Entrance surface dose measurement on the thyroid gland in orthopantomography: The need for optimization

Abstract

Background: The anatomic position and proven radiosensitivity of the thyroid make it an organ of concern in dental X-ray examinations. A National Radiation Protection Department (NRPD)-sponsored pilot study carried out in the Dental Radiology Department of RUMS., to assess if the radiation dose in panoramic radiographies could be reduced without significant impairment of the subjective image quality. Materials and Methods: Thermoluminescent dosimetry (TLD) is widely acknowledged to be the recommended method for measuring entrance surface doses (ESD). In this study, ESD was measured using LiF thermoluminescent dosimeters (TLD-100) on the thyroid of 40 patients who had referred to the School of Dentistry, Rafsanjan University of Medical Sciences. Patients were not exposed to any additional radiation and the radiographs were used for diagnostic purposes. TLDs were calibrated with radiation energies similar to those commonly used in orthopantomography. Results: The overall mean ESD on the thyroid in orthopantomography was 0.071 ± 0.012 mGy (ranged from 0.01 to 0.40 mGy). The mean ESD for radiographies performed with 66 kVp (20 patients) and 68 kVp (20 patients) were 0.072 ± 0.019, and 0.070 ± 0.016 respectively. No statistically significant difference was found between these means. Conclusions: The measured surface doses in our study are inconsistent with the only one already reported about the same experiment. However, due to lack of national diagnostic reference levels for orthopantomography, it is not clear whether in case of the PM 2002 CC unit used in this experiment, reducing the radiation dose to a level that still keeps a diagnostically acceptable image quality is necessary