M Keshtkar, V Saba, M A Mosleh-Shirazi
Radiology Department, Faculty of Paramedicine, Aja University of Medical Sciences, Tehran, Iran.
Ionizing and Non-Ionizing Radiation Protection Research Center and Department of Radio-Oncology, Shiraz University of Medical Sciences, Shiraz.
J Biomed Phys Eng. 2018 Dec 1;8(4):341-346. eCollection 2018 Dec.
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.
计算机断层扫描(CT)的使用增加及其高辐射剂量引发了人们对其潜在辐射致癌风险的极大关注。根据国际放射防护委员会(ICRP)指定的组织权重因子,乳腺是一种放射敏感组织。此外,患者体表的剂量最大。因此,应采取策略降低乳腺的辐射剂量。本综述的目的是介绍在胸部CT中用于降低乳腺辐射剂量的方法,并回顾相关的已开展研究。文献表明,铋屏蔽会增加图像噪声和CT值,还会引入条纹伪影。管电流调制(TCM)技术和迭代重建算法可以在一定程度上降低对放射敏感器官的剂量,并提供 superior 图像质量,而没有铋屏蔽的缺点。然而,并非所有CT扫描仪都具备这些技术,尤其是在低收入国家。这些中心可能不得不继续使用铋屏蔽来降低剂量,直到这些 superior 技术能够以较低成本在所有CT扫描仪上普及。此外,设计和制造对图像质量影响较小的新型屏蔽是很有必要的。