Factors influencing the effective dose associated with CBCT: a systematic review
Due to potential impact of the effects of ionizing radiation used in medical and dental examinations on public health in recent years, many studies are being conducted to quantify the radiation dose values, evaluate scanners, and indicate factors that could influence or reduce radiation doses.
This study aimed to evaluate, by a systematic review, the factors that influence the effective radiation dose associated with cone beam computed tomography and respective effects, and compared the effective dose of different cone beam computed tomography (CBCT) scanners with similar exposure parameters.
Materials and methods
A search was conducted on five databases from 2007 to 2015.
The search identified 741 abstracts, among which 44 eligible articles were retrieved in full text. Twenty-three studies met the inclusion criteria and were included. Additional copper filter was evaluated in one study, patient size in 2 studies, region of interest in 1 study, use of a thyroid shield in 2 studies, scan angle in 3 studies, exposure time in 10 studies, FOV diameter in 17 studies, FOV height in 17 studies, kV in 16 studies, mA in 18 studies, mAs in 13 studies, voxel in 8 studies, and resolution in 3 studies. When similar exposure parameters were evaluated, it was observed that CBCT scanner with lower effective dose was Kodak® 9000C 3D (mean 21.2 μSv) in selected studies.
Thirteen factors were related to changes in the effective dose emitted by different scanners. More studies are needed to identify the image quality requirements in addition to measure the radiation.
Studies that give more information for professionals who request and interpret the exams and for technicians who perform 3D images about effective radiation dose associated with CBCT are necessary.
KeywordsTomography Radiation exposure measurement Radiation dosage
The work was supported by the researchers themselves.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
For this type of study, formal consent is not required.
- 6.Pearce MS, Salotti JA, Little MP, McHugh K, Lee C, Kim KP, Howe NL, Ronckers CM, Rajaraman P, Craft AW, Parker L, Berrington de González A (2012) Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet 380:499–505CrossRefPubMedPubMedCentralGoogle Scholar
- 31.PRISMA. Reporting guideline for systematic reviews and metaanalyses; 2009. Available at: http://www.prisma-statement.org/statement.htm. Accessed on June 24, 2015.
- 35.Koivisto J, Kiljunen T, Tapiovaara M, Wolff J, Kortesniemi M (2012) Assessment of radiation exposure in dental cone-beam computerized tomography with the use of metal-oxide semiconductor field-effect transistor (MOSFET) dosimeters and Monte Carlo simulations. Oral Surg Oral Med Oral Pathol Oral Radiol 114:393–400CrossRefPubMedGoogle Scholar
- 40.Morant J, Salvadó M, Hernández-Girón I, Casanovas R, Ortega R, Calzado A (2013) Dosimetry of a cone beam CT device for oral and maxillofacial radiology using Monte Carlo techniques and ICRP adult reference computational phantoms. Dentomaxillofac Radiol 42:92555893CrossRefPubMedPubMedCentralGoogle Scholar
- 50.Pauwels R, Zhang G, Theodorakou C, Walker A, Bosmans H, Jacobs R, Bogaerts R, Horner K, The SEDENTEXCT Project Consortium (2014) Effective radiation dose and eye lens dose in dental cone beam CT: effect of field of view and angle of rotation. Br J Radiol 87:20130654CrossRefPubMedPubMedCentralGoogle Scholar
- 54.National Council on Radiation Protection & Measurements (2009) Radiation Protection in Dentistry (Report No. 160). NRCP Publications, BethesdaGoogle Scholar
- 55.American Academy of Oral and Maxillofacial Radiology (2013) Clinical recommendations regarding use of cone beam computed tomography in orthodontics. Position statement by the American Academy of Oral and Maxillofacial Radiology. Oral Surg Oral Med Oral Pathol Oral Radiol 116:238–257CrossRefGoogle Scholar
- 57.2007 Recommendations of the International Commission on Radiological Protection. Available at: htpp://www.icrp.org. Accessed April 5, 2015.
- 60.Bornstein MM, Scarfe WC, Vaughn VM, Jacobs R (2014) Cone beam computed tomography in implant dentistry: a systematic review focusing on guidelines, indications, and radiation dose risks. Int J Oral Maxillofac Implants 29 Suppl:55–77. https://doi.org/10.11607/jomi.2014suppl.g1.4 CrossRefPubMedGoogle Scholar
- 66.Radiation Protection. Cone Beam CT for dental and maxillofacial radiology. Evidence based guidelines. The SEDENTEXCT project (2008–2011). In May 2012. Available at: http://wwwsedentexcteu/content/guidelines-cbct-dental-and-maxillofacial-radiology