Document Type : Original Research

Authors

1 MSc, Student Research Committee, Babol University of Medical Sciences, Babol, Iran

2 PhD, Department of Medical Physics Radiobiology and Radiation Protection, School of Medicine, Babol University of Medical Sciences, Babol, Iran

3 MD, Department of Pediatric Radiology, Babol University of Medical Sciences, Babol, Iran

4 MD, Department of Radiology and Radiotherapy, School of Medicine, Babol University of Medical Sciences, Babol, Iran

5 MSc, Department of Medical Physics Radiobiology and Radiation Protection, School of Medicine, Babol University of Medical Sciences, Babol, Iran

6 PhD, Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran

10.31661/jbpe.v0i0.2104-1307

Abstract

Background: Computed tomography (CT) is a routine procedure for diagnosing using ionization radiation which has hazardous effects especially on sensitive organs.
Objective: The aim of this study was to quantify the dose reduction effect of lead apron shielding on the testicular region during routine chest CT scans.
Material and Methods: In this measurement study, the routine chest CT examinations were performed for 30 male patients with common lead aprons folded and positioned in testis regions. The patient’s mean body mass index (BMI) was 26.2 ± 4.6 kg/m2. To calculate the doses at testis region, three thermoluminescent dosimeters (TLD-100) were attached at the top surface of the apron as an indicator of the doses without shielding, and three TLDs under the apron for doses with shielding. The TLD readouts were compared using SPSS software (Wilcoxon test) version 16.
Results: The radiation dose in the testicular regions was reduced from 0.46 ± 0.04 to 0.20 ± 0.04 mGy in the presence of lead apron shielding (p < 0.001), the reduction was equal to 56%. Furthermore, the heritable risk probability was obtained at 2.0 ×10-5 % and 4.6 ×10-5 % for the patients using the lead apron shield versus without shield, respectively.
Conclusion: Applying common lead aprons as shielding in the testis regions of male patients undergoing chest CT scans can reduce the radiation doses significantly. Therefore, this shield can be recommended for routine chest CT examinations.

