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Culloty M, de Labouchere S, Curran G, Bezzina P, England A, Rawashdeh M, Ali MA, McEntee M. Attitudes and awareness regarding the European consensus statement on the use of patient contact shielding. J Med Imaging Radiat Sci 2025; 56:101888. [PMID: 40117999 DOI: 10.1016/j.jmir.2025.101888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Revised: 12/14/2024] [Accepted: 02/19/2025] [Indexed: 03/23/2025]
Abstract
INTRODUCTION Lead contact shielding has been an essential element of patient radiation protection since its introduction in the early 1900s. The European Consensus Statement (ECS) on Patient Contact Shielding argues that diagnostic radiation doses have decreased to negligible levels. Given the potential for lead shielding to be misaligned or displaced, the ECS recommends refraining from its use to prevent the occurrence of repeated radiation exposures. This study aims to describe the awareness of radiographers concerning the European Consensus Statement with emphasis dedicated to shielding outside the FOV or out-of-field shielding (OFS). METHODS An online survey was designed to assess radiographer's awareness and attitudes to the ECS. This survey incorporated quantitative and qualitative elements. The survey was distributed to a target population of registered radiographers. RESULTS There were 112 participants who registered as Irish radiographers. Seventy-nine (71 %) participants knew of the European Consensus publication on patient contact shielding. Eighty-one (72.3 %) participants agreed that the risk from ionising radiation in general radiography exams is negligible. Seventy-two (63.4 %) participants felt more training should be provided on OFS. Thirty-two (28.6 %) participants agreed that some patients are more sensitive to ionising radiation, and shielding may be the safest action. CONCLUSION The results of this study indicate that responding radiographers are aware of the European Consensus Statement and largely agree with its recommendations to discontinue the use of shielding during low-dose X-ray examinations. Additionally, the study reveals that most radiographers do not employ lead shielding in various common clinical practice scenarios. IMPLICATIONS FOR PRACTICE Further investigation is required to evaluate radiographer's attitudes toward contact shielding. Future research might explore the psychological impact on patients, infection concerns, departmental protocols, and discomfort related to contact shielding.
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Affiliation(s)
- Mark Culloty
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland
| | - Stephanie de Labouchere
- Cantonal University Hospital Vaud (CHUV)2, Lausanne, Switzerland; Department of Radiologic Medical Imaging Technology3, HESAV School of Health Sciences, University of Applied Sciences and Arts Western Switzerland (HES-SO), Switzerland
| | - Grainne Curran
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland
| | - Paul Bezzina
- Department of Radiography, Faculty of Health Sciences, University of Malta
| | - Andrew England
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland
| | - Mohammad Rawashdeh
- Medical Imaging Sciences, College of Health Sciences, Gulf Medical University, Ajman, United Arab Emirates; Faculty of Health Sciences, Jordan University of Sciences and Technology, Irbid, Jordan.
| | - Magdi A Ali
- Medical Imaging Sciences, College of Health Sciences, Gulf Medical University, Ajman, United Arab Emirates
| | - Mark McEntee
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland; Institute of Regional Health Research, University of Southern Denmark, Denmark
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2
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O'Rourke M, Moore N, Young R, Svetlic S, Bucknall H, McEntee MF, Alzyoud KS, England A. An investigation into the knowledge, attitudes, and practice of radiation protection in interventional radiology and cardiac catheter-laboratories. J Med Imaging Radiat Sci 2024; 55:101440. [PMID: 38908031 DOI: 10.1016/j.jmir.2024.101440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 05/20/2024] [Accepted: 05/21/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND According to current literature, there is a lack of information regarding the radiation protection (RP) practices of interventional radiology (IR) and cardiology catheter laboratory (CCL) staff. This study aims to determine the RP practices of staff within IR and CCLs internationally and to suggest areas for improvement. METHODS A cross-sectional study in the form of an online questionnaire was developed. Participation was advertised via online platforms and through email. Participants were included if they were healthcare professionals currently working in IR and CCLs internationally. Questionnaire design included Section 1 demographic data, Section 2 assessed RP training and protocols, Section 3 surveyed the use of different types of RP lead shields, both personal and co-worker use and Section 4 assessed other methods of minimising radiation dose within practice. Questions were a mix of open and closed ended, descriptive statistics were used for closed questions and thematic analysis was employed for open ended responses. RESULTS A total of 178 responses to the questionnaire were recorded with 130 (73 %) suitable for analysis. Most respondents were female (n = 94, 72 %) and were radiographers (n = 97, 75 %). Only 68 (53 %) had received training, the majority receiving this in-house (n = 54, 79 %). 118 (98 %) of respondents had departmental protocols in place for RP. Radiology managers (n = 106, 82 %) were most likely to contribute to such protocols. Multiple methods of dose minimisation exist, these include low-dose fluoroscopy, staff rotation, radiation dose audits and minimal time in the controlled areas. Respondents reported that lead apron shields were wore personally by 99 % of respondents and by co-workers in 95 % of cases. CONCLUSION The practices of RP by IR and CCL staff in this survey was variable and can be improved. The unavailability of basic radiation protection tools and RP specific training courses/modules were some of the reasons for sub-optimal self-protection against ionising radiation reported by respondents.
