A representative study of pediatric panoramic and cephalometric radiation exposure to organs of the head and neck

The purpose of this study was to measure juvenile patient radiation dose to organs of the head and neck during digital panoramic and cephalometric radiography using anthropomorphic CIRS phantoms at 5 and 10-years-old with nanoDot optically stimulated luminescent dosimeters (OSLDs). OSLDs were placed at 21 head and neck organ sites of the phantom heads. Phantom heads were subjected to panoramic and cephalometric imaging protocols using manufacturers’ predefined exposure settings. Radiation dose fractions to various organ sites were determined using reference values from the ICRP-89 document. Organ equivalent doses and overall effective doses were based on ICRP-103 tissue weighting factors. Overall measured organ doses were higher for the 5-year-old than for the 10-year-old for both the panoramic and the cephalometric imaging protocols. The highest doses seen were in the salivary glands, extrathoracic airway, and the oral mucosa. The organ equivalent dose in microsieverts (µSv) also yielded similar results. The effective dose for the 5-year-old was 27.8 µSv for the panoramic and 6.5 µSv for the cephalometric, while the 10-year-old results were 26.3 µSv for the panoramic and 3.8 µSv for the cephalometric. The effective doses estimated for this study for the 5-year-old and 10-year-old during cephalometric procedures are lower than the US natural background reading of 8.5 µSv per day and lower than the US average exposure per day of 17 µSv. The effective doses estimated in this study for the panoramic procedure for both phantoms were above the natural background and above the national average per day. These data support the notion that child-appropriate technique factors and geometry factors should be used for panoramic and cephalometric imaging protocols.