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Exploring Past to Present Shielding Guidelines.

Bethany K Stearns1, Kristin Seitz1, Quest M Folck1

  • 1Bethany K Stearns, MS, R.T.(R)(MR)(CT), CHEP; Kristin Seitz, BSMI, R.T.(R)(MR)(CT), MRSO(MRSC); Quest M Folck, BS, R.T.(R)(CT); are graduate students in the Master of Science Radiologic Sciences program at Southern Illinois University in Carbondale.

Radiologic Technology
|November 8, 2023
PubMed
Summary

Routine fetal and gonadal shielding in medical imaging is no longer necessary. Evidence shows shielding can increase patient dose and interfere with modern imaging technology, posing risks like infection.

Keywords:
automatic exposuredose reductiongonadal shieldingpatient shieldingpatient shielding recommendations

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Area of Science:

  • Medical Physics
  • Radiological Protection
  • Diagnostic Imaging

Background:

  • The American Association of Physicists in Medicine (AAPM) issued a 2019 statement recommending limitations on routine fetal and gonadal shielding.
  • This review examines the evidence supporting and challenging the continued use of shielding in medical imaging.

Approach:

  • A systematic literature search was conducted across 5 online databases.
  • Articles were selected from scholarly journals and radiology trade publications, published between January 1, 2016, and August 9, 2022.
  • The review focused on data relevant to the AAPM's 2019 statement and historical context.

Key Points:

  • Patient shielding during medical imaging, including CT, fluoroscopy, and dental scans, did not consistently reduce radiation dose and, in some cases, increased it.
  • Shielding can interfere with dose-reducing technologies like automatic exposure control and dose modulation.
  • Common errors in shield placement, potential for infection, and lead dust contamination were identified as risks.

Conclusions:

  • The evidence strongly supports discontinuing routine patient shielding in radiographic procedures.
  • Technological advancements and a better understanding of radiation protection have rendered traditional shielding unnecessary.
  • Educational materials for radiologic technologists and students require updates to reflect current best practices.