Research Article| Volume 135, ISSUE 5, P686-697, May 2023

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Optimizing effective dose and image quality in cone beam CT sialography

Published:December 30, 2022DOI:


      The purpose of this study was to develop protocols that optimize patient radiation dose and image quality for cone beam computed tomographic (CBCT) sialography for the major salivary glands.

      Study Design

      Radiation absorbed dose measurements were repeated in triplicate using 25 sites in the head and neck of a Radiation ANalog DOsimetry system (RANDO) phantom, and effective doses were calculated across a range of peak kilovoltage (kVp) and milliamperage (mA) settings using an 8 cm (diameter) by 5 cm (height) field of view (FOV) for submandibular imaging and an 8 cm (diameter) by 8 cm (height) FOV for parotid imaging. Image signal difference-to-noise ratio (SDNR) was determined, and the figure-of-merit (FOM), a measure of image quality, was calculated.


      For submandibular sialography, 85 kVp and 6 mA were chosen as the optimal exposure parameters, resulting in a mean effective dose of 82.47 µSv and a mean SDNR of 13.86, with a mean FOM of 2.33 µSv−1. For parotid sialography, 70 kVp and 6 mA were chosen, and these settings resulted in a mean effective dose of 39.99 µSv, a mean SDNR of 17.43, and a mean FOM of 7.60 µSv−1.


      Low-dose 3-dimensional sialography with high image quality and minimal effective dose can be delivered using CBCT with localized, small FOVs.
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        • Jadu FM.
        Salivary gland diseases.
        in: Mallya SM Lam EWN White and Pharoah's Oral Radiology Principles and Interpretation. Elsevier, St. Louis2019: 622-635
        • Kessler AT
        • Bhatt AA
        Review of the major and minor salivary glands, Part 1: anatomy, infectious, and inflammatory processes.
        J Clin Imaging Sci. 2018; 8: 47
        • Ogle OE.
        Salivary gland diseases.
        Dent Clin North Am. 2020; 64: 87-104
        • Burke CJ
        • Thomas RH
        • Howlett D.
        Imaging the major salivary glands.
        Br J Oral Maxillofac Surg. 2011; 49: 261-269
        • Mallya SM.
        Other imaging modalities.
        in: Mallya SM Lam EWN White and Pharoah's Oral Radiology Principles and Interpretation. Elsevier, Maryland Heights, MO2019: 218-238
        • Jadu FM
        • Yaffe MJ
        • Lam EWN.
        A comparative study of the effective radiation doses from cone beam computed tomography and plain radiography for sialography.
        Dentomaxillofac Radiol. 2010; 39: 257-263
        • Jadu FM
        • Hill ML
        • Yaffe MJ
        • Lam EWN.
        Optimization of exposure parameters for cone beam computed tomography sialography.
        Dentomaxillofac Radiol. 2011; 40: 362-368
        • Jadu FM
        • Lam EWN.
        A comparative study of the diagnostic capabilities of 2D plain radiograph and 3D cone beam CT sialography.
        Dentomaxillofac Radiol. 2013; 42: 1-8
      1. International Commission on Radiological Protection. The 2007 Recommendations of the ICRP Publication 103.
        Ann ICRP. 2007; 37: 1-332
        • Huda W.
        Review of Radiologic Physics.
        4th ed. Wolters Kluwer, Philadelphia2016
        • Lukat TD
        • Wong JCM
        • Lam EWN.
        Small field of view cone beam CT temporomandibular joint imaging dosimetry.
        Dentomaxillofac Radiol. 2013; 4220130082
        • Schulze D
        • Heiland M
        • Thurmann H
        • Adam G.
        Radiation exposure during midfacial imaging using 4- and 16-slice computed tomography, cone beam computed tomography systems and conventional radiography.
        Dentomaxillofac Radiol. 2004; 33: 83-86
        • Ludlow JB
        • Davies-Ludlow LE
        • Brooks SL
        • Howerton WB.
        Dosimetry of 3 CBCT devices for oral and maxillofacial radiology: CB Mercuray, NewTom 3G and i-CAT.
        Dentomaxillofac Radiol. 2006; 35: 219-226
        • Nickoloff E.
        Current adult and pediatric CT doses.
        Pediatr Radiol. 2002; 32: 250-260
        • Bushberg JT
        • Seibert JA
        • Leidholdt Jr, EM
        • Boone JM
        The Essential Physics of Medical Imaging.
        3rd ed. Wolters Kluwer and Lippincott, Williams and Wilkins, Philadelphia, PA2012
        • Park HN
        • Min CK
        • Kim KA
        • Koh KJ.
        Optimization of exposure parameters and relationship between subjective and technical image quality in cone-beam computed tomography.
        Imag Sci Dent. 2019; 49: 139-151
        • Bechara B
        • McMahan CA
        • Moore WS
        • Noujeim M
        • Geha H
        • Teixeira FB.
        Contrast-to-noise ratio difference in small field of view cone beam computed tomography machines.
        J Oral Sci. 2012; 54: 227-232
        • Horsburgh A
        • Massoud TF.
        The salivary ducts of Wharton and Stenson: analysis of normal variant sialographic morphometry and a historical review.
        Ann Anat. 2013; 195: 238-242
        • Zenk J
        • Hosemann WG
        • Iro H.
        Diameters of the main excretory ducts of the adult human submandibular and parotid gland: a histologic study.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998; 85: 576-580
        • Molen AD.
        Comparing cone beam computed tomography systems from an orthodontic perspective.
        Semin Orthod. 2011; 17: 34-38
        • Baba R
        • Ueda K
        • Okabe M.
        Using a flat-panel detector in high resolution cone beam CT for dental imaging.
        Dentomaxillofac Radiol. 2004; 33: 285-290
        • Shokri A
        • Jamalpour MR
        • Khavid A
        • Mohseni Z
        • Sadeghi M.
        Effect of exposure parameters of cone beam computed tomography on metal artifact reduction around the dental implants in various bone densities.
        BMC Med Imag. 2019; 19: 1-10
        • Yang CC.
        Characterization of scattered X-ray photons in dental cone-beam computed tomography.
        PLoS One. 2016; 11: 1-14