임상가를 위한 특집 4 - CBCT 검사법의 정도관리 및 선량

Radiation Doses and Quality Assurance in Cone Beam CT(CBCT)

  • 최용석 (경희대학교 치의학전문대학원 영상치의학교실) ;
  • 김규태 (경희대학교 치의학전문대학원 영상치의학교실) ;
  • 황의환 (경희대학교 치의학전문대학원 영상치의학교실)
  • Choi, Yong-Suk (Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Kyung Hee University) ;
  • Kim, Gyu-Tae (Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Kyung Hee University) ;
  • Hwang, Eui-Hwan (Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Kyung Hee University)
  • 투고 : 2014.02.04
  • 심사 : 2014.02.27
  • 발행 : 2014.03.01

초록

3-dimensional information for anatomic stucture plays a role as integral part in clinical aspect of dental practice. CBCT(cone beam computed tomography) has been accepted as useful diagnostic tool offering Volume data and images for evaluating teeth and jaws in lower radiation dose than conventional CT. CBCT equipment is essential for the quality assurance of it to ensure continued satisfactory performance and result of adequate images. Dental practitioner and oral and maxillofacial radiologist should have a responsibility and critical thinking to deliver this technology to patients in a responsible way, so that diaganostic value is maximised and radiation doses kept as low as resonably achievable. CBCT imaging modality should be used only after a review of the patient's health and imaging history and the completion of a thorough clinical examination. Clinical guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances Dental practitioners should prescribe CBCT imaging only when they expect that the diagnostic yield will benefit patient care, enhance patient safety or improve clinical outcomes significantly. Knowledge of patient dose is essential for clinicians who are making the decision regarding the justification of the exposure. There are some limitation in the measurement of patient dose in CBCT for the approval and adaptation of conventinal methodolgy in CT. It is also important to ensure that doses are optimised and in line with any national and international guidelines. The higher radiation doses of CBCT compared with conventional radiography, mean that high standards must be maintained. The Quality Assurance(QA) programme should entail surveys and checks that are performed according to a regular timetable. QA programme should be maintained by staff to ensure adherence to the programme and to raise its importance among staff.

