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Fetal shielding combined with state of the art CT dose reduction strategies during maternal chest CT.
Eur J Radiol 2014; 83(7):1199-1204EJ

Abstract

PURPOSE

Custom bismuth-antimony shields were previously shown to reduce fetal dose by 53% on an 8DR (detector row) CT scanner without dynamic adaptive section collimation (DASC), automatic tube current modulation (ATCM) or adaptive statistical iterative reconstruction (ASiR). The purpose of this study is to compare the effective maternal and average fetal organ dose reduction both with and without bismuth-antimony shields on a 64DR CT scanner using DASC, ATCM and ASiR during maternal CTPA.

MATERIALS AND METHODS

A phantom with gravid prosthesis and a bismuth-antimony shield were used. Thermoluminescent dosimeters (TLDs) measured fetal radiation dose. The average fetal organ dose and effective maternal dose were determined using 100 kVp, scanning from the lung apices to the diaphragm utilizing DASC, ATCM and ASiR on a 64DR CT scanner with and without shielding in the first and third trimester. Isolated assessment of DASC was done via comparing a new 8DR scan without DASC to a similar scan on the 64DR with DASC.

RESULTS

Average third trimester unshielded fetal dose was reduced from 0.22 mGy ± 0.02 on the 8DR to 0.13 mGy ± 0.03 with the conservative 64DR protocol that included 30% ASiR, DASC and ATCM (42% reduction, P<0.01). Use of a shield further reduced average third trimester fetal dose to 0.04 mGy ± 0.01 (69% reduction, P<0.01). The average fetal organ dose reduction attributable to DASC alone was modest (6% reduction from 0.17 mGy ± 0.02 to 0.16 mGy ± 0.02, P=0.014). First trimester fetal organ dose on the 8DR protocol was 0.07 mGy ± 0.03. This was reduced to 0.05 mGy ± 0.03 on the 64DR protocol without shielding (30% reduction, P=0.009). Shields further reduced this dose to below accurately detectable levels. Effective maternal dose was reduced from 4.0 mSv on the 8DR to 2.5 mSv on the 64DR scanner using the conservative protocol (38% dose reduction).

CONCLUSION

ASiR, ATCM and DASC combined significantly reduce effective maternal and fetal organ dose during CTPA. Shields continue to be an effective means of fetal dose reduction.

Authors+Show Affiliations

Department of Diagnostic Imaging, University of Saskatchewan, Canada. Electronic address: lch088@mail.usask.ca.Department of Diagnostic Imaging, University of Saskatchewan, Canada.Department of Diagnostic Imaging, University of Saskatchewan, Canada.Saskatchewan Ministry of Labour Relations and Workplace Safety, Canada.Saskatchewan Ministry of Labour Relations and Workplace Safety, Canada.Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Canada.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24838282

Citation

Chatterson, Leslie C., et al. "Fetal Shielding Combined With State of the Art CT Dose Reduction Strategies During Maternal Chest CT." European Journal of Radiology, vol. 83, no. 7, 2014, pp. 1199-1204.
Chatterson LC, Leswick DA, Fladeland DA, et al. Fetal shielding combined with state of the art CT dose reduction strategies during maternal chest CT. Eur J Radiol. 2014;83(7):1199-1204.
Chatterson, L. C., Leswick, D. A., Fladeland, D. A., Hunt, M. M., Webster, S., & Lim, H. (2014). Fetal shielding combined with state of the art CT dose reduction strategies during maternal chest CT. European Journal of Radiology, 83(7), pp. 1199-1204. doi:10.1016/j.ejrad.2014.04.020.
Chatterson LC, et al. Fetal Shielding Combined With State of the Art CT Dose Reduction Strategies During Maternal Chest CT. Eur J Radiol. 2014;83(7):1199-1204. PubMed PMID: 24838282.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fetal shielding combined with state of the art CT dose reduction strategies during maternal chest CT. AU - Chatterson,Leslie C, AU - Leswick,David A, AU - Fladeland,Derek A, AU - Hunt,Megan M, AU - Webster,Stephen, AU - Lim,Hyun, Y1 - 2014/04/30/ PY - 2014/01/13/received PY - 2014/04/14/revised PY - 2014/04/15/accepted PY - 2014/5/20/entrez PY - 2014/5/20/pubmed PY - 2015/2/6/medline KW - ASiR KW - ATCM KW - DASC KW - Fetal dose reduction KW - Maternal CTPA KW - Shielding KW - Thoracic SP - 1199 EP - 1204 JF - European journal of radiology JO - Eur J Radiol VL - 83 IS - 7 N2 - PURPOSE: Custom bismuth-antimony shields were previously shown to reduce fetal dose by 53% on an 8DR (detector row) CT scanner without dynamic adaptive section collimation (DASC), automatic tube current modulation (ATCM) or adaptive statistical iterative reconstruction (ASiR). The purpose of this study is to compare the effective maternal and average fetal organ dose reduction both with and without bismuth-antimony shields on a 64DR CT scanner using DASC, ATCM and ASiR during maternal CTPA. MATERIALS AND METHODS: A phantom with gravid prosthesis and a bismuth-antimony shield were used. Thermoluminescent dosimeters (TLDs) measured fetal radiation dose. The average fetal organ dose and effective maternal dose were determined using 100 kVp, scanning from the lung apices to the diaphragm utilizing DASC, ATCM and ASiR on a 64DR CT scanner with and without shielding in the first and third trimester. Isolated assessment of DASC was done via comparing a new 8DR scan without DASC to a similar scan on the 64DR with DASC. RESULTS: Average third trimester unshielded fetal dose was reduced from 0.22 mGy ± 0.02 on the 8DR to 0.13 mGy ± 0.03 with the conservative 64DR protocol that included 30% ASiR, DASC and ATCM (42% reduction, P<0.01). Use of a shield further reduced average third trimester fetal dose to 0.04 mGy ± 0.01 (69% reduction, P<0.01). The average fetal organ dose reduction attributable to DASC alone was modest (6% reduction from 0.17 mGy ± 0.02 to 0.16 mGy ± 0.02, P=0.014). First trimester fetal organ dose on the 8DR protocol was 0.07 mGy ± 0.03. This was reduced to 0.05 mGy ± 0.03 on the 64DR protocol without shielding (30% reduction, P=0.009). Shields further reduced this dose to below accurately detectable levels. Effective maternal dose was reduced from 4.0 mSv on the 8DR to 2.5 mSv on the 64DR scanner using the conservative protocol (38% dose reduction). CONCLUSION: ASiR, ATCM and DASC combined significantly reduce effective maternal and fetal organ dose during CTPA. Shields continue to be an effective means of fetal dose reduction. SN - 1872-7727 UR - https://www.unboundmedicine.com/medline/citation/24838282/Fetal_shielding_combined_with_state_of_the_art_CT_dose_reduction_strategies_during_maternal_chest_CT_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0720-048X(14)00220-4 DB - PRIME DP - Unbound Medicine ER -