{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:17:55Z","timestamp":1792783075156,"version":"4.5.0"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T00:00:00Z","timestamp":1694649600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T00:00:00Z","timestamp":1694649600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Valtion erityisvastuualuerahoitus"},{"name":"University of Turku (UTU) including Turku University Central Hospital","id":[{"id":"https:\/\/ror.org\/05vghhr25","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim of the patient out-of-plane shield is to reduce the patient radiation dose. Its effect on tube current modulation was evaluated with the out-of-plane shield visible in the localizer but absent in the scan range in chest CT with different CT scanners.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An anthropomorphic phantom was scanned with six different CT scanners from three different vendors. The chest was first scanned without any shielding, and then with the out-of-plane shield within the localizer but outside the imaged volume. All pitch values of each scanner were used. The tube current values with and without the out-of-plane shield were collected and used to evaluate the effect of overscanning and tube current modulation (TCM) on patient radiation dose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The highest increase in cumulative mA was 217%, when the pitch was 1.531. The tube current value increased already 8.9\u00a0cm before the end of the scanned anatomy and the difference between the tube current of the last slices (with and without the out-of-plane shield in the localizer) was 976%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Applying an out-of-plane shield outside the scanned volume but visible in the localizer images may increase the patient dose considerably if the scanner\u2019s TCM function is based only on localizer images.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical relevance statement<\/jats:title>\n                    <jats:p>The use of an out-of-plane shield in CT may strongly increase the tube current modulation and thus provide the patient with a higher radiation dose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:italic>\u2022 Applying an out-of-plane shield outside the scanned volume but visible in the localizer images may increase patient radiation dose considerably.<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:italic>\u2022 The effect is visible with scanners that use solely localizer-based tube current modulation.<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:italic>\u2022 Features like overscanning may be difficult for the user to notice when planning the scanning, and yet they may affect tube current modulation and through it to patient dose.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00330-023-10211-3","type":"journal-article","created":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T00:02:23Z","timestamp":1694649743000},"page":"2480-2486","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["To shield or not to shield: shielding may have unintended effects on patient dose in CT"],"prefix":"10.1007","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6428-0556","authenticated-orcid":false,"given":"Heli Riitta Sinikka","family":"Larjava","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chibuzor T. M.","family":"Eneh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannele M.","family":"Niiniviita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,9,14]]},"reference":[{"key":"10211_CR1","doi-asserted-by":"publisher","unstructured":"European Commission (2015) Radiation Protection No 180. Medical radiation exposure of the European population, Part 1\/2. Publications Office of the European Union, Luxembourg. https:\/\/doi.org\/10.2833\/708119","DOI":"10.2833\/708119"},{"key":"10211_CR2","doi-asserted-by":"crossref","unstructured":"United Nations (2011) Summary of low-dose radiation effects on health. United Nations Scientific Committee on the Effects of Atomic Radiation, sources and effects of ionizing radiation, Vienna. Available via https:\/\/www.unscear.org\/unscear\/uploads\/documents\/unscear-reports\/UNSCEAR_2010_Report.pdf. 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