Image quality of a portable X-ray device (Nomad Pro 2) compared to a wall-mounted device in intraoral radiography

Image Quality Assessment of Digital Radiographs Captured by Hand-Held Devices Versus Wall-Mounted Devices: A Retrospective Comparative Study

Background In diagnostic radiology, the image quality of radiographs is paramount for impeccable diagnosis as it is essential for efficient treatment planning and patient care. In comparison to their well-established wall-mounted equivalents, the growing use of handheld devices raises concerns regarding their diagnostic effectiveness by questioning their image quality. Hence, to fully comprehend the clinical importance of handheld X-ray equipment, it is important to look into their image quality for better diagnostic performance. Aim The study aimed to determine the image quality of handheld X-ray units and compare them with wall-mounted X-ray units in routine dental practice based on objectifiable image quality parameters. Materials and Methods For the study, 200 digital radiographic images (102 taken using handheld and 98 using wall-mounted X-ray units) were collected randomly from archives, including radiographs with cone-cut and positional errors. Five observers, three faculty members, and two postgraduates, who were all blinded, subjectively judged the image quality using a five-point rating scale for five individual parameters: contrast, sharpness, cone-cut, and error in vertical and horizontal angulations of position indicating device separately. The mean score for all observers was calculated, and statistical analysis was performed using the Mann-Whitney U test. The scoring of one faculty member experienced in oral radiology as baseline data was used to compare interobserver agreement among the other observers. Results There is a significant difference between the two groups in cone-cut and error in horizontal angulation. There is no significant difference between the two groups when parameters such as contrast, sharpness, and error in vertical angulation are considered. The images from handheld devices showed better image quality (p = 0.006) compared to the wall-mounted device. There was 87% interobserver agreement between the five observers. Conclusion The present study demonstrated a significant difference between the handheld device and the wall-mounted device when all the five parameters including errors are considered to assess the image quality. Hence, handheld devices can be used for regular clinical practice as an alternative to wall-mounted devices. Nevertheless, stringent radiation safety precautions are essential.

ASSESSMENT OF OCCUPATIONAL RADIATION DOSE FROM CAMERA MODEL INTRAORAL HANDHELD X-RAY DEVICE WITHOUT STRAY RADIATION PROTECTION SHIELD

The aim of this study was to assess the occupational exposure from portable X-ray device without stray radiation protection shield measured using thermoluminescent dosemeters (TLDs). A total of 108 intraoral periapical radiographies of six sextants were performed. The TLDs were located on right index finger and left palm, between the pupils of the eyes at the edges of the Nasion point, Manubrium of Sternum bone and genital area. The detected mean doses per procedure were 70, 99, 60, 51, 51 and 58 μSv in the right finger, left palm, level of the Nasion point, under left clavicle, above the sternum manubrium and at the gonad area, respectively. Maximum number of radiographic images that the operator is allowed to perform depends on eye exposure and in accordance with International Commission on Radiological Protection is 0.16 (0.12-0.23) per hour or 1.28 (0.96-1.84) per day.

Accuracy in positioning of dental X-ray images - A comparative study of a portable X-ray device and a wall-mounted device

Introduction

The benefits of portable dental X-ray devices remain controversially debated. This study aimed to compare the accuracy in positioning dental X-ray images using handheld (Nomad Pro 2) and wall-mounted (Heliodent Plus) X-ray devices.

Materials and methods

Radiographical imaging was exercised on a maxillofacial phantom using the handheld dental X-ray device Nomad Pro 2 (Kavo Kerr, Biberach, Germany) and the wall-mounted dental X-ray device Heliodent Plus (Sirona Dental Systems, Bensheim, Germany). Accuracy of device positioning (i.e., centeredness and perpendicularity) was measured as horizontal and vertical deviation (pixels and millimeters) from a centrally positioned crosshair. The reproducibility of the results was tested for 80 images per device and operator. IBM SPSS (SPSS Inc., Chicago, IL) was used for statistical analyses.

Results

Centeredness of produced dental X-rays was significantly better for the wall-mounted device than for the handheld device in both deviation from the x-axis (p = 0.042) and y-axis (p = 0.020). The perpendicularity of the produced dental X-rays was significantly better for the handheld device than for the wall-mounted device for both horizontal (p < 0.001) and vertical (p < 0.001) plains.

Conclusions

Handheld dental X-ray devices appear to provide a high degree of accuracy in image positioning, especially in regard to proper perpendicular image angulation.

Diagnostic image quality of hand-held and wall-mounted X-ray devices in bitewing radiography: a non-inferiority clinical trial

OBJECTIVES

The present clinical trial was intended to clarify whether subjective assessments of diagnostic X-ray image quality achieved via hand-held (HH) Nomad Pro 2 (KaVo Kerr, Brea, CA, USA) X-ray device is non-inferior that of the wall-mounted (WM) KaVo Focus (KaVo Dental, Bieberich, Germany).

METHODS

A prospective, cross-over, and in vivo non-inferiority clinical trial was conducted to compare these two diagnostic modalities. Based on sampling calculations, 205 patients were selected for study, generating 410 paired bitewing radiographs in randomized sequence. The films were assessed independently, engaging three observers blinded to modality for random, side-by-side-comparisons. Diagnostic image quality was rated as follows: no preference, HH preference, or WM preference. Observer judgements were combined accordingly to reach a majority.

RESULTS

Collective observer ratings indicated no preference for diagnostic image quality in 63.9% of cases, with WM preference at 16.6% and HH preference at 19.5%. The difference in HH and WM preferences (19.5%-16.6% = 2.9%) was within the expected 95% confidence interval. Majority agreement was reached in 82.7%.

CONCLUSIONS

Subjectively assessed diagnostic image quality in bitewing radiographs acquired by HH and WM devices did not differ significantly. The hand-held device is thus non-inferior to the WM in this regard. Our data set of paired bitewing radiographs may subsequently aid in future research.