In-Plane Bismuth Breast Shields for Pediatric CT: Effects on Radiation Dose and Image Quality Using Experimental and Clinical Data
Bradley L. Fricke1,
Lane F. Donnelly1,
Donald P. Frush2,
Terry Yoshizumi2,
Vladimir Varchena3,
Stacy A. Poe1 and
Javier Lucaya4
1 Departments of Radiology and Pediatrics, Cincinnati Children's Hospital
Medical Center and University of Cincinnati College of Medicine, 3333 Burnet
Ave., Cincinnati, OH 45229-3039.
2 Department of Radiology, Box 3808, Duke University Medical Center, Durham, NC
27710.
3 Computed Imaging Reference Systems, Inc., Norfolk, VA 23513.
4 Radiologia Pediatrica, Hospital Materno-Infantil Vall d'He, pg. Vall d'Hebron
119-129, E-08-35, Barcelona, Spain.
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Fig. 1. —Photograph shows materials used to construct in-plane bismuth
breast shields: two sheets of bismuth-coated latex (2-ply) were placed on top
of 1-cm foam pad. Protective tape was then placed over pictured materials and
superior aspect of shield was labeled as such. Scale is in centimeters.
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Fig. 2A. —Images illustrate position of breast shields in relation to
chest. Photograph shows medium-sized breast shield placed over garments of
10-year-old girl. Note position of shield.
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Fig. 2B. —Images illustrate position of breast shields in relation to
chest. Scout image from CT examination of 5-year-old girl who underwent CT of
chest to evaluate potential mediastinal mass. Note position of medium-sized
shield.
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Fig. 2C. —Images illustrate position of breast shields in relation to
chest. Scout image from CT examination of 15-year-old girl who underwent CT of
chest to exclude recurrent lymphoma. Note position of large breast shield.
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Fig. 3A. —Normal lung in 12-year-old girl with bony pelvic mass who
underwent CT to exclude metastatic disease. CT scan obtained at level of
inplane breast shield shows lung detail.
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Fig. 3B. —Normal lung in 12-year-old girl with bony pelvic mass who
underwent CT to exclude metastatic disease. CT scan obtained at level superior
to breast shield shows no perceptible difference in image quality between lung
at level not shielded and at level shielded.
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Fig. 4. —CT image of 14-year-old with breast shield in place shows
technique for region-of-interest placement for noise determination. Four 2- to
3-mm regions of interest were placed, one each in anterior and posterior
aspects of each lung. Regions were measured both at level of shielded and at
level of non-shielded lung.
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Fig. 5A. —Normal lung in 10-year-old girl who underwent CT on two
separate occasions to exclude metastatic disease. CT scan obtained with breast
shield in place shows lung detail at level of shield.
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Fig. 5B. —Normal lung in 10-year-old girl who underwent CT on two
separate occasions to exclude metastatic disease. CT scan obtained 3 months
before A (before implementation of breast shield program) shows similar
image quality without shield in place.
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Fig. 6A. —Lung nodule in 17-year-old girl with history of ovarian
dysgerminoma. CT scan obtained with breast shield in place shows lung nodule
(arrow) in right lower lobe.
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Fig. 6B. —Lung nodule in 17-year-old girl with history of ovarian
dysgerminoma. CT scan obtained 3 months before A (before implementation
of breast shield program) shows nodule (arrow) with similar image
quality as that when shield is in place.
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Copyright © 2003 by the American Roentgen Ray Society.
