Pediatric Risk of Orthodontic CBCT Imaging: Development of Simplified Dosimetry

正畸 CBCT 成像的儿科风险：简化剂量测定的发展

• 批准号: 8174865
• 负责人: John B Ludlow
• 金额: $ 20.14万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-13 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8174865
• 关键词: 10 year old; Address; Adoption; Adult; Advocate; Area; Calibration; California; Child; Childhood; Clinical; Communities; Complex; Data; Data Set; Dental General Practice; Dental Schools; Dentistry; Development; Devices; Diagnosis; Diagnostic; Dose; Evaluation; Foundations; Future; Goals; Gold; Head and neck structure; Image; Investigation; Ionizing radiation; Lead; Link; Malignant Neoplasms; Manufacturer Name; Measures; Medical; Methods; Modality; Noise; Orthodontic; Patients; Plexiglas; Plexiglass; Policy Maker; Population; Protocols documentation; Reading; Reporting; Research; Retinal Cone; Risk; Risk Estimate; Risk-Benefit Assessment; Scanning; Schools; Simulate; Source; Techniques; Technology; Time; Treatment Efficacy; X-Ray Computed Tomography; base; community based practice; cone-beam computed tomography; design; dosimetry; high risk; imaging modality; improved; maxillofacial; medical examination; older patient; tool; treatment planning

DESCRIPTION (provided by applicant): While CT is being used in all aspects of medical diagnosis, a dramatic increase in the use of cone beam CT (CBCT), a form of CT, has occurred in dentistry during the last decade. In particular this technology has found application in orthodontic treatment planning, which is often initiated in young patients. The currently available data regarding dose and risk to patients undergoing CBCT are incomplete and underestimate the risk to pediatric patients. Moreover, current techniques for measuring patient dose/risk from CBCT examinations are either excessively complex or unreliable. To address these important issues we propose a thorough investigation of CBCT dosimetery and the development of a simple device that may be used to inexpensively and accurately determine patient dose and measure image quality. This will be accomplished through first conducting a thorough dosimetry investigation of current CBCT machines using an anthropomorphic phantom. Exposure variables such as current (mA), exposure time(s), and peak kilovoltage (kVp) will be evaluated so that the effect of each of these variables on patient risk can be estimated. Modulation transfer function (MTF) and Contrast to noise ratio (CNR) will be calculated as objective measures of image quality. This data will then be used to develop a simple and inexpensive method to accurately determine effective dose and image quality using readings from a simple Plexiglas phantom with a minimal number of dosimeters. This simplified phantom device will promote accurate and standardized reporting of dose for risk estimation of CBCT examinations. PUBLIC HEALTH RELEVANCE: First, this project will produce data documenting the potential risk routine CBCT examinations may pose to pediatric patients and will be used to advise manufacturers, inform clinicians, and guide policy makers in the judicious use and improvement of CBCT technology. Second, the simplified phantom device will promote accurate and standardized reporting of dose for risk estimation of CBCT examinations. Finally, results from these studies will provide a foundation on which future research can develop clinical standards criteria for optimal levels of image quality, taking into consideration both diagnostic yield and dose.

描述（由申请人提供）：虽然 CT 被用于医学诊断的各个方面，但在过去十年中，锥形束 CT (CBCT)（CT 的一种形式）的使用急剧增加。特别是，该技术已在正畸治疗计划中得到应用，该治疗通常在年轻患者中启动。目前关于接受 CBCT 患者的剂量和风险的可用数据不完整，并且低估了儿科患者的风险。此外，目前通过 CBCT 检查测量患者剂量/风险的技术要么过于复杂，要么不可靠。为了解决这些重要问题，我们建议对 CBCT 剂量测定进行彻底研究，并开发一种简单的设备，可用于廉价且准确地确定患者剂量并测量图像质量。这将通过首先使用拟人模型对当前 CBCT 机器进行彻底的剂量测定研究来实现。将评估电流 (mA)、暴露时间和峰值千电压 (kVp) 等暴露变量，以便估计每个变量对患者风险的影响。调制传递函数（MTF）和对比度噪声比（CNR）将被计算作为图像质量的客观衡量标准。然后，这些数据将用于开发一种简单且廉价的方法，通过使用最少数量的剂量计从简单的有机玻璃模型中读取数据来准确确定有效剂量和图像质量。这种简化的模型设备将促进准确和标准化的剂量报告，以进行 CBCT 检查的风险评估。 公共健康相关性：首先，该项目将生成记录常规 CBCT 检查可能对儿科患者造成的潜在风险的数据，并将用于为制造商提供建议、告知临床医生并指导政策制定者明智地使用和改进 CBCT 技术。其次，简化的体模装置将促进准确和标准化的剂量报告，以用于 CBCT 检查的风险估计。最后，这些研究的结果将为未来的研究奠定基础，在考虑诊断率和剂量的情况下，制定最佳图像质量水平的临床标准。