Female Breast Radiation Exposure During Thorax Multidetector Computed Tomography and the Effectiveness of Bismuth Breast Shield to Reduce Breast Radiation Dose

Yılmaz, Mehmet; Albayram, Sait; Yaşar, Doğan; Özer, Harun; Adaletli, İbrahim; Dogan, Sait Mesut; Akman, Canan; Altuğ, Ayça

doi:10.1097/01.rct.0000235070.50055.e6

Cited by 73 publications

(58 citation statements)

References 24 publications

(12 reference statements)

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“…Although some authors advocate their use owing to their significant breast dose reducing effect 9,17,18 , other studies referred to increased noise level, decreased image quality, and the presence of streak and beam hardening artifacts induced by the shields 10,11 . Consequently, the American Association of Physicists in Medicine recently issued a statement on the use of bismuth shielding in CT scanning which makes note of several disadvantages to their use.…”

Section: Discussionmentioning

confidence: 99%

Iterative reconstruction of pulmonary MDCT angiography: Effects on image quality, effective dose and estimated organ dose to the breast

Žižka¹,

Ryška²,

Štěpanovská³

et al. 2014

BIOMED PAP

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Aims.To compare the image characteristics, effective dose and estimated organ dose to the female breast in pulmonary MDCT angiography (MDCTA), reconstructed with either standard filtered back projection (FBP), or iterative reconstruction in image space (IRIS). Methods. Pulmonary MDCTA performed in 116 females (age 18 -77 years; body mass index 15 -48) was reconstructed with FBP (n=52) or IRIS (n=64). Scans were acquired on a 128-row MDCT system using automatic tube current modulation, 100 kV tube voltage, and a quality reference mAs value of 120 (FBP) and 80 (IRIS). Dose was calculated from CT dose index (CTDIvol) and dose length product (DLP) values utilising ImPACT software. Image noise was measured within the pulmonary artery. Qualitative visual assessment of the scans was performed (1=negligible noise, 5=noise obscuring diagnostic information). Results. The average CTDIvol yielded 4.33 mGy for FBP and 3.54 mGy for IRIS, respectively (18.2% decrease). The average effective scan dose was 2.73±0.57 mSv (FBP) and 2.29±0.68 mSv (IRIS), respectively (16.1% decrease). The estimated average organ dose to the breast decreased from 5.1±1.1 mGy (FBP) to 4.2±1.2 mGy (IRIS, 17.6% decrease). No nondiagnostic scans (score 5) were encountered in either group. Significant improvement in image noise levels (P<0.01) and subjective image quality (P<0.02) were noted in IRIS group. Conclusion. Pulmonary MDCTA utilizing a 100 kV technique, automatic tube current modulation, and iterative image reconstruction offers robust results in routine conditions among an unselected female population, with breast doses being comparable to two-view digital mammography. Moreover, iterative reconstruction offers improvements in both image noise and visual perception of the scans, thus suggesting a potential for further dose reduction.

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Section: Discussionmentioning

confidence: 99%

Iterative reconstruction of pulmonary MDCT angiography: Effects on image quality, effective dose and estimated organ dose to the breast

Žižka¹,

Ryška²,

Štěpanovská³

et al. 2014

BIOMED PAP

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“…They partially absorb the direct radiation beam to underlying anatomic structures, without significantly impacting the image quality of adjacent structures. Bismuth shields can reduce radiation dose to the adult female breast by up to 40% (Yilmaz et al, 2007). However, when bismuth shields are used together with automatic exposure modulation, the latter may compensate for the radiation attenuation caused by the shield, offsetting the radiation savings benefits of the shield.…”

Section: Radiation Protection Measures In Diagnostic Imagingmentioning

confidence: 99%

Radiation Protection in Medical Imaging

Colosi¹,

Colosi²,

Mureşan³

et al. 2011

Medical Imaging

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“…The radiation dose received by radiosensitive organs, such as the breasts, in computed tomography coronary angiography (CTCA) is a critical concern for women because of the increased incidence of breast cancer in the population [1]. Higher effective doses from CTCA examinations have been reported in females than in males [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…Using breast shields such as bismuth may significantly decrease the radiation dose to the breasts, but these types of shields also cause image artifacts that reduce diagnostic accuracy [1,6]. The imaging quality with shielded coronary arteries produces inconclusive results [1,7,8].…”