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Affiliation(s)
- Megan O'Rourke
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland
| | - Niamh Moore
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland
| | - Rena Young
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland
| | - Silvia Svetlic
- Department of Radiology, San Raffaelle Hospital, Milan, Italy
| | - Helen Bucknall
- Department of Radiology, St. George's Hospital, London, UK
| | - Mark F McEntee
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland; Faculty of Medicine, University of Sydney, Sydney, Australia; School of Health Sciences, University of Southern Denmark, Denmark
| | - Kholoud S Alzyoud
- The Hashemite University, Faculty of Allied Health Sciences, Zarqa, Jordan
| | - Andrew England
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland.
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Nozoe S, Terazaki K, Sasaki M, Nakata M. Efficacy of gonadal shielding in dose reduction for female pelvic radiography. RADIATION PROTECTION DOSIMETRY 2024; 200:770-778. [PMID: 38726990 DOI: 10.1093/rpd/ncae116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/13/2024] [Accepted: 04/23/2024] [Indexed: 06/05/2024]
Abstract
This study aimed to evaluate the dose reduction using gonad shielding (GS) during pelvic imaging. Three types of pelvic images (radiography, magnetic resonance and computed tomography) were fused to elucidate the three-dimensional relationship between the position of ovaries and GS. To estimate the dose received by the ovaries, the off-axis dose at any given depth was measured under two different imaging conditions using thermoluminescence dosemeters and a polymethyl methacrylate phantom. The mean ovarian depth was 8.4 cm. The mean estimated ovarian dose without an additional filter was 0.36 mGy without GS and 0.14 mGy with GS. The mean estimated ovarian dose with an additional filter was 0.24 mGy without GS and 0.10 mGy with GS. The efficacy of ovarian dose reduction should be evaluated based on the achieved ovarian dose, considering the ovarian depth and use of additional filtration, rather than the ovarian protection rate of GS.
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Affiliation(s)
- Saki Nozoe
- Division of Clinical Radiology Service, Kyoto University Hospital, Kyoto, Japan
| | - Kei Terazaki
- Division of Clinical Radiology Service, Kyoto University Hospital, Kyoto, Japan
| | - Makoto Sasaki
- Division of Clinical Radiology Service, Kyoto University Hospital, Kyoto, Japan
| | - Manabu Nakata
- Division of Clinical Radiology Service, Kyoto University Hospital, Kyoto, Japan
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Stogiannos N, Psimitis A, Bougias H, Georgiadou E, Leandrou S, Papavasileiou P, Polycarpou I, Malamateniou C, McEntee MF. Exploring radiographers' perceptions and knowledge about patient lead shielding: a cross-sectional study in Greece and Cyprus. RADIATION PROTECTION DOSIMETRY 2023; 199:1401-1409. [PMID: 37415570 DOI: 10.1093/rpd/ncad194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/02/2023] [Accepted: 06/19/2023] [Indexed: 07/08/2023]
Abstract
The present study aimed to explore radiographers' knowledge, clinical practice and perceptions regarding the use of patient lead shielding in Greece and Cyprus. Qualitative data were analyzed using conceptual content analysis and through the classification of findings into themes and categories. A total of 216 valid responses were received. Most respondents reported not being aware of the patient shielding recommendations issued by the American Association of Physicists in Medicine (67%) or the guidance issued by the British Institute of Radiology (69%). Shielding-related training was generally not provided by radiography departments (74%). Most of them (85%) reported that they need specific guidance on lead shielding practices. Also, 82% of the respondents said that lead shielding should continue to be used outside the pelvic area when imaging pregnant patients. Pediatric patients are the most common patient category to which lead shielding was applied. Significant gaps in relevant training have been identified among radiographers in Greece and Cyprus, highlighting the need for new protocols and provision of adequate training on lead shielding practices. Radiography departments should invest in appropriate shielding equipment and adequately train their staff.