키워드

참고문헌

  1. Lee ET, Kim GT, Choi YS, Hwang EH Radiation absorbed doses of cone beam computed tomography. Korean J Oral Maxillofac Radiol 2007; 37 : 87-92
  2. Han CW, Kim GT, Choi YS, Hwang EH Image characteristics of cone beam computed tomography using a CT performance phantom. Korean J Oral Maxillofac Radiol 2007; 37 : 157-63.
  3. Naitoh M, Katsumata A, Kubota Y, Ariji E. Assessment of three-dimensional X-ray images: reconstruction from conventional tomograms, compact computerized tomography images, and multislice helical computerized tomography images. J Oral Implantol 2005; 31: 234-41. https://doi.org/10.1563/1548-1336(2005)31[234:AOTXIR]2.0.CO;2
  4. Terakado M, Hashimoto K, Arai Y, Honda M, Sekiwa T, Sato H. Diagnostic imaging with newly developed ortho cubic super-high resolution computed tomography (Ortho-CT). Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000; 89: 509-18. https://doi.org/10.1016/S1079-2104(00)70133-8
  5. Hashimoto K, Kawashima S, Araki M, Iwai K, Sawada K, Akiyama Y. Comparison of image performance between cone-beam computed tomography for dental use and four-row multidetector helical CT. J Oral Sci 2006; 48: 27-34. https://doi.org/10.2334/josnusd.48.27
  6. Choi YS, Hwang EH, Lee SR. Clinical application of cone beam computed tomography in dental implant. J Korean Dent Assoc 2006; 44: 172-9.
  7. Kobayashi K, Shimoda S, Nakagawa Y, Yamamoto A. Accuracy in measurement of distance using limited cone-beam computerized tomography. Int J Oral Maxillofac Implants 2004; 19: 228-31.
  8. Mah JK, Danforth RA, Bumann A, Hatcher D. Radiation absorbed in maxillofacial imaging with a new dental computed tomography device. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003; 96: 508-13. https://doi.org/10.1016/S1079-2104(03)00350-0
  9. Ludlow JB, Davies-Ludlow LE, Brooks SL, Howerton WB. Dosimetry of 3 CBCT devices for oral and maxillofacial radiology: CB Mercuray, NewTom 3G and i-CAT. Dentomaxillofac Radiol 2006; 35: 219-26. https://doi.org/10.1259/dmfr/14340323
  10. Ludlow JB, Davies-Ludlow LE, Brooks SL. Dosimetry of two extraoral direct digital imaging devices: NewTom cone beam CT and Orthophos Plus DS panoramic unit. Dentomaxillofac Radiol 2003; 32: 229-34. https://doi.org/10.1259/dmfr/26310390
  11. Tsiklakis K, Donta C, Gavala S, Karayianni K, Kamenopoulou V, Hourdakis CJ. Dose reduction in maxillofacial imaging using low dose Cone Beam CT. Eur J Radiol 2005 ;56:413-7. https://doi.org/10.1016/j.ejrad.2005.05.011
  12. Schulze D, Heiland M, Thurmann H, Adam G. Radiation exposure during midfacial imaging using 4- and 16-slice computed tomography, cone beam computed tomography systems and conventional radiography. Dentomaxillofac Radiol 2004 ;33:83-6. https://doi.org/10.1259/dmfr/28403350
  13. The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103. Ann ICRP. 2007;37(2-4):1-332.
  14. Bamba J, Araki K, Endo A, Okano T. Image quality assessment of three cone beam CT machines using the SEDENTEXCT CT phantom. Dentomaxillofac Radiol. 2013;42:20120445. https://doi.org/10.1259/dmfr.20120445
  15. Alqerban A, Hedesiu M, Baciut M, Nackaerts O, Jacobs R, Fieuws S; SedentexCT Consortium, Willems G. Pre-surgical treatment planning of maxillary canine impactions using panoramic vs cone beam CT imaging. Dentomaxillofac Radiol. 2013;42:20130157. https://doi.org/10.1259/dmfr.20130157
  16. Araki K, Patil S, Endo A, Okano T. Dose indices in dental cone beam CT and correlation with dose-area product. Dentomaxillofac Radiol. 2013;42:20120362. https://doi.org/10.1259/dmfr.20120362
  17. Pauwels R, Nackaerts O, Bellaiche N, Stamatakis H, Tsiklakis K, Walker A, Bosmans H, Bogaerts R, Jacobs R, Horner K; SEDENTEXCT Project Consortium. Variability of dental cone beam CT grey values for density estimations. Br J Radiol. 2013 Jan;86(1021):20120135. https://doi.org/10.1259/bjr.20120135
  18. Pauwels R, Theodorakou C, Walker A, Bosmans H, Jacobs R, Horner K, Bogaerts R; SEDENTEXCT Project Consortium. Dose distribution for dental cone beam CT and its implication for defining a dose index. Dentomaxillofac Radiol. 2012;41(7):583-93. https://doi.org/10.1259/dmfr/20920453
  19. Pauwels R, Beinsberger J, Stamatakis H, Tsiklakis K, Walker A, Bosmans H, Bogaerts R, Jacobs R, Horner K; SEDENTEXCT Project Consortium. Comparison of spatial and contrast resolution for cone-beam computed tomography scanners. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114(1):127-35. https://doi.org/10.1016/j.oooo.2012.01.020
  20. Guerrero ME, Nackaerts O, Beinsberger J, Horner K, Schoenaers J, Jacobs R; SEDENTEXCT Project Consortium. Inferior alveolar nerve sensory disturbance after impacted mandibular third molar evaluation using cone beam computed tomography and panoramic radiography: a pilot study. J Oral Maxillofac Surg. 2012;70(10):2264-70 https://doi.org/10.1016/j.joms.2012.04.015
  21. Hedesiu M, Baciut M, Baciut G, Nackaerts O, Jacobs R; SEDENTEXCT Consortium. Comparison of cone beam CT device and field of view for the detection of simulated periapical bone lesions. Dentomaxillofac Radiol. 2012;41(7):548-52. https://doi.org/10.1259/dmfr/19322177
  22. Christell H, Birch S, Hedesiu M, Horner K, Ivanauskait? D, Nackaerts O, Rohlin M, Lindh C; SEDENTEXCT consortium. Variation in costs of cone beam CT examinations among healthcare systems. Dentomaxillofac Radiol. 2012;41(7):571-7. https://doi.org/10.1259/dmfr/22131776
  23. Christell H, Birch S, Horner K, Rohlin M, Lindh C; SEDENTEXCT consortium. A framework for costing diagnostic methods in oral health care: an application comparing a new imaging technology with the conventional approach for maxillary canines with eruption disturbances. Community Dent Oral Epidemiol. 2012;40(4):351-61. https://doi.org/10.1111/j.1600-0528.2012.00674.x
  24. Theodorakou C, Walker A, Horner K, Pauwels R, Bogaerts R, Jacobs R; SEDENTEXCT Project Consortium. Estimation of paediatric organ and effective doses from dental cone beam CT using anthropomorphic phantoms. Br J Radiol. 2012; 85(1010):153-60. https://doi.org/10.1259/bjr/19389412
  25. Vandenberghe B, Luchsinger S, Hostens J, Dhoore E, Jacobs R; SEDENTEXCT Project Consortium. The influence of exposure parameters on jawbone model accuracy using cone beam CT and multislice CT. Dentomaxillofac Radiol. 2012;41(6):466-74. https://doi.org/10.1259/dmfr/81272805
  26. Pauwels R, Stamatakis H, Bosmans H, Bogaerts R, Jacobs R, Horner K, Tsiklakis K; SEDENTEXCT Project Consortium. Quantification of metal artifacts on cone beam computed tomography images. Clin Oral Implants Res. 2013;24 Suppl A100:94-9. https://doi.org/10.1111/j.1600-0501.2011.02382.x
  27. Pauwels R, Stamatakis H, Manousaridis G, Walker A, Michielsen K, Bosmans H, Bogaerts R, Jacobs R, Horner K, Tsiklakis K; SEDENTEXCT Project Consortium. Development and applicability of a quality control phantom for dental cone-beam CT. J Appl Clin Med Phys. 2011 Nov 15;12(4):3478.
  28. Alqerban A, Jacobs R, Fieuws S, Nackaerts O; SEDENTEXCT Project Consortium, Willems G. Comparison of 6 cone-beam computed tomography systems for image quality and detection of simulated canine impaction-induced external root resorption in maxillary lateral incisors. Am J Orthod Dentofacial Orthop. 2011;140(3):e129-39. https://doi.org/10.1016/j.ajodo.2011.03.021
  29. Pauwels R, Beinsberger J, Collaert B, Theodorakou C, Rogers J, Walker A, Cockmartin L, Bosmans H, Jacobs R, Bogaerts R, Horner K; SEDENTEXCT Project Consortium. Effective dose range for dental cone beam computed tomography scanners. Eur J Radiol. 2012;81(2):267-71 https://doi.org/10.1016/j.ejrad.2010.11.028