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Application of Different methods for Reducing Radiation Dose to Breast during MDCT

Document Type : Review Article

Authors

1 Radiology Department, Faculty of Paramedicine, Aja University of Medical Sciences, Tehran, Iran

2 Ionizing and Non-Ionizing Radiation Protection Research Center and Department of Radio-Oncology, Shiraz University of Medical Sciences, Shiraz

Abstract

The increased use of computed tomography (CT) and its high radiation dose have led to great concerns about its potential for radiation induced cancer risks. Breast is a radiosensitive tissue based on tissue weighting factors assigned by the International Commission on Radiological Protection (ICRP). Moreover, the dose is maximal on the surface of the patient. Therefore, strategies should be taken to reduce radiation dose to the breast. The aim of this review is to introduce methods used for reducing radiation dose to breast in thoracic CT and review related performed studies. The literature indicates that bismuth shielding increases image noise and CT numbers as well as introducing streak artifacts. Tube current modulation (TCM) technique and iterative reconstruction algorithms can provide some levels of dose reduction to radiosensitive organs and superior image quality without the disadvantages of bismuth shielding. However, they are not available on all CT scanners, especially in low-income countries. Such centers may have to continue using bismuth shields to reduce the dose until these superior techniques become available at lower costs in all CT scanners. Furthermore, design and manufacture of new shields with the lower impact on image quality are desirable.

