Gonad Shielding for Patients Undergoing Conventional Radiological Examinations: Is There Cause for Concern?

Karami, Vahid; Zabihzadeh, Mansour; Gholami, Mehrdad

doi:10.17795/jjhr-31170

Cited by 9 publications

(13 citation statements)

References 11 publications

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“…Similarly, bismuth shields could reduce radiation exposure by 17 to 62%, based on anatomical region and X-ray tube setup [18,27]. Although the effectiveness of shielding has been documented for some X-ray examinations, evidence showed that shielding tools are not available in some X-ray centers and if so, their use is frequently ignored [17,28]. Several studies have focused on the availability and use of shielding tools in diagnostic X-ray centers across the country and contradictory results been reported.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Shielding in Diagnostic X-ray Centers in the Islamic Republic of Iran: A Systematic Review

Chavideh

Khorshidi

Baghmalek

et al. 2019

MHS

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Shielding has been recommended as an effective tool against radiation exposure. Several studies have published on the availability and use of shielding tools in diagnostic X-ray centers across the country and contradictory results been reported. Therefore, the aim of this systematic review was to find out the status of radiation protection in term of availability and use of shielding tools in diagnostic X-ray centers in Iran. An extensive literature search was conducted in the PubMed/Medline, Embase, ISI, Cochrane Library, SID, Magiran, IranMedex, Irandoc and Google-Scholar search engine. We also manually searched the reference lists of the relevant studies. Two authors independently assessed the eligibility of all studies and extracted data. Thirty-seven studies published from 1998 to 2019 were included in this systematic review. In all, 1089 diagnostic X-ray centers, 4439 radiographs and performance of 1472 radiographers were covered in these studies. The availability of lead apron, gonad shield and thyroid collar were ranged from 7 to 95.5%, 26.6 to 94% and 7 to 94%, respectively. Moreover, their usage was ranged from 0 to 85.5%, 0 to 35% and 0 to 38.4%, respectively. In addition, lens shield was discussed in one study with availability of 0%. During 1998 to 2019, the status of shielding had not improved across the country. Therefore adherence to the safety guideline as far as possible is required to protection patients from undue exposure to radiation.

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Section: Introductionmentioning

confidence: 99%

Prevalence of Shielding in Diagnostic X-ray Centers in the Islamic Republic of Iran: A Systematic Review

Chavideh

Khorshidi

Baghmalek

et al. 2019

MHS

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“…The low adherence rate of radiographers applying lead shields is reported to result from the complexity in identifying gonadal position in relation to surface landmarks and the risk of obscuring bony structures. 5,24,25 Our developed bismuth ovarian shield protects the ovaries, colon, and pelvis bone by covering the entire pelvic region. Because bismuth shields can be placed more easily without concern for obscuring diagnostic features, these developed shields are easier to use, especially in crowded and emergency radiology centres.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, shielding the gonads with 1-mm lead sheet has been common practice among radiographers since the 1950s. 5 However, positioning of such shields is frequently incorrect. This results in repeated examinations that consequently increase the total radiation dose.…”

Section: Introductionmentioning

confidence: 99%

Bismuth Radioprotective Gonadal Shields: Prevalence of Use and Effect on Image Quality during Paediatric Pelvic Radiography

Karami¹,

Zabihzadeh²,

Shams³

2018

Hong Kong J Radiol

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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.

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“…X-ray field collimation has been also recognized as one of the most important factors influencing image quality and patient dose. According to the safety principle ALARA, radiographers have to limit radiation field to anatomical area of interest (15,16).…”

Section: Introductionmentioning

confidence: 99%

Challenges of Irradiation on Extrathoracic and Non-thoracic Organs in Portable Neonatal Chest Radiography: Do We Need Mandatory Protective Rules?

2021

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Background: A chest X-ray (CXR) is known as the most common radiography used for adult and pediatric patients worldwide. Improper X-ray field collimation can result in excessive radiation dose on non-thoracic organs in chest radiographs. Objectives: This study was to investigate X-ray field collimation quality in neonatal chest radiography. Methods: A total of 213 chest radiographs of neonates from three hospitals were analyzed for collimation quality assessment in a retrospective study. Accordingly, ideal imaging field (IIF) and current imaging field (CIF) were initially defined. The margins of the IIF included acromioclavicular (AC) level to lower costal margin (i.e. top to bottom) and one centimeter beyond the broadest area of the chest on each side (that is, right to left). The CIF size was also defined as the square borders of collimators. Results: The findings revealed that the area of the CIF was 1.65 ± 0.39 times to the ideal imaging firlddd (IIF) for three hospitals, suggesting that collimation quality in neonatal chest radiographs was not accurate and it had defects. According to the results, acceptable collimation percentage (36.6%) in Hospital A was more than that in two other centers, and the given center also provided the lowest radiation due to the exposure of non-thoracic structures to primary beams. Conclusions: It was concluded that training radiographers and using patient immobilization devices and stabilizers were of important points that could reduce radiation exposure to non-thoracic organs in pediatric CXR.

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Gonad Shielding for Patients Undergoing Conventional Radiological Examinations: Is There Cause for Concern?

Cited by 9 publications

References 11 publications

Prevalence of Shielding in Diagnostic X-ray Centers in the Islamic Republic of Iran: A Systematic Review

Prevalence of Shielding in Diagnostic X-ray Centers in the Islamic Republic of Iran: A Systematic Review

Bismuth Radioprotective Gonadal Shields: Prevalence of Use and Effect on Image Quality during Paediatric Pelvic Radiography

Challenges of Irradiation on Extrathoracic and Non-thoracic Organs in Portable Neonatal Chest Radiography: Do We Need Mandatory Protective Rules?

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