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01-02-2021 | Radiation Protection | Original Article

Does dose optimisation in digital panoramic radiography affect diagnostic performance?

Authors: Luciano Augusto Cano Martins, Danieli M. Brasil, Laís A. Forner, Cassiana Viccari, Francisco Haiter-Neto, Deborah Q. Freitas, Matheus L. Oliveira

Published in: Clinical Oral Investigations | Issue 2/2021

Abstract

Objectives

To compare the overall diagnostic performance of digital panoramic radiographs obtained with low-dose protocols and to estimate the absorbed dose in the head and neck.

Materials and methods

Forty-eight panoramic radiographs were obtained from eight imaging phantoms using six exposure protocols of progressively lower tube voltages (kVp) and currents (mA), as follows: (1) 70 kVp and 12.5 mA, (2) 66 kVp and 10 mA, (3) 66 kVp and 8 mA, (4) 66 kVp and 5 mA, (5) 66 kVp and 4 mA and (6) 66 kVp and 3.2 mA. Five oral radiologists independently evaluated the images and reported all detectable radiographic findings. Intra-examiner reproducibility was assessed by re-evaluation of 25% of the images. The data were analysed using the McNemar and weighted Kappa tests. Absorbed doses of the six protocols were obtained from thermoluminescent dosimeters placed inside a Rando phantom and compared using one-way ANOVA with post hoc Tukey (α = 0.05).

Results

The overall diagnostic performance of panoramic radiographs obtained with low-dose protocols did not differ from that of panoramic radiographs obtained with the highest dose (p > 0.05). Moreover, substantial agreement was observed between all protocols. Protocol 1 resulted in the highest absorbed dose and protocols 4, 5 and 6 in the lowest absorbed doses, with the difference being significant (p ≤ 0.05).

Conclusion

Although digital panoramic radiography is considered a relatively low-dose examination, the radiation dose can be further reduced without negatively affecting its overall diagnostic performance.

Clinical relevance

Considering the risks associated with X-rays, digital panoramic radiographs can be obtained at even lower exposure levels.

Nascimento EHL, Oenning ACC, Freire BB, Gaêta-Araujo H, Haiter-Neto F, Freitas DQ (2018) Comparison of panoramic radiography and cone beam CT in the assessment of juxta-apical radiolucency. Dentomaxillofac Radiol 47:20170198. https://doi.org/10.1259/dmfr.20170198CrossRefPubMed

Kadesjö N, Lynds R, Nilsson M, Shi XQ (2018) Radiation dose from X-ray examinations of impacted canines: cone beam CT vs two-dimensional imaging. Dentomaxillofac Radiol 47:20170305. https://doi.org/10.1259/dmfr.20170305CrossRefPubMed

Molander B, Gröndahl HG, Ekestubbe A (2004) Quality of film-based and digital panoramic radiography. Dentomaxillofac Radiol 33:32–36. https://doi.org/10.1259/dmfr/17777906CrossRefPubMed

Baksi BG, Alpöz E, Soǧur E, Mert A (2010) Perception of anatomical structures in digitally filtered and conventional panoramic radiographs: a clinical evaluation. Dentomaxillofac Radiol 39:424–430. https://doi.org/10.1259/dmfr/30570374CrossRefPubMedPubMedCentral

de Azevedo Vaz SL, Neves FS, Figueirêdo EP, Haiter-Neto F, Campos PSF (2013) Accuracy of enhancement filters in measuring in vitro peri-implant bone level. Clin Oral Implants Res 24:1074–1077. https://doi.org/10.1111/j.1600-0501.2012.02511.xCrossRefPubMed

Belém MDF, Ambrosano GMB, Tabchoury CPM, Ferreira-Santos RI, Haiter-Neto F (2013) Performance of digital radiography with enhancement filters for the diagnosis of proximal caries. Braz Oral Res 27:245–251. https://doi.org/10.1590/S1806-83242013000300004CrossRefPubMed

Pelekos G, Tse JMN, Ho D, Tonetti MS (2019) Defect morphology, bone thickness, exposure settings and examiner experience affect the diagnostic accuracy of standardized digital periapical radiographic images but not of cone beam computed tomography in the detection of peri-implant osseous defects: an in vitro study. J Clin Periodontol 46:1294–1302. https://doi.org/10.1111/jcpe.13200CrossRefPubMed

Granlund C, Thilander-Klang A, Ylhan B, Lofthag-Hansen S, Ekestubbe A (2016) Absorbed organ and effective doses from digital intra-oral and panoramic radiography applying the ICRP 103 recommendations for effective dose estimations. Br J Radiol 89:20151052. https://doi.org/10.1259/bjr.20151052CrossRefPubMedPubMedCentral

Benchimol D, Koivisto J, Kadesjö N, Shi X-Q (2018) Effective dose reduction using collimation function in digital panoramic radiography and possible clinical implications in dentistry. Dentomaxillofac Radiol 47:20180007. https://doi.org/10.1259/dmfr.20180007CrossRefPubMedPubMedCentral

10.

Pauwels R, Beinsberger J, Collaert B, Theodorakou C, Rogers J, Walker A, Cockmartin L, Bosmans H, Jacobs R, Bogaerts R, Horner K, The SEDENTEXCT Project Consortium (2012) Effective dose range for dental cone beam computed tomography scanners. Eur J Radiol 81:267–271. https://doi.org/10.1016/j.ejrad.2010.11.028CrossRefPubMed

11.

International Commission on Radiological Protection (2007) The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103. Ann ICRP 37:1–332

12.

