In-Plane Bismuth Breast Shields for Pediatric CT: Effects on Radiation  Dose and Image Quality Using Experimental and Clinical Data

Fricke, Bradley L.; Donnelly, Lane F.; Frush, Donald P.; Yoshizumi, Terry T.; Varchena, V; Poe, Stacy A.; Lucaya, Javier

doi:10.2214/ajr.180.2.1800407

Cited by 169 publications

(95 citation statements)

References 28 publications

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“…Compared with adults, pediatric patients are at a higher risk with high radiation dosages because they are more susceptible to the carcinogenic effects of radiation (21).…”

Section: Discussionmentioning

confidence: 99%

CT Fluoroscopy Shielding: Decreases in Scattered Radiation for the Patient and Operator

Neeman

Dromi

Sarin

et al. 2006

Journal of Vascular and Interventional Radiology

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PURPOSE-High-radiation exposure occurs during computed tomographic (CT) fluoroscopy. Patient and operator doses during thoracic and abdominal interventional procedures were studied in the present experiment, and a novel shielding device to reduce exposure to the patient and operator was evaluated. MATERIALS AND METHODS-With a 16-slice CT scanner in CT fluoroscopy mode (120 kVp, 30 mA), surface dosimetry was performed on adult and pediatric phantoms. The shielding was composed of tungsten antimony in the form of a lightweight polymer sheet. Doses to the patient were measured with and without shielding for thoracic and abdominal procedures. Doses to the operator were recorded with and without phantom, gantry, and table shielding in place. Double-layer leadfree gloves were used by the operator during the procedures.RESULTS-Tungsten antimony shielding adjacent to the scan plane resulted in a maximum dose reduction of 92.3% to the patient. Maximum 85.6%, 93.3%, and 85.1% dose reductions were observed for the operator's torso, gonads, and hands, respectively. The use of double-layer lead-free gloves resulted in a maximum radiation dose reduction of 97%.CONCLUSIONS-Methods to reduce exposure during CT fluoroscopy are effective and should be searched for. Significant reduction in radiation doses to the patient and operator can be accomplished with tungsten antimony shielding.Computed tomography (CT) has been used to guide interventional procedures of the chest and abdomen for nearly two decades (1,2). CT-guided procedures have continued to increase in number (3) and are less invasive than many surgical options. Despite advances in other areas of imaging, CT has remained the imaging study of choice for many procedures because of its inherently superior contrast and spatial resolution in comparison with conventional fluoroscopy and ultra-sonography (US). However, unlike other imaging modalities, conventional CT lacks real-time imaging capabilities. Therefore, CT-guided procedures generally take longer because the region of interest must be intermittently scanned to confirm safe adjustment and placement of the needle or catheter.CT fluoroscopy is a technique that has been developed in the past decade (4). In this acquisition mode, CT images are reconstructed and displayed nearly in real time. This provides the interventionalist with immediate feedback during the procedure. CT fluoroscopy has been shown to reduce procedure time (5) and increase efficacy compared with standard CT guidance (6).The inherent drawback of CT fluoroscopy is rather high radiation exposure to the patient and operator, which may explain why CT fluoroscopy has not been more broadly accepted (7). Radiation exposure for the patient is primarily along the scan plane. Because the exposure along the scan plane is cumulative, deterministic effects can be significant (8,9). Scattered radiation from the direct beam and collimator leakage also contribute to the patient dose (10).For the operator, exposure is primarily a function of scattered radiation ...

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“…Compared with adults, pediatric patients are at a higher risk with high radiation dosages because they are more susceptible to the carcinogenic effects of radiation (21).…”

Section: Discussionmentioning

confidence: 99%

CT Fluoroscopy Shielding: Decreases in Scattered Radiation for the Patient and Operator

Neeman

Dromi

Sarin

et al. 2006

Journal of Vascular and Interventional Radiology

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“…It usually concerns eyes in head examinations, and breasts and thyroid in chest and neck examinations. The study results are based on measurements performed on phantoms [7,9], as well as on the data of patients exposed to radiation [8,10], and they show 26%-42% of the dose reduction. The material which those shields were made of was bismuth.…”

