The effects of bismuth breast shields in conjunction with automatic tube current modulation in CT imaging

There are mechanisms within CT scanners and shielding that can be used to lower dose to patients.

The objective of our study was to evaluate the dose changes and image quality with and without a breast shield for multidetector CT of the chest with angular tube current modulation.

An anthropomorphic 5-year-old phantom was scanned with and without bismuth breast shielding and with and without angular tube current modulation. Image quality was assessed by measuring signal-to-noise ratio and contrast-to-noise ratio as well as measuring qualitatively. ANOVA single-factor p-value analysis of paired datasets was used for the statistical analysis.

The breast shielding and angular tube current modulation resulted in a dose reduction to 85% for the breast and 90% overall. Although no qualitative differences were noted with and without the breast shielding used with angular tube current modulation, there were statistically significant differences in the contrast-to-noise ratio and CT numbers.

When used with angular tube current modulation, breast shields influence the contrast-to-noise ratio and CT numbers, and therefore should not be used for chest CT. Greater dose reduction can be obtained by reducing the reference mAs (or reference noise index).