Referral for diagnostic imaging

Hello.

We appreciate your trust and thank you for referring patients to us for CBCT examinations.

In accordance with the Swedish Radiation Safety Authority’s regulations on medical exposures (SSMFS 2018:5), Chapter 2, Section 1 states that referral guidelines must be available to those who issue referrals for diagnostic examinations within the facility.

This information is therefore intended to serve as guidance when referring patients for diagnostic imaging, with a particular focus on CBCT, where the justification assessment is of great importance.

A CBCT examination must always be justified in accordance with applicable radiation safety regulations. This means that the examination must be clinically indicated and performed only when the clinical question cannot be answered using conventional imaging (intraoral X-rays or panoramic X-rays).

As the referring physician, you are responsible for:

• state the reason for the referral,
• attach relevant 2D images,
• and provide the information necessary for the radiologist to make an accurate and reliable assessment.

CBCT should not be used for screening purposes or when the clinical question can be answered using an intraoral image or an OPG. The examination should not be ordered if the clinical question is unclear or there is no indication. If the referral is incomplete, we may request additional information or decline the referral.

The checklists and guidelines included in this guide are intended to assist you as the referring physician and ensure that the radiologist receives a complete set of information. A well-prepared case reduces processing time, improves the quality of the report, and contributes to an optimal and low-dose examination for the patient.

The referring physician is responsible for ensuring that the referral is clinically justified and complete. The radiologist is responsible for performing the examination, optimizing radiation dose, and providing a diagnostic interpretation.

Please note that additional information may be required depending on the clinical question. We may therefore request supplementary material when necessary for the diagnosis. Referrals lacking a clinical question or relevant 2D images may need to be supplemented before a CBCT is performed.

• Patient Information
• Clinical Presentation
• Date of Previous X-ray
• Relevant 2D Images (Digital)
• Relevant Medical History
• Referring Physician’s Contact Information
• Any Special Requests (Implant Program, Incision Orientation, etc.)

CBCT examinations are performed according to the ALADA principle (As Low As Diagnostically Acceptable), which means that the radiation dose is kept as low as possible based on the clinical question. Therefore, it is important that CBCT be ordered only when the diagnostic question cannot be answered with 2D X-rays, and that relevant images and information be included to avoid repeat imaging or additional examinations.

If you have any questions, need additional information, or require advice regarding referrals, you are always welcome to contact us.

Thank you for your cooperation—we look forward to continuing to work together.

Best regards,
Swedish Dental