Studies on pelletised lithium magnesium borate TL material for eye lens dosimetry.

Recent epidemiological studies in various cohorts confirm that radiation induced cataract may occur at a threshold dose as low as 0.5 Gy. ICRP has recognised the higher radiosensitivity of eye lens and recommended to reduce annual eye lens dose limit from 150 to 20 mSv. Present dosimetry for eye lens is largely based on LiF based dosimeters. The present work is an attempt towards using near tissue equivalent lithium borate material namely lithium magnesium borate doped with terbium (LMB:Tb) in eye lens dosimetry. The material in powder form was synthesised using solid state sintering method and pelletised using poly tetra fluoro ethylene (PTFE) as binding agent. It was observed that 130 mg of 1 mm thick LMB:Tb pellet bound with PTFE showed stable glow curve structure and attractive dosimetric features in terms of sensitivity, fading, linearity, reusability etc. A proposal of 1.5 mm Teflon encapsulation corresponding to tissue equivalent thickness of 3 mm was put forward for an ideal dosimeter for the measurement in terms of Hp(3). Energy and angular dependence studies based on FLUKA simulations suggest a flat response for the prototype design. In addition to PTFE, various tissue equivalent encapsulations such as polyimide, polyamide 6 and PMMA were also evaluated using FLUKA code.

Radiation Exposure Characteristics among Healthcare Workers: Before and After Japan's Ordinance Revision.

ABSTRACT: Radioactive materials and ionizing radiation have both medical value and disease risks, necessitating radiation dose measurement and risk reduction strategies. The International Commission on Radiological Protection (ICRP) lowered the lens of the eye exposure limit, leading to Japan's revised "Ionizing Radiation Ordinance." However, the effects on radiation exposure in medical settings and compliance feasibility remain unclear. To examine the impact of the revision to the "Ionizing Radiation Ordinance" and use it for measures to reduce exposure to radiation, a comprehensive analysis was conducted on data collected from Nagasaki University Hospital, Hiroshima University Hospital, and Fukushima Medical University Hospital in 2018, 2020, and April to September 2021. This included information on age, sex, occupation, department, and monthly radiation doses of workers, aiming to assess the impact of the revision to the "Ionizing Radiation Ordinance" on radiation exposure before and after its enforcement. Out of 9,076 cases studied, 7,963 (87.7%) had radiation doses below the measurable limit throughout the year. Only 292 cases (3.2%) exceeded 1 mSv y -1 , with 9 doctors and 2 radiological technologists surpassing 5 mSv y -1 . Radiological technologists showed significantly higher doses compared to doctors, dentists, and nurses (p < 0.01), while male subjects had significantly higher exposure doses than females (p < 0.01). No significant changes in radiation exposure were observed before and after the revision of the Ionizing Radiation Ordinance; however, variations in radiation exposure control were noted, particularly among nurses and radiological technologists, suggesting the impact of the revision and the need for tailored countermeasures to reduce radiation dose in each group.

Comparison of adult and child radiation equivalent doses from 2 dental cone-beam computed tomography units.

INTRODUCTION: With the advent of cone-beam computed tomography (CBCT) scans, there has been a transition toward these scans' replacing traditional radiographs for orthodontic diagnosis and treatment planning. Children represent a significant proportion of orthodontic patients. Similar CBCT exposure settings are predicted to result in higher equivalent doses to the head and neck organs in children than in adults. The purpose of this study was to measure the difference in equivalent organ doses from different scanners under similar settings in children compared with adults. METHODS: Two phantom heads were used, representing a 33-year-old woman and a 5-year-old boy. Optically stimulated dosimeters were placed at 8 key head and neck organs, and equivalent doses to these organs were calculated after scanning. The manufacturers' predefined exposure settings were used. RESULTS: One scanner had a pediatric preset option; the other did not. Scanning the child's phantom head with the adult settings resulted in significantly higher equivalent radiation doses to children compared with adults, ranging from a 117% average ratio of equivalent dose to 341%. Readings at the cervical spine level were decreased significantly, down to 30% of the adult equivalent dose. When the pediatric preset was used for the scans, there was a decrease in the ratio of equivalent dose to the child mandible and thyroid. CONCLUSIONS: CBCT scans with adult settings on both phantom heads resulted in higher radiation doses to the head and neck organs in the child compared with the adult. In practice, this might result in excessive radiation to children scanned with default adult settings. Collimation should be used when possible to reduce the radiation dose to the patient. While CBCT scans offer a valuable tool, use of CBCT scans should be justified on a specific case-by-case basis.

