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Submitted by Aoife Gallagher, Medical PHysics & Bioengineering Dept., St.James's Hospital
   Commenting on behalf of the organisation
Document Radiological Protection in Cone Beam Computed Tomography (CBCT)
 


1)      IPEM Report 91, 2005 is referenced in Section 9.2 “Quality Control of CBCT equipment” as a document in which QA test methodologies for CBCT equipment are detailed.  


Comment : IPEM Report 91 does not specifically cover CBCT equipment. The IPEM is currently reviewing Report 91 (Conference organised for 12th December 2014 to discuss future QA Guidelines. See website for further information - http://www.ipem.ac.uk/ConferencesEvents/ForthcomingConferences/EventDetails.aspx?dateid=290). The conference details identify CBCT equipment as an example of a new technology which is not covered by Report 91 but needs to be included in future guidelines.


RP 162 “Criteria for acceptability of medical radiological equipment used in diagnostic radiology, nuclear medicine and radiotherapy” (2012) however does outline suspension performance levels for CBCT QA tests. The content of RP 162 document is primarily based on the data formulated by the SEDENTEXCT Group in RP 172 together with that recommended by the HPA in 2010.


 


2)      Section 10 “Recommendations”……. “Expanded availability and newer applications have put CBCT technology in the hands of medical professionals who traditionally do not use CT”.


Comment : CBCT technology is not only new for the medical professionals using it, it is also new for many equipment service engineers. In general CBCT equipment is serviced by engineers who are members of well established companies with considerable experience in servicing many types of imaging equipment, including MDCT systems. This however is not always the case in relation to dental CBCT equipment. It is recognised that many small dental companies have been set up worldwide that employ engineers to service intra-oral, panoramic, and Ceph equipment. Many of these same companies have now extended their remit to servicing CBCT equipment. In some cases staff do not have the appropriate training or the necessary test equipment to assess CBCT system performance. It must be ensured that local service engineers undertake the necessary training to service CBCT equipment prior to embarking on making adjustments to these systems. This is to ensure the equipment is “fit for purpose” when it is returned to clinical use post service. This matter should be considered for inclusion in this report.


3)      Section 8.3 “Who should be the trainer?”…… “Health professionals who use radiation ….. understand problems with the radiation equipment they deal with ………… and the lack of radiation measuring and radiological protection tools”.


Comment : From experience I do not agree that all clinical users appreciate a lack of radiation measuring or radiological protection tools. Generally unless the matter is specifically brought to their attention the absence of specific radiation measuring and protection tools can go unnoticed.