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Use of bismuth shield for protection of superficial radiosensitive organs in patients undergoing computed tomography: a literature review and meta-analysis

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Abstract

The study aimed to assess the effect of bismuth (Bi) shielding on dose reduction and image quality in computed tomography (CT) through a literature review. A search was conducted in the following databases: Web of Science, PubMed, Google Scholar, and Scopus. Studies that reported estimated dose reduction with bismuth shielding during imaging of the eye, thyroid, and breast were included, and a meta-regression analysis was used to examine the influence of the CT scanner type on the dose reduction. The studies included a total of 237 patients and 34 pediatric and adult anthropomorphic phantoms for whom the radiation dose was reported. Bismuth shielding was recommended in 88.89% of the studies based on the maintenance of appropriate image quality under shielding. Noise associated with Bi shielding was 7.5%, 263%, and 23.5% for the eye, thyroid, and breast, respectively. The fixed-effects pooled estimate of dose reduction was 34% (95% CI: 13–55; p < 0.001) for the eye, 37% (95% CI 14–61; p < 0.001) for the thyroid, and 36% (95% CI 36–55; p < 0.001) for the breast. The image quality, usage of foams, CT scanner type, beam energies, and backscatter radiation were important factors that directly affected the efficacy of Bi shielding to reduce the radiation dose at the superficial radiosensitive organs.

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Acknowledgements

This study was supported by the office of the vice president of research of Tabriz University of Medical Sciences, Tabriz, Iran.

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Authors and Affiliations

  1. Medical Radiation Sciences Research Team, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, Iran

    Parinaz Mehnati

  2. Department of Medical Physics, School of Medicine, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, Iran

    Parinaz Mehnati, Reza Malekzadeh & Mohammad Yousefi Sooteh

  3. Student Research Committee, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, Iran

    Reza Malekzadeh

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  1. Parinaz Mehnati
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Correspondence to Reza Malekzadeh.

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Mehnati, P., Malekzadeh, R. & Sooteh, M.Y. Use of bismuth shield for protection of superficial radiosensitive organs in patients undergoing computed tomography: a literature review and meta-analysis. Radiol Phys Technol 12, 6–25 (2019). https://doi.org/10.1007/s12194-019-00500-2

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