Background: Cone Beam Computed Tomography (CBCT) represents the optimal imaging solution for the evaluation of the maxillofacial and dental area when quantitative geometric and volumetric accuracy is necessary (e.g., in implantology and orthodontics). Moreover, in recent years, this technique has given excellent results for the imaging of lower and upper extremities. Therefore, significant interest has been increased in using CBCT to investigate larger and non-traditional anatomical districts. Objective: The purpose of this work is to review the scientific literature in Pubmed and Scopus on CBCT application beyond head districts by paying attention to image quality and radiological doses. Method: The search for keywords was conducted in Pubmed and Scopus databases with no back-date restriction. Papers on applications of CBCT to head were excluded from the present work. From each considered paper, parameters related to image quality and radiological dose were extracted. An overall qualitative evaluation of the results extracted from each issue was done by comparing the conclusive remarks of each author regarding doses and image quality. PRISMA statements were followed during this process. Results: The review retrieved 97 issues from 83 extracted papers; 46 issues presented a comparison between CBCT and Multi-Detector Computed Tomography (MDCT), and 51 reviewed only CBCT. The radiological doses given to the patient with CBCT were considered acceptable in 91% of cases, and the final image quality was found in 99%. Conclusion: CBCT represents a promising technology not only for imaging of the head and upper and lower extremities but for all the orthopedic districts. Moreover, the application of CBCT derived from C-arms (without the possibility of a 360 ° rotation range) during invasive investigations demonstrates the feasibility of this technique for non-standard anatomical areas, from soft tissues to vascular beds, despite the limits due to the incomplete rotation of the tube.
Concern about the radiation dose to children from diagnostic radiology examinations has recently been popularly expressed, particularly related to Computed Tomography (CT) procedures. The common belief is that children receive higher doses compared to adults since the optimization of the procedure settings for different anatomies are not always implemented (i.e., FOV, kV and mA not optimized for children). Since the dosimetric quantities related to effective dose are essentially defined for adults, it becomes important to study and propose methods applicable also to pediatric cases. In current clinical and radiological practice, sizes, shapes, and data for pediatric organs are commonly derived from adult ones, but these statements do not reduce dosimetric problems at the definition of scaling algorithms. The aim of this study is to analyze the differences in pediatric vs adult dosimetry, starting from measured organ doses in cone-beam computed tomography (CBCT) procedures for maxillofacial region. Two different anthropomorphic phantoms (child vs adult phantoms) were scanned, acquiring all data: results will be presented in terms of organ and derived doses, discussing approaches and differences.
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