Lead versus Bismuth-Antimony Shield for Fetal Dose Reduction at Different Gestational Ages at CT Pulmonary Angiography

Chatterson, Leslie; Leswick, David A.; Fladeland, Derek; Hunt, Megan M.; Webster, Stephen T

doi:10.1148/radiol.11101575

Cited by 30 publications

(20 citation statements)

References 19 publications

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“…It uses recent advanced mathematical models to reduce noise, thereby allowing high quality image acquisition at a lower tube current, thus enabling significant reductions in dose. 3,8,37 There have been numerous studies recently aimed at evaluating the effectiveness of ASiR as a dose reduction method. One study by Mathieu and Cody 35 used ASiR on a phantom during a routine chest CT and noted dose reductions ranging from 30% to 44%.…”

Section: Iterative Reconstruction Algorithmsmentioning

confidence: 99%

“…7 However, its use was replaced by bismuth shielding, which provided improved opportunities to reduce dose to superficial organs within the field of view. 8 While various studies have proven that lead and bismuth provide equivalent dose reductions [9][10][11] ; bismuth shields are designed for specific superficial organs and have the added benefit of being lightweight and easy to manoeuvre. 8 Recently, the use of bismuth shields has sparked debate in relation to issues caused during scans.…”

Section: Introductionmentioning

confidence: 99%

“…8 While various studies have proven that lead and bismuth provide equivalent dose reductions [9][10][11] ; bismuth shields are designed for specific superficial organs and have the added benefit of being lightweight and easy to manoeuvre. 8 Recently, the use of bismuth shields has sparked debate in relation to issues caused during scans. According to the American Association of Physicists in Medicine (AAPM), these issues relate to the degradation of image quality, unpredictable and unreliable results when combined with automated exposure control (AEC) and wasted radiation.…”

Section: Introductionmentioning

confidence: 99%

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The Current Use and Effectiveness of Bismuth Shielding in Computed Tomography: A Systematic Review

Lawrence¹,

Seeram²

2017

Radiol Open J

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CitationThe increased use of computed tomography (CT) has raised concerns regarding the radiation dose received by radiosensitive organs. It is important that practical and reliable dose reduction strategies are implemented to reduce patient radiation exposure. Aims: The purpose of this article is to evaluate the current clinical use and effectiveness of bismuth shielding as a dose reduction technique and assess its impact on image quality, in an attempt to develop a recommendation for dose reduction in CT. Methods: A systematic review of current literature was conducted using the PubMed and Scopus databases. A total of 50 relevant articles were thoroughly assessed and evaluated.Results: This review found that whilst bismuth shielding proves to provide significant dose reductions to radiosensitive organs, numerous concerns exist including wasted radiation, reduced image quality and unpredictable results when combined with AEC. Alternative methods such as tube current modulation and iterative reconstruction algorithms can provide equivalent dose savings at superior image quality, without the limitations of bismuth shields. Conclusion: Until these alternative methods become available in all departments, bismuth shielding remains a viable dose reduction strategy.

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Section: Iterative Reconstruction Algorithmsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Current Use and Effectiveness of Bismuth Shielding in Computed Tomography: A Systematic Review

Lawrence¹,

Seeram²

2017

Radiol Open J

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“…In an attempt to reduce the weight of protection materials, several vendors have developed composite lead‐equivalent materials using mixtures of different elements such as lead, tin, copper, bismuth‐antimony, and yttrium. These composite materials have good shielding capabilities against diagnostic x‐rays 9, 10. For example, bismuth‐antimony aprons have been widely used as lead‐free radiation protection materials in medical situations.…”

Section: Introductionmentioning

confidence: 99%

Estimation of the shielding ability of a tungsten functional paper for diagnostic x‐rays and gamma rays

