Radioprotection to the Gonads in Pediatric Pelvic Radiography: Effectiveness of Developed Bismuth Shield

Background: The use and effectiveness of traditional lead gonad shields in pediatric pelvic radiography has been challenged by several literatures over the past two decades. The aim of this study was to develop a new radioprotective gonad shields to be use in pediatric pelvic radiography. Materials and Methods: The commercially available 0.06 mm lead equivalent bismuth garment has cropped squarely and used as ovarian shield to cover the entire region of pelvis. In order to prevent deterioration of image quality due to beam hardening artifacts, a 1-cm foam as spacer was located between the shield and patients pelvis. Moreover, we added a lead piece at the cranial position of the bismuth garment to absorb the scatter radiations to the radiosensitive organs. In girls, 49 radiographs with shield and 46 radiographs without shield was taken. The radiation dose was measured using thermoluminescent dosimeters (TLDs). Image quality assessments were performed using the European guidelines. For boys, the lead testicular shields was developed using 2 cm bismuth garment, added to the sides. The prevalence and efficacy of testicular shields was assessed in clinical practice fromFebruary 2016 to June 2016. Results: Without increasing the dose to the breast, thyroid and the lens of the eyes, the use of bismuth shield has reduced the entrance skin dose(ESD) of the pelvis and radiation dose to the ovaries by 62.2% and 61.7%, respectively (P