BACKGROUND: Guidelines for ovarian shielding are to place a lead shield in the midline of the abdomen at the level of the umbilicus. However, the ovaries are routinely seen at other locations on all types of imaging examinations. OBJECTIVE: To determine the position of the ovaries in girls, newborn to 18 years of age, in order to assess efficacy of ovarian shield placement. MATERIALS AND METHODS: We identified 336 girls who underwent lumbar spine and pelvic MRI. Images were reviewed noting the position of the ovaries relative to anatomic landmarks: symphysis pubis, iliac crest and anterior superior iliac spine (ASIS). In 174 girls a total of 307 ovaries were visualized. The girls were divided into three age groups and analyzed together. Right and left ovaries were analyzed together. The mean, 95% confidence interval (CI), standard deviations and range were calculated. RESULTS: The ovaries lay at or below the iliac crest (the level of the umbilicus), most often just medial to the ASIS and above the pubic symphysis in girls of all ages. CONCLUSION: Current methods of shielding only the midline of the pelvis for the purpose of reducing radiation dose to the ovaries during radiographic imaging are ineffective given that the ovaries are almost always positioned laterally in the pelvis. Therefore current shielding techniques should be changed; lead ovarian shields should be placed in a lateral position or even abandoned if relevant anatomy will be obscured.
BACKGROUND: Guidelines for ovarian shielding are to place a lead shield in the midline of the abdomen at the level of the umbilicus. However, the ovaries are routinely seen at other locations on all types of imaging examinations. OBJECTIVE: To determine the position of the ovaries in girls, newborn to 18 years of age, in order to assess efficacy of ovarian shield placement. MATERIALS AND METHODS: We identified 336 girls who underwent lumbar spine and pelvic MRI. Images were reviewed noting the position of the ovaries relative to anatomic landmarks: symphysis pubis, iliac crest and anterior superior iliac spine (ASIS). In 174 girls a total of 307 ovaries were visualized. The girls were divided into three age groups and analyzed together. Right and left ovaries were analyzed together. The mean, 95% confidence interval (CI), standard deviations and range were calculated. RESULTS: The ovaries lay at or below the iliac crest (the level of the umbilicus), most often just medial to the ASIS and above the pubic symphysis in girls of all ages. CONCLUSION: Current methods of shielding only the midline of the pelvis for the purpose of reducing radiation dose to the ovaries during radiographic imaging are ineffective given that the ovaries are almost always positioned laterally in the pelvis. Therefore current shielding techniques should be changed; lead ovarian shields should be placed in a lateral position or even abandoned if relevant anatomy will be obscured.
Authors: L F Donnelly; K H Emery; A S Brody; T Laor; V M Gylys-Morin; C G Anton; S R Thomas; D P Frush Journal: AJR Am J Roentgenol Date: 2001-02 Impact factor: 3.959
Authors: Donald P Frush; Christopher C Slack; Caroline L Hollingsworth; George S Bisset; Lane F Donnelly; Jiang Hsieh; Trudy Lavin-Wensell; John R Mayo Journal: AJR Am J Roentgenol Date: 2002-11 Impact factor: 3.959
Authors: Per Hall; Hans-Olov Adami; Dimitrios Trichopoulos; Nancy L Pedersen; Pagona Lagiou; Anders Ekbom; Martin Ingvar; Marie Lundell; Fredrik Granath Journal: BMJ Date: 2004-01-03
Authors: Wassim Chemaitilly; Zhenghong Li; Matthew J Krasin; Russell J Brooke; Carmen L Wilson; Daniel M Green; James L Klosky; Nicole Barnes; Karen L Clark; Jonathan B Farr; Israel Fernandez-Pineda; Michael W Bishop; Monika Metzger; Ching-Hon Pui; Sue C Kaste; Kirsten K Ness; Deo Kumar Srivastava; Leslie L Robison; Melissa M Hudson; Yutaka Yasui; Charles A Sklar Journal: J Clin Endocrinol Metab Date: 2017-07-01 Impact factor: 5.958
Authors: Francesca E Duncan; Jennifer K Jozefik; Alison M Kim; Jennifer Hirshfeld-Cytron; Teresa K Woodruff Journal: US Obstet Gynecol Date: 2011-01-01
Authors: Lene B Laborie; Trude G Lehmann; Ingvild Ø Engesæter; Lars B Engesæter; Karen Rosendahl Journal: Clin Orthop Relat Res Date: 2013-02-15 Impact factor: 4.176
Authors: Kate E Waimey; Brigid M Smith; Rafael Confino; Jacqueline S Jeruss; Mary Ellen Pavone Journal: J Womens Health (Larchmt) Date: 2015-06-15 Impact factor: 2.681
Authors: Marij J Frantzen; Simon Robben; Alida A Postma; Johannes Zoetelief; Joachim E Wildberger; Gerrit J Kemerink Journal: Insights Imaging Date: 2011-09-25