Skin Entrance Dose Assessment in Panoramic Radiography: A Local Diagnostic Reference Level
Abstract
Purpose: The present study aimed to assess the Entrance Skin Doses (ESD) at the thyroid gland region and evaluate the local Diagnostic Reference Level (DRL) in panoramic radiography in a city (Yasuj, Iran).
Materials and Methods: In the current study, 31 patients (17 women and 14 men) with a mean age of 33.90±16.49 years were included. To assess the ESD values, 3 thermoluminescence dosimeters (TLD-100) were attached to the thyroid gland region for each patient. The DRLs were estimated as the third quartile of the ESD values. The ESD variations among the different genders (men and women), devices, and age groups (children [5-10 years], adolescents [11-19 years], and adults [˃19 years]) were calculated. T-test, one-way ANOVA, and Bonferroni's post hoc test were used for parametric tests; Kruskal-Wallis and Spearman's correlation coefficient were used for the non-parametric tests.
Results: Mean ESD and DRL values were obtained at 72±21 µGy and 0.091±0.02 mGy, respectively. For ESDs, there was no significant difference between different genders (men: 76±20 µGy and women: 69±23 µGy) as well as among the three investigated devices (P-value˃ 0.05). The ESD values of children were significantly lower than adolescent and adult patients (P-value<0.001); however, there was no statistically significant difference between the adolescent and adult patients (P-value =0.057).
Conclusion: Compared to national/international, the DRL value in our study was relatively low; patient doses can be decreased in the panoramic examinations by increasing the knowledge of health workers of the radiation parameters, specifically operators.
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12- Hamid Osman et al., "Diagnostic reference level for adult pelvic examination in several hospitals of Taif and Kharaj city, Saudi Arabia." Applied Radiation and Isotopes, Vol. 180p. 110049, (2022).
13- Edwin Ralph Daniels, "Measurement of radiation doses to patients undergoing routine X-ray examinations in Windhoek, Namibia to develop diagnostic reference levels." Cape Peninsula University of Technology, (2019).
14- Pratik Kumar and Anil Kumar Pandey, "THE BIOLOGICAL EFFECTS OF RADIATION." Diagnostic Radiology: Advances in Imaging Technology, p. 407, (2019).
15- Ehsan Moudi, Sina Haghanifar, Hoora Hadian, Ali Shabestani Monfared, Gholamreza Deilam, and Nika Bahemmat, "Assessment of radiation exposure of Head and Neck during panoramic radiography in different age groups." Science Journal of Clinical Medicine, Vol. 3 (No. 1), p. 10, (2014).
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26- Dennis Rottke, Linda Grossekettler, Kunihiku Sawada, Philipp Poxleitner, and Dirk Schulze, "Influence of lead apron shielding on absorbed doses from panoramic radiography." Dentomaxillofacial Radiology, Vol. 42 (No. 10), p. 20130302, (2013).
27- SJ Han and S Kim, "Attribution of the rise in radiation dose to the relaxed panoramic radiography diagnostic reference level in Korea." International Journal of Radiation Research, Vol. 20 (No. 1), pp. 249-52, (2022).
28- G Hodolli, S Kadiri, Gazmend Nafezi, Meleq Bahtijari, and Naim Syla, "Diagnostic reference levels at intraoral and dental panoramic examinations." International Journal of Radiation Research, Vol. 17 (No. 1), pp. 147-50, (2019).
29- Amal Jose, A Saravana Kumar, KN Govindarajan, B Devanand, and N Elango, "Assessment of adult diagnostic reference levels for panoramic radiography in Tamil Nadu region." Journal of Medical Physics, Vol. 44 (No. 4), p. 292, (2019).
30- Eun-Kyung Kim et al., "Patient dose in adult and pediatric dental panoramic radiography in Korea." The Journal of the Korean dental association, Vol. 55 (No. 8), pp. 516-26, (2017).
31- G Manousaridis, C Koukorava, CJ Hourdakis, V Kamenopoulou, E Yakoumakis, and K Tsiklakis, "Establishment of diagnostic reference levels for dental panoramic radiography in Greece." Radiation protection dosimetry, Vol. 165 (No. 1-4), pp. 111-14, (2015).
