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<0.001). Image quality remained diagnostically acceptable in all shielded and non-shielded images, without non-diagnostic or poor quality image. In boy patients, the prevalence of shielding in lead and developed testicular shields were obtained 63.25% and 19.74%, respectively; the accuracy positioning of the shield 90% and 34%, as well as.
Conclusion: The ovarian shield designed in this study has significantly reduced the radiation dose to the ovaries without adversely affecting diagnostically image quality. The testicular shield has improved the accuracy positioning of the shield. These developed shields have potential to be use in clinical practice.