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Thyroid shielding in cone beam computed tomography: recommendations towards appropriate use.

Ruben Pauwels1,2, Keith Horner3, Jenia Vassileva4

  • 1Mechanical Engineering Department, KU Leuven, Leuven, Belgium.

Dento Maxillo Facial Radiology
|June 26, 2019
PubMed
Summary

Thyroid shielding significantly reduces radiation dose during dental cone beam CT (CBCT) scans, especially for children and adults under 50. Use thyroid collars routinely, but avoid them if imaging below the mandible to prevent artifacts.

Keywords:
cone beam CTradiation doseradiation protectionthyroidthyroid collar

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Area of Science:

  • Radiology
  • Medical Physics
  • Dental Imaging

Background:

  • Thyroid gland radiosensitivity varies with age and sex, posing higher risks to younger individuals and females.
  • Dental cone beam CT (CBCT) involves ionizing radiation, necessitating protective measures for sensitive organs like the thyroid.
  • Previous studies highlight the need for evidence-based guidelines on thyroid shielding during CBCT procedures.

Purpose of the Study:

  • To establish recommendations for the appropriate use of thyroid shielding in dental CBCT.
  • To synthesize current evidence on thyroid radiosensitivity, dosimetric data, and shielding effects.
  • To provide practical guidance for clinicians regarding thyroid protection during CBCT examinations.

Main Methods:

  • Review of current scientific literature on thyroid radiosensitivity and CBCT dosimetry.
  • Analysis of dosimetric data comparing thyroid dose with and without shielding using reference phantoms.
  • Evaluation of potential adverse effects, such as image artifacts, associated with thyroid shielding.

Main Results:

  • A thyroid collar with 0.25 mm lead-equivalent thickness consistently reduces thyroid equivalent dose by an average of 45.9%.
  • Routine thyroid shielding is recommended for pediatric patients and adults up to age 50 undergoing CBCT.
  • Shielding can be applied post-scout imaging to prevent automatic exposure control adjustments.

Conclusions:

  • Thyroid shielding is an effective method for dose reduction in dental CBCT, particularly for radiosensitive populations.
  • Recommendations support routine use in children and adults under 50, with specific considerations for artifact avoidance.
  • Future CT advancements may influence current shielding perspectives, emphasizing ongoing evaluation of best practices.