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Reduction of dose to the female breast in thoracic CT: a comparison of standard-protocol, bismuth-shielded, partial and tube-current-modulated CT examinations

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Abstract

We evaluated the potential for reduction of dose to the female breast in computed tomography (CT) of the thorax by using three different techniques: bismuth shielding, partial CT scanning and tube-current modulation (TCM). Measurements and simulations of dose and image quality were performed for a 64-slice CT system using a semi-anthropomorphic thorax phantom with breasts added. Three-dimensional dose distributions were calculated by Monte Carlo (MC) methods. Noise was determined by measurements and simulations. Bismuth shielding resulted in a dose reduction of about 50% for the breast, noise increased up to 40% and image quality was impaired by artifacts. In partial CT scans, not irradiating the breasts directly, dose to the breasts was reduced typically by 50%. To sustain a constant noise level, an increase of irradiation in the anteroposterior position resulted in a higher dose to the spine. Reduction of dose to the breasts of about 10% was achieved with TCM; distribution of noise was homogeneous and image quality uniform. Reduction of dose to the female breast was achieved by using all adapted CT methods. Bismuth shielding may compromise image quality, increase noise level and introduce streak artifacts. Partial and TCM examinations reduced dose to the breast without influencing image quality.

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Acknowledgements

This work was financially supported by the EC-EURATOM 6 Framework Program (2002–2006) and forms part of the “Safety and Efficacy of Computed Tomography (CT): A broad perspective” project (contract no. FP/002388).

We also would like to thank Tanja Gagliardi, M.D., Inselspital Bern, for fruitful discussions, inspirations and support with this topic.

Many thanks to our colleagues Paul Deak, Oliver Langner and Michael Knaup from the Institute of Medical Physics in Erlangen for their support in dose calculations, dose measurements and image reconstruction.

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  1. Institute of Medical Physics, Henkestrasse 91, 91052, Erlangen, Germany

    Sabrina V. Vollmar & Willi A. Kalender

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  1. Sabrina V. Vollmar
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  2. Willi A. Kalender
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Correspondence to Sabrina V. Vollmar.

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Vollmar, S.V., Kalender, W.A. Reduction of dose to the female breast in thoracic CT: a comparison of standard-protocol, bismuth-shielded, partial and tube-current-modulated CT examinations. Eur Radiol 18, 1674–1682 (2008). https://doi.org/10.1007/s00330-008-0934-9

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  • DOI: https://doi.org/10.1007/s00330-008-0934-9

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