Patient Shielding in Diagnostic Imaging: Discontinuing a Legacy Practice

Gonad shielding in pelvic radiography: modern optimised X-ray systems might allow its discontinuation

“…A few suggest reconsidering or ending the practice in female children [6][7][8][9][11][12][13], in male children [7,9,12] or in all [3,10]. Marsh and Silosky are more outspoken when referring to the officially still endorsed practice of gonad shielding as "…the folly of its continued use…" [4]. They question the linear-no-threshold model and the cumulative nature of small doses, maybe rightly, but in our opinion, it is wise to abide by the prevailing views disseminated by the international organisations in the radiation protection field.…”

“…The benefit of gonad shielding in anteroposterior (AP) pelvic radiography is currently under debate. The ICRP (2013) [1] and IAEA (2018) [2] endorse this practice, whereas others, such as the Dutch guidelines [3], Marsh and Silosky [4] and the AAPM [5], no longer recommend it. Other authors dismiss gonad shielding partly or express their doubts about existing benefits [6][7][8][9][10][11][12][13].…”

The eventual rejection of the linear no‐threshold theory will lead to a drastic reduction in the demand for diagnostic medical physics services

“…We continue to cling to this dogma in many areas of the field, including gonadal shielding and CT protocols. Despite the potential negative impact of gonadal shielding on image quality and the corresponding risk of misdiagnosis, it is only now that the idea of revising gonadal shielding recommendations is being given serious consideration . The primary reason for the continued adherence to this practice is blind loyalty to the dogma of low‐dose radiation effects, and the distorted perception and prioritization of risks that this loyalty causes.…”

Adiós al blindaje de pacientes en Radiología: Un cambio de paradigma

“…También está demostrado que la radiación dispersa o secundaria, generada por una radiografía tomada fuera del área de protección, no es afectada por el blindaje (3) . Por último, los exposímetros automáticos pueden ser "engañados" por los elementos de blindaje e incrementar paradojalmente las dosis.…”

“…Asimismo, en un reciente artículo publicado en American Journal of Roentegenology, (AJR), científicos de la Universidad de Colorado, recomiendan abandonar definitivamente esta práctica (3) .…”