2) Patient shielding is ineffective in reducing internal scatter. In medical x-ray imaging, the main source of radiation dose to internal organs that are outside the imaging field of view is x-rays that scatter inside the body. However, surface shielding covering these organs has no impact on this scatter.
The use of gonadal and fetal shielding can negatively affect the efficacy of the exam.
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1) Shielding can obscure anatomy, resulting in a repeated exam or compromised diagnostic information. Shielding placed inside the imaging field of view, or shielding that moves into the imaging field of view, can obscure important anatomy or pathology, or introduce artifacts. In such cases, if the procedure is not repeated the interpreting physician may lack important diagnostic information; if it is repeated, there will be a substantial increase in dose. Evidence shows that this is a more common problem than usually assumed (7-9).
2) Shielding can negatively affect automatic exposure control and image quality. All modern X-ray imaging systems use automatic exposure control, and the presence of shielding in the imaging field of view can drastically increase X-ray output, increasing patient radiation dose and degrading image quality (10).
About AAPM
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