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Affiliation(s)
- Nikolaos Stogiannos
- Discipline of Medical Imaging and Radiation Therapy, University College Cork, Cork, T12 R229, Ireland
- Division of Midwifery and Radiography, City University of London, London, EC1V OHB, United Kingdom
- Medical Imaging Department, Corfu General Hospital, Corfu 49100, Greece
| | | | - Haralabos Bougias
- Department of Clinical Radiology, Ioannina University Hospital, Ioannina 45110, Greece
| | | | - Stephanos Leandrou
- School of Science, European University Cyprus, Nicosia 1516, Cyprus
- School of Mathematical Sciences, Computer Science and Engineering, City University of London, London, EC1V 0HB, United Kingdom
| | - Periklis Papavasileiou
- Section of Radiography and Radiotherapy, Department of Biomedical Sciences, School of Health Sciences, University of West Attica, Athens 12243, Greece
| | - Irene Polycarpou
- Department of Health Sciences, European University Cyprus, Nicosia 1516, Cyprus
| | - Christina Malamateniou
- Division of Midwifery and Radiography, City University of London, London, EC1V OHB, United Kingdom
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne 1007, Switzerland
| | - Mark F McEntee
- Discipline of Medical Imaging and Radiation Therapy, University College Cork, Cork, T12 R229, Ireland
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Sarıbal GŞ, Canger EM, Yaray K. Evaluation of the radiation protection effectiveness of a lead-free homopolymer in cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:91-101. [PMID: 37002015 DOI: 10.1016/j.oooo.2023.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 12/26/2022] [Accepted: 01/28/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVE The objective was to compare the radiation protection effectiveness of a lead-free thermoplastic homopolymer (Anti-RAD) to conventional lead shielding in cone beam computed tomography (CBCT) exposures. STUDY DESIGN Thermoluminescent dosimeters were placed on a human bone- and soft tissue-equivalent phantom to record equivalent doses in the thyroid gland, thyroid skin, and breast areas. CBCT images were obtained with the following 3 protocols: (1) without radiation shielding; (2) with 0.5-mm lead equivalent lead-containing shielding; and (3) with 0.5-mm lead equivalent Anti-RAD shielding. Independent t tests were used to evaluate the results. RESULTS Compared with exposures without shielding, both lead and Anti-RAD protective devices reduced thyroid gland equivalent doses by approximately 40%, thyroid skin doses by approximately 75%, right breast skin doses by approximately 80%, and left breast skin doses by 75%. The differences in equivalent dose for both types of shielding compared with exposure with no shielding were statistically significant (P ≤ .042). However, there were no significant differences in dose reduction at any site between lead and Anti-RAD shielding (P ≥ .135). CONCLUSIONS Radiation protection equivalent to lead can be provided with the Anti-RAD shield. With the use of this material, disadvantages such as damage to the aprons, lead toxicity, weight of lead aprons, and microbial contamination can be reduced.
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Affiliation(s)
- Gamze Şirin Sarıbal
- Research Assistant, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey.