In vitro ultraviolet-induced damage in human corneal, lens, and retinal pigment epithelial cells.

PURPOSE: The purpose was to develop suitable in vitro methods to detect ocular epithelial cell damage when exposed to UV radiation, in an effort to evaluate UV-absorbing ophthalmic biomaterials. METHODS: Human corneal epithelial cells (HCEC), lens epithelial cells (HLEC), and retinal pigment epithelial cells (ARPE-19) were cultured and Ultraviolet A/Ultraviolet B (UVA/UVB) blocking filters and UVB-only blocking filters were placed between the cells and a UV light source. Cells were irradiated with UV radiations at various energy levels with and without filter protections. Cell viability after exposure was determined using the metabolic dye alamarBlue and by evaluating for changes in the nuclei, mitochondria, membrane permeability, and cell membranes of the cells using the fluorescent dyes Hoechst 33342, rhodamine 123, calcein AM, ethidium homodimer-1, and annexin V. High-resolution images of the cells were taken with a Zeiss 510 confocal laser scanning microscope. RESULTS: The alamarBlue assay results of UV-exposed cells without filters showed energy level-dependent decreases in cellular viability. However, UV treated cells with 400 nm LP filter protection showed the equivalent viability to untreated control cells at all energy levels. Also, UV irradiated cells with 320 nm LP filter showed lower cell viability than the unexposed control cells, yet higher viability than UV-exposed cells without filters in an energy level-dependent manner. The confocal microscopy results also showed that UV radiation can cause significant dose-dependent degradations of nuclei and mitochondria in ocular cells. The annexin V staining also showed an increased number of apoptotic cells after UV irradiation. CONCLUSIONS: The findings suggest that UV-induced HCEC, HLEC, and ARPE-19 cell damage can be evaluated by bioassays that measure changes in the cell nuclei, mitochondria, cell membranes, and cell metabolism, and these assay methods provide a valuable in vitro model for evaluating the effectiveness of UV-absorbing ophthalmic biomaterials, including contact lenses and intraocular lenses.

Trends in Estimated Thyroid, Salivary Gland, Brain, and Eye Lens Doses From Intraoral Dental Radiography Over Seven Decades (1940 TO 2009).

The purpose of this study is to support retrospective dose estimation for epidemiological studies by providing estimates of historical absorbed organ doses to the brain, lens of the eye, salivary glands, and thyroid from intraoral dental radiographic examinations performed from 1940 to 2009. We simulated organ doses to an adult over 10 y time periods from 1940 to 2009, based on commonly used sets of x-ray machine settings collected from the literature. Simulations to estimate organ dose were performed using personal computer x-ray Monte Carlo software. Overall, organ doses were less than 1 mGy for a single intraoral radiograph for all decades. From 1940 to 2009, doses to the brain, eye lens, salivary glands, and thyroid decreased by 86, 96, 95, and 89%, respectively. Of these four organs, the salivary glands received the highest doses, with values decreasing from about 0.23 mGy in the 1940s to 0.025 mGy in the 2000s for a single intraoral radiograph. Based on simulations using collected historical data on x-ray technical parameters, improvements in technology and optimization of the technical settings used to perform intraoral dental radiography have resulted in a decrease in absorbed dose to the brain, eye lens, salivary glands, and thyroid over the period from 1940 to 2009.

Doses in eye lens, thyroid, salivary glands, mammary glands, and gonads, due to radiation scattered in dental orthopantomography.

In the aim to support treatments and diagnostics in Dentistry the most common radiographies are the periapical radiography and the dental panoramic. In the dental panoramic the X-ray beam is addressed into a large zone of the face obtaining the image of the upper and lower jaw. In this procedure part of the X-rays are scattered reaching some other parts of the patient body. In this work the absorbed dose in the eye lens, thyroid, salivary glands, mammary glands, and gonads, was measured in patients undergoing a dental orthopantomography. Measurements were carried out with thermolmuminiscent dosimeters. With the absorbed doses the Effective dose were calculated. The highest dose was obtained in the salivary glands (30.4 µSv) and the lowest dose was obtained in thyroid (3.8 µSv).

