Verification of Effectiveness of Gonad Shielding in Female Hip Joint Radiography

Abstract

Purpose: It has been reported that the placement of protective equipment in female pelvic radiography is predominantly inadequate compared with that of male. We analyzed the actual situation of ovarian shielding by protective devices using X-ray, CT, and MR images obtained in the past, and evaluated the effectiveness of gonadal protection in female hip radiography. Methods: The ovaries were contoured in MR images and the pelvic bone was extracted by CT images. The MR/CT fusion images were created using a 3D workstation. The amount of physiological fluctuation in the ovarian location was measured. The fusion images in the ray-summation display were manually superimposed with the X-ray image, and the percentage of ovaries that could be shielded by the protective device was classified into four categories: (a) complete protection, (b) partial protection, (c) failure of protection, and (d) image retaking. Results: The mean and maximum ovarian fluctuations were 1.1 cm and 3.9 cm in the superior and inferior directions, respectively, and 0.7 cm and 2.0 cm in the left and right directions, respectively. The percentage of ovaries shielded was 18.9% for complete protection, 58.5% for partial protection, 15.1% for inadequate protection, and 7.5% for image retaking. Conclusion: The effectiveness of gonadal protection is low because the protective device could not cover the entire ovary in about 80% of the female hip radiographs.