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Appropriate timing in the use of breast shields in children can further reduce MDCT radiation dose
February 13, 2008Using breast shields during pediatric chest MDCT reduces radiation dose and minimally increases image noise, according to a recent study conducted by researchers at Duke University Medical Center in Durham, NC and the University of Arkansas for Medical Sciences and Arkansas Children's Hospital in Little Rock.
"It's important for radiologists to limit dose in CT, especially to children, and especially to radiosensitive regions, such as breast tissue; and radiologists should be familiar with strategies to do this," said Donald P. Frush, MD, lead author of the study. "Two strategies are breast shielding, and the other is automatic tube current modulation (ATCM). However, the combination of the shield and ATCM may not be effective since the equipment might increase the dose to penetrate the shield," said Dr. Frush. "We wanted to see if there was a way to circumvent this and in fact there was: by placing the shields on the patient after the topogram (scout) from which the tube current would be modulated. This was tested using a GE scanner and it may not work with other scanners," he said.
Researchers performed MDCT on the chest an anthropomorphic phantom that represented a 5-year-old child. They obtained two scans in each of four sequences: without the shield, with a 2-ply bismuth shield, ATCM after placement of the shield and ATCM before placement of the shield.
The study showed that the bismuth breast shield reduced radiation dose to the breast by 26% and shielding and ATCM reduced the dose by 52%. The study also showed that multiple organ doses were lowest when the shield was placed after the scout radiograph was obtained. With this technique, image noise increased, but the images were still of good quality.
"Radiologists need to understand their equipment's ATCM before using shielding. Parents should inquire about dose reduction strategies before their child undergoes a CT scan and physicians who refer pediatric patients to radiologists should understand that research is continuing to minimize radiation dose in CT," said Dr. Frush.
American Roentgen Ray Society
The study showed that the bismuth breast shield reduced radiation dose to the breast by 26% and shielding and ATCM reduced the dose by 52%. The study also showed that multiple organ doses were lowest when the shield was placed after the scout radiograph was obtained. With this technique, image noise increased, but the images were still of good quality.
"Radiologists need to understand their equipment's ATCM before using shielding. Parents should inquire about dose reduction strategies before their child undergoes a CT scan and physicians who refer pediatric patients to radiologists should understand that research is continuing to minimize radiation dose in CT," said Dr. Frush.
American Roentgen Ray Society
Radiation Dose Current Events and Radiation Dose News RSSFirst use of antibody and stem cell transplantation to successfully treat advanced leukemia
For the first time, researchers at Fred Hutchinson Cancer Research Center have reported the use of a radiolabeled antibody to deliver targeted doses of radiation, followed by a stem cell transplant, to successfully treat a group of leukemia and pre-leukemia patients for whom there previously had been no other curative treatment options.
Study of concurrent radiotherapy, chemotherapy shows promise in small cell lung cancer
Treating limited stage small cell lung cancer(LSCL) with a combination of accelerated high-dose radiotherapy and chemotherapy has shown encouraging results.
Short-term hormone therapy and intermediate dose radiation increases survivial for early stage prostate cancer
Short-term hormone therapy given prior to and during intermediate dose radiation treatment for men with early stage prostate cancer increases their chance of living longer, compared to those who receive the same radiation alone.
Task force develops new radiation guidelines for brachytherapy
Radiation dose delivered to the prostate and nearby organs in every brachytherapy procedure should be carefully analyzed using post-implant CT or MRI and uniformly documented in every patient.
Identification of highly radiosensitive patients may lead to side effect-free radiotherapy
An international group of scientists has taken the first step on the road to targeting radiotherapy dosage to individual patients by means of their genetic characteristics.
Radiologists find a technique to significantly reduce patient radiation dose during CT angiography
Radiologists have discovered that prospective electrocardiogram (ECG) gating allows them to significantly reduce the patient radiation dose delivered during computed tomography (CT) angiography, a common noninvasive technique used to evaluate vascular disease.
Comprehensive cardiac CT scan may give clearer picture of significant heart disease
A team of researchers led by Massachusetts General Hospital (MGH) radiologists has developed a computed-tomography-based protocol that identifies both narrowing of coronary arteries and areas of myocardial ischemia - restricted blood flow to heart muscle tissue - giving a better indication of clinically significant coronary artery disease.
Radiologists, medical physicists work to make imaging procedures safer
The Radiological Society of North America (RSNA) reaffirmed its commitment to patient safety today in responding to a study and accompanying perspective on radiation dose from medical imaging procedures in the New England Journal of Medicine (NEJM).
Iterative reconstruction technique significantly reduces patient radiation dose during CT scans
Computed tomography (CT) scans are responsible for more than two thirds of the total radiation dose associated with medical imaging exams.
Perform non-radiation ERCP during pregnancy: Is it safe?
Hormonal changes during pregnancy increase the lithogenicity of bile and impair gallbladder emptying, which create a favorable environment for gallstone formation.
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