Radiology

Question 1

Image Gently - “One size does not fit all. When we image, image gently.”

Answer 1

• • An initiative of The Society for Pediatric Radiology where medical and dental professionals are expected to respect ALARA (as low as reasonably achievable) principle when exposing patients to ionizing radiation and to individualize and personalize prescription of radiographs for each patient.
  • Endorsed by both AAPD and American Academy of Oral and Maxillofacial Radiology (AAOMR).

• Created educational materials and resources for dental professionals and healthcare professionals to share with patients, CE opportunities and information on upcoming meetings focused on pediatric radiation protection.
* Each dental professional should check state/local regulations and laws (e.g. facility design, shielding, use and maintenance of equipment).

Question 2

Radiology: General considerations

Answer 2

• Biological risks of diagnostic dental radiation: deterministic effects are not at play, only stochastic (probability) effects are – the younger the individual and the faster the tissue grows, the higher the potential risk to develop a fatal cancer from being exposed to ionizing radiation.
• Potential risks to develop fatal cancer after exposure to different types of diagnostic radiographs:

Question 3

Estimated risk of fatal cancer (adult) from 2 dental radiographs (50kV, D-speed, circular collimation)

Answer 3

1 in 2 million

Question 4

Estimated risk of fatal cancer (adult) from 2 dental radiographs (70kV, F-speed/digital, rectangular collimation)

Answer 4

1 in 20 million

Question 5

Estimated risk of fatal cancer (adult) from panoramic radiograph

Answer 5

1 in 1 million

Question 6

Estimated risk of fatal cancer (adult) from panoramic radiograph

Answer 6

1 in 1 million

Question 7

Estimated risk of fatal cancer (adult) from skull frontal radiograph

Answer 7

1 in 670,000

Question 8

Estimated risk of fatal cancer (adult) from lateral skull radiograph

Answer 8

1 in 2 million

Question 9

Estimated risk of fatal cancer (adult) from frontal chest radiograph

Answer 9

1 in 1 million

Question 10

Estimated risk of fatal cancer (adult) from CT of thorax

Answer 10

1 in 2500

Question 11

Estimated risk of fatal cancer (adult) from CT of skull

Answer 11

1 in 10,000

Question 12

Multiplication factor w/ regard to age for assessing risk to develop fatal cancer from radiation exposure: <10yr

Answer 12

x3

Question 13

Multiplication factor w/ regard to age for assessing risk to develop fatal cancer from radiation exposure: 10-20yr

Answer 13

x2

Question 14

Multiplication factor w/ regard to age for assessing risk to develop fatal cancer from radiation exposure: 10-20yr

Answer 14

x1.5

Question 15

Multiplication factor w/ regard to age for assessing risk to develop fatal cancer from radiation exposure: 30-50yr

Answer 15

x0.5

Question 16

Multiplication factor w/ regard to age for assessing risk to develop fatal cancer from radiation exposure: 50-80yr

Answer 16

x0.3

Question 17

Multiplication factor w/ regard to age for assessing risk to develop fatal cancer from radiation exposure: >80yr

Answer 17

x0

Question 18

Effects of acute exposure to up to 2500 uSv ionizing radiation

Answer 18

None

Question 19

Effects of acute exposure to 2500-10,000 uSv ionizing radiation

Answer 19

Changes in blood, lower WBC counts

Question 20

Effects of acute exposure to 10,000-20,000 uSv ionizing radiation

Answer 20

Vomiting w/in 3hr, fatigue, loss of appetite, blood changes (still reversible – recovery w/in a few weeks)

Question 21

Effects of acute exposure to 20,000-60,000 uSv ionizing radiation

Answer 21

Vomiting w/in 2hr, dramatic changes in the blood, hair loss w/in 2 wks (recovery w/in 1mo to 1 year in 70% of cases)

Question 22

Effects of acute exposure to 60,000-100,000 uSv ionizing radiation

Answer 22

Vomiting w/in 1hr, dramatic changes in the blood, death follows w/in 2 wks in more than 80% of cases