Cone beam CT in the evaluation of paranasal sinuses in pediatric cystic fibrosis: radiological findings and dosimetric comparison with conventional maxillofacial CT in children with sinus pathology.

OBJECTIVES

This study aims to compare the radiation dose to critical organs delivered by cone beam computed tomography (CBCT) versus conventional CT in the evaluation of sinonasal disease in pediatric patients with cystic fibrosis (CF).

METHODS

A retrospective study was conducted on 321 patients. The CF group included 155 patients (mean age 12.0 years) who underwent CBCT between 2016 and 2024. The control group consisted of 166 age-matched patients (mean age 14.4 years) who underwent CT for ENT indications. Organ doses (salivary glands, oral mucosa, and brain) were calculated using Monte Carlo-based software and compared using unpaired t-tests.

RESULTS

CBCT resulted in significantly lower radiation doses across all evaluated organs. Mean dose to the salivary glands was 2.60 ± 0.72 mGy for CBCT versus 4.69 ± 3.02 mGy for CT (p < 0.01); oral mucosa received 2.88 ± 0.79 mGy (CBCT) vs. 4.04 ± 2.43 mGy (CT, p < 0.01); and brain dose was 1.31 ± 0.36 mGy (CBCT) vs. 5.51 ± 1.67 mGy (CT, p < 0.01).

CONCLUSION

CBCT provides a reliable and significantly safer alternative to CT for assessing paranasal sinus disease in pediatric CF patients.

ADVANCES IN KNOWLEDGE: With substantially lower radiation exposure and excellent spatial resolution for bony structures, CBCT should be considered as the routine imaging method for longitudinal follow-up and preoperative evaluation in this vulnerable population.