Bismuth Shielding, Organ-based Tube Current Modulation, and Global Reduction of Tube Current for Dose Reduction to the Eye at Head CT

Wang, Jia; Duan, Xinhui; Christner, Jodie A.; Leng, Shuai; Grant, Katharine L.; McCollough, Cynthia H.

doi:10.1148/radiol.11110470

Cited by 104 publications

(103 citation statements)

References 26 publications

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“…Apart from examining the radiation dose to the eye lens region, the correctness of the CT number and image noise level of the resultant image were also important when considering the efficacy of bismuth shield application (Wang et al, 2012). Generally, the bismuth shield application would lead to a beam hardening effect and starvation of information-carrying photons, resulting in an incorrect CT number being calculated during acquisition (Lee et al, 2011;Kim et al, 2013).…”

Section: Resultsmentioning

confidence: 99%

“…Also, despite the drastic advancement in the latest CT systems with advanced strategies in reducing the overall radiation dose to the patient, making the implementation of bismuth shields less frequent (Kalra et al, 2004(Kalra et al, , 2005Lee et al, 2010), the efficacy of reducing the eye lens dose during CT brain imaging by a bismuth shield and organ-based tube current modulation was similar (Wang et al, 2012).…”

Section: Current Strategies To Reduce the Eye Lens Dose During Ct Bramentioning

confidence: 99%

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Reducing the radiation dose to the eye lens region during CT brain examination: the potential beneficial effect of the combined use of bolus and a bismuth shield

et al. 2015

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-Objective:Computed Tomography (CT) is the leading contributor to medical exposure to ionizing radiation. Although the use of CT brain scans for patients with head injuries and convulsions has shown a tremendous growth, it has raised substantial concerns in the general public because of the risk of radiation-induced cataracts: the current available strategies to reduce the radiation dose to the eye lens region are limited. Therefore, the present research project was initiated with the aim of evaluating the potential benefit of the combined use of bolus and a bismuth shield on reducing the radiation dose to the eye lens region during CT brain examination. Materials and methods: We conducted a series of phantom studies to measure the entrance surface dose (ESD) that is delivered to the eye lens region during CT brain examination under the effect of different scanning and shielding setups. Results: Our results indicated, during CT brain examination: (1) a drastic reduction of 92.5% in the ESD to the eye lens region was found when the CT gantry was tilted from 0• (overall ESD = 30.7 mGy) to 30• cranially (overall ESD = 2.4 mGy), and (2) when the CT gantry was positioned at 0• (the common practice in the clinical setting), the setups with the application of a) a bismuth shield, b) a bismuth shield with a face shield (air gap), c) a bismuth shield with bolus, and d) a bismuth shield with bolus and an air gap can result in an acceptable level of image quality with a smaller overall ESD delivered to the eye lens region (overall ESD = 23.2 mGy, 24 mGy, 21 mGy and 19.9 mGy, respectively) than the setup without the bismuth shield applied (overall ESD = 30.7 mGy). Conclusion: When the primary beam scanning through the eye lens region is unavoidable during CT brain examination, the combined use of a bismuth shield with bolus and a face shield is an easyto-use and inexpensive shielding setup to reduce the radiation dose delivered to the eye lens region while maintaining the correct CT number and a low degree of image noise in the resultant image.

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Section: Resultsmentioning

confidence: 99%

Section: Current Strategies To Reduce the Eye Lens Dose During Ct Bramentioning

confidence: 99%

Reducing the radiation dose to the eye lens region during CT brain examination: the potential beneficial effect of the combined use of bolus and a bismuth shield

et al. 2015

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“…17 Although the eyes are rarely the area of interest during such examinations, they are often incidentally included within the scan region. This is an area of concern as the eye lens is one of the most radiosensitive organs in the human body.…”

Section: Dose Reductionmentioning

confidence: 99%

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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“…그러나 최근 연구에서 수정체의 방사선 감수성은 이전의 추정치보 다 실질적으로 더 높다고 보고하고 있다 [22] . Wang 등 의 연구 따르면 기존의 OB-TCM은 두부 CT에서 인 공음영의 발생 없이 눈에서의 선량이 30.4% 감소되었 다고 보고하였다 [24] . Reimann 등의 연구에서도 OB-TCM은 두부 CT에서 전체적인 선량감소 뿐 아 니라 전면에서 46%∼59%의 선량감소 효과를 가지는 영상을 제공한다고 하였다 [25] .…”

Section: ⅰ Introductionunclassified

“…Reimann 등의 연구에서도 OB-TCM은 두부 CT에서 전체적인 선량감소 뿐 아 니라 전면에서 46%∼59%의 선량감소 효과를 가지는 영상을 제공한다고 하였다 [25] . 50% 정도를 감약 시킨다 [24], [26] . …”

Section: ⅰ Introductionunclassified

The Evaluation of Eye Dose and Image Quality According to The New Tube Current Modulation and Shielding Techniques in Brain CT

Kwon¹,

Kim²

2015

Journal of the Korean Society of Radiology

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The eye of human is a radiation sensitive organ and this organ should be shielded from radiation exposure during brain CT procedures. In the brain CT procedures, bismuth protector using to reduce the radiation exposure dose for eye. But protecting the bismuth always accompanies problem of the image quality reduction including artifact. This study aim is the eye radiation exposure dose and image quality evaluation of the new tube current modulation such as new organ based-tube current modulation, longitudinal-TCM, angular-TCM between shielding scan technique using bismuth and lead glasses. As a result, radiation dose of eye is reduced 25.88% in new OB TCM technique then reference scan technique and SNR new OB TCM is 6.05 higher than bismuth shielding scan technique and lower than reference scan technique. In clinical brain CT, new OB TCM technique will contribute to reduction of radiation dose for eye without decrease of image quality.

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Bismuth Shielding, Organ-based Tube Current Modulation, and Global Reduction of Tube Current for Dose Reduction to the Eye at Head CT

Cited by 104 publications

References 26 publications

Reducing the radiation dose to the eye lens region during CT brain examination: the potential beneficial effect of the combined use of bolus and a bismuth shield

Reducing the radiation dose to the eye lens region during CT brain examination: the potential beneficial effect of the combined use of bolus and a bismuth shield

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

The Evaluation of Eye Dose and Image Quality According to The New Tube Current Modulation and Shielding Techniques in Brain CT

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