Journal of Nuclear Cardiology

, Volume 19, Issue 1, pp 100–108

Effect of bismuth breast shielding on radiation dose and image quality in coronary CT angiography

  • Andrew J. Einstein
  • Carl D. Elliston
  • Daniel W. Groves
  • Bin Cheng
  • Steven D. Wolff
  • Gregory D. N. Pearson
  • M. Robert Peters
  • Lynne L. Johnson
  • Sabahat Bokhari
  • Gary W. Johnson
  • Ketan Bhatia
  • Theodore Pozniakoff
  • David J. Brenner
Original Article

Abstract

Background

Coronary computed tomographic angiography (CCTA) is associated with high radiation dose to the female breasts. Bismuth breast shielding offers the potential to significantly reduce dose to the breasts and nearby organs, but the magnitude of this reduction and its impact on image quality and radiation dose have not been evaluated.

Methods

Radiation doses from CCTA to critical organs were determined using metal-oxide-semiconductor field-effect transistors positioned in a customized anthropomorphic whole-body dosimetry verification phantom. Image noise and signal were measured in regions of interest (ROIs) including the coronary arteries.

Results

With bismuth shielding, breast radiation dose was reduced 46%-57% depending on breast size and scanning technique, with more moderate dose reduction to the heart, lungs, and esophagus. However, shielding significantly decreased image signal (by 14.6 HU) and contrast (by 28.4 HU), modestly but significantly increased image noise in ROIs in locations of coronary arteries, and decreased contrast-to-noise ratio by 20.9%.

Conclusions

While bismuth breast shielding can significantly decrease radiation dose to critical organs, it is associated with an increase in image noise, decrease in contrast-to-noise, and changes tissue attenuation characteristics in the location of the coronary arteries.

Keywords

Coronary CT angiography radiation dose bismuth shielding breast shielding 

Copyright information

© American Society of Nuclear Cardiology 2011

Authors and Affiliations

  • Andrew J. Einstein
    • 1
    • 2
  • Carl D. Elliston
    • 3
  • Daniel W. Groves
    • 1
  • Bin Cheng
    • 4
  • Steven D. Wolff
    • 1
    • 2
    • 5
  • Gregory D. N. Pearson
    • 2
  • M. Robert Peters
    • 2
    • 5
  • Lynne L. Johnson
    • 1
  • Sabahat Bokhari
    • 1
  • Gary W. Johnson
    • 3
  • Ketan Bhatia
    • 1
  • Theodore Pozniakoff
    • 1
    • 2
  • David J. Brenner
    • 3
  1. 1.Cardiology Division, Department of MedicineColumbia University Medical Center/New York-Presbyterian HospitalNew YorkUSA
  2. 2.Department of RadiologyColumbia University Medical Center/New York-Presbyterian HospitalNew YorkUSA
  3. 3.Center for Radiological ResearchColumbia University Medical Center/New York-Presbyterian HospitalNew YorkUSA
  4. 4.Department of BiostatisticsColumbia University Medical Center/New York-Presbyterian HospitalNew YorkUSA
  5. 5.Advanced Cardiovascular ImagingNew YorkUSA

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