32- TOOSI MOHAMMAD TAGHI BAHREYNI and FATEMEH AKBARI, "Diagnostic reference level arising from dental panoramic radiography." (2012).
33- Fatemeh Naserpour, Nahid Hassanpour, Fatemeh Panahi, Vahid Karami, and Mehrdad Gholami, "An estimate of radiation dose to the lens of the eyes, parotid gland, and thyroid gland in dental panoramic radiography." Iranian Journal of Medical Physics, (2019).
2- JA Roberts, NA Drage, J Davies, and David William Thomas, "Effective dose from cone beam CT examinations in dentistry." The British journal of radiology, Vol. 82 (No. 973), pp. 35-40, (2009).
3- S1 Kapila, RS Conley, and WE Harrell Jr, "The current status of cone beam computed tomography imaging in orthodontics." Dentomaxillofacial Radiology, Vol. 40 (No. 1), pp. 24-34, (2011).
4- Ladan Hafezi, S Marjan Arianezhad, and Seyed Mahdi Hosseini Pooya, "Evaluation of the radiation dose in the thyroid gland using different protective collars in panoramic imaging." Dentomaxillofacial Radiology, Vol. 47 (No. 6), p. 20170428, (2018).
5- Anthony D Wrixon, "New ICRP recommendations." Journal of radiological protection, Vol. 28 (No. 2), p. 161, (2008).
6- Claire Cousins et al., "International commission on radiological protection." ICRP publication, Vol. 120pp. 1-125, (2011).
7- National Research Council, "Health risks from exposure to low levels of ionizing radiation: BEIR VII phase 2." (2006).
8- Razzagh Abedi-Firouzjah et al., "Data on the cancer risk and mortalities induced by annual background radiations at various ages in Kohgiluyeh and Boyer-Ahmad province, Iran." Data in Brief, Vol. 30p. 105487, (2020).
9- Mohammad Mirdoraghi, Amin Banaei, and Jafar Fatahi Asl, "Data on the estimating the risk of cancer due to some common radiographs in Tehran city." Data in Brief, Vol. 20pp. 1269-73, (2018).
10- A Chaparian and F Dehghanzade, "Evaluation of radiation-induced cancer risk to patients undergoing intra-oral and panoramic dental radiographies using experimental measurements and Monte Carlo calculations." International Journal of Radiation Research, Vol. 15 (No. 2), p. 197, (2017).
11- Ruben Pauwels et al., "Estimating cancer risk from dental cone-beam CT exposures based on skin dosimetry." Physics in Medicine & Biology, Vol. 59 (No. 14), p. 3877, (2014).
12- Hamid Osman et al., "Diagnostic reference level for adult pelvic examination in several hospitals of Taif and Kharaj city, Saudi Arabia." Applied Radiation and Isotopes, Vol. 180p. 110049, (2022).
13- Edwin Ralph Daniels, "Measurement of radiation doses to patients undergoing routine X-ray examinations in Windhoek, Namibia to develop diagnostic reference levels." Cape Peninsula University of Technology, (2019).
14- Pratik Kumar and Anil Kumar Pandey, "THE BIOLOGICAL EFFECTS OF RADIATION." Diagnostic Radiology: Advances in Imaging Technology, p. 407, (2019).
15- Ehsan Moudi, Sina Haghanifar, Hoora Hadian, Ali Shabestani Monfared, Gholamreza Deilam, and Nika Bahemmat, "Assessment of radiation exposure of Head and Neck during panoramic radiography in different age groups." Science Journal of Clinical Medicine, Vol. 3 (No. 1), p. 10, (2014).
16- SMJ Mortazavi et al., "Entrance surface dose measurement on the thyroid gland in orthopantomography: The need for optimization." (2004).
17- H Zamani, AA Parach, SH Razavi, M Shabani, Gh Ataei, and MH Zare, "Estimating the radiation surface dose and measuring the dose area product to provide the diagnostic reference level in panoramic radiography." International Journal of Radiation Research, Vol. 19 (No. 4), pp. 963-70, (2021).
18- A Ahmadi, A Negarestani, S Sina, and S Sarshough, "Measurement of entrance skin dose and the dose received by different organs in panoramic dental imaging." Journal of Biomedical Physics & Engineering, Vol. 10 (No. 5), p. 569, (2020).
