title: The reduction of dose in paediatric panoramic radiography: the impact of collimator height and programme selection.
abstract: OBJECTIVE
  The aim of this work was to estimate the doses to radiosensitive organs in the head of a young child undergoing panoramic radiography and to establish the effectiveness of a short collimator in reducing dose.
  
  
  METHODS
  Thermoluminescent dosemeters were used in a paediatric head phantom to simulate an examination on a 5-year-old child. The panoramic system used was an Instrumentarium OP200 D (Instrumentarium Dental, Tuusula, Finland). The collimator height options were 110 and 140 mm. Organ doses were measured using exposure programmes intended for use with adult and child size heads. The performance of the automatic exposure control (AEC) system was also assessed.
  
  
  RESULTS
  The short collimator reduced the dose to the brain and the eyes by 57% and 41%, respectively. The dose to the submandibular and sublingual glands increased by 32% and 20%, respectively, when using a programme with a narrower focal trough intended for a small jaw. The effective dose measured with the short collimator and paediatric programme was 7.7 μSv. The dose to the lens of the eye was 17 μGy. When used, the AEC system produced some asymmetry in the dose distribution across the head.
  
  
  CONCLUSIONS
  Panoramic systems when used to frequently image children should have programmes specifically designed for imaging small heads. There should be a shorter collimator available and programmes that deliver a reduced exposure time and allow reduction of tube current. Programme selection should also provide flexibility for focal trough size, shape and position to match the smaller head size.
authors.affiliation: Department of Medical Physics, Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK.
authors.forename: A T
authors.initials: AT
authors.lastname: Davis
authors.forename: H
authors.initials: H
authors.lastname: Safi
authors.forename: S M
authors.initials: SM
authors.lastname: Maddison
mesh_terms: D001921:Brain / Q000528:radiation effects; D002675:Child, Preschool; D004867:Equipment Design; D005123:Eye / Q000528:radiation effects; D006257:Head / Q000528:radiation effects*; D006801:Humans; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000517:prevention & control; D011835:Radiation Protection / Q000592:standards*; D011862:Radiography, Panoramic / Q000295:instrumentation*; D012469:Salivary Glands / Q000528:radiation effects
keywords: collimation; panoramic; pediatric; radiation dosimetry; radiography