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Bismuth Shielding in Head Computed Tomography-Still Necessary?

Jana Di Rosso1, Andreas Krasser2, Sebastian Tschauner1

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Summary

Bismuth shielding significantly reduces eye lens radiation dose during pediatric cranial CT scans. Combining bismuth shielding with other techniques like AEC and OBTCM further enhances dose reduction, though it may increase orbital image noise, which can be mitigated by foam.

Keywords:
bismuthcrystallineionizinglensmultidetector computed tomographyradiationradiation protection

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Area of Science:

  • Radiological physics
  • Medical imaging
  • Radiation protection

Background:

  • Cranial CT scans expose the radiosensitive eye lens to radiation, posing a greater risk to children.
  • Current guidelines (IRCP 2021) discourage patient contact shielding in most areas.
  • This study investigates the continued utility of bismuth shielding (BS) and its combination with other dose reduction technologies.

Purpose of the Study:

  • To evaluate the effectiveness of bismuth shielding (BS) in reducing eye lens radiation dose during pediatric cranial CT.
  • To assess the impact of combining BS with Automatic Exposure Control (AEC) and other dose reduction methods.
  • To analyze the effect of BS and standoff foam on image quality in the orbital and cranial regions.

Main Methods:

  • Pediatric anthropomorphic phantom used for cranial CT scans on two MDCT scanners.
  • Eye lens doses measured using thermoluminescent dosimeters.
  • Assessed image quality impact of BS, with and without standoff foam.

Main Results:

  • BS significantly reduced eye lens dose on both scanners (GE: 41.50%, Siemens: 29.75%).
  • Combination with AEC further lowered dose (GE: 60.75%, Siemens: 41.25%).
  • Maximum dose reduction achieved with BS + AEC + OBTCM (GE: 71.25%, Siemens: 58.75%). BS increased orbital image noise, mitigated by foam; cranial image noise unaffected.

Conclusions:

  • Bismuth shielding effectively reduces radiation dose to the eye lens in pediatric cranial CT.
  • Combining BS with AEC and OBTCM significantly enhances dose reduction.
  • While BS increases orbital noise, standoff foam mitigates this without affecting cranial image quality.