[Oradlist] Certificate of Need for CBCT

[Craig Dial]

I had the State of California Radiological Health Branch inspect both
our NewToms and our I-CATs.

They came to the conclusion that the Cone beam scanner emitted a very
low energy source, these units are tightly collimated, had virtually no
secondary scatter, and could not be adjusted to over compensate the
patient dose. 

The CBCT units are basically a ceph unit taking multiple cephalometrics
from different angles, and cephalometrics has been determined as a
dental x-ray device. Then we use the scan to create typical dental
images like a orthodontic ceph, panoramics, crossectionals for dental
implant treatment planning and TMJ imaging. 

If you like, I can put anyone interested in contact with the State of
Ca. Radiological Health Branch so they may in turn explain this to your
state department. 

I am going out of town as of this afternoon to a meeting in San
Francisco for the AADMRT. This meeting will be all about CBCT. If I
gather any more information at this meeting regarding this topic, I will
be happy to share.

Sincerely,


Craig Dial 
www.ddicenters.com


-----Original Message-----
From: Abramovitch, Kenneth [mailto:kenneth.abramovitch at uth.tmc.edu] 
Sent: Thursday, April 07, 2005 8:24 AM
To: Oral Radiology Discussion Group
Subject: RE: [Oradlist] Certificate of Need for CBCT

Thanks for this very useful advice.  I believe that Craig Dial stated in
a previous ORADLIST communication that in California, the CBCT is listed
as dental tomography unit.  But if you're out there, you may confirm
this.  

KA 

-----Original Message-----
From: oradlist-bounces at lists.ucla.edu
[mailto:oradlist-bounces at lists.ucla.edu] On Behalf Of Sharon Brooks
Sent: Wednesday, April 06, 2005 3:19 PM
To: oradlist
Subject: [Oradlist] Certificate of Need for CBCT

Hello, Friends

I just received an interesting e-mail from our head radiation safety
officer for the University of Michigan. As many of you know, I have an
i-CAT CBCT. Like many states, Michigan requires that all x-ray machines
be registered and this machine is duly registered as a "dental
tomography" unit. So far, so good.

The head health physicist for the state recently contacted the RSO and
asked whether this was a CT unit, because if it is, we have to go
through all the paperwork for a Certificate of Need (CON) to justify why
we have this machine. I have heard from the Xoran people that Michigan
has the most onerous CON program in the entire country. The original
idea was that hospitals had to justify purchases of costly equipment
based on a need for the equipment, showing that the service to be
provided was not available in other areas close by. Theoretically it
would save health care dollars by not duplicating equipment.

He was asking about details of how the machine works and whether we had
to call it a CT scanner. I told him that an alternative designation
sometimes seen in the literature is Digital Volume Tomography (DVT) and
that I would be happy to call it that if it would make the state
happier.

I thought I would share this with you in case others who are
contemplating buying one of these machines have similar concerns from
their state or university. I'll let you know what they say. The state
health physicist is a pretty reasonable guy, but like many government
officials, he holds pretty close to the letter of the law, not just the
spirit.

Sharon Brooks

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