Measurement of skin dose from cone-beam computed tomography imaging.

OBJECTIVE: To measure surface skin dose from various cone-beam computed tomography (CBCT) scanners using point-dosimeters. MATERIALS & METHODS: A head anthropomorphic phantom was used with nanoDOT optically stimulated luminescence (OSL) dosimeters (Landauer Corp., Glenwood, IL) attached to various anatomic landmarks. The phantom was scanned using multiple exposure protocols for craniofacial evaluations in three different CBCT units and a conventional x-ray imaging system. The dosimeters were calibrated for each of the scan protocols on the different imaging systems. Peak skin dose and surface doses at the eye lens, thyroid, submandibular and parotid gland levels were measured. RESULTS: The measured skin doses ranged from 0.09 to 4.62 mGy depending on dosimeter positions and imaging systems. The average surface doses to the lens locations were ~4.0 mGy, well below the threshold for cataractogenesis (500 mGy). The results changed accordingly with x-ray tube output (mAs and kV) and also were sensitive to scan field of view (SFOV). As compared to the conventional panoramic and cephalometric imaging system, doses from all three CBCT systems were at least an order of magnitude higher. CONCLUSIONS: Peak skin dose and surface doses at the eye lens, thyroid, and salivary gland levels measured from the CBCT imaging systems were lower than the thresholds to induce deterministic effects. However, our findings do not justify the routine use of CBCT imaging in orthodontics considering the lifetime-attributable risk to the individual.

Measurement of focal spot size with slit camera using computed radiography and flat-panel based digital detectors.

The purpose of this study was to evaluate the use of digital x-ray imaging detectors for the measurement of diagnostic x-ray tube focal spot size using a slit camera. Slit camera images of two focal spots for a radiographic x-ray tube were acquired with direct-exposure film (DF) (as specified by the National Electrical Manufacturers Association [NEMA] Standards Publication No. XR 5, 1992), computed radiography (CR) imaging plates, and an a-Si:H/CsI:Tl-based flat-panel (FP) detector. Images obtained with the CR and the FP were acquired over a broad range of detector entrance exposure levels. The DF slit images were evaluated according to NEMA specifications (visually, using a 7x magnifying glass with reticule) by six medical physicists. Additionally, the DF images were digitized and the focal spot sizes obtained from the digital profiles of the slit. The CR and the FP images were analyzed in a manner similar to the digitized DF images. It took less than 20 minutes for a complete CR or FP measurement of focal spot size in two dimensions. In comparison, a typical DF measurement with visual evaluation takes at least 60 minutes, in our experience. In addition to a great reduction in measurement time achieved by using digital detectors, the tube loading requirements were reduced to approximately 20 mAs compared with approximately 1000 mAs when using the DF technique. The calculated focal spot sizes for CR and FP differed from those of digitized DF by -2.4% to +4.8% (sigma=2.5%), far less than the -16.6% to +9.3% (sigma=8.1%) variability introduced by the visual evaluation of the slit image. In addition, the calculated focal spot sizes for the CR and the FP images maintained a coefficient of variation <1.0% over the broad range of exposure levels. Based upon these results, we conclude that (1) FP and CR detectors yield consistent results in measurements of x-ray tube focal spot sizes, (2) compared to DF, CR and FP significantly reduce measurement time and tube loading requirements, (3) CR and FP readily permit digital profile analysis, thereby eliminating observer error, and (4) unlike DF, CR and FP are independent of exposure level.

Microcalcification detectability for four mammographic detectors: flat-panel, CCD, CR, and screen/film).

Amorphous silicon/cesium iodide (a-Si:H/CsI:Tl) flat-panel (FP)-based full-field digital mammography systems have recently become commercially available for clinical use. Some investigations on physical properties and imaging characteristics of these types of detectors have been conducted and reported. In this perception study, a phantom containing simulated microcalcifications (microCs) of various sizes was imaged with four detector systems: a FP system, a small field-of-view charge coupled device (CCD) system, a high resolution computed radiography (CR) system, and a conventional mammography screen/film (SF) system. The images were reviewed by mammographers as well as nonradiologist participants. Scores reflecting confidence ratings were given and recorded for each detection task. The results were used to determine the average confidence-rating scores for the four imaging systems. Receiver operating characteristics (ROC) analysis was also performed to evaluate and compare the overall detection accuracy for the four detector systems. For calcifications of 125-140 microm in size, the FP system was found to have the best performance with the highest confidence-rating scores and the greatest detection accuracy (Az = 0.9) in the ROC analysis. The SF system was ranked second while the CCD system outperformed the CR system. The p values obtained by applying a Student t-test to the results of the ROC analysis indicate that the differences between any two systems are statistically significant (p<0.005). Differences in microC detectability for the large (150-160 microm) and small (112-125 microm) size microC groups showed a wider range of p values (not all p values are smaller than 0.005, ranging from 0.6 to <0.001) compared to the p values obtained for the medium (125-140 microm) size microC group. Using the p values to assess the statistical significance, the use of the average confidence-rating scores was not as significant as the use of the ROC analysis p value for p value.