Use of bismuth shield for protection of superficial radiosensitive organs in patients undergoing computed tomography: a literature review and meta-analysis

Mehnati, Parinaz; Malekzadeh, Reza; Sooteh, Mohammad Yousefi

doi:10.1007/s12194-019-00500-2

Cited by 31 publications

(21 citation statements)

References 56 publications

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“…Results showed that in chest CT, the breast's highest dose was recorded at the skin layer, and the lowest dose at the fourth layer in the These studies have shown that in dose decline is better in the skin layer (26,27) . A study demonstrated that using Bismuth shields induces declines in the doses of superficial organs (11) .…”

Section: Discussionmentioning

confidence: 81%

“…Also, there are some studies that did not measure the radiation dose in the glandular tissue, but pointed out lower doses in the deeper portions of the breast because of X-ray attenuation of the breast tissue itself (2,9,12) . It should be noted that, when using bismuth shields for superficial organs, the dose recorded in the deeper layers of the breast was higher than the skin layer, while the dose without shielding in deeper layer was lower in comparison with the skin layer (11,26) . One possible reason for the difference in dose reduction in the two layers (skin and fourth) of the breast is the role of shields as a filter for lower, kVp, energy of X-ray polyenergetic beam that triggers decreases in breast skin dose, while the deep layers of the breast received harder X-Ray beams (28) .…”

Section: Discussionmentioning

confidence: 96%

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Polyurethane compositions of Bismuth used for breast shields during chest CT

et al. 2021

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Background: Bismuth Polyurethane composite is a novel shield for breast protection while saving image quality in chest CT. Bismuth different concentrations used for constructing polymer composites breast shields in this study. Materials and Methods: Bismuth with particle size <150 micrometer used in bismuth polyurethane composite (BPC) with a ratio of 10%, 15% and 1.1, 2.2 mm thicknesses. The BPC was examined on the female chest phantom (skin and fourth layers), 120 kV and 80 mA selected as an exposure factors in chest CT. The dose reduction was recorded by TLD and the image quality was evaluated quantitatively and quantitatively. Results: Using BPC shields 10% and 15% (2.2 mm) induced to breast dose reduction to 69.1% and 77.5% for skin layer and 44.7% and 52.8% for fourth layer, respectively. The image noise Increasing in BPC for breast and mediastinum areas were 9.43% (P=0.347) and 15.44% (P=0.386), respectively. Conclusion: Application of Bismuth with different weight ratios in polyurethane composite was useful shield for radiation dose reduction of the breast in chest CT.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 96%

Polyurethane compositions of Bismuth used for breast shields during chest CT

et al. 2021

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“…In a recent meta-analysis of studies that together included 237 human subjects and 34 pediatric and adult phantoms, the efficacy of bismuth shielding in reducing radiation dose was influenced by several factors, including CT scanner type, use of foams, beam energies, backscatter radiation, and image quality [ 12 ]. Nevertheless, a high percentage (89%) of studies in that meta-analysis recommended bismuth shielding based on maintenance of image quality under shielding.…”

Section: Discussionmentioning

confidence: 99%

Bismuth Pelvic X-Ray Shielding Reduces Radiation Dose Exposure in Pediatric Radiography

Wang

Ting²,

Lai

et al. 2021

BioMed Research International

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Background. Radiation using conventional X-ray is associated with exposure of radiosensitive organs and typically requires the use of protection. This study is aimed at evaluating the use of bismuth shielding for radiation protection in pediatric pelvic radiography. The effects of the anteroposterior and lateral bismuth shielding were verified by direct measurements at the anatomical position of the gonads. Methods. Radiation doses were measured using optically stimulated luminescence dosimeters (OSLD) and CIRS ATOM Dosimetry Verification Phantoms. Gonad radiographs were acquired using different shields of varying material (lead, bismuth) and thickness and were compared with radiographs obtained without shielding to examine the effects on image quality and optimal reduction of radiation dose. All images were evaluated separately by three pediatric orthopedic practitioners. Results. Results showed that conventional lead gonadal shielding reduces radiation doses by 67.45%, whereas dose reduction using one layer of bismuth shielding is 76.38%. The use of two layers of bismuth shielding reduces the dose by 84.01%. Using three and four layers of bismuth shielding reduces dose by 97.33% and 99.34%, respectively. Progressively lower radiation doses can be achieved by increasing the number of bismuth layers. Images obtained using both one and two layers of bismuth shielding provided adequate diagnostic information, but those obtained using three or four layers of bismuth shielding were inadequate for diagnosis. Conclusions. Bismuth shielding reduces radiation dose exposure providing appropriate protection for children undergoing pelvic radiography. The bismuth shielding material is lighter than lead, making pediatric patients more comfortable and less apt to move, thereby avoiding repeat radiography.

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“…Mehnati et al assessed the effect of bismuth shielding on dose reduction and image quality in CT and found that bismuth shields were effective in decreasing the patients' superficial radiation dose without significantly lowering image quality. They recommended that performing a foam of optimum 1-2 cm thickness can be effective in decreasing the noise of images acquired with bismuth shielding (20). Therefore, performing bismuth shielding can be an effective technique for reducing thyroid cancer risk in cervical CT.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Thyroid Cancer Risk After Cervical Computed Tomography: The Impact of Bismuth Shielding

2021

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Background: Computed tomography (CT) is vastly applied in X-ray procedures because of its high quality in detecting the anatomical structures of the body. However, it leads to an increase in patient dose, resulting in carcinogenesis. In the head and neck CT, the thyroid is the most important at-risk organ. The aim of this study was to estimate thyroid cancer risk in cervical CT with and without a bismuth shield. Materials and Methods: After obtaining permission from the authors, data related to the thyroid dose of patients undergoing cervical CT in the study by Santos et al (2019) were used, and then thyroid cancer risk was calculated for different ages at exposure in male and female patients using the biological effects of the ionizing radiation (BEIR) VII model. Results: Using bismuth shielding reduced thyroid dose by 37% and 39% in male and female phantoms, respectively. Thyroid cancer estimation demonstrated that the risk was nearly two-fold in females compared to males. Finally, bismuth shielding reduced 40% of cancer risk, and it decreased in both genders by increasing age at exposure. Conclusion: According to our findings, excess relative risk (ERR) up to 0.06% was associated with cervical CT. Although ERR amounts were low, the effect of radiation on thyroid cancer risk should not be neglected. Accordingly, it is suggested that future trials use bismuth shielding to reduce thyroid cancer risk.

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Use of bismuth shield for protection of superficial radiosensitive organs in patients undergoing computed tomography: a literature review and meta-analysis

Cited by 31 publications

References 56 publications

Polyurethane compositions of Bismuth used for breast shields during chest CT

Polyurethane compositions of Bismuth used for breast shields during chest CT

Bismuth Pelvic X-Ray Shielding Reduces Radiation Dose Exposure in Pediatric Radiography

Assessment of Thyroid Cancer Risk After Cervical Computed Tomography: The Impact of Bismuth Shielding

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