Using patient shielding - What is the risk?

Area of Science:

• Radiological protection
• Medical imaging
• Public health

Background:

• Patient contact shielding is a long-standing practice in diagnostic X-ray examinations to protect radiosensitive organs.
• Evidence suggests this practice may be ineffective, counterproductive, and contribute to public overestimation of radiation hazards.
• Disparities in shielding application have prompted professional bodies to issue guidance, sparking debate on its necessity and criteria.

Purpose of the Study:

• To re-evaluate the criteria for using patient contact shielding in diagnostic X-ray examinations.
• To propose a more transparent and consistent approach to patient shielding recommendations.
• To address the disparity in shielding application and enhance clarity for healthcare professionals and patients.

Main Methods:

• Review of existing evidence on the effectiveness of patient contact shielding.
• Analysis of the decision-making process for implementing shielding, including risk assessment.
• Discussion of a proposed threshold for radiation dose and/or risk to guide shielding decisions.

Main Results:

• The current criteria for patient shielding are based on subjective risk assessments and reported effectiveness, leading to inconsistencies.
• A clear, stated threshold for dose and/or risk below which shielding is not required is suggested.
• Implementing such a threshold would improve uniformity and transparency in shielding practices.

Conclusions:

• Patient contact shielding practices require re-evaluation based on evidence and clear risk criteria.
• Establishing explicit dose/risk thresholds will enhance consistency, clarity, and public understanding of radiation safety in diagnostic imaging.
• This approach will facilitate the integration of future research into updated shielding guidelines.