| | - Emin Murat Canger
- Associate Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University-Kayseri, Turkey
| | - Kadir Yaray
- Department of Radiation Oncology, University of Erciyes Faculty of Medicine, Kayseri, Turkey
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Hurley L, Alashban Y, Albeshan S, England A, McEntee MF. The effect of breast shielding outside the field of view on breast entrance surface dose in axial X-ray examinations: a phantom study. Diagn Interv Radiol 2023; 29:555-560. [PMID: 37129301 PMCID: PMC10679606 DOI: 10.4274/dir.2023.232126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/03/2023] [Indexed: 05/03/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the effect of outside-field-of-view (FOV) lead shielding on the entrance surface dose (ESD) of the breast on an anthropomorphic X-ray phantom for a variety of axial skeleton X-ray examinations. METHODS Using an anthropomorphic phantom and radiation dosimeter, the ESD of the breast was measured with and without outside-FOV shielding in anterior-posterior (AP) abdomen, AP cervical spine, occipitomental 30° (OM30) facial bones, AP lumbar spine, and lateral lumbar spine radiography. The effect of several exposure parameters, including a low milliampere-seconds technique, grid use, automatic exposure control use, wraparound lead (WAL) use, trolley use, and X-ray table use, on the ESD of the breast with and without outside-FOV shielding was investigated. The mean ESD (μSv) and standard deviation for each radiographic protocol were calculated. A one-tailed Student's t-test was carried out to evaluate whether ESD to the breast was reduced with the use of outside-FOV shielding. RESULTS A total of 920 breast ESD measurements were recorded across the different protocol parameters. The largest decrease in mean ESD of the breast with outside-FOV shielding was 0.002 μSv (P = 0.084), recorded in the AP abdomen on the table with a grid, OM30 on the table with a grid, OM30 standard protocol on the trolley, and OM30 on the trolley with WAL protocols. This decrease was found to be statistically non-significant. CONCLUSION This study found no significant decrease in the ESD of the breast with the use of outside-FOV shielding for the AP abdomen, AP cervical spine, OM30 facial bones, AP lumbar spine, or lateral lumbar spine radiography across a range of protocols.
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Affiliation(s)
- Lauren Hurley
- Department of Medical Imaging and Radiation Therapy, University College Cork, School of Medicine, Brookfield Health Sciences, Munster, Ireland
| | - Yazeed Alashban
- Department of Radiological Sciences, King Saud University, College of Applied Medical Sciences, Riyadh, Saudi Arabia
| | - Salman Albeshan
- Department of Radiological Sciences, King Saud University, College of Applied Medical Sciences, Riyadh, Saudi Arabia
| | - Andrew England
- Department of Medical Imaging and Radiation Therapy, University College Cork, School of Medicine, Brookfield Health Sciences, Munster, Ireland
| | - Mark F. McEntee
- Department of Medical Imaging and Radiation Therapy, University College Cork, School of Medicine, Brookfield Health Sciences, Munster, Ireland
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7
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Dias Cardoso CEM, Bezzina P, Portelli JL. Gonad contact shielding in digital radiography: A questionnaire survey. Eur J Radiol 2023; 158:110620. [PMID: 36521379 DOI: 10.1016/j.ejrad.2022.110620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/16/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE The use of gonad contact shielding (GCS) in radiology departments has varied across countries, possibly because, until recently, there was no agreed consensus with mixed evidence supporting its use. This study aims to explore radiographers' use and opinion on GCS in digital radiography (DR) and to evaluate whether radiographers' use of GCS is associated with their gender, highest educational qualification, and/or years of experience. METHOD An online survey was sent via email to potential participants through the Society of Medical Radiographers Malta (SRM) as well as social media posts on local radiography pages. Descriptive and inferential statistics were used to analyse the collected data. RESULTS Almost half of the registered radiographers working in radiology departments in Malta (n = 101/203) completed the survey (49.7 % response rate). 61.4 % of participating radiographers indicated they 'often' use GCS in some patients, with 56.4 % stating they perceive GCS as an effective tool to protect the gonads from radiation exposure in DR. Equally, 56.4 % claimed that GCS use is guided by local rules and/or departmental protocols. While 58.4 % indicated that patients' gender does not impact their use of GCS, patients' age does influence their use. No statistically significant association was noted between radiographers' likeliness of using GCS and their gender, highest educational qualification, and/or years of experience. CONCLUSIONS Some misconceptions and uncertainties among radiographers concerning the benefits and risks of using GCS were noted. Local radiology departments should look into their protocols and assess the need for an update aligned with the latest recommendations.
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Affiliation(s)
| | - Paul Bezzina
- Radiography Department, Faculty of Health Sciences, University of Malta, Msida MSD2090, Malta.
| | - Jonathan L Portelli
- Radiography Department, Faculty of Health Sciences, University of Malta, Msida MSD2090, Malta.