ESTIMATION OF EFFECTIVE DOSE OF DENTAL X-RAY DEVICES.

This study aims to estimate the effective doses of dental X-ray devices under common scanning protocols. After putting TLDs in the Alderson Radiation Therapy Phantom, we exposed the phantom under common scanning protocols of three dental X-ray devices, namely CBCT, dental panoramic machine and intraoral round cone device. Then effective doses were calculated using the measured absorbed doses of organs and tissues. Tissue weighting factors recommended by the ICRP were adopted in the calculation. Effective doses under common scanning protocols of three Dental X-ray devices were obtained. The effective dose of dental CT was 0.20 mSv, and that of dental panoramic machine and intraoral radiography were 0.013 and 0.0050 mSv, respectively. The tissue absorbed doses of dental CT scan were 0.63 mGy of brain, 7.7 mGy of salivary glands, 8.7 mGy of thyroid and 4.0 mGy of the lens of the eye. The tissue absorbed doses from dental panoramic machine are 0.62 mGy of salivary glands and 0.25 mGy of thyroid. And finally the tissue absorbed dose of intraoral radiography was 0.80 mGy of salivary gland. Among the three dental X-ray devices studied, dental CBCT scan can cause much higher effective dose than the other two. Brain, salivary glands, thyroid and the lens of the eye are tissues receiving relatively higher absorbed doses.

Absorbed doses for patients undergoing panoramic radiography, cephalometric radiography and CBCT.

OBJECTIVES: Contemporary dental radiology offers a wide spectrum of imaging methods but it also contributes to an increase in the participation of dental radiological diagnosis in the patient's exposure to ionizing radiation. The aim of this study is to determine the absorbed doses of the brain, spinal column, thyroid and eye lens for patients during panoramic radiography, cephalometric radiography and cone beam computed tomography (CBCT). MATERIAL AND METHODS: The thermoluminescent dosimetry and anthropomorphic phantom was used for measuring the doses. The 15 panoramic, 4 cephalometric and 4 CBCT exposures were performed by placing high-sensitivity thermoluminescent detectors (TLD) in 18 anatomical points of the phantom. RESULTS: The maximum absorbed dose recorded during performed measurements corresponds to the point representing the brainstem and it is 10 mGy. The dose value recorded by the TLD placed in the thyroid during CBCT imaging in relation to the panoramic radiography differs by a factor of 13.5. CONCLUSIONS: Cone beam computed tomography, in comparison with panoramic or cephalometric imaging technique, provides higher radiation doses to the patients. Int J Occup Med Environ Health 2017;30(5):705-713.

Risk of eye lens radiation exposure for members of the public.

In 2011, the International Commission on Radiological Protection (ICRP) reviewed its recommendation concerning the equivalent dose limit for the eye lens, lowering it to 20 mSv in a year, for occupational exposure in planned exposure situations. The ICRP's statement does not contain any explicit recommendations regarding the organ dose limit for the eye lens for public exposure. For the moment, no change is proposed. But, to be coherent in the overall approach, the current equivalent limit for the public might be lowered. A similar yardstick than in the former recommendation may be used, that is to say a reduction of 10 times lower than that for occupational exposure. In this context, additional data on potential scenarios for public exposure of the eye lens are necessary. This paper, mainly based on a literature study, aims to provide, as far as possible, an exhaustive list of the situations in which members of the public can be exposed at the level of the eye lens. Once these situations have been defined, some calculations, made to assess the associated doses to the eye lens, are presented. This literature study did not reveal any current situations where members of the public would receive significant radiation doses to the eye lens. Indeed, the situations in which the dose to the eye lens might reach around 1 mSv per year for the public are extremely rare.

Evaluation of new transparent tungsten containing nanocomposites for radiation protection screens.

Evaluation of the new lead-free optically transparent nanocomposites is provided in this paper along with the introduction to their fabrication technologies and the results of investigation of their X-ray attenuating and optical properties before and after their exposure to high doses. These materials might be considered for the construction of X-ray protective screens that are used to protect medical personnel against scattered X rays during close-to patient operations. Rough selection of possible composites was performed according to X-ray attenuation modelling results. Experimental nanocomposites were prepared dissolving tungstates in different solvents or embedding tungsten structures into polymer matrix. It was found that the lead equivalent thickness of fabricated experimental samples varied from 0.15 to 0.75 mmPb and was higher for samples, containing polyanions of phosphotungstic acid. Transparency of the experimental samples to visible light varied from 20 to 60 % and was slightly increasing with irradiation dose due to radiation-induced processes in polymers.