Keywords

References
  1. Brenner DJ, Hall EJ. Computed tomography--an increasing source of radiation exposure. N Engl J Med. 2007;357:2277-84. doi: 10.1056/NEJMra072149. PubMed PMID: 18046031.
  2. Kalra MK, Maher MM, Toth TL, Hamberg LM, Blake MA, Shepard JA, et al. Strategies for CT radiation dose optimization. Radiology. 2004;230:619-28. doi: 10.1148/radiol.2303021726. PubMed PMID: 14739312.
  3. Karami V, Zabihzadeh M, Keshtkar M. Evaluation of the Entrance Surface Dose (ESD) and Radiation Dose to the Radiosensitive Organs in Pediatric Pelvic Radiography. Int J Pediatr. 2017;5:5013-22.
  4. Curtis JR. Computed tomography shielding methods: a literature review. Radiol Technol. 2010;81:428-36. PubMed PMID: 20445137.
  5. Wrixon AD. New ICRP recommendations. J Radiol Prot. 2008;28:161-8. doi: 10.1088/0952-4746/28/2/R02. PubMed PMID: 18495983.
  6. Zakariaee SS, Saba V, Valizadeh A. Study the Effect of Gantry Tilting and Tube Voltage Reducing on the Eye Lens Dose Reduction in Computed Tomography Using MCNPx. Paramedical Sciences and Military Health. 2017;12:39-49.
  7. Zeinali-Rafsanjani B, Faghihi R, Mosleh-Shirazi MA, Mosalaei A, Hadad K. Revision of orthovoltage chest wall treatment using Monte Carlo simulations. Technol Health Care. 2017;25:413-24. doi: 10.3233/THC-161276. PubMed PMID: 27886021.
  8. Mohammadyari P, Faghihi R, Mosleh-Shirazi MA, Lotfi M, Hematiyan MR, Koontz C, et al. Calculation of dose distribution in compressible breast tissues using finite element modeling, Monte Carlo simulation and thermoluminescence dosimeters. Phys Med Biol. 2015;60:9185-202. doi: 10.1088/0031-9155/60/23/9185. PubMed PMID: 26572554.
  9. Zeinali Rafsanjani B, Mosleh-Shirazi MA, Faghihi R, Mosalaei A, Omidvari S, Hadad K, et al. Breast cancer and its radiotherapeutic methods. Iranian Journal of Medical Physics. 2012;9:75-85.
  10. Keshtkar M, Shahbazi-Gahrouei D, Khoshfetrat SM, Mehrgardi MA, Aghaei M. Aptamer-conjugated Magnetic Nanoparticles as Targeted Magnetic Resonance Imaging Contrast Agent for Breast Cancer. J Med Signals Sens. 2016;6:243-7. PubMed PMID: 28028501; PubMed Central PMCID: PMC5157001.
  11. Mohammadianpanah M, Ahmadloo N, Mozaffari MA, Mosleh-Shirazi MA, Omidvari S, Mosalaei A. Primary localized stages I and II non-Hodgkin’s lymphoma of the nasopharynx: a retrospective 17-year single institutional experience. Ann Hematol. 2009;88:441-7. doi: 10.1007/s00277-008-0627-0. PubMed PMID: 18931844.
  12. Mohammadianpanah M, Ashouri Y, Hoseini S, Amadloo N, Talei A, Tahmasebi S, et al. The efficacy and safety of neoadjuvant chemotherapy +/- letrozole in postmenopausal women with locally advanced breast cancer: a randomized phase III clinical trial. Breast Cancer Res Treat. 2012;132:853-61. doi: 10.1007/s10549-011-1814-6. PubMed PMID: 22002564.
  13. Omidvari S, Shafizad A, Razmjou-Ghalaei S, Nasrolahi H, Ahmadloo N, Ansari M, et al. Efficacy of Topical Honey, Topical Hydrocortisone 1% and Simple Washing on Healing of Radiation-induced Dermatitis in Breast Cancer Patients. Journal of Isfahan Medical School. 2011;28:1-9.
  14. Lawrence S, Seeram E. The current use and effectiveness of bismuth shielding in computed tomography: A systematic review. Radiol Open J. 2017;2:7-16. doi: 10.17140/roj-2-113.
  15. Zakariaee SS, Saba V. A Mathematical Head Phantom for Dosimetry Measurements by Monte Carlo Method. Paramedical Sciences and Military Health. 2016;11:12-20.
  16. Lambert JW, Gould RG. Evaluation of a Net Dose-Reducing Organ-Based Tube Current Modulation Technique: Comparison With Standard Dose and Bismuth-Shielded Acquisitions. AJR Am J Roentgenol. 2016;206:1233-40. doi: 10.2214/AJR.15.15778. PubMed PMID: 27058461.
  17. Coursey C, Frush DP, Yoshizumi T, Toncheva G, Nguyen G, Greenberg SB. Pediatric chest MDCT using tube current modulation: effect on radiation dose with breast shielding. AJR Am J Roentgenol. 2008;190:W54-61. doi: 10.2214/AJR.07.2017. PubMed PMID: 18094273.
  18. Wang J, Duan X, Christner JA, Leng S, Yu L, McCollough CH. Radiation dose reduction to the breast in thoracic CT: comparison of bismuth shielding, organ-based tube current modulation, and use of a globally decreased tube current. Med Phys. 2011;38:6084-92. doi: 10.1118/1.3651489. PubMed PMID: 22047373.
  19. Kim YK, Sung YM, Choi JH, Kim EY, Kim HS. Reduced radiation exposure of the female breast during low-dose chest CT using organ-based tube current modulation and a bismuth shield: comparison of image quality and radiation dose. AJR Am J Roentgenol. 2013;200:537-44. doi: 10.2214/AJR.12.9237. PubMed PMID: 23436842.
  20. Hoang JK, Yoshizumi TT, Choudhury KR, Nguyen GB, Toncheva G, Gafton AR, et al. Organ-based dose current modulation and thyroid shields: techniques of radiation dose reduction for neck CT. AJR Am J Roentgenol. 2012;198:1132-8. doi: 10.2214/AJR.11.7445. PubMed PMID: 22528904.
  21. Lai N, Chen T, Tyan Y, Tsai H. Off-centre effect on dose reduction to anterior surfaces with organ-based tube-current modulation. Radiation Measurements. 2013;59:155-9. doi: 10.1016/j.radmeas.2013.04.023.
  22. Foley SJ, McEntee MF, Rainford LA. An evaluation of in-plane shields during thoracic CT. Radiat Prot Dosimetry. 2013;155:439-50. doi: 10.1093/rpd/nct030. PubMed PMID: 23460031.
  23. Mathieu KB, Cody DD. Partial arc beam filtration: a novel approach to reducing CT breast radiation dose. AJR Am J Roentgenol. 2013;200:601-7. doi: 10.2214/AJR.12.8771. PubMed PMID: 23436850; PubMed Central PMCID: PMC3855393.
  24. Hopper KD. Orbital, thyroid, and breast superficial radiation shielding for patients undergoing diagnostic CT. Semin Ultrasound CT MR. 2002;23:423-7. PubMed PMID: 12509112.
  25. Yilmaz MH, Albayram S, Yasar D, Ozer H, Adaletli I, Selcuk D, et al. Female breast radiation exposure during thorax multidetector computed tomography and the effectiveness of bismuth breast shield to reduce breast radiation dose. J Comput Assist Tomogr. 2007;31:138-42. doi: 10.1097/01.rct.0000235070.50055.e6. PubMed PMID: 17259846.
  26. Tappouni R, Mathers B. Scan Quality and Entrance Skin Dose in Thoracic CT: A Comparison between Bismuth Breast Shield and Posteriorly Centered Partial CT Scans. ISRN Radiol. 2013;2013:457396. doi: 10.5402/2013/457396. PubMed PMID: 24967274; PubMed Central PMCID: PMC4045517.
  27. Hohl C, Wildberger JE, Suss C, Thomas C, Muhlenbruch G, Schmidt T, et al. Radiation dose reduction to breast and thyroid during MDCT: effectiveness of an in-plane bismuth shield. Acta Radiol. 2006;47:562-7. PubMed PMID: 16875333.
  28. Catuzzo P, Aimonetto S, Fanelli G, Marchisio P, Meloni T, Mistretta L, et al. Dose reduction in multislice CT by means of bismuth shields: results of in vivo measurements and computed evaluation. Radiol Med. 2010;115:152-69. doi: 10.1007/s11547-009-0469-4. PubMed PMID: 20012921.
  29. Einstein AJ, Elliston CD, Groves DW, Cheng B, Wolff SD, Pearson GD, et al. Effect of bismuth breast shielding on radiation dose and image quality in coronary CT angiography. J Nucl Cardiol. 2012;19:100-8. doi: 10.1007/s12350-011-9473-x. PubMed PMID: 22068687; PubMed Central PMCID: PMC3266996.
Journal of Biomedical Physics and Engineering
Volume 8, Issue 4 - Serial Number 4
30
December 2018
Pages 341-346
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