The use of Cone Beam CT (CBCT) devices in health care has increased in recent years. Unfortunately, this trend has not been followed by a standardization of dose metrics for Quality Control (QC), or a necessary evolution of applied dosimetry for assessment of patient dose.
The European Federation of Organisations in Medical Physics (EFOMP) has drafted a report on the property of QC for CBCT devices. The report contains objective, practical and unifying methodology for QC of CBCT used in oral radiology, radiotherapy, interventional radiology and guided surgery. The dose metrics discussed include the Computed Tomography Dose Index (CTDI), Kerma-Area Product (KAP) and detector incident air kerma. The report concludes that KAP-meters are preferable for QC as long as they can be mounted on the X-ray tube housing. Otherwise measurements of detector incident kerma seem to offer a practical solution for QC.
The European Radiation Dosimetry Group (EURADOS) are preparing a literature review on patient dose from various applications of CBCT, which will in part be included in the EFOMP report. Most studies on patient dose from CBCT examinations and interventional procedures are based on thermoluminescent dosimeter (TLD) measurements in Rando phantoms. While helpful to the community, these studies yield substantial uncertainty when applied in the clinical reality of medical physicists working with justification and optimization. Applied dosimetry for CBCT needs to evolve and adopt recent theoretical advances to allow robust estimates of patient dose.