Advancements in X-ray tube and X-ray detector technology over the past 50 years have resulted in a benefit for patients: a significant reduction in the radiation dose necessary for exams that use X-rays.

In addition, methods for “shielding’’ patients have also changed, resulting is less risk for patients. Dr. Scott Loomis, a radiologist at UCHealth Yampa Valley Medical Center, shares what has changed and why below.

What is radiology shielding?

Shielding is the practice of using a protective shield to cover parts of the body, most often reproductive organs or the fetus in a pregnant patient, that are in or just out of the field of view of the X-ray.

“Shielding was originally performed to reduce potential risks of radiation exposure, including increased cancer risk, sterility and increased risk of creating hereditable gene mutations, in sperm or ovaries,” Loomis said. “This was primarily based on population outcomes from atomic bomb survivors, which involved extremely high radiation exposures. However, more recent research has shown that, at the extremely low radiation doses used for medical X-rays performed today, these risks become nonexistent.”

Additionally, it has been shown that using shielding during an X-ray exam can actually result in higher radiation exposure to the patient. This can happen if the shield is in the field of view of the X-ray, which can cause the X-ray machine to increase the radiation dose because it senses the presence of the dense shield. And, the shield can sometimes end up covering a part of the body that needs to be seen by X-ray, which can result in repeat X-ray exams.

What is changing?

In the past, a radio-protective shield, usually in the form of a lead apron, was placed over the patient’s lap or pelvis when an X-ray was being performed. However, in 2019, the American Association of Physicists in Medicine published a statement which recommended limited use of routine shielding during radiology exams. The new guidelines are supported by the American College of Radiology, the Radiological Society of North America and Image Wisely, a radiation safety organization.

“For patients undergoing computed tomography, commonly known as CT, or X-ray exams, routine shielding is no longer necessary,” Loomis said. “The radiation exposure on these exams today is extremely low and has negligible effects on reproductive organs.”

Why is the radiologist or radiology technician still wearing a lead apron?

Patients may see a radiologist or radiology technologist wearing lead aprons during certain types of exams that use continuous X-ray, or fluoroscopy. This is because the radiation dose to the person performing that type of exam can be higher than regular X-ray exams, and there may be several of these types of exams each day.

But what about radiation exposure?

“The knowledge gained from CT or X-ray exams almost always outweighs the risk of any radiation exposure,” Loomis said. “Both radiologists and radiology technologists work closely with the ordering providers in the community to ensure the correct exams are performed to answer a clinical question.”

CTs tend to have a higher radiation dose than X-rays but provide far more information about bones and soft tissues.

What if I still want to wear a radiation shield during my exam?

Radiation shields remain available for patients should someone desire to still wear one during a CT or X-ray exam.

“While shields are no longer necessary, we want patients to be comfortable during their procedure and are happy to offer one if the patient desires one,” Loomis said. “We encourage anyone having a radiology exam to ask questions. We want our patients to be informed and at ease with the care they receive.”

Lindsey Reznicek is a communications specialist with UCHealth Yampa Valley Medical Center. She can be reached at lindsey.reznicek@uchealth.org.