[Imaging quality and dosage in ENT--what do we really need?].

BACKGROUND: Today, imaging of nose, paranasal sinuses and temporal bone by CT is standard in preoperative diagnostics. The need of reduction of applied dosage leads to the necessity of research in necessary imaging quality. Therefore this paper deals with new developed anatomical checklists and the analysis of imaging quality on anterior and lateral skull base.
MATERIAL AND METHODS: With 3 human complete heads over 400 examinations were performed on one cone beam CT device under varying x-ray-tube adjustments. 31 anatomic parameters were evaluated (Excellent, well, poor, not evaluable) for every data set. A summation score was built for every examination.
RESULTS: As well for paranasal sinuses as for temporal bone a constant excellent imaging quality could be seen in high dosages. Certainly, in low dosages a reduction of imaging quality was detected. The optimal range (all parameters visualized well as average) could be evaluated for paranasal sinuses between 2,0 and 3,0 mGy and between 3,0 and 4,0 mGy for temporal bone. So, a reduction of 70-80% in comparison to highest adjustments of today is possible and realistic. In comparison to standard protocols, a reduction of about 50% can be reached.
CONCLUSION: The possibility of dose reduction by discussion of the necessary imaging quality from clinical point of view could be shown. © Georg Thieme Verlag KG Stuttgart · New York.