Cone-Beam Computed Tomography (CBCT) imaging has been demonstrated to be a suitable imaging technique for high contrast applications which concurrently prefer high, and possibly also isotropic, image resolution for the visualization of submillimeter anatomical features [1]. As a consequence, CBCT has shown to be an excellent candidate for use in extremity, dento-maxillofacial as well as Ear, Nose and Throat (ENT) imaging. Hence during the last decade, there has been an increasing use of this imaging modality in clinical practice for a broad range of applications, such as fracture assessment, temporal bone and sinus imaging, or implant placement and follow-up, etc. [1], [2]. Currently, technical developments in CBCT imaging are still ongoing. Lately, there has been a growing interest in the development of Dual Energy (DE) CBCT imaging [1]–[3], which would open the possibility for material quantification and improved tissue visualization (especially regarding soft tissue). Some interesting new clinical applications in the field of musculoskeletal imaging would include the evaluation of gout, bone marrow edema, as well as the visualization of tendons, ligaments and intervertebral disks. Additionally, DE imaging offers the possibility to reduce beam hardening artefacts, which is of fundamental importance for patients with metal implants [2].     

DE CBCT imaging for musculoskeletal applications will soon be introduced in clinical practice. Since this is a new imaging modality, it is important to assess the radiation-induced risk, usually evaluated in terms of effective dose [4]. However, accurate patient effective dose levels cannot yet be found in literature. Therefore, the aim of this work was to determine population average patient effective dose levels for adult and pediatric patients for a recently developed NewTom 7G DE CBCT system (CEFLA Medical Equipment, Imola, Italy) for different musculoskeletal applications in DE CBCT imaging.