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Background: Gonad shielding is one of the fundamental methods by which to protect reproductive organs in patients undergoing conventional radiological examinations. A lack of or inadequate shielding of the gonads may increase the exposure of these organs and result in malignancies future generations. Objectives: The aim of this study is to investigate the prevalence of gonad shielding in patients undergoing conventional radiological examinations and the availability of gonad shields and gonad shielding protocols in radiology departments. Materials and Methods: A retrospective, observational cross-sectional study on the application of gonad shielding, the availability of gonad shields and the existence of gonad shielding protocols in radiology departments was performed in five different hospitals in Ahvaz, Iran. Results: The highest application of gonad shielding was 6.6% for the pediatric hospital. The prevalence of gonad shielding was less than 0.2%. In 64.3% of the radiography rooms, at least one flat-contact gonad shield of a large size was available. Only large-sized gonad shields were available. Curved-contact and shadow gonad shields did not exist. Gonad shielding protocols were not existence in any of the fourteen radiography rooms investigated. Conclusions: Comprehensive protection programs with on-the-job training courses for staff members are strongly recommended, as well as, the provision of radiological shields and gonad shielding protocols in radiology departments to reduce the patient's radiation dose during radiological examinations.

Objective: Traditional lead gonadal shields may not be effective to reduce radiation exposure, owing to poor compliance from radiographers and frequent repeated examinations due to obscured diagnostic areas. This study aimed to evaluate the effect of bismuth shields on image quality during paediatric pelvic radiography. Methods: We previously developed bismuth radioprotective gonadal shields for use in paediatric pelvic radiography at our institution. We retrospectively retrieved and reviewed radiographic images from an existing digital image library. All images were examined for the presence and accurate positioning of gonadal shields. The diagnostic image quality was assessed by an experienced evaluation panel with selected imaging criteria adapted from the European guidelines. Results: A bismuth shield was present in 154 of 198 radiographs of boys and in 170 of 182 radiographs of girls. In boys, the shield protected the testes area adequately in 92 images and partially in 51 images. The shield obscured the remaining 11 images, rendering image quality suboptimal according to the European guidelines. In girls, the shield protected the ovaries adequately in 169 images and partially in one image. No significant differences were seen between the quality of shielded and non-shielded images. Conclusion: Our study demonstrated that these shields do not have a detrimental effect on image quality and can be recommended for routine use.

Objective:We aimed to assess qualitatively the effects of a bismuth breast shield by measuring image noise and computed tomography (CT) number changes with 0-, 1-, 2-, and 3-cm shield-to-phantom distances. We also sought to assess the dose reduction achieved by the shield and to evaluate its effect on image quality. Methods: A cylindrical body phantom was scanned using an adult thoracic CT protocol with 0-, 1-, 2-, and 3-cm foam spacers placed between the shield and the phantom, measuring the noise and CT numbers (in Hounsfield units [HU]) of the image data. We also used the shield with 3-cm spacer over the left breast in 180 female patients referred for chest CT. Dose measurements were performed using thermoluminescent dosimeters. The image quality was assessed following European guidelines. Results: A 0-cm shield-to-phantom distance significantly increased noise and CT numbers of the image data. The 3-cm shield-to-phantom distance effectively lowered shield-induced image noise; however, the HUs remained significantly increased over all shield-to-phantom distances (p < 0.001). In the patient study, the average absorbed doses to the shielded and non-shielded breasts were 13.6±3.1 mGy and 24.04±4.7 mGy, respectively; a 43.4% dose reduction. Conclusion:Combining a bismuth shield with a 3-cm shield-to-breast foam spacer significantly reduced radiation exposure without qualitative or quantitative deterioration of images in terms of image noise. However, increases in the HUs of the images persisted.

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