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

Lawrence, Stephanie; Seeram, Euclid

doi:10.17140/roj-2-113

Cited by 18 publications

(20 citation statements)

References 35 publications

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“…Newer reconstruction algorithms are iterative reconstructions allowing high quality image acquisition at a lower tube current, while reducing image noise [14]. Adaptive statistical iterative reconstruction is one example that has been studied recently as a dose reduction method.…”

Section: Iterative Reconstructionmentioning

confidence: 99%

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Application of Different methods for Reducing Radiation Dose to Breast during MDCT

2018

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The increased use of computed tomography (CT) and its high radiation dose have led to great concerns about its potential for radiation induced cancer risks. Breast is a radiosensitive tissue based on tissue weighting factors assigned by the International Commission on Radiological Protection (ICRP). Moreover, the dose is maximal on the surface of the patient. Therefore, strategies should be taken to reduce radiation dose to the breast. The aim of this review is to introduce methods used for reducing radiation dose to breast in thoracic CT and review related performed studies. The literature indicates that bismuth shielding increases image noise and CT numbers as well as introducing streak artifacts. Tube current modulation (TCM) technique and iterative reconstruction algorithms can provide some levels of dose reduction to radiosensitive organs and superior image quality without the disadvantages of bismuth shielding. However, they are not available on all CT scanners, especially in low-income countries. Such centers may have to continue using bismuth shields to reduce the dose until these superior techniques become available at lower costs in all CT scanners. Furthermore, design and manufacture of new shields with the lower impact on image quality are desirable.

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Section: Iterative Reconstructionmentioning

confidence: 99%

“…Scanning parameters modification are not discussed in this paper, and only special techniques are introduced. Special techniques are consist of organ-based tube current modulation (TCM), globally tube current reduction, reconstruction algorithms and shielding [14].…”

mentioning

confidence: 99%

Application of Different methods for Reducing Radiation Dose to Breast during MDCT

2018

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“…[ 1 , 2 ] The breast is one of several radiosensitive organs, the others being the lens of the eye, thyroid, and gonads, that commonly receive repeated doses of radiation for diagnostic purposes, and this can lead to a greater stochastic risk of future malignancies. [ 3 , 4 ] Consequently, the importance of reducing radiation dose in all patients undergoing CT studies cannot be overemphasized. In many institutions, bismuth breast shielding is used because it is favorable in cost, effectiveness, and ease of manipulation.…”

Section: Introductionmentioning

confidence: 99%

“…[ 10 , 15 , 16 ] Therefore, alternative strategies, including but not limited to organ-based and global tube current modulation and iterative reconstruction (IR) techniques, have been deployed. [ 4 ] To our best knowledge, the literature provides no information about the effects of these alternatives, when combined with bismuth breast shielding, on dose reduction and image quality of breast CT scans. Therefore, our aim was to investigate the influence of placing bismuth shields over female breasts on the dose reduction rate, the effect of IR on image quality when the breasts are protected with bismuth shields, and the value of using these techniques in daily practice.…”

Section: Introductionmentioning

confidence: 99%

Bismuth breast-shield use in chest computed tomography for efficient dose reduction and sufficient image quality

Lee

Hsieh

et al. 2021

Medicine

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Background: Radiosensitivity in the breasts increases the risk of carcinogenesis from exposure to the ionizing radiation of computed tomography (CT) administered in the course of medical attention. Bismuth shielding techniques have been used to reduce radiation, but image noise increased, degrading image quality. Purpose: The aim of this study was to investigate how the use of iterative reconstruction (IR) combined with bismuth shielding influences image quality. Materials and Methods: Women aged at least 20 years with body mass indexes <28 were recruited and randomly assigned to 1 of 3 CT scanning protocols without shielding, with a bismuth breast shield before the scout view, or with a bismuth breast shield after the scout view. All obtained images were reconstructed using an IR algorithm. To evaluate radiation dose, 2 Gafchromic films were placed over the clothes, 1 near each nipple. Results: Average dose reduction was significant (27.99%, P < .05) when bismuth shielding was applied after the scout view. Using the contrast-to-noise ratio, the image quality was found to be superior when the IR algorithm was applied. Using quantitative evaluations by 2 radiologists applying a 4-point Likert scale, significant differences in image quality were not found among the 3 protocols. Conclusion: Bismuth breast shields, particularly when used after acquiring scout images, are effective at reducing radiation dose without undermining the diagnostic value of the images when the IR technique is applied.

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“…Using a bismuth shield in CT imaging is an effective way to reduce the absorbed dose of ovaries (6,7). Bismuth shield reduces the surface dose of the organ by absorbing low energy photons (8).…”

Section: Introductionmentioning

confidence: 99%

Reduction of Ovarian Radiation Dose and Image Quality Disruptive Effects: New Constructed Shields for CT Scanning of Abdomen and Pelvis

Bagheri

Aval

2020

J Arch Mil Med

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Background: Cumulative dose of ovary as a radiosensitive organ during abdominal and pelvic CT scan imaging is still a controversial challenge that requires practical dose reduction strategies. Although bismuth shields can reduce the dose in the right proportions, their use is controversial due to the reduced image quality. Objectives: The aim of this study was to investigate the performance of a new combination of X-ray absorber structures that have less effect on image quality parameters. Methods: First, various shields with different weight percentages of Cu and Bi were made, then the percentage of dose reduction and image quality were evaluated via phantoms. Finally, Shield with the least effect on image quality was evaluated for clinical evaluation on 20 patients. Results: Shielding with thicknesses of 1T and 3T reduced the Entrance skin dose of ovarian by about 52% and 73%, respectively. Shields with 90% cu-10% Bi and 100% Bi structures had the least and most destructive effects on image quality, respectively, and also have the same image quality. The 10% Bi-90% Cu shield provided a 21% greater dose reduction than the bismuth shield. Also, this 1T thick shield did not create an artifact in the reconstructed images. Conclusions: Shields are flexible, inexpensive, and user-friendly for ovarian shielding in abdominal and pelvic CT scans. Unlike bismuth shields, shields do not have the detrimental effects of image quality degradation.

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

Cited by 18 publications

References 35 publications

Application of Different methods for Reducing Radiation Dose to Breast during MDCT

Application of Different methods for Reducing Radiation Dose to Breast during MDCT

Bismuth breast-shield use in chest computed tomography for efficient dose reduction and sufficient image quality

Reduction of Ovarian Radiation Dose and Image Quality Disruptive Effects: New Constructed Shields for CT Scanning of Abdomen and Pelvis

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