Dose Estimation by Geant4-Based Simulations for Cone-Beam CT Applications: A Systematic Review

The last two decades have witnessed increasing use of X-ray imaging and, hence, the exposure of humans to potentially harmful ionizing radiation. Computed tomography accounts for the largest portion of medically-related X-ray exposure. Accurate knowledge of ionizing radiation dose from Cone-Beam CT (CBCT) imaging is of great importance to estimate radiation risks and justification of imaging exposures. This work aimed to review the published evidence on CBCT dose estimation by focusing on studies that employ Geant4-based toolkits to estimate radiation dosage. A systematic review based on a scientometrics approach was conducted retrospectively, from January 2021, for a comprehensive overview of the trend, thematic focus, and scientific production in this topic. The search was conducted using WOS, PubMed, and Scopus databases, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. In total, 93 unique papers were found, of which only 34 met the inclusion criteria. We opine that the findings of this study provides a basis to develop accurate simulations of CBCT equipment for optimizing the trade-off between clinical benefit and radiation risk.