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8
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Nozoe S, Terazaki K, Nakata M. [Verification of Effectiveness of Gonad Shielding in Female Hip Joint Radiography]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2022; 78:1314-1322. [PMID: 36184464 DOI: 10.6009/jjrt.2022-1314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE It has been reported that the placement of protective equipment in female pelvic radiography is predominantly inadequate compared with that of male. We analyzed the actual situation of ovarian shielding by protective devices using X-ray, CT, and MR images obtained in the past, and evaluated the effectiveness of gonadal protection in female hip radiography. METHODS The ovaries were contoured in MR images and the pelvic bone was extracted by CT images. The MR/CT fusion images were created using a 3D workstation. The amount of physiological fluctuation in the ovarian location was measured. The fusion images in the ray-summation display were manually superimposed with the X-ray image, and the percentage of ovaries that could be shielded by the protective device was classified into four categories: (a) complete protection, (b) partial protection, (c) failure of protection, and (d) image retaking. RESULTS The mean and maximum ovarian fluctuations were 1.1 cm and 3.9 cm in the superior and inferior directions, respectively, and 0.7 cm and 2.0 cm in the left and right directions, respectively. The percentage of ovaries shielded was 18.9% for complete protection, 58.5% for partial protection, 15.1% for inadequate protection, and 7.5% for image retaking. CONCLUSION The effectiveness of gonadal protection is low because the protective device could not cover the entire ovary in about 80% of the female hip radiographs.
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Affiliation(s)
- Saki Nozoe
- Division of Clinical Radiology Service, Kyoto University Hospital
| | - Kei Terazaki
- Division of Clinical Radiology Service, Kyoto University Hospital
| | - Manabu Nakata
- Division of Clinical Radiology Service, Kyoto University Hospital
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Samara ET, Cester D, Furlan M, Pfammatter T, Frauenfelder T, Stüssi A. Efficiency evaluation of leaded glasses and visors for eye lens dose reduction during fluoroscopy guided interventional procedures. Phys Med 2022; 100:129-134. [DOI: 10.1016/j.ejmp.2022.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 10/17/2022] Open
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Samara ET, Saltybaeva N, Sans Merce M, Gianolini S, Ith M. Systematic literature review on the benefit of patient protection shielding during medical X-ray imaging: Towards a discontinuation of the current practice. Phys Med 2022; 94:102-109. [PMID: 35030383 DOI: 10.1016/j.ejmp.2021.12.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/15/2021] [Accepted: 12/28/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Patient shielding during medical X-ray imaging has been increasingly criticized in the last years due to growing evidence that it often provides minimal benefit and may even compromise image quality. In Europe, and as also shown in a short assessment in Switzerland, the use of patient shielding is inhomogeneous. The aim of this study was to systematically review recent literature in order to assess benefits and appraise disadvantages related to the routine use of patient shielding. METHODS To evaluate benefits and disadvantages related to the application of patient shielding in radiological procedures, a systematic literature review was performed for CT, radiography, mammography and fluoroscopy-guided medical X-ray imaging. In addition, reports from medical physics societies and authorities of different countries were considered in the evaluation. RESULTS The literature review revealed 479 papers and reports on the topic, from which 87 qualified for closer analysis. The review considered in- and out-of-plane patient shielding as well as shielding for pregnant and pediatric patients. Dose savings and other dose and non-dose related effects of patient shielding were considered in the evaluation. CONCLUSIONS Although patient shielding has been used in radiological practice for many years, its use is no longer undisputed. The evaluation of the systematic literature review of recent studies and reports shows that dose savings are rather minimal while significant dose- and non-dose-related detrimental effects are present. Consequently, the routine usage of patient protection shielding in medical X-ray imaging can be safely discontinued for all modalities and patient groups.
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Affiliation(s)
- Eleni Theano Samara
- Radiation Protection Unit, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Natalia Saltybaeva
- Radiation Protection Unit, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Marta Sans Merce
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
| | | | - Michael Ith
- Department of Diagnostic, Interventional and Pediatric Radiology (DIPR), Inselspital, Bern University Hospital, University of Bern, Switzerland
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11
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Frush DP, Strauss KJ. Changing the practice of routine gonadal shielding during radiography: 'Y'? Pediatr Radiol 2022; 52:7-9. [PMID: 34741179 DOI: 10.1007/s00247-021-05230-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 09/23/2021] [Accepted: 10/15/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Donald P Frush
- Department of Radiology, Duke University Medical Center, Room #2568, 40 Duke Medicine Circle, Red Zone, Duke South, Box 3808, Durham, NC, 27710, USA.