Section: Resultsmentioning

confidence: 99%

New Material for Shields in X-Ray Diagnostic Procedures

Staniszewska¹,

Zaborski²,

Kusiak³

et al. 2016

UCMS

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Shielding with the use of materials strongly absorbing X-rays is one of the oldest methods reducing patients' exposure to radiation. This article presents the results of the research aimed at developing a material, which will reduce radiation dose more efficiently than the materials produced so far, and will not change features of the computed tomography (CT) image. The current study focuses on elastomeric composites containing bismuth, wolfram, and gadolinium as the elements strongly absorbing X-rays in the range of energies used in diagnostic radiography. The aim of the study was to evaluate the effect of the made shields on the quality of CT image and properties reducing radiation. Measurements with the use of dosimetry phantoms have proven that the impact of shields on the distribution of energy absorbed in the inside of the object is limited to the regions situated directly under the shield surface. The material containing bismuth, wolfram and gadolinium most efficiently reduced doses measured in the BODY phantom. Hence, real shield efficacy was verified by measuring dose distribution on the surface of the phantom imitating a 5-year-old child (CIRS) and comparing the dose values registered without the shield and those achieved after using the shield. On the basis of the results achieved in the study was concluded that 50% attenuation of X-ray beam emitted by the CT scanner is available using the (Bi+W+Gd shield) and the effect of reduction of X-radiation intensity is visible in the surface layer of the exposed object located directly beneath the shield.

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“…However, this involves the issues of economic feasibility and safety. In recent years, shielding materials using bismuth have been developed [12][13][14][15]. Gwon et al [16] evaluated the dose of the eye lens of a dummy phantom by using a glass dosimeter in order to evaluate the reduction of eye lens dose and the shielding effect using bismuth for shielding in a CT scan of the eye and head.…”

Section: Discussionmentioning

confidence: 99%

Performance Analysis of Low-level Radiation Shielding Sheet with Diamagnetic Nanoparticles

Cho¹,

Kim²

2015

Journal of Magnetics

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In this study, the authors attempted to produce a medical radiation shielding fiber that can be produced at a nanosize scale and that is, unlike lead, harmless to the human body. The performance of the proposed medical radiation shielding fiber was then evaluated. First, diamagnetic bismuth oxide, an element which, among elements that have a high atomic number and density, is harmless to the human body, was selected as the shielding material. Next, 10-100 nm sized nanoparticles in powder form were prepared by ball milling the bismuth oxide (Bi 2 O 3 ), the average particle size of which is 1-500 µm, for approximately 10 minutes. The manufactured bismuth oxide was formed into a colloidal solution, and the radiation shielding fabric was fabricated by curing after coating the solution on one side or both sides of the fabric. The thicknesses of the shielding sheets prepared with bismuth oxide were 0.1, 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, and 1.0 mm. An experimental method was used to measure the absorbed dose and irradiation dose by using the lead equivalent test method of X-ray protection goods presented by Korean Industrial Standards; the resultant shielding rate was then calculated. From the results of this study, the X-ray shielding effect of the shielding sheet with 0.1 mm thickness was about 55.37% against 50 keV X-ray, and the X-ray shielding effect in the case of 1.0 mm thickness showed shielding characteristics of about 99.36% against 50 keV X-ray. In conclusion, it is considered that nanosized-bismuth radiation shielding fiber developed in this research will contribute to reducing the effects of primary X-ray and secondary X-ray such as when using a scattering beam at a low level exposure.

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In-Plane Bismuth Breast Shields for Pediatric CT: Effects on Radiation Dose and Image Quality Using Experimental and Clinical Data

Abstract: Bismuth in-plane breast shielding for pediatric MDCT decreased radiation dose to the breast without qualitative or quantitative changes in image quality.

Cited by 169 publications

References 28 publications

CT Fluoroscopy Shielding: Decreases in Scattered Radiation for the Patient and Operator

CT Fluoroscopy Shielding: Decreases in Scattered Radiation for the Patient and Operator

New Material for Shields in X-Ray Diagnostic Procedures

Performance Analysis of Low-level Radiation Shielding Sheet with Diamagnetic Nanoparticles

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