Related Experiment Video
Updated: Jul 2, 2026
X-ray Dose Reduction through Adaptive Exposure in Fluoroscopic Imaging
Published on: September 11, 2011
Out-of-field surface dose readings during panoramic radiography: Comparison of standard and manufacturer low-exposure
1Department of Radiotherapy, Vocational School of Health Services, Altınbaş University, Kartaltepe Mah., Incirli Cad. No:11, Bakirkoy, 34144, Istanbul, Türkiye.
Background:
Panoramic radiography is a low-dose dental examination; however, scattered and leakage radiation may reach tissues outside the primary beam. This controlled anthropomorphic phantom technical-repeat study compared out-of-field surface dose readings, interpreted as relative surface exposure indicators, between a standard panoramic protocol and a manufacturer-provided low-exposure protocol.
Methods:
An adult female anthropomorphic phantom (CIRS 002LFC) was imaged on a NewTom GiANO HR unit using a standard protocol (72 kVp, 7 mA, 13.6 s) and a manufacturer low-exposure protocol (72 kVp, 8 mA, 8.0 s). Electronic personal dosimeters with Hp(10)-based output were positioned at the thyroid-region surface, upper thoracic surface, and pelvic midline surface and remained fixed at their respective sites throughout data collection. Background radiation was measured and subtracted, and a 5-min interval was observed between exposures. Twenty repeated acquisitions were obtained per site and protocol. Descriptive statistics, absolute mean differences, percentage reductions, and repeatability metrics were emphasized. Paired within-site comparisons were used only as technical comparisons within the fixed phantom setup.
Results:
Mean out-of-field surface dose readings under the standard versus low-exposure protocols were 0.0230 ± 0.0030 versus 0.0141 ± 0.0012 μSv at the thyroid-region surface, 0.0256 ± 0.0008 versus 0.0089 ± 0.0014 μSv at the upper thoracic surface, and 0.0119 ± 0.0006 versus 0.0096 ± 0.0008 μSv at the pelvic surface. Relative reductions were 38.6%, 65.0%, and 19.5%, respectively. All within-site technical comparisons showed lower readings with the low-exposure protocol.
Discussion:
Under fixed phantom geometry, the low-exposure setting consistently produced lower out-of-field surface dose readings than the standard protocol. These findings represent protocol-dependent differences in relative surface exposure indicators under controlled phantom conditions and should not be interpreted as absorbed skin dose, organ dose, effective dose, or patient-level risk estimates. Because diagnostic image quality was not assessed, the observed reduction in surface dose readings cannot by itself establish clinical optimization or justify protocol substitution.
Conclusion:
The manufacturer-provided low-exposure panoramic protocol reduced out-of-field surface dose readings at all measured sites in this anthropomorphic phantom. The results provide technical dosimetric support for further evaluation of the low-exposure panoramic protocol; however, diagnostic image quality must be verified separately before routine clinical implementation or protocol substitution.
Plain Language Summary:
Dental X-ray scans use low radiation doses, but some radiation can still reach areas outside the main target. This study used a human-shaped model to compare a standard scan with a lower-exposure scan by measuring radiation levels at different body sites. This study found that the lower-exposure setting reduced radiation levels at all measured areas compared with the standard scan. This matters because reducing unnecessary radiation may help improve patient safety, although image quality must also be checked before changing practice.