| | - Keith J Strauss
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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12
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Hiles P, Gilligan P, Damilakis J, Briers E, Candela-Juan C, Faj D, Foley S, Frija G, Granata C, de Las Heras Gala H, Pauwels R, Sans Merce M, Simantirakis G, Vano E. European consensus on patient contact shielding. Insights Imaging 2021; 12:194. [PMID: 34939154 PMCID: PMC8695402 DOI: 10.1186/s13244-021-01085-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/19/2021] [Indexed: 12/25/2022] Open
Abstract
Patient contact shielding has been in use for many years in radiology departments in order to reduce the effects and risks of ionising radiation on certain organs. New technologies in projection imaging and CT scanning such as digital receptors and automatic exposure control systems have reduced doses and improved image consistency. These changes and a greater understanding of both the benefits and the risks from the use of shielding have led to a review of shielding use in radiology. A number of professional bodies have already issued guidance in this regard. This paper represents the current consensus view of the main bodies involved in radiation safety and imaging in Europe: European Federation of Organisations for Medical Physics, European Federation of Radiographer Societies, European Society of Radiology, European Society of Paediatric Radiology, EuroSafe Imaging, European Radiation Dosimetry Group (EURADOS), and European Academy of DentoMaxilloFacial Radiology (EADMFR). It is based on the expert recommendations of the Gonad and Patient Shielding (GAPS) Group formed with the purpose of developing consensus in this area. The recommendations are intended to be clear and easy to use. They are intended as guidance, and they are developed using a multidisciplinary team approach. It is recognised that regulations, custom and practice vary widely on the use of patient shielding in Europe and it is hoped that these recommendations will inform a change management program that will benefit patients and staff.
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Affiliation(s)
- Peter Hiles
- Glan Clwyd Hospital, Bodelwyddan, Denbighshire, UK.
| | - Patrick Gilligan
- European Federation of Organizations for Medical Physics, Utrecht, The Netherlands.,Mater Private Hospital, Eccles St., Dublin, Ireland
| | - John Damilakis
- European Society of Radiology - EuroSafe Imaging, Vienna, Austria.,University of Crete, Iraklion, Crete, Greece
| | - Eric Briers
- Member ESR-Patient Advisory Group, Patient Advocate, Hasselt, Belgium
| | - Cristian Candela-Juan
- European Federation of Organizations for Medical Physics, Utrecht, The Netherlands.,Centro Nacional de Dosimetría (CND), Instituto Nacional de Gestión Sanitaria, Valencia, Spain
| | - Dario Faj
- European Radiation Dosimetry Group, Neuherberg, Germany.,Faculty of Dental Medicine and Health, Osijek, Croatia
| | - Shane Foley
- European Federation of Radiographer Societies, Utrecht, Belgium.,Radiography and Diagnostic Imaging, University College Dublin, Dublin, Ireland
| | - Guy Frija
- European Society of Radiology - EuroSafe Imaging, Vienna, Austria.,Université de Paris, Paris, France
| | - Claudio Granata
- European Society of Paediatric Radiology, Le Kremlin-Bicêtre, France.,Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Hugo de Las Heras Gala
- European Federation of Organizations for Medical Physics, Utrecht, The Netherlands.,Federal Office for Radiation Protection, Oberschleißheim, Germany
| | - Ruben Pauwels
- Aarhus Institute of Advanced Studies, Aarhus University, Aarhus, Denmark
| | - Marta Sans Merce
- European Radiation Dosimetry Group, Neuherberg, Germany.,Geneva University Hospitals, Geneva, Switzerland
| | - Georgios Simantirakis
- European Radiation Dosimetry Group, Neuherberg, Germany.,Greek Atomic Energy Commission, Agia Paraskevi, Athens, Greece
| | - Eliseo Vano
- European Society of Radiology - EuroSafe Imaging, Vienna, Austria.,Radiology Department, Complutense University, Madrid, Spain
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13
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Hiles P, Gilligan P, Damilakis J, Briers E, Candela-Juan C, Faj D, Foley S, Frija G, Granata C, de Las Heras Gala H, Pauwels R, Sans Merce M, Simantirakis G, Vano E. European consensus on patient contact shielding. Radiography (Lond) 2021; 28:353-359. [PMID: 34953726 DOI: 10.1016/j.radi.2021.