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Bismuth breast-shield use in chest computed tomography for efficient dose reduction and sufficient image quality
Chih-Hsiang Ko1,2, Shiou-Ping Lee2, Yi-Chien Hsieh1,2
1Department of Radiology, Wan Fang Hospital, Taipei Medical University.
Medicine
|June 23, 2021
Summary
Bismuth breast shielding effectively reduces radiation dose during CT scans, especially when applied after scout imaging. This method, combined with iterative reconstruction, maintains diagnostic image quality and lowers cancer risk.
Area of Science:
- Medical Imaging
- Radiology
- Radiation Oncology
Background:
- Breast radiosensitivity increases cancer risk from computed tomography (CT) radiation.
- Bismuth shielding reduces radiation but can degrade image quality due to increased noise.
Purpose of the Study:
- To evaluate the impact of iterative reconstruction (IR) combined with bismuth shielding on CT image quality.
- To determine optimal application timing for bismuth breast shields.
Main Methods:
- Women underwent CT scans with three protocols: no shield, shield before scout, shield after scout.
- Images were reconstructed using an iterative reconstruction (IR) algorithm.
- Radiation dose was measured using Gafchromic films; image quality was assessed quantitatively and qualitatively.
Main Results:
- Bismuth shielding after scout view significantly reduced radiation dose by 27.99% (P < .05).
- Iterative reconstruction (IR) improved image quality, assessed by contrast-to-noise ratio.
- Radiologists found no significant difference in image quality across the three protocols.
Conclusions:
- Bismuth breast shields effectively reduce radiation dose, particularly when applied after scout imaging.
- Iterative reconstruction (IR) preserves diagnostic image quality when using bismuth shielding.
- This approach lowers radiation-induced cancer risk without compromising CT scan diagnostic value.
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