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Should I get a conventional CAT scan or an I-CAT (3D cone beam)?

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Practicing since : 2001
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I have the choice of getting an I-cat (3D cone beam) CT scan or a regular CT scan for my sinuses. I would prefer the ICat simply because of the lower radiation, and due to multiple x-rays and CT scans in the past, I have been advised to limit the CT scans I receive in the future. However, I am worried that if I choose to do an ICat instead of the regular CT scan: 1. the picture will not be as clear or accurate as that of a conventional Cat Scan and 2. that the image produced by that ICat is not easily readable by all doctors (if I were to take the ICat scan and go to another doctor for a second opinion, I am worried he would not be able to read the ICan scan and would make me get a CT scan).
Are these worries unfounded or should I get a conventional Cat Scan?
Posted Tue, 8 May 2012 in Ear, Nose and Throat Problems
Answered by Dr. Naveen Kumar 12 hours later

Thanks for the query

Regarding the imaging studies of the nose and paranasal sinuses, it is always better to go for the more conventional and widely used plain Computed Tomography (CT scan).

The merits and demerits of conventional CT scan are:

1. CT scan is a painless non invasive procedure with good sensitivity to detect pathology of the head and paranasal sinuses.
2. CT scan is much cheaper than an MRI or CONE BEAM COMPUTED TOMOGRAPHY (CBCT) and also equally as fast as the former.
3. Conventional CT scanning does not need much expertise to read the scan and most of the ENT specialists are well oriented to this investigation.
4. Newer generation CT scanning can also create 3 dimensional images almost similar to that of CBCT.
5. Exposure to radiation is more in conventional CT scan when compared to CBCT.

The merits and demerits of CBCT are:

1. It provides exceptionally good 3 dimensional images which help s analyze the nasal airway, paranasal sinuses and dental images. Most commonly used for dental procedures.
2. Radiation exposure is less compared to that of conventional CT scan
3. Not all doctors can read this film like a normal CTs can
4. If surgery has to be planned, then many doctors would prefer to have a conventional CTscan for locating the landmarks during surgery.

Hence to sum it up, even though CBCT is a better radiological tool when compared to conventional CTscan, the latter is the most sought after investigation for diagnosing sinonasal problems. Do not worry, the amount of radiation what you get with the conventional CT scan is not going to cause any health hazards unless you are in debilitated condition, which you are not so. So, please get a normal CT scan of the nose and paranasal sinuses done in both axial and coronal views.

I hope I have answered your query. I will be available for the follow-up queries.

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
Follow-up: Should I get a conventional CAT scan or an I-CAT (3D cone beam)? 40 hours later
Thanks for your answer, very insightful.

Specifically in terms of accuracy, is one of the scans more accurate than the other? (would one be able to detect abnormalities or polyps better than the other)

And lastly, what is your opinion of nasal rinses/neti-pot, is it something you recommend? I also heard that one is not supposed to use them when the nose is blocked, do you know if this is true?
Answered by Dr. Naveen Kumar 7 hours later

Welcome back

There is a very minimal difference between both the types of scans, and both can pick of the abnormalities in the nose. But, if a doctor is looking at a surgery point of view, then plain CT scan of the paranasal sinuses is required.

Nasal douching (neti pot) is very helpful in patients with long term sinusitis problems (both allergic rhino-sinusitis and chronic sinusitis); you can definitely give a try. It is not harmful even when you use it during nasal block.

Wish you good health

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
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