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Patient contact shielding has been in use for many years in radiology departments in order to reduce the effects and risks of ionising radiation on certain organs. New technologies in projection imaging and CT scanning such as digital receptors and automatic exposure control (AEC) systems have reduced doses and improved image consistency. These changes and a greater understanding of both the benefits and the risks from the use of shielding have led to a review of shielding use in radiology. A number of professional bodies have already issued guidance in this regard. This paper represents the current consensus view of the main bodies involved in radiation safety and imaging in Europe: European Federation of Organisations for Medical Physics, European Federation of Radiographer Societies, European Society of Radiology, European Society of Paediatric Radiology, EuroSafe Imaging, European Radiation Dosimetry Group (EURADOS), and European Academy of DentoMaxilloFacial Radiology (EADMFR). It is based on the expert recommendations of the Gonad and Patient Shielding (GAPS) Group formed with the purpose of developing consensus in this area. The recommendations are intended to be clear and easy to use. They are intended as guidance, and they are developed using a multidisciplinary team approach. It is recognised that regulations, custom and practice vary widely on the use of patient shielding in Europe and it is hoped that these recommendations will inform a change management program that will benefit patients and staff.
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Affiliation(s)
- P Hiles
- Glan Clwyd Hospital, Bodelwyddan, Denbighshire, UK.
| | - P Gilligan
- European Federation of Organizations for Medical Physics, Utrecht, the Netherlands; Mater Private Hospital, Eccles St., Dublin 7, Ireland
| | - J Damilakis
- European Society of Radiology, EuroSafe Imaging, Vienna, Austria; University of Crete, Iraklion, Crete, Greece
| | - E Briers
- Member ESR-Patient Advisory Group, Patient Advocate, Hasselt, Belgium
| | - C Candela-Juan
- European Federation of Organizations for Medical Physics, Utrecht, the Netherlands; Centro Nacional de Dosimetría (CND), Instituto Nacional de Gestión Sanitaria, Valencia, Spain
| | - D Faj
- European Radiation Dosimetry Group, Neuherberg, Germany; Faculty of Dental Medicine and Health, Osijek, Croatia
| | - S Foley
- European Federation of Radiographer Societies, Utrecht, the Netherlands; Radiography & Diagnostic Imaging, University College Dublin, Ireland
| | - G Frija
- European Society of Radiology, EuroSafe Imaging, Vienna, Austria; Université de Paris, France
| | - C Granata
- European Society of Paediatric Radiology, Le Kremlin-Bicêtre, France; Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - H de Las Heras Gala
- European Federation of Organizations for Medical Physics, Utrecht, the Netherlands; Federal Office for Radiation Protection, Oberschleißheim, Germany
| | - R Pauwels
- Aarhus Institute of Advanced Studies, Aarhus University, Denmark
| | - M Sans Merce
- European Radiation Dosimetry Group, Neuherberg, Germany; Geneva University Hospitals, Geneva, Switzerland
| | - G Simantirakis
- European Radiation Dosimetry Group, Neuherberg, Germany; Greek Atomic Energy Commission, Agia Paraskevi, Athens, Greece
| | - E Vano
- European Society of Radiology, EuroSafe Imaging, Vienna, Austria; Radiology Department, Complutense University, Spain
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Hiles P, Gilligan P, Damilakis J, Briers E, Candela-Juan C, Faj D, Foley S, Frija G, Granata C, de Las Heras Gala H, Pauwels R, Sans Merce M, Simantirakis G, Vano E. European consensus on patient contact shielding. Phys Med 2021; 96:198-203. [PMID: 34955383 DOI: 10.1016/j.ejmp.2021.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Patient contact shielding has been in use for many years in radiology departments in order to reduce the effects and risks of ionising radiation on certain organs. New technologies in projection imaging and CT scanning such as digital receptors and automatic exposure control (AEC) systems have reduced doses and improved image consistency. These changes and a greater understanding of both the benefits and the risks from the use of shielding have led to a review of shielding use in radiology. A number of professional bodies have already issued guidance in this regard. This paper represents the current consensus view of the main bodies involved in radiation safety and imaging in Europe: European Federation of Organisations for Medical Physics, European Federation of Radiographer Societies, European Society of Radiology, European Society of Paediatric Radiology, EuroSafe Imaging, European Radiation Dosimetry Group (EURADOS), and European Academy of DentoMaxilloFacial Radiology (EADMFR). It is based on the expert recommendations of the Gonad and Patient Shielding (GAPS) Group formed with the purpose of developing consensus in this area. The recommendations are intended to be clear and easy to use. They are intended as guidance, and they are developed using a multidisciplinary team approach. It is recognised that regulations, custom and practice vary widely on the use of patient shielding in Europe and it is hoped that these recommendations will inform a change management program that will benefit patients and staff.