19- Maryam Sadeghi, Reza Faghihi, and Sedigheh Sina, "Developing an optimum protocol for thermoluminescence dosimetry with GR-200 chips using taguchi method." Radiation protection dosimetry, Vol. 175 (No. 2), pp. 284-94, (2017).
20- H Hasanzadeh, A Sharafi, M Allah Verdi, and A Nikoofar, "Assessment of absorbed dose to thyroid, parotid and ovaries in patients undergoing Gamma Knife radiosurgery." Physics in Medicine & Biology, Vol. 51 (No. 17), p. 4375, (2006).
21- Shreeniwas Omanwar, KA Koparkar, and Hardev Singh Virk, "Recent advances and opportunities in tld materials: A review." in Defect and Diffusion Forum, (2014), Vol. 347: Trans Tech Publ, pp. 75-110.
22- Ernest U Ekpo, Alishja C Hoban, and Mark F McEntee, "Optimisation of direct digital chest radiography using Cu filtration." Radiography, Vol. 20 (No. 4), pp. 346-50, (2014).
23- Philippe Brosi, Anja Stuessi, Francis R Verdun, Peter Vock, and Rainer Wolf, "Copper filtration in pediatric digital X-ray imaging: its impact on image quality and dose." Radiological physics and technology, Vol. 4pp. 148-55, (2011).
24- B Poppe et al., "Dose-area product measurements in panoramic dental radiology." Radiation protection dosimetry, Vol. 123 (No. 1), pp. 131-34, (2007).
25- Sophia Gavala, Catherine Donta, Kostas Tsiklakis, Argyro Boziari, Vasiliki Kamenopoulou, and Harry C Stamatakis, "Radiation dose reduction in direct digital panoramic radiography." European journal of radiology, Vol. 71 (No. 1), pp. 42-48, (2009).
26- Dennis Rottke, Linda Grossekettler, Kunihiku Sawada, Philipp Poxleitner, and Dirk Schulze, "Influence of lead apron shielding on absorbed doses from panoramic radiography." Dentomaxillofacial Radiology, Vol. 42 (No. 10), p. 20130302, (2013).
27- SJ Han and S Kim, "Attribution of the rise in radiation dose to the relaxed panoramic radiography diagnostic reference level in Korea." International Journal of Radiation Research, Vol. 20 (No. 1), pp. 249-52, (2022).
28- G Hodolli, S Kadiri, Gazmend Nafezi, Meleq Bahtijari, and Naim Syla, "Diagnostic reference levels at intraoral and dental panoramic examinations." International Journal of Radiation Research, Vol. 17 (No. 1), pp. 147-50, (2019).
29- Amal Jose, A Saravana Kumar, KN Govindarajan, B Devanand, and N Elango, "Assessment of adult diagnostic reference levels for panoramic radiography in Tamil Nadu region." Journal of Medical Physics, Vol. 44 (No. 4), p. 292, (2019).
30- Eun-Kyung Kim et al., "Patient dose in adult and pediatric dental panoramic radiography in Korea." The Journal of the Korean dental association, Vol. 55 (No. 8), pp. 516-26, (2017).
31- G Manousaridis, C Koukorava, CJ Hourdakis, V Kamenopoulou, E Yakoumakis, and K Tsiklakis, "Establishment of diagnostic reference levels for dental panoramic radiography in Greece." Radiation protection dosimetry, Vol. 165 (No. 1-4), pp. 111-14, (2015).
32- TOOSI MOHAMMAD TAGHI BAHREYNI and FATEMEH AKBARI, "Diagnostic reference level arising from dental panoramic radiography." (2012).
33- Fatemeh Naserpour, Nahid Hassanpour, Fatemeh Panahi, Vahid Karami, and Mehrdad Gholami, "An estimate of radiation dose to the lens of the eyes, parotid gland, and thyroid gland in dental panoramic radiography." Iranian Journal of Medical Physics, (2019).
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How to Cite
1.
Panahi R, Niknam G, Vafapour H. Skin Entrance Dose Assessment in Panoramic Radiography: A Local Diagnostic Reference Level. Frontiers Biomed Technol. 2026;.