Keywords

  1. Valentin J. Managing patient dose in multi-detector computed tomography (MDCT). ICRP Publication 102. Ann ICRP. 2007;1-8. doi: 10.1016/j.icrp.2007.09.001. PubMed PMID: 18069128.
  2. Hart D, Wall BF, Hillier MC, Shrimpton PC. Frequency and collective dose for medical and dental X-ray examinations in the UK, 2008. HPA-CRCE-012; UK: HPA; 2010.
  3. Davoudi M, Khoramian D, Abedi-Firouzjah R, Ataei G. STRATEGY OF COMPUTED TOMOGRAPHY IMAGE OPTIMISATION IN CERVICAL VERTEBRAE AND NECK SOFT TISSUE IN EMERGENCY PATIENTS. Radiat Prot Dosimetry. 2019;187(1):98-102. doi: 10.1093/rpd/ncz145. PubMed PMID: 31135908.
  4. Khoramian D, Sistani S, Firouzjah RA. Assessment and comparison of radiation dose and image quality in multi-detector CT scanners in non-contrast head and neck examinations. Pol J Radiol. 2019;84(3):61-7. doi: 10.5114/pjr.2019.82743. PubMed PMID: 31019596. PubMed PMCID: PMC6479057.
  5. Turner AC, Zankl M, DeMarco JJ, et al. The feasibility of a scanner-independent technique to estimate organ dose from MDCT scans: Using to account for differences between scanners. Med Phys. 2010;37(4):1816-25. doi: 10.1118/1.3368596. PubMed PMID: 20443504. PubMed PMCID: PMC2861967.
  6. Cohen BL. A test of the linear-no threshold theory of radiation carcinogenesis. Environ Res. 1990;53(2):193-220. doi: 10.1016/s0013-9351(05)80119-7. PubMed PMID: 2253600.
  7. Khorramian D, Sistani S, Banaei A, Bijari S. Estimation and assessment of the effective doses for radiosensitive organs in women undergoing chest CT scans with or without automatic exposure control system. Tehran Univ Med J. 2017;75(7):496-503.
  8. Hart D, Hillier MC, Wall BF. Doses to patients from medical X-ray examinations in the UK-2000 review. NRPB report; UK: NRPB; 2002.
  9. Edgar RG, Patel M, Bayliss S, et al. Treatment of lung disease in alpha-1 antitrypsin deficiency: a systematic review. Int J Chron Obstruct Pulmon Dis. 2017;12(1):1295-08. doi: 10.2147/COPD.S130440. PubMed PMID: 28496314. PubMed PMCID: PMC5422329.
  10. Iball GR, Brettle DS. Organ and effective dose reduction in adult chest CT using abdominal lead shielding. Br J Radiol. 2011;84(1007):1020-26. doi: 10.1259/bjr/53865832. PubMed PMID: 22011831. PubMed PMCID: PMC3473701.
  11. Protection R. The 2007 recommendations of the International Commission on Radiological Protection. ICRP publication 103. Ann ICRP. 2007;37(2-4):1-332. doi: 10.1016/j.icrp.2007.10.003. PubMed PMID: 18082557.
  12. Hohl C, Mahnken AH, Klotz E, Das M, et al. Radiation dose reduction to the male gonads during MDCT: the effectiveness of a lead shield. Am J Roentgenol. 2005;184(1):128-30. doi: 10.2214/ajr.184.1.01840128. PubMed PMID: 15615962.
  13. Shielding B. Assessing the image quality and eye lens dose reduction using bismuth shielding in computed tomography of brain. J Kerman Univ Med Sci. 2018;25(6):471-82.
  14. Dauer LT, Casciotta KA, Erdi YE, Rothenberg LN. Radiation dose reduction at a price: the effectiveness of a male gonadal shield during helical CT scans. BMC Med Imaging. 2007;7(5):1-7. doi: 10.1186/1471-2342-7-5. PubMed PMID: 17367529. PubMed PMCID: PMC1831769.
  15. Daniels C, Furey E. The effectiveness of surface lead shielding of gonads outside the primary X-ray beam. J Med Imaging Radiat Sci. 2008;39(4):189-91. doi: 10.1016/j.jmir.2008.09.001. PubMed PMID: 31051779.
  16. Sancaktutar AA, Bozkurt Y, Önder H, et al. A new practical model of testes shield: the effectiveness during abdominopelvic computed tomography. J Androl. 2012;33(5):984-89. doi: 10.2164/jandrol.111.015560. PubMed PMID: 22207708.
  17. Groves AM, Owen KE, Courtney HM, et al. 16-detector multislice CT: dosimetry estimation by TLD measurement compared with Monte Carlo simulation. Br J Radiol. 2004;77(920):662-65. doi: 10.1259/bjr/48307881. PubMed PMID: 15326044.
  18. Wrixon AD. New ICRP recommendations. J Radiol Prot. 2008;28(2):161. doi: 10.1088/0952-4746/28/2/R02. PubMed PMID: 18495983.
  19. De González AB, Mahesh M, Kim K-P, et al. Projected cancer risks from computed tomographic scans performed in the United States in 2007. Arch Intern Med. 2009;169(22):2071-77. doi: 10.1001/archinternmed.2009.440. PubMed PMID: 20008689. PubMed PMCID: PMC6276814.
  20. Linton OW, Mettler Jr FA. National conference on dose reduction in CT, with an emphasis on pediatric patients. Am J Roentgenol. 2003;181(2):321-29. doi: 10.2214/ajr.181.2.1810321. PubMed PMID: 12876005.
  21. Slovis TL. The ALARA concept in pediatric CT: myth or reality? Radiology. 2002;223(1):5-6. doi: 10.1148/radiol.2231012100. PubMed PMID: 11930041.
  22. Grobe H, Sommer M, Koch A, Hietschold V, Henniger J, Abolmaali N. Dose reduction in computed tomography: the effect of eye and testicle shielding on radiation dose measured in patients with beryllium oxide-based optically stimulated luminescence dosimetry. Eur Radiol. 2009;19(5):1156-60. doi: 10.1007/s00330-008-1241-1. PubMed PMID: 19082601.
  23. Zarb F, Rainford L, McEntee MF. AP diameter shows the strongest correlation with CTDI and DLP in abdominal and chest CT. Radiat Prot Dosimetry. 2010;140(3):266-73. doi: 10.1093/rpd/ncq115. PubMed PMID: 20332128.
  24. Price R, Halson P, Sampson M. Dose reduction during CT scanning in an anthropomorphic phantom by the use of a male gonad shield. Br J Radiol. 1999;72(857):489-94. doi: 10.1259/bjr.72.857.10505015. PubMed PMID: 10505015.
  25. Hidajat N, Schröder RJ, Vogl T, Schedel H, Felix R. The efficacy of lead shielding in patient dosage reduction in computed tomography. ROFO. 1996;165(5):462-65. doi: 10.1055/s-2007-1015790. PubMed PMID: 8998318.
  26. Shah DJ, Sachs RK, Wilson DJ. Radiation-induced cancer: a modern view. Br J Radiol. 2012;85(1020):1166-73. doi: 10.1259/bjr/25026140. PubMed PMID: 23175483. PubMed PMCID: PMC3611719.
  27. ICRP. Radiological protection in medicine. ICRP Publication 105. Ann ICRP. 2007;37(6):1-64.