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Affiliation(s)
- Peter Hiles
- Glan Clwyd Hospital, Bodelwyddan, Denbighshire, UK.
| | - Patrick Gilligan
- European Federation of Organizations for Medical Physics, Utrecht, The Netherlands; Mater Private Hospital, Eccles St., Dublin 7, Ireland
| | - John Damilakis
- European Society of Radiology - EuroSafe Imaging, Vienna, Austria; University of Crete, Iraklion, Crete, Greece
| | - Eric Briers
- Member ESR-Patient Advisory Group, Patient Advocate, Hasselt, Belgium
| | - Cristian Candela-Juan
- European Federation of Organizations for Medical Physics, Utrecht, The Netherlands; Centro Nacional de Dosimetría (CND), Instituto Nacional de Gestión Sanitaria, Valencia, Spain
| | - Dario Faj
- European Radiation Dosimetry Group, Neuherberg, Germany; Faculty of Dental Medicine and Health, Osijek, Croatia
| | - Shane Foley
- European Federation of Radiographer Societies, Utrecht, The Netherlands; Radiography & Diagnostic Imaging, University College Dublin, Ireland
| | - Guy Frija
- European Society of Radiology - EuroSafe Imaging, Vienna, Austria; Université de Paris, France
| | - Claudio Granata
- European Society of Paediatric Radiology, Le Kremlin-Bicêtre, France; Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Hugo de Las Heras Gala
- European Federation of Organizations for Medical Physics, Utrecht, The Netherlands; Federal Office for Radiation Protection, Oberschleißheim, Germany
| | - Ruben Pauwels
- Aarhus Institute of Advanced Studies, Aarhus University, Denmark
| | - Marta Sans Merce
- European Radiation Dosimetry Group, Neuherberg, Germany; Geneva University Hospitals, Geneva, Switzerland
| | - Georgios Simantirakis
- European Radiation Dosimetry Group, Neuherberg, Germany; Greek Atomic Energy Commission, Agia Paraskevi, Athens, Greece
| | - Eliseo Vano
- European Society of Radiology - EuroSafe Imaging, Vienna, Austria; Radiology Department, Complutense University, Spain
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Hiles P. Using patient shielding - What is the risk? THE BRITISH JOURNAL OF RADIOLOGY 2021; 94:20210701. [PMID: 34347543 DOI: 10.1259/bjr.20210701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The practice of placing radiation protective shielding on patients ('in contact') in order to reduce the dose to certain radiosensitive organs for diagnostic X-ray examination, has been employed for decades. However, there has been a growing body of evidence that this practice is often ineffective or even counterproductive and the use of such shielding can also overemphasise the hazards of ionising radiation in the public mind. This has led to a growing disparity in the application of patient contact shielding and culminated in several professional bodies issuing guidance and statements to provide a consistent approach to patient contact shielding. This, in turn, has led to a healthy discussion and re-evaluation of when and why patient contact shielding should be used, where the main issue centres around the criteria used to arrive at the recommendations. The decision process involves considering, among others, the reported effectiveness of the shielding and a subjective assessment of the subsequent risks from their use. In order to improve the transparency of these recommendations, it is therefore suggested that a threshold for dose and/or risk should be clearly stated, below which no protection is required. A suggested starting point for defining this threshold is discussed. This would enhance uniformity of application and provide clarity for staff, patients and the public. It would also ensure that any future research in this area could be easily incorporated into the general guidance.
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Affiliation(s)
- Peter Hiles
- Glan Clwyd Hospital, Bodelwyddan, United Kingdom
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