Efficacy of lead foil for reducing doses in the head and neck: a simulation study using digital intraoral systems.

OBJECTIVES: To assess the efficacy of lead foils in reducing the radiation dose received by different anatomical sites of the head and neck during periapical intraoral examinations performed with digital systems. METHODS: Images were acquired through four different manners: phosphor plate (PSP; VistaScan(®) system; Dürr Dental GmbH, Bissingen, Germany) alone, PSP plus lead foil, complementary metal oxide semiconductor (CMOS; DIGORA(®) Toto, Soredex(®), Tuusula, Finland) alone and CMOS plus lead foil. Radiation dose was measured after a full-mouth periapical series (14 radiographs) using the long-cone paralleling technique. Lithium fluoride (LiF 100) thermoluminescent dosemeters were placed in an anthropomorphic phantom at points corresponding to the tongue, thyroid, crystalline lenses, parotid glands and maxillary sinuses. RESULTS: Dosemeter readings demonstrated the efficacy of the addition of lead foil in the intraoral digital X-ray systems provided in reducing organ doses in the selected structures, approximately 32% in the PSP system and 59% in the CMOS system. CONCLUSIONS: The use of lead foils associated with digital X-ray sensors is an effective alternative for the protection of different anatomical sites of the head and neck during full-mouth periapical series acquisition.

Characterization and implementation of OSL dosimeters for use in evaluating the efficacy of organ-based tube current modulation for CT scans of the face and orbits.

PURPOSE: The purpose of this work was to characterize commercially available optically stimulated luminescent (OSL) dosimeters for general clinical applications and apply the results to the development of a method to evaluate the efficacy of a vendor-specific organ-based tube current modulation application for both phantom and clinical computed tomography (CT) scans of the face and orbits. METHODS: This study consisted of three components: (1) thorough characterization of the dosimeters for CT scans in phantom, including evaluations of depletion, fading, angular dependence, and conversion from counts to absorbed dose; (2) evaluation of the efficacy of using plastic glasses to position the dosimeters over the eyes in both phantom and clinical studies; and (3) preliminary dosimetry measurements made using organ-based tube current modulation in computed tomography dose index (CTDI) and anthropomorphic phantom studies. RESULTS: (1) Depletion effects were found to have a linear relationship with the output of the OSL dosimeters (R(2) = 0.96). Fading was found to affect dosimeter readings during the first two hours following exposure but had no effect during the remaining 60-h period observed. No significant angular dependence was observed for the exposure conditions used in this study (with p-values ranging from 0.9 to 0.26 for all t-tests). Dosimeter counts varied linearly with absorbed dose when measured in the center and 12 o'clock positions of the CTDI phantoms. These linear models of counts versus absorbed dose had overlapping 95% confidence intervals for the intercepts but not for the slopes. (2) When dosimeters were positioned using safety glasses, there was no adverse effect on image quality, and there was no statistically significant difference between this placement and placement of the dosimeters directly on the eyes of the phantom (p = 0.24). (3) When using organ-based tube current modulation, the dose to the lens of the eye was reduced between 19% and 43%, depending on the scan protocol used and the positioning of the phantom. Furthermore, the amount of dose reduction was significantly affected by the vertical position of the phantom, with the largest reduction in dose seen when the phantom was centered in the gantry. CONCLUSIONS: (1) An appropriate correction factor, specific to CT scanning, was developed to account for depletion and fading characteristics of the dosimeters. Additionally, an equation to convert dosimeter counts to absorbed dose was established. (2) The use of plastic safety glasses was validated as an appropriate positioning device when measuring dose to the lens of the eye. (3) The use of organ-based tube current modulation can reduce dose to the lens of the eye during CT scanning. The amount of dose reduction, however, is largely influenced by the positioning of the anatomy in the gantry.

Curing efficiency and ocular hazards of dental photopolymerization sources.

