Kaplan Summer L, Magill Dennise, Felice Marc A, Xiao Rui, Ali Sayed, Zhu Xiaowei
Department of Radiology, The Children's Hospital of Philadelphia, 34th Street & Civic Center Boulevard, Philadelphia, PA, 19104, USA.
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Pediatr Radiol. 2018 Feb;48(2):227-234. doi: 10.1007/s00247-017-3996-5. Epub 2017 Oct 18.
Gonadal shielding remains common, but current estimates of gonadal radiation risk are lower than estimated risks to colon and stomach. A female gonadal shield may attenuate active automatic exposure control (AEC) sensors, resulting in increased dose to colon and stomach as well as to ovaries outside the shielded area.
We assess changes in dose-area product (DAP) and absorbed organ dose when female gonadal shielding is used with AEC for pelvis radiography.
We imaged adult and 5-year-old equivalent dosimetry phantoms using pelvis radiograph technique with AEC in the presence and absence of a female gonadal shield. We recorded DAP and mAs and measured organ absorbed dose at six internal sites using film dosimetry.
Female gonadal shielding with AEC increased DAP 63% for the 5-year-old phantom and 147% for the adult phantom. Absorbed organ dose at unshielded locations of colon, stomach and ovaries increased 21-51% in the 5-year-old phantom and 17-100% in the adult phantom. Absorbed organ dose sampled under the shield decreased 67% in the 5-year-old phantom and 16% in the adult phantom.
Female gonadal shielding combined with AEC during pelvic radiography increases absorbed dose to organs with greater radiation sensitivity and to unshielded ovaries. Difficulty in proper use of gonadal shields has been well described, and use of female gonadal shielding may be inadvisable given the risks of increasing radiation.
性腺屏蔽仍很常见,但目前对性腺辐射风险的估计低于对结肠和胃部的估计风险。女性性腺屏蔽可能会削弱自动曝光控制(AEC)传感器的功能,导致结肠、胃部以及屏蔽区域外的卵巢所接受的剂量增加。
我们评估在骨盆X线摄影中使用女性性腺屏蔽并结合AEC时剂量面积乘积(DAP)和器官吸收剂量的变化。
我们使用骨盆X线摄影技术并结合AEC,对成年和5岁等效剂量学体模进行成像,分别在有和没有女性性腺屏蔽的情况下进行。我们记录了DAP和mAs,并使用胶片剂量测定法测量了六个内部部位的器官吸收剂量。
对于5岁体模,使用女性性腺屏蔽并结合AEC使DAP增加了63%,对于成年体模则增加了147%。在5岁体模中,结肠、胃部和卵巢未屏蔽部位的器官吸收剂量增加了21% - 51%,在成年体模中增加了17% - 100%。在屏蔽下方采样的器官吸收剂量在5岁体模中减少了67%,在成年体模中减少了16%。
在骨盆X线摄影期间,女性性腺屏蔽与AEC相结合会增加对辐射敏感性较高的器官以及未屏蔽卵巢的吸收剂量。性腺屏蔽使用不当的问题已有充分描述,鉴于增加辐射的风险,使用女性性腺屏蔽可能不可取。