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Depending on the clinical question, the imaging parameters should be adjusted to adhere to the ALARA (as low as reasonably achievable) principle.
The radiation dose should be kept as low as possible following the ALARA (as low as reasonably achievable) principle and it should be in balance with image quality.
Imaging techniques using ionising radiation, including orthopantomography (OPT), computed tomography (CT) and cone beam CT (CBCT) warrant careful use in accordance with the ALARA (As Low As Reasonably Achievable) principle [6].
Although the ALARA (as low as reasonably achievable) principle is sound advice, there are clearly groups of cancer-sufferers such as those in children and young adults where the probability of inducing a second, radiation-associated cancer exceeds the benefits that can be accrued from the study.
The uncertainties regarding safety are evident in the recommendations of prudent use and adherence to the ALARA (As Low As Reasonably Achievable) principle [ 41, 46].
Overall, adherence to the ALARA (as low as reasonably achievable) principle continues to be important guidance for all physicians in paediatric care.
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DRLs should be used to identify hospitals that are routinely using higher or lower CT dose levels and to generate triggers to optimise radiation doses according to the ALARA (As Low As Reasonably Achievable) principles.
However,owing to the higher radiation dose applied, especially to children and adolescents when using cone beam computed tomography (CBCT) imaging, this technique requires a clear indication and benefit for the patient strictly adhering to ALARA (as low as reasonably achievable) principles in medicine [ 24].
In Europe, for substances whose exposure is avoidable, the ALARA (as-low-as-reasonably-achievable) principle may be invoked.
While the lower value is more realistic for comparison to other studies, this does show that very high densities are achievable in principle with this organism.
No additional exposure to radiation would be necessary if the assessment of skeletal maturity were performed through routine radiographs, keeping in mind the 'As Low as Reasonably Achievable' (ALARA) principle (Kumar et al. 2011).
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