The spectral distributions of a range of dental photocuring sources were measured at the exit window and at a distance of 10 cm. The former enabled the evaluation of a newly proposed photocuring efficiency index which correlates well with the depth of cure of the photopolymerized resins, thus providing a basis for the comparison of different photocuring sources. The spectral irradiance of the sources obeyed the inverse-square law, allowing a comparison with the ACGIH threshold limit values. According to these criteria, no ocular hazard is posed to the patient or clinician by u.v.-A or u.v.-B radiation nor to the patient by the visible light when momentarily exposed to the sources. Similarly the ACGIH criterion indicates that the clinician does not risk chorioretinal injury provided the exposure is restricted to less than 140 s in a 3 h period.

Lenticular opacities in populations exposed to chronic low-dose-rate gamma radiation from radiocontaminated buildings in Taiwan.

Chen, W-L., Hwang, J-S., Hu, T-H., Chen, M-S. and Chang, W. P. Lenticular Opacities in Populations Exposed to Chronic Low-Dose-Rate Gamma Radiation from Radiocontaminated Buildings in Taiwan. Radiat. Res. 156, 71-77 (2001). Epidemiological and experimental studies have revealed the cataractogenic potential of large acute doses of radiation. However, studies on the dose-response effect and the incidence of lenticular changes after exposure to chronic low doses of radiation have seldom been conducted. To evaluate quantitatively the lenticular changes in a population exposed to chronic low-dose-rate gamma radiation in their daily living or school environment in steel buildings contaminated with (60)Co in Taiwan, a total of 114 exposed individuals participated in a thorough ophthalmological examination in 1998. The lenticular opacities were evaluated by slit-lamp biomicroscopy after full pupil dilatation and were scored by the Lens Opacities Classification System III (LOCS III) and a modified subclinical minor lenticular focal defects system. These individuals were further divided into those less than 20 years old, those between 20 and 40 years old, and those more than 40 years old to evaluate the effects of age. The cumulative doses were assessed for each individual using the Taiwan Cumulative Dose (TCD) estimation system. A significant dose-dependent increase in the numbers of focal lens defects in those less than 20 years old was demonstrated, while less significant changes were observed in the other two age groups or by the LOCS III scoring. Results suggested that chronic low-dose-rate irradiation might induce minor lenticular changes, especially in lenses of young subjects. The delayed clinical changes in these young exposed subjects warrants further long-term follow-up.

Radioprotection to the eye during CT scanning.

BACKGROUND AND PURPOSE: The lens of the eye is sensitive to radiation. Children undergoing CT of the head and patients undergoing repeated CT scanning of the head are vulnerable to this complication. The purpose of this study was to test the ability of a heavy metal, bismuth, in reducing radiation to the lens of the eye during routine cranial CT. METHODS: Both phantom and human studies were done. Using a standard head-attenuating phantom, scanning was performed with detectors placed over the eye, first without the protectors, and then with shielding by one (1T), two (2T), or three thickness (3T) of bismuth-coated latex. The patient study included 30 patients randomized into one of three groups with eye protection provided by 1T, 2T, or 3T of the bismuth-coated latex. Control measurements were done using thermoluminescent dosimeters over the forehead above each eye. Image artifact from the bismuth shields was assessed. RESULTS: The phantom study demonstrated that the use of bismuth-coated shielding over the eyes decreased radiation dosage by 48.5%, 59.8%, and 65.4% using 1T, 2T, and 3T, respectively. The effect of eye shielding in decreasing radiation dosage to the eye was highly significant for all three thicknesses (P = 2.9 x 10(-81) to 1.9 x 10(-89)). In the patient study, the use of 1T, 2T, and 3T of bismuth-coated latex saved an average radiation dose of 39.6%, 43.5%, and 52.8%, respectively. While the use of shielding was statistically significant in saving radiation for all thicknesses (P = 2.2 x 10(-10) to 1.4 x 10(-21)), there was no statistical difference between 1T, 2T, and 3T of bismuth-coated latex shielding found in patients. However, the trend was for increased radiation savings to the eye with increased thickness of shielding used. A review of all 30 studies showed no significant artifact caused by the eye shielding, regardless of thickness. CONCLUSION: Bismuth-coated latex shielding of the eye during cranial CT is simple to apply, inexpensive, and causes up to a 50% reduction in radiation to the lens of the eye.

[The radiation loading of the crystalline lens and thyroid during high-resolution computed tomography of the teeth]. / Untersuchung zur Strahlenbelastung von Augenlinse und Schilddrüse bei der hochauflösenden Computertomographie der Zähne.

