Trade-off between breast dose and image quality using composite bismuth shields in computed tomography: A phantom study.

Introduction: Many researchers have suggested that bismuth composite shields (BCS) reduce breast dose remarkably; however, the level of this reduction and its impact on image quality has not been assessed. This study aimed to evaluate the efficiency of nano- and micro- BCS in reducing the dose and image quality during chest computed tomography (CT) scans.

Materials And Methods: Bismuth shields composed of 15 weighting percentage (wt%) and 20 wt% bismuth oxide (BiO) nano- and micro-particles mixed in silicon rubber polymer were constructed in 1 and 1.5 mm thicknesses. The physical properties of nanoparticles were assessed using a scanning electron microscope (SEM), X-ray diffraction (XRD), and energy-dispersive X-ray (EDX). Breast radiation doses were measured experimentally during chest CT using PMMA standard dosimetry phantom (body phantom, 76-419-4150, Fluke Biomedical) in the presence of the shields. The image quality was assessed by calculating signal and noise values in different regions.

Results: The SEM images showed that the average size of BiO nano- and micro-particles was about 70 nm and 150 μm, respectively. The breast doses were reduced by increasing the shield thickness/bismuth weight percentage. The maximum dose reduction was related to the 20% weight of BiO nano-particles and a thickness of 1.5 mm. The minimum dose reduction was related to the 15% weight of BiO micro-particles with a thickness of 1 mm. The mean noise was higher in nano-particle bismuth shields than in micro-particles.

Conclusion: Composite shields containing bismuth nano- and micro-particles can reduce the breast dose during chest CT examinations while negatively impacting diagnostic image quality. Several critical factors, such as bismuth concentration, particle size, and shield thickness, directly affect the efficiency.