[The End of Patient Shielding: Rationale for Discontinuing the Practice]

Gonadal shielding has been a standard practice in diagnostic radiology for more than 70 years, originally introduced to reduce hereditary risks from ionizing radiation. However, advancements in digital imaging technology have substantially decreased patient radiation doses, and epidemiological studies have not shown any significant genetic risk associated with diagnostic imaging. Current evidence suggests that the potential harms of routine patient shielding, such as increased radiation dose from automatic exposure control malfunction and the possibility of obscuring critical anatomical details, now outweigh its benefits. Consequently, major international organizations, including the American Association of Physicists in Medicine, have recommended discontinuing routine patient shielding, including gonadal and fetal shields. This review summarizes the scientific rationale for this change, outlines the updated global guidelines, and discusses strategies for education and communication to facilitate their implementation. Optimal radiation protection should be achieved through justification and protocol optimization rather than routine patient shielding.