CBCT 검사법의 정도관리 및 선량
Radiation Doses and Quality Assurance in Cone Beam CT(CBCT)
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치과의사에게 영상학적 정보는 질환의 범위와 진행정도를 평가하고 치료계획의 수립에 있어 판단의 증거가 되며 질환의 경과를 추적 관찰할 뿐만 아니라 치료의 효과와 질환의 예후를 평가하고 결정하는 데 중요한 역할을 수행한다. 특히 악안면영역의 경조직 질환을 주로 다루는 치과의사에게 있어 방사선학적 검사를기반으로 한 영상정보는 진단체계를 확립하는데 필수적인 사항이라 하겠다. 특히 치과임상에서 방사선학적 검사의 사용은 소아 및 청소년기의 환자들에게 다른 영역의 방사선 검사보다 조기에 적용되며 넓게 사용되는 진단 도구로서 그 중요성이 인정된다. 기존의 치과임상에서 일반방사선영상을 기반으로한 진단체계와 더불어 최근 십여년간 새로운 영상기법인 콘빔형전산화단층영상(Cone Beam ComputedTomography, CBCT)의 도입과 임상적 적용은 치과의 진단체계에 새로운 패러다임으로 다가왔다. 기존의 일반방사선영상의 정보를 보충하며 새로운 해부학적 정보를 제공하는 중요한 수단이 되고 있다. CBCT 영상은 구강악안면영역의 삼차원적 위치 및구조에 대한 정보를 제공하고, 다양한 분야의 임상영역의 요구가 증가함에 따라 지속적으로 그 사용빈도와유용성이 증가되고 있다. 그 이유로는 일반전산화단층영상(conventional Computed Tomography,CT)와 비교하여 장비의 규모가 적어지고 경제적으로적은 비용을 발생시키며, 낮은 선량으로 검사가 이뤄진다는 장점을 갖고 있음을 들 수 있다
Abstract
3-dimensional information for anatomic stucture plays a role as integral part in clinical aspect of dental practice. CBCT(cone beam computed tomography) has been accepted as useful diagnostic tool offering Volume data and images for evaluating teeth and jaws in lower radiation dose than conventional CT. CBCT equipment is essential for the quality assurance of it to ensure continued satisfactory performance and result of adequate images. Dental practitioner and oral and maxillofacial radiologist should have a responsibility and critical thinking to deliver this technology to patients in a responsible way, so that diaganostic value is maximised and radiation doses kept as low as resonably achievable. CBCT imaging modality should be used only after a review of the patient’s health and imaging history and the completion of a thorough clinical examination. Clinical guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances Dental practitioners should prescribe CBCT imaging only when they expect that the diagnostic yield will benefit patient care, enhance patient safety or improve clinical outcomes significantly. Knowledge of patient dose is essential for clinicians who are making the decision regarding the justification of the exposure. There are some limitation in the measurement of patient dose in CBCT for the approval and adaptation of conventinal methodolgy in CT. It is also important to ensure that doses are optimised and in line with any national and international guidelines. The higher radiation doses of CBCT compared with conventional radiography, mean that high standards must be maintained. The Quality Assurance(QA) programme should entail surveys and checks that are performed according to a regular timetable. QA programme should be maintained by staff to ensure adherence to the programme and to raise its importance among staff.
