Gonadal shielding should be discontinued for most diagnostic imaging exams

Abstract

Radiation protection of patients and staff during diagnostic imaging procedures is an important aspect of the medical physics profession. Despite the large number of reports and guidelines published by specialized radiation protection organizations and professional societies, there are still some controversies regarding the utility and efficiency of some practices in terms of reducing the dose to patients during typical radiological imaging procedures. It is the role of medical physicists providing physics support to diagnostic imaging facilities and involved in clinical routine activities to debate important issues related to the design of optimal dose reduction strategies with the aims of protecting the patient from unnecessary exposure to ionizing radiation and limiting medically necessary exposure to the minimum required to answer the specific clinical question at hand. Among many other issues, the role of gonadal shielding to protect the patient’s reproductive organs in radiology has long been debated without reaching a consensus, resulting in contradictory guidelines on their relevance in clinical practice. Regardless of the contradictions in the scientific literature on the importance of gonadal shielding, one might argue that the patients feel that gonadal shielding is often employed to protect them from ionizing radiation and that they are put at an increased risk in its absence. This is the topic addressed in this month’s Point/Counterpoint debate.