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

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 radiatio...

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Bibliographic Details
Published in:Journal of nuclear cardiology 2012-02, Vol.19 (1), p.100-108
Main Authors: Einstein, Andrew J., Elliston, Carl D., Groves, Daniel W., Cheng, Bin, Wolff, Steven D., Pearson, Gregory D.N., Robert Peters, M., Johnson, Lynne L., Bokhari, Sabahat, Johnson, Gary W., Bhatia, Ketan, Pozniakoff, Theodore, Brenner, David J.
Format: Article
Language:English
Subjects:
Bismuth
bismuth shielding
Breast - radiation effects
breast shielding
Cardiology
Coronary Angiography - adverse effects
Coronary Angiography - instrumentation
Coronary Angiography - methods
Coronary CT angiography
Dosimetry
Female
Humans
Imaging
Lung
Medicine
Medicine & Public Health
Noise levels
Nuclear Medicine
Organ Specificity
Organs
Original Article
Phantoms, Imaging
Radiation Dosage
radiation dose
Radiation Injuries - etiology
Radiation Injuries - prevention & control
Radiation Protection - instrumentation
Radiology
Reproducibility of Results
Sensitivity and Specificity
Tomography, X-Ray Computed - adverse effects
Tomography, X-Ray Computed - instrumentation
Tomography, X-Ray Computed - methods
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Summary: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. 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. 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%. 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.
ISSN:1071-3581
1532-6551
DOI:10.1007/s12350-011-9473-x