Would thyroid and breast shielding be beneficial in CT of the head?

Beaconsfield, Tina; Nicholson, Richard L.; Thornton, Allan F.; Al-Kutoubi, Aghiad

doi:10.1007/s003300050456

Cited by 49 publications

(44 citation statements)

References 5 publications

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“…According to his results, the use of a lap apron may reduce the potential dose to the breasts by an order of magnitude or more, and thereby rendering the dose to the breasts negligible. Beaconsfield et al 23 found that wearing a 5-mm lead-equivalent bib in conjunction with two thyroid collars reduced the breast dose from 320 to 75 mGy (76%) and, therefore, strongly recommended the use of lead shields as a simple precaution, especially for paediatric patients and young adults.…”

Section: Discussionmentioning

confidence: 99%

Radiation exposure to foetus and breasts from dental X-ray examinations: effect of lead shields

Kelaranta

Ekholm

Toroi

et al. 2016

Dentomaxillofacial Radiology

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Objectives: Dental radiography may involve situations where the patient is known to be pregnant or the pregnancy is noticed after the X-ray procedure. In such cases, the radiation dose to the foetus, though low, needs to be estimated. Uniform and widely used guidance on dental X-ray procedures during pregnancy are presently lacking, the usefulness of lead shields is unclear and practices vary. Methods: Upper estimates of radiation doses to the foetus and breasts of the pregnant patient were estimated with an anthropomorphic female phantom in intraoral, panoramic, cephalometric and CBCT dental modalities with and without lead shields. Results: The upper estimates of foetal doses varied from 0.009 to 6.9 mGy, and doses at the breast level varied from 0.602 to 75.4 mGy. With lead shields, the foetal doses varied from 0.005 to 2.1 mGy, and breast doses varied from 0.002 to 10.4 mGy. Conclusions: The foetal dose levels without lead shielding were ,1% of the annual dose limit of 1 mSv for a member of the public. Albeit the relative shielding effect, the exposure-induced increase in the risk of breast cancer death for the pregnant patient (based on the breast dose only) and the exposure-induced increase in the risk of childhood cancer death for the unborn child are minimal, and therefore, need for foetal and breast lead shielding was considered irrelevant. Most important is that pregnancy is never a reason to avoid or to postpone a clinically justified dental radiographic examination.

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Section: Discussionmentioning

confidence: 99%

Radiation exposure to foetus and breasts from dental X-ray examinations: effect of lead shields

Kelaranta

Ekholm

Toroi

et al. 2016

Dentomaxillofacial Radiology

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“…11 Although the effective dose from CBCT scanning remained far below that of CT protocols, 21 lead collars were also recommended when performing CBCT scanning. 22 This is confirmed by the present study that thyroid collar can significantly reduce the dose to the thyroid.…”

Section: Discussionmentioning

confidence: 99%

“…10 A thyroid collar was found to reduce radiation doses significantly during CT scanning of the head. [11][12][13][14] However, until now there have been no studies published to evaluate the radioprotective effects of thyroid collars during CBCT scanning. The aim of this study was to evaluate the radiation dose of CBCT when applying thyroid collars.…”

Section: Introductionmentioning

confidence: 99%

Dose reduction of cone beam CT scanning for the entire oral and maxillofacial regions with thyroid collars

Li²,

Sanderink³

et al. 2012

Dentomaxillofacial Radiology

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Objective: The aim of this study was to evaluate the influence of thyroid collars on radiation dose during cone beam CT (CBCT) scanning. Methods: Average tissue-absorbed dose for a NewTom 9000 CBCT scanner (Quantitative Radiology, Verona, Italy) was measured using thermoluminescent dosemeter chips in a phantom. The scans were carried out with and without thyroid collars. Effective organ dose and total effective dose were derived using International Commission on Radiological Protection 2007 recommendations. Results: The effective organ doses for the thyroid gland and oesophagus were 31.0 mSv and 2.4 mSv, respectively, during CBCT scanning without a collar around the neck. When the thyroid collars were used loosely around the neck, no effective organ dose reduction was observed. When one thyroid collar was used tightly on the front of the neck, the effective organ dose for the thyroid gland and oesophagus were reduced to 15.9 mSv (48.7% reduction) and 1.4 mSv (41.7% reduction), respectively. Similar organ dose reduction (46.5% and 41.7%) was achieved when CBCT scanning was performed with two collars tightly on the front and back of the neck. However, the differences to the total effective dose were not significant among the scans with and without collars around the neck (p 5 0.775). Conclusions: Thyroid collars can effectively reduce the radiation dose to the thyroid and oesophagus if used appropriately.

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“…Shielding in this manner has been used in dental and conventional radiology as well as fluoroscopy and has been shown to yield significant dose savings [2][3][4][5][6][7]. This technique, referred to as ''out-of-plane'' shielding, has also been advocated in CT for protection of the breast and thyroid [8][9][10][11][12]. However, the main use of such shielding has been in protecting the foetus of pregnant patients undergoing head, neck, chest or extremity CT scans.…”

mentioning

confidence: 99%

Organ and effective dose reduction in adult chest CT using abdominal lead shielding

Iball¹,

Brettle²

2011

BJR

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Objectives: The purpose of this study was to evaluate and compare organ and effective dose savings that could be achieved using conventional lead aprons and a new, custom-designed shield as out-of-plane shielding devices during chest CT scans. Methods: Thermoluminescent dosimeters were used to measure doses throughout the abdomen and pelvis during CT scans of the chest of a RANDO phantom. Dose measurements were made with no shielding, with lead aprons and with the new shield around the abdomen and pelvis in order to quantify the achievable organ and effective dose reductions. Results: Average dose savings in the 10 phantom sections ranged from 5% to 78% with the highest point dose saving of 93% being found in the mid-pelvis. When shielding was used, the maximum measured organ dose reduction was a 72% dose saving to the testes. Significant dose savings were found throughout the abdomen and pelvis, which contributed to an effective dose saving of 4% that was achieved over and above the dose savings obtained through conventional optimisation strategies. This could yield significant population dose savings and reductions in collective radiation risk. Conclusion: In this study significant organ and effective dose reductions have been achieved through the use of abdominal shielding during chest CT examinations and it is therefore recommended that out-of-plane patient shielding devices should be used for all chest CT scans and potentially for every CT scan, irrespective of body part.

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Would thyroid and breast shielding be beneficial in CT of the head?

Cited by 49 publications

References 5 publications

Radiation exposure to foetus and breasts from dental X-ray examinations: effect of lead shields

Radiation exposure to foetus and breasts from dental X-ray examinations: effect of lead shields

Dose reduction of cone beam CT scanning for the entire oral and maxillofacial regions with thyroid collars

Organ and effective dose reduction in adult chest CT using abdominal lead shielding

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