Reduction of Ovarian Radiation Dose and Image Quality Disruptive Effects: New Constructed Shields for CT Scanning of Abdomen and Pelvis

Background: Cumulative dose of ovary as a radiosensitive organ during abdominal and pelvic CT scan imaging is still a controversial challenge that requires practical dose reduction strategies. Although bismuth shields can reduce the dose in the right proportions, their use is controversial due to the reduced image quality. Objectives: The aim of this study was to investigate the performance of a new combination of X-ray absorber structures that have less effect on image quality parameters. Methods: First, various shields with different weight percentages of Cu and Bi were made, then the percentage of dose reduction and image quality were evaluated via phantoms. Finally, Shield with the least effect on image quality was evaluated for clinical evaluation on 20 patients. Results: Shielding with thicknesses of 1T and 3T reduced the Entrance skin dose of ovarian by about 52% and 73%, respectively. Shields with 90% cu-10% Bi and 100% Bi structures had the least and most destructive effects on image quality, respectively, and also have the same image quality. The 10% Bi-90% Cu shield provided a 21% greater dose reduction than the bismuth shield. Also, this 1T thick shield did not create an artifact in the reconstructed images. Conclusions: Shields are flexible, inexpensive, and user-friendly for ovarian shielding in abdominal and pelvic CT scans. Unlike bismuth shields, shields do not have the detrimental effects of image quality degradation.