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. 2012 Feb;19(1):100-8.
doi: 10.1007/s12350-011-9473-x. Epub 2011 Nov 9.

Effect of bismuth breast shielding on radiation dose and image quality in coronary CT angiography

Andrew J Einstein  1 , Carl D Elliston, Daniel W Groves, Bin Cheng, Steven D Wolff, Gregory D N Pearson, M Robert Peters, Lynne L Johnson, Sabahat Bokhari, Gary W Johnson, Ketan Bhatia, Theodore Pozniakoff, David J Brenner
Affiliations

Effect of bismuth breast shielding on radiation dose and image quality in coronary CT angiography

Andrew J Einstein et al. J Nucl Cardiol. 2012 Feb.

Abstract

Background: Coronary computed tomographic angiography (CCTA) is associated with high radiation dose to the female breasts. Bismuth breast shielding offers the potential to significantly reduce dose to the breasts and nearby organs, but the magnitude of this reduction and its impact on image quality and radiation dose have not been evaluated.

Methods: Radiation doses from CCTA to critical organs were determined using metal-oxide-semiconductor field-effect transistors positioned in a customized anthropomorphic whole-body dosimetry verification phantom. Image noise and signal were measured in regions of interest (ROIs) including the coronary arteries.

Results: With bismuth shielding, breast radiation dose was reduced 46%-57% depending on breast size and scanning technique, with more moderate dose reduction to the heart, lungs, and esophagus. However, shielding significantly decreased image signal (by 14.6 HU) and contrast (by 28.4 HU), modestly but significantly increased image noise in ROIs in locations of coronary arteries, and decreased contrast-to-noise ratio by 20.9%.

Conclusions: While bismuth breast shielding can significantly decrease radiation dose to critical organs, it is associated with an increase in image noise, decrease in contrast-to-noise, and changes tissue attenuation characteristics in the location of the coronary arteries.

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Figures

Figure 1
Figure 1
Modified physical anthropomorphic phantom with medium-sized (left) and large sized (right) breast phantoms attached.
Figure 2
Figure 2
Phantom with MOSFETs attached to measure radiation doses to internal organs during CCTA. Here, MOSFETs are positioned both in breasts and internal organs for illustrative purposes.
Figure 3
Figure 3
Phantom positioned on a scanner with bismuth breast shield in place. MOSFET detectors can be observed emerging from below shield in the upper right hand corner.
See this image and copyright information in PMC

References

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