Radiological protection in computed tomography and cone beam computed tomography

Area of Science:

• Radiological Physics
• Medical Imaging Safety
• Radiation Protection

Background:

• The International Commission on Radiological Protection (ICRP) has previously published guidance on patient dose management in computed tomography (CT) and multi-detector CT (MDCT).
• Increasing patient doses in CT were identified, prompting recommendations for manufacturers and users, emphasizing integrated safety features.
• Emerging cone beam CT (CBCT) systems present new radiological protection challenges due to their geometry and expanding use, often by untrained personnel.

Purpose of the Study:

• To address the radiological protection issues associated with cone beam CT (CBCT) systems.
• To summarize previous approaches for CT and MDCT and present preliminary information on new ICRP work for CBCT.
• To highlight critical challenges in CBCT radiation safety.

Main Methods:

• Review of established radiological protection strategies for conventional CT and MDCT.
• Identification and analysis of specific issues related to CBCT by an ICRP task group.
• Synthesis of preliminary findings and published work on CBCT radiation protection.

Main Results:

• Identified key CBCT challenges: lack of standardized dosimetry, misconception of low dose, insufficient user training, and inadequate dose information/tracking.
• Highlighted that some CBCT applications, like C-arm CT in interventional procedures, involve higher patient doses than often perceived.
• Established a foundation for updated guidance on CBCT radiological protection.

Conclusions:

• There is a critical need for standardized dosimetry and improved radiological protection practices in CBCT.
• Addressing the misconception of CBCT as inherently low-dose is essential for patient safety.
• Enhanced training and dose monitoring are crucial for safe CBCT utilization across medical and dental fields.