Bismuth Shielding in Head Computed Tomography—Still Necessary?
<b>Introduction:</b> Cranial CT scans are associated with radiation exposure to the eye lens, which is a particularly radiosensitive organ. Children are more vulnerable to radiation than adults. Therefore, it is essential to use the available dose reduction techniques to minimize radiati...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-12-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/13/1/25 |
| _version_ | 1797358620902424576 |
|---|---|
| author | Jana Di Rosso Andreas Krasser Sebastian Tschauner Helmuth Guss Erich Sorantin |
| author_facet | Jana Di Rosso Andreas Krasser Sebastian Tschauner Helmuth Guss Erich Sorantin |
| author_sort | Jana Di Rosso |
| collection | DOAJ |
| description | <b>Introduction:</b> Cranial CT scans are associated with radiation exposure to the eye lens, which is a particularly radiosensitive organ. Children are more vulnerable to radiation than adults. Therefore, it is essential to use the available dose reduction techniques to minimize radiation exposure. According to the European Consensus on patient contact shielding by the IRCP from 2021, shielding is not recommended in most body areas anymore. This study aims to evaluate whether bismuth shielding as well as its combination with other dose-saving technologies could still be useful. <b>Methods:</b> Cranial CT scans of a pediatric anthropomorphic phantom were performed on two up-to-date MDCT scanners. Eye lens dose measurements were performed using thermoluminescent dosimeters. Furthermore, the impact of BS and of the additional placement of standoff foam between the patient and BS on image quality was also assessed. <b>Results:</b> Bismuth shielding showed a significant lens dose reduction in both CT scanners (GE: 41.50 ± 4.04%, <i>p</i> < 0.001; Siemens: 29.75 ± 6.55%, <i>p</i> = 0.00). When combined with AEC, the dose was lowered even more (GE: 60.75 ± 3.30%, <i>p</i> < 0.001; Siemens: 41.25 ± 8.02%, <i>p</i> = 0.00). The highest eye dose reduction was achieved using BS + AEC + OBTCM (GE: 71.25 ± 2.98%, <i>p</i> < 0.001; Siemens: 58.75 ± 5.85%, <i>p</i> < 0.001). BS caused increased image noise in the orbital region, which could be mitigated by foam placement. Eye shielding had no effect on the image noise in the cranium. <b>Conclusions:</b> The use of BS in cranial CT can lead to a significant dose reduction, which can be further enhanced by its combination with other modern dose reduction methods. BS causes increase in image noise in the orbital region but not in the cranium. The additional use of standoff foam reduces image noise in the orbital region. |
| first_indexed | 2024-03-08T15:04:21Z |
| format | Article |
| id | doaj.art-c0e4025a1040401caf2043673c798ca8 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-08T15:04:21Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-c0e4025a1040401caf2043673c798ca82024-01-10T15:00:41ZengMDPI AGJournal of Clinical Medicine2077-03832023-12-011312510.3390/jcm13010025Bismuth Shielding in Head Computed Tomography—Still Necessary?Jana Di Rosso0Andreas Krasser1Sebastian Tschauner2Helmuth Guss3Erich Sorantin4Division of Paediatric Radiology, Department of Radiology, Medical University of Graz, 8036 Graz, AustriaCompetence Centre for Medical Physics and Radiation Protection, University Hospital Graz, 8036 Graz, AustriaDivision of Paediatric Radiology, Department of Radiology, Medical University of Graz, 8036 Graz, AustriaCompetence Centre for Medical Physics and Radiation Protection, University Hospital Graz, 8036 Graz, AustriaDivision of Paediatric Radiology, Department of Radiology, Medical University of Graz, 8036 Graz, Austria<b>Introduction:</b> Cranial CT scans are associated with radiation exposure to the eye lens, which is a particularly radiosensitive organ. Children are more vulnerable to radiation than adults. Therefore, it is essential to use the available dose reduction techniques to minimize radiation exposure. According to the European Consensus on patient contact shielding by the IRCP from 2021, shielding is not recommended in most body areas anymore. This study aims to evaluate whether bismuth shielding as well as its combination with other dose-saving technologies could still be useful. <b>Methods:</b> Cranial CT scans of a pediatric anthropomorphic phantom were performed on two up-to-date MDCT scanners. Eye lens dose measurements were performed using thermoluminescent dosimeters. Furthermore, the impact of BS and of the additional placement of standoff foam between the patient and BS on image quality was also assessed. <b>Results:</b> Bismuth shielding showed a significant lens dose reduction in both CT scanners (GE: 41.50 ± 4.04%, <i>p</i> < 0.001; Siemens: 29.75 ± 6.55%, <i>p</i> = 0.00). When combined with AEC, the dose was lowered even more (GE: 60.75 ± 3.30%, <i>p</i> < 0.001; Siemens: 41.25 ± 8.02%, <i>p</i> = 0.00). The highest eye dose reduction was achieved using BS + AEC + OBTCM (GE: 71.25 ± 2.98%, <i>p</i> < 0.001; Siemens: 58.75 ± 5.85%, <i>p</i> < 0.001). BS caused increased image noise in the orbital region, which could be mitigated by foam placement. Eye shielding had no effect on the image noise in the cranium. <b>Conclusions:</b> The use of BS in cranial CT can lead to a significant dose reduction, which can be further enhanced by its combination with other modern dose reduction methods. BS causes increase in image noise in the orbital region but not in the cranium. The additional use of standoff foam reduces image noise in the orbital region.https://www.mdpi.com/2077-0383/13/1/25bismuthradiationionizingradiation protectionlenscrystalline |
| spellingShingle | Jana Di Rosso Andreas Krasser Sebastian Tschauner Helmuth Guss Erich Sorantin Bismuth Shielding in Head Computed Tomography—Still Necessary? Journal of Clinical Medicine bismuth radiation ionizing radiation protection lens crystalline |
| title | Bismuth Shielding in Head Computed Tomography—Still Necessary? |
| title_full | Bismuth Shielding in Head Computed Tomography—Still Necessary? |
| title_fullStr | Bismuth Shielding in Head Computed Tomography—Still Necessary? |
| title_full_unstemmed | Bismuth Shielding in Head Computed Tomography—Still Necessary? |
| title_short | Bismuth Shielding in Head Computed Tomography—Still Necessary? |
| title_sort | bismuth shielding in head computed tomography still necessary |
| topic | bismuth radiation ionizing radiation protection lens crystalline |
| url | https://www.mdpi.com/2077-0383/13/1/25 |
| work_keys_str_mv | AT janadirosso bismuthshieldinginheadcomputedtomographystillnecessary AT andreaskrasser bismuthshieldinginheadcomputedtomographystillnecessary AT sebastiantschauner bismuthshieldinginheadcomputedtomographystillnecessary AT helmuthguss bismuthshieldinginheadcomputedtomographystillnecessary AT erichsorantin bismuthshieldinginheadcomputedtomographystillnecessary |