020/ESI-03994
Background/introduction
Before the invention of advanced technologies, conventional radiogram (Caldwell or Water's views) was considered to evaluate Para Nasal Sinus (PNS). However, simple radiogram has poor sensitivity and specificity in demonstrating anatomy and in detection of pathology. Failure to detect sinusitis can lead to serious complications, such as cellulitis and osteomyelitis.
After the advent of advanced technologies in radiological imaging, CT scan is considered as the gold standard test for evaluation and accurate diagnosis of various pathological conditions of PNS .As CT scan shows multiple sections with finer imaging, it provides an accurate diagnosis of the disease as well as its progression and prognosis. CT scan despite its multiple advantages has its major limitation in the form of far higher radiation dose and cost.
Digital tomosynthesis [DT] has emerged as a technical and feasible imaging modality. It is a form of limited-angle computed tomography that allows reconstruction of multiple section images from a set of projection data acquired over a limited range of X-ray tube angles. Although the radiation dose of DT is relatively higher than that of plain radiography (XR), DT is the most advanced digital radiography technology, which can be applied easily as an alternative to XR in many regions, including PNS evaluation.
Many studies were done previously regarding the effectiveness of DT in evaluation of breast and lung evaluation in comparison to digital mammography and x ray chest / CT chest and has been found to be effective low radiation alternative with high sensitivity for lesion detection. However, there is limited data on the diagnostic accuracy for evaluation of PNS.
We in this study assess if digital tomosynthesis can be used as an alternative to plain X-ray PNS, reducing the need for further evaluation by CT-PNS; by comparing radiation dose and image quality between standard paranasal sinus radiography, and paranasal sinus digital tomosynthesis with CT PNS as the standard of reference.