NYC Dental CBCT Rules

As writte in a previous post the NYC DOH has Repealed and Reenacted the Radiation Control Rule (Article 175 of the NYC Health Code).

Below are the specific requirements regarding Dental CBCT. If you need a Medical Physicst to review your QA program contact us.

Page 58-59 of Article 175

(r) Facilities possessing a Cone Beam Computed Tomography (CBCT) unit.

(1) Notwithstanding anything in this Article to the contrary, dental facilities possessing a CBCT unit must develop and maintain a written quality assurance program, including a written QA manual and a written radiation safety policy and procedures manual for all CBCT dental equipment possessed by the facility. (i) For all dental CBCT units, the registrant must establish annual QA testing of x-ray parameters sufficient to maintain patient doses and image quality consistent over time. The annual tests will evaluate, at a minimum, collimation, filtration, patient dose, accuracy and reproducibility of x-ray techniques and the operational status of x-ray safety features.

(ii) For all CBCT units, the QA tests must follow the manufacturer’s recommended tests and frequency and utilize the manufacturer’s QA phantom. The QA test results will be retained for review by the Department for 5 years, the facility must establish QA testing that includes, at a minimum, the manufacturer’s recommended QA tests plus the additional QA tests described in subparagraph (iii) of this subdivision.

(iii) Semi-annual QA tests to determine image noise, image uniformity, reconstructed image measurement accuracy, high contrast spatial resolution of the CBCT unit.

(iv) Dental facilities possessing a CBCT unit must use a medical physicist who is a QMP in performing its QA activities.

(2) Dental facilities possessing CBCT equipment must annually determine the patient radiation dose (using direct measurement or indirect means to estimate dose) for the most common CBCT scan used at the facility as conducted by a QMP.

(3) Dental facilities possessing CBCT equipment must conduct annual QA tests to measure reproducibility of imaging parameters (kVp, exposure time and dimensions of the scan beam), reproducibility of exposure per the most common scan and beam filtration (HVL).

(4) Conditions of operation for the CBCT unit.

(i) Facilities possessing a CBCT unit must adhere to the requirements of sections §§175.46 and 175.47 regarding the shielding requirements and operator protection for all CBCT units possessed by the dental facility.

(ii) All operators of the CBCT must undergo training on the proper operation of the CBCT units and documentation of this training must be retained by the dental facility for review by the Department until after the next scheduled inspection is completed by the Department.

(iii) All operators must be able to communicate with and visually observe the patient during the CBCT examination from the operator’s protected position.

(iv) CBCT patient exams will not be conducted solely for cosmetic purposes with no diagnostic value to the patient.

(v) The logbook for CBCT exams must contain all relevant diagnostic examination information, including but not limited to, x-ray technique, scan time, anatomical exam site and reason for examination.