The radiation dose to the ocular lens and thyroid gland during high resolution CT of the jaw was measured in a head phantom and in 9 patients. The dose for the lens and thyroid gland resulting from 10 cuts was 0.7 and 0.9 mGy, respectively. By shielding the thyroid gland against scatter a reduction of 20% is possible. Radiation exposure is considerably higher than during conventional dental x-ray examinations. Compared with CT examinations of the head and neck region, radiation exposure of both organs is about the same.

[Dosage measurements in spiral CT examinations of the head and neck region]. / Dosismessungen bei Spiral-CT-Untersuchungen der Kopf-Hals-Region.

PURPOSE: In view of the increasing frequency of computed tomographic examinations the organ doses of the thyroid gland and the eye lenses in spiral CT examinations of the head and neck should be determined. MATERIAL AND METHODS: Standard CT-examinations of the neck, the paranasal sinuses in axial and coronal sections, and the mandibula were simulated by help of an Alderson-Rando phantom. Dose measurements were performed as well in 28 patients. The examinations were carried out in spiral mode ("Somatom AR.SP", "Picker PQ 2000", and "Toshiba Xpress SX") and conventional single slice technique ("Somatom Plus"). Three LiF-TLD were placed on each eyelid and three on the thyroid. RESULTS: With direct exposure to the x-ray-beam the organ doses did not exceed 64 mGy. When exposed by scatter radiation only, doses may be reduced by a factor of up to 10. The measurements in 28 patients showed similar results. CONCLUSIONS: The organ doses in spiral CT correspond with data known from conventional CT.

Order of magnitude dose reduction in intraoral radiography.

This comparative clinical investigation concerns the radiation dose from intraoral radiography using E-speed film and rectangular and circular beam collimation. Dose to organs not of diagnostic importance (brain, lens of the eye, thyroid, and breast) is reduced by approximately an order of magnitude when rectangular collimation and E-speed film are used in periapical radiography. And dose to the thyroid and breast is further reduced by a third with the use of a full leaded apron and thyroid shield.

Dosimetric advantages of enhanced dynamic wedge in small field irradiation for the treatment of macular degeneration.

Exudative macular degeneration is a process that affects the central retina and is the chief cause of blindness in people over 55 years old. Radiation appears to improve or stabilize visual acuity in some of these patients, although definitive clinical studies are ongoing. The delivery of radiation in patients with macular degeneration is unique and challenging because of the location of the surrounding structures, such as the lens and the opposite retina. The "standard" treatment technique has been an anterior oblique beam 20 degrees above lateral to limit dose to these structures. In preference to the undesirable hot spot caused by this single-beam technique, we have employed a superior and inferior oblique pair utilizing the Enhanced Dynamic Wedge (EDW). Couch rotation was used to establish the desired treatment angles. The anterior half of the fields were blocked with the asymmetric jaw (AJ). Studies were performed to determine the value of these methods in reducing lens dose. Although the peripheral dose measurements at Dmax using a 60 degrees metal wedge for > or = 10 cm square fields were higher than for an open field or the EDW, for the small retinal fields there was no lens-dose reduction attributable to the EDW. However, the steep wedge angles achievable with the EDW were useful for optimizing the dose distribution for the most desirable field angles. As expected, the independent collimator was more effective in reducing transmitted dose to the lens than a typical Cerrobend block. Measurements required to predict dose in and out of the field are discussed along with the dosimeters employed in evaluating small fields (less than 5 cm square) with the EDW. The technical challenges of positioning, immobilization, treatment planning and treatment delivery are presented.

Absorbed doses at varying tube voltage in lateral cephalography.

Absorbed doses in organs of special interest from lateral cephalography were measured by thermoluminescence dosimetry in a tissue equivalent phantom head. The radiographic examination was performed in a standardized manner by using a carefully collimated radiation field and a near-focus dodger. The actual tube voltages ranged from 63-127 kVp. The absorbed dose was described as a function of tube voltage. In all measurement sites the absorbed dose decreased with increasing tube voltage. This reduction was most obvious in the low tube voltage range. From the results a lowest recommendable tube voltage was given for the different measurement sites varying from approximately 75 kVp (thyroid region) to approximately 100 kVp (parotid region). A high tube voltage was found to be important for a low absorbed dose in different organs in lateral cephalography.