In scoliosis imaging, which option best reduces breast dose when feasible?

• A. PA Position Only
• B. PA Position And With Breast Shields
• C. Lateral Position And With Breast Shields
• D. PA Position, Lateral Position, And With Breast Shields

Answer: (B)

The main idea is to minimize radiation to breast tissue during scoliosis imaging by using a projection that places the breasts away from the primary beam and by applying shielding when it won’t compromise the exam.

A PA projection reduces breast dose compared with an AP view because the beam enters from the back and the breasts sit farther from the entrance, lowering the entrance skin dose and reducing scatter reaching breast tissue. Adding breast shielding further decreases exposure to the breast without compromising the spine image, as long as shielding is positioned so it doesn’t obscure anatomy.

Using a lateral view would add another exposure and positions the breast differently, increasing overall dose to the area despite shielding. Therefore, combining a PA projection with breast shields yields the lowest breast dose when feasible.