Section: Introductionmentioning

confidence: 99%

Chest Circumference as a Predictive Parameter of Computed Tomography Coronary Angiography Radiation Doses from Dual-Source Computed Tomography

Sagsoz

Bayraktutan

Oğul

et al. 2013

EAJM

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Objective: Our aim in this study was to determine the relationship between chest circumference and the radiation doses received by breast tissues during Dual-Source Computed Tomography (DSCT) cardiac scans. Materials and Methods:Routine cardiac DSCT examinations with similar exposure lengths were applied to 30 female patients. The scanogram image, multi-slice helical scan x-ray tube voltage and anode-cathode current were adjusted automatically according to attenuation for each patient during the scanogram acquisition. The standard protocol was otherwise applied to all patients. The 30 patients had an average weight of 67.8±15.3 kg, and the average length of the scanned region was 278.0±11.6 mm. Radiation doses were calculated from the dose-length product (DLP) and the computed tomography dose index (CTDI) scanner data values. The correlations between radiation dose and chest circumference were investigated. The level of significance was set at p<0.05. Results:For routine cardiac DSCT scans, the average values were as follows: total DLP: 715.54±317.01 mGycm, CTDIvol: 40.79±19.41 mGy, and effective dose (ED): 17.89±7.93 mSv. The chest circumference of patients correlates well with their radiation exposure (p<0.01). Conclusion:The distribution of different tissues throughout the human body may vary among races and genders. Because of this, many researchers use body mass index (BMI) to set image quality and predict the radiation dose distribution from general computed tomography (CT) examinations. Additional anthropomorphic phantom studies should be conducted to determine more accurate conversion factors and, hence, better ED predictions.Key Words: Breast, Cardiac, DSCT, Radiation dose Özet Amaç: Bu çalışmadaki amacımız göğüs çevresi ve Dual-Source Bilgisayarlı Tomografi (DSCT) kardiyak taramaları sırasında meme dokusu tarafından alınan radyasyon dozları arasındaki ilişkiyi belirlemektir. Gereç ve Yöntem:Benzer tarama uzunluklarına sahip rutin kardiyak DSCT incelemeler 30 kadın hastaya uygulandı. Spot görüntü, çok kesitli helikal tarama x-ışını tüpü gerilim ve anot-katot akımı spot gö-rüntü alınması sırasında belirlenerek her hasta için azaltma miktarına göre otomatik olarak ayarlandı. Aksi belirtilmedikçe standart protokol tüm hastalara uygulandı. 30 hastanın, ortalama ağırlığı 67.8±15.3 kg'dı ve taranan bölgenin ortalama uzunluğu 278.0±11.6 mm idi. Radyasyon dozları doz uzunluk çarpımı (DLP) ve bilgisayarlı tomografi doz indeksi (CTDI) tarayıcı verilerinden hesaplandı. Radyasyon dozu ve göğüs çevresi uzunluğu arasındaki ilişki araştırıldı. Anlamlılık düzeyi p<0.05 olarak tespit edildi. Sonuç: İnsan vücudu boyunca farklı dokuların dağılımı ırklar ve cinsiyetler arasında farklılık gösterebilmektedir. Bu sebeple, birçok araştırmacı görüntü kalitesini ayarlayabilmek ve genel bilgisayarlı tomografi (BT) incelemelerinde soğrulan radyasyon doz dağılımını tahmin etmek için vücut kitle indeksini (BMI) kullanmaktadır. Daha iyi ED tahminleri ve daha doğru dönüşüm faktörleri belirlemek amacıyla ek antropomorfik fantom...

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Female Breast Radiation Exposure During Thorax Multidetector Computed Tomography and the Effectiveness of Bismuth Breast Shield to Reduce Breast Radiation Dose

Abstract: Bismuth in-plane shielding for routine thoracic MDCT decreased radiation dose to the breast without qualitative changes in image quality. The other radiosensitive superficial organs (eg, testes and thyroid gland) specifically must be protected with shielding.

Cited by 73 publications

References 24 publications

Iterative reconstruction of pulmonary MDCT angiography: Effects on image quality, effective dose and estimated organ dose to the breast

Iterative reconstruction of pulmonary MDCT angiography: Effects on image quality, effective dose and estimated organ dose to the breast

Radiation Protection in Medical Imaging

Chest Circumference as a Predictive Parameter of Computed Tomography Coronary Angiography Radiation Doses from Dual-Source Computed Tomography

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