참고문헌 (29)
- 이의태, "Cone beam형 전산화단층촬영에 의한 흡수선량", Imaging Science in Dentistry, 37(2), pp.87~92 (2007), 대한구강악안면방사선학회
- 한충완, "CT performance phantom을 이용한 cone beam형전산화단층영상의 특성", Imaging Science in Dentistry, 37(3), pp.157~163 (2007), 대한구강악안면방사선학회
- Naitoh M, "Assessment of three-dimensional X-ray images:reconstruction from conventional tomograms, compact computerized tomography images, and multislice helical computerized tomography images", J Oral Implantol, 31, pp.234~241 (2005)
- Terakado M, "Diagnostic imaging with newly developed ortho cubic super-high resolution computed tomography(Ortho-CT)", Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 89, pp.509~518 (2000)
- Hashimoto K, "Comparison of image performance between cone-beam computed tomography for dental use and four-row multidetector helical CT", J Oral Sci, 48, pp.27~34 (2006)
- 최용석, "치과임플란트 시술 시 conebeam형 전산화단층촬영장치(CBCT)", 대한치과의사협회지, 44(3), pp.172~179 (2006), 대한치과의사협회
- Kobayashi K, "Accuracy in measurement of distance using limited cone-beam computerized tomography", Int J Oral Maxillofac Implants, 19, pp.228~231 (2004)
- Mah JK, "Radiation absorbed in maxillofacial imaging with a new dental computed tomography device", Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 96, pp.508~513 (2003)
- Ludlow JB, "Dosimetry of 3 CBCT devices for oral and maxillofacial radiology: CB Mercuray, NewTom 3G and i-CAT", Dentomaxillofac Radiol, 35, pp.219~226 (2006)
- Ludlow JB, "Dosimetry of two extraoral direct digital imaging devices : NewTom cone beam CT and Orthophos Plus DS panoramic unit", Dentomaxillofac Radiol, 32, pp.229~234 (2003)
- Tsiklakis K, "Dose reduction in maxillofacial imaging using low dose Cone Beam CT", Eur J Radiol, 56, pp.413~417 (2005)
- Schulze D, "Radiation exposure during midfacial imaging using 4- and 16-slice computed tomography, cone beam computed tomography systems and conventional radiography", Dentomaxillofac Radiol, 33, pp.83~86 (2004)
- "The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103", Ann ICRP, 37(2-4), pp.1~332 (2007)
- Bamba J, "Image quality assessment of three cone beam CT machines using the SEDENTEXCT CT phantom", Dentomaxillofac Radiol, 42, pp.20120445~ (2013)
- Alqerban A, "Pre-surgical treatment planning of maxillary canine impactions using panoramic vs cone beam CT imaging", Dentomaxillofac Radiol, 42, pp.20130157~ (2013)
- Araki K, "Dose indices in dental cone beam CT and correlation with dose-area product", Dentomaxillofac Radiol, 42, pp.20120362~ (2013)
- Pauwels R, "SEDENTEXCT Project Consortium. Variability of dental cone beam CT grey values for density estimations", Br J Radiol, 86(1021), pp.20120135~ (2013)
- Pauwels R, "Dose distribution for dental cone beam CT and its implication for defining a dose index", Dentomaxillofac Radiol, 41(7), pp.583~593 (2012)
- Pauwels R, "Comparison of spatial and contrast resolution for cone-beam computed tomography scanners", Oral Surg Oral Med Oral Pathol Oral Radiol, 114(1), pp.127~135 (2012)
- Guerrero ME, "SEDENTEXCT Project Consortium. Inferior alveolar nerve sensory disturbance after impacted mandibular third molar evaluation using cone beam computed tomography and panoramic radiography: a pilot study", J Oral Maxillofac Surg, 70(10), pp.2264~2270 (2012)
- Hedesiu M, "SEDENTEXCT Consortium. Comparison of cone beam CT device and field of view for the detection of simulated periapical bone lesions", Dentomaxillofac Radiol, 41(7), pp.548~552 (2012)
- Christell H, "SEDENTEXCT consortium. Variation in costs of cone beam CT examinations among healthcare systems", Dentomaxillofac Radiol, 41(7), pp.571~577 (2012)
- Christell H, "SEDENTEXCT consortium. A framework for costing diagnostic methods in oral health care: an application comparing a new imaging technology with the conventional approach for maxillary canines with eruption disturbances", Community Dent Oral Epidemiol, 40(4), pp.351~361 (2012)
- Theodorakou C, "SEDENTEXCT Project Consortium. Estimation of paediatric organ and effective doses from dental cone beam CT using anthropomorphic phantoms", Br J Radiol, 85(1010), pp.153~160 (2012)
- Vandenberghe B, "SEDENTEXCT Project Consortium. The influence of exposure parameters on jawbone model accuracy using cone beam CT and multislice CT", Dentomaxillofac Radiol, 41(6), pp.466~474 (2012)
- Pauwels R, "SEDENTEXCT Project Consortium. Quantification of metal artifacts on cone beam computed tomography images", Clin Oral Implants Res, 24(Suppl A100), pp.94~99 (2013)
- Pauwels R, "SEDENTEXCT Project Consortium. Development and applicability of a quality control phantom for dental cone-beam CT", J Appl Clin Med Phys, 12(4), pp.3478~ (2011)
- Alqerban A, "SEDENTEXCT Project Consortium, Willems G. Comparison of 6 cone-beam computed tomography systems for image quality and detection of simulated canine impaction-induced external root resorption in maxillary lateral incisors", Am J Orthod Dentofacial Orthop, 140(3), pp.e129~e139 (2011)
- Pauwels R, "SEDENTEXCT Project Consortium. Effective dose range for dental cone beam computed tomography scanners", Eur J Radiol, 81(2), pp.267~271 (2012)