Monzen

Kanno

Fujimoto

et al. 2017

J Applied Clin Med Phys

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Tungsten functional paper (TFP) is a novel paper‐based radiation‐shielding material. We measured the shielding ability of TFP against x‐rays and gamma rays. The TFP was supplied in 0.3‐mm‐thick sheets that contained 80% tungsten powder and 20% cellulose (C6H10O5) by mass. In dose measurements for x‐rays (60, 80, 100, and 120 kVp), we measured doses after through 1, 2, 3, 5, 10, and 12 TFP sheets, as well as 0.3 and 0.5 mm of lead. In lead equivalence measurements, we measured doses after through 2 and 10 TFP sheets for x‐rays (100 and 150 kVp), and 0, 7, 10, 20, and 30 TFP sheets for gamma rays from cesium‐137 source (662 keV). And then, the lead equivalent thicknesses of TFP were determined by comparison with doses after through standard lead plates (purity >99.9%). Additionally, we evaluated uniformity of the transmitted dose by TFP with a computed radiography image plate for 50 kVp x‐rays. A single TFP sheet was found to have a shielding ability of 65%, 53%, 48%, and 46% for x‐rays (60, 80, 100, and 120 kVp), respectively. The lead equivalent thicknesses of two TFP sheets were 0.10 ± 0.02, 0.09 ± 0.02 mmPb, and of ten TFP sheets were 0.48 ± 0.02 and 0.51 ± 0.02 mmPb for 100 and 150 kVp x‐rays, respectively. The lead equivalent thicknesses of 7, 10, 20, and 30 sheets of TFP for gamma rays from cesium‐137 source were estimated as 0.28, 0.43, 0.91, and 1.50 mmPb with an error of ± 0.01 mm. One TFP sheet had nonuniformity, however, seven TFP sheets provided complete shielding for 50 kVp x‐rays. TFP has adequate radiation shielding ability for x‐rays and gamma rays within the energy range used in diagnostic imaging field.

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“…To overcome these problems, some researchers have explored ways of providing effective X‐ray protection using alternative materials . In an attempt to reduce the weight of protection materials, several vendors have developed composite lead‐equivalent materials using mixtures of different elements such as lead, tin, copper, bismuth‐antimony, and yttrium . Tungsten functional paper (TFP: Toppan Printing Co., Ltd., Tokyo, Japan), which is the paper with thickness of 0.3 mm and containing 80% tungsten powder by weight, has been developed as a lead free radiation shielding alternative, that has the advantages of paper in that it is easy to cut, fold, and stick onto other materials.…”

Section: Introductionmentioning

confidence: 99%

A novel radiation protection device based on tungsten functional paper for application in interventional radiology

Monzen

Tamura

Shimomura

et al. 2017

J Applied Clin Med Phys

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Tungsten functional paper (TFP), which contains 80% tungsten by weight, has radiation‐shielding properties. We investigated the use of TFP for the protection of operators during interventional or therapeutic angiography. The air kerma rate of scattered radiation from a simulated patient was measured, with and without TFP, using a water‐equivalent phantom and fixed C‐arm fluoroscopy. Measurements were taken at the level of the operator's eye, chest, waist, and knee, with a variable number of TFP sheets used for shielding. A Monte Carlo simulation was also utilized to analyze the dose rate delivered with and without the TFP shielding. In cine mode, when the number of TFP sheets was varied through 1, 2, 3, 5, and 10, the respective reduction in the air kerma rate relative to no TFP shielding was as follows: at eye level, 24.9%, 29.9%, 41.6%, 50.4%, and 56.2%; at chest level, 25.3%, 33.1%, 34.9%, 46.1%, and 44.3%; at waist level, 45.1%, 57.0%, 64.4%, 70.7%, and 75.2%; and at knee level, 2.1%, 2.2%, 2.1%, 2.1%, and 2.1%. In fluoroscopy mode, the respective reduction in the air kerma rate relative to no TFP shielding was as follows: at eye level, 24.8%, 30.3%, 34.8%, 51.1%, and 58.5%; at chest level, 25.8%, 33.4%, 35.5%, 45.2%, and 44.4%; at waist level, 44.6%, 56.8%, 64.7%, 71.7%, and 77.2%; and at knee level, 2.2%, 0.0%, 2.2%, 2.8%, and 2.5%. The TFP paper exhibited good radiation‐shielding properties against the scattered radiation encountered in clinical settings, and was shown to have potential application in decreasing the radiation exposure to the operator during interventional radiology.

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Lead versus Bismuth-Antimony Shield for Fetal Dose Reduction at Different Gestational Ages at CT Pulmonary Angiography

Abstract: Reducing voltage and limiting z-axis is more effective than shields at reducing fetal dose. Shielding improves reduction with no significant difference between lead and bismuth-antimony shields when conservative scanning parameters are observed.

Cited by 30 publications

References 19 publications

The Current Use and Effectiveness of Bismuth Shielding in Computed Tomography: A Systematic Review

The Current Use and Effectiveness of Bismuth Shielding in Computed Tomography: A Systematic Review

Estimation of the shielding ability of a tungsten functional paper for diagnostic x‐rays and gamma rays

A novel radiation protection device based on tungsten functional paper for application in interventional radiology

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