Okano T, Sur J (2010) Radiation dose and protection in dentistry. Jpn Dent Sci Rev 46:112–121. https://doi.org/10.1016/j.jdsr.2009.11.004CrossRef

13.

Dannewitz B, Hassfeld S, Eickholz P, Mühling J (2002) Effect of dose reduction in digital dental panoramic radiography on image quality. Dentomaxillofac Radiol 31:50–55. https://doi.org/10.1038/sj.dmfr.4600651CrossRefPubMed

14.

Martin CJ (2007) Optimisation in general radiography. Biomed Imaging Interv J 3:e18. https://doi.org/10.2349/biij.3.2.e18CrossRefPubMedPubMedCentral

15.

Oenning AC, Jacobs R, Pauwels R, Stratis A, Hedesiu M, Salmon B, Dimitra Research Group (2018) Cone-beam CT in paediatric dentistry: DIMITRA project position statement. Pediatr Radiol 48:308–316. https://doi.org/10.1007/s00247-017-4012-9CrossRefPubMed

16.

Ludlow JB, Davies-Ludlow LE, Brooks SL (2003) Dosimetry of two extraoral direct digital imaging devices: NewTom cone beam CT and Orthophos Plus DS panoramic unit. Dentomaxillofac Radiol 32:229–234. https://doi.org/10.1259/dmfr/26310390CrossRefPubMed

17.

Ludlow JB, Davies-Ludlow LE, Brooks SL, Howerton WB (2006) Dosimetry of 3 CBCT devices for oral and maxillofacial radiology: CB Mercuray, NewTom 3G and i-CAT. Dentomaxillofac Radiol 35:219–226. https://doi.org/10.1259/dmfr/14340323CrossRefPubMed

18.

Davis SD, Ross CK, Mobit PN, Van der Zwan L, Chase WJ, Shortt KR (2003) The response of lif thermoluminescence dosimeters to photon beams in the energy range from 30 kV x rays to 60Co gamma rays. Radiat Prot Dosim 106:33–43. https://doi.org/10.1093/oxfordjournals.rpd.a006332CrossRef

19.

Tassoker M, Magat G, Sener S (2018) A comparative study of cone-beam computed tomography and digital panoramic radiography for detecting pulp stones. Imaging Sci Dent 48:201–212. https://doi.org/10.5624/isd.2018.48.3.201CrossRefPubMedPubMedCentral

20.

An JH, Il KY, Kim SS, Park SB, Son WS, Kim SH (2019) Root proximity of miniscrews at a variety of maxillary and mandibular buccal sites: reliability of panoramic radiography. Angle Orthod 89:611–616. https://doi.org/10.2319/100318-713.1CrossRefPubMed

21.

Alkurt MT, Peker I, Usalan G, Altunkaynak B (2008) Clinical evaluation of dose reduction on image quality of panoramic radiographs. J Contemp Dent Pract 9:34–41. https://doi.org/10.5005/jcdp-9-5-34CrossRefPubMed

22.

Brasil DM, Yamasaki MC, Santaella GM, Guido MCZ, Freitas DQ, Haiter-Neto F (2019) Influence of VistaScan image enhancement filters on diagnosis of simulated periapical lesions on intraoral radiographs. Dentomaxillofac Radiol 48:20180146. https://doi.org/10.1259/dmfr.20180146CrossRefPubMed

23.

Nascimento EHL, Gaêta-Araujo H, Galvão NS, Moreira-Souza L, Oliveira-Santos C, Freitas DQ (2019) Effect of brightness and contrast variation for detectability of root resorption lesions in digital intraoral radiographs. Clin Oral Investig 23:3379–3386. https://doi.org/10.1007/s00784-018-2764-8CrossRefPubMed

24.

Moreira-Souza L, Michels M, Lagos de Melo LP, Oliveira ML, Asprino L, Freitas DQ (2019) Brightness and contrast adjustments influence the radiographic detection of soft tissue calcification. Oral Dis 25:1809–1814. https://doi.org/10.1111/odi.13148CrossRefPubMed

25.

Ostovarrad F, Nemati S, Shokri A, Baghizadeh E, Yousefi Z (2019) Evaluation of the effect of the inversion filter on enhancing the visibility of the mandibular incisive canal in comparison with original images. Dent Med Probl 56:279–283. https://doi.org/10.17219/dmp/108596CrossRefPubMed

26.

Galvão NS, Nascimento EHL, Lima CAS, Freitas DQ, Haiter-Neto F, Oliveira ML (2019) Can a high-density dental material affect the automatic exposure compensation of digital radiographic images? Dentomaxillofac Radiol 48:20180331. https://doi.org/10.1259/dmfr.20180331CrossRefPubMed

27.

Gijbels F, Jacobs R, Bogaerts R, Debaveye D, Verlinden S, Sanderink G (2005) Dosimetry of digital panoramic imaging. Part I: patient exposure. Dentomaxillofac Radiol 34:145–149. https://doi.org/10.1259/dmfr/28107460CrossRefPubMed

Title: Does dose optimisation in digital panoramic radiography affect diagnostic performance?
Authors: Luciano Augusto Cano Martins
Danieli M. Brasil
Laís A. Forner
Cassiana Viccari
Francisco Haiter-Neto
Deborah Q. Freitas
Matheus L. Oliveira
Publication date: 01-02-2021
Publisher: Springer Berlin Heidelberg
Keyword: Radiation Protection
Published in: Clinical Oral Investigations / Issue 2/2021
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-020-03535-7

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Springer Medicine

Does dose optimisation in digital panoramic radiography affect diagnostic performance?

Abstract

Objectives

Materials and methods

Results

Conclusion

Clinical relevance

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusion

Clinical relevance

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