Efficacy of gonadal shielding in pediatric pelvis X-rays

Gürsu, Sarper; Gursu, T; Çamurcu, Yalkın; Yıldırım, Timur; Gürsu, Alper Hazım; Şahin, Vedat

doi:10.5606/ehc.2013.20

Cited by 9 publications

(7 citation statements)

References 5 publications

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“…Reported negative effects ("risks") of shielding include [7] the following: testes dose reduction of less than 95% due to misplaced shields (e.g. 77% in 10-15-year olds) [7], the need of retakes (Gürsu et al reported a retake rate of 3% in children up to 17 years) [90], a dose increase if the shield covers (part of) the automatic exposure control (AEC) detector [13], and loss of diagnostic information, and distraction of the technologist by handling the shield. The small risk reductions seen at the bottom of Table 5 (a risk < 1 × 10 −6 is considered inconsequential [91]) have to be viewed in the light of such effects.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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Objective: As gonad shielding is currently under debate, this study evaluates the practice, from its introduction in about 1905 until today. Methods: The literature was searched for developments in shielding and insights into the effects of ionising radiation on gonads. Based on own pre-1927 dose reconstructions, reported doses after 1927, a 2015-report from the European Union and recent own measurements, the effects of technological evolution and optimisation on radiation dose and hereditary risk were assessed. Results: In the 1900s, gonad shielding was first applied to prevent male sterility, but was discontinued when instrumental developments led to reduced radiation doses. In the 1950s, concerns about hereditary risks intensified and gonad shielding was recommended again, becoming routine worldwide. Imaging-chain improvements over time were considerable: in 2018, the absorbed dose was 0.5% of its 1905 value for the testes and 2% for the ovaries, our optimised effective dose a factor five lower than the value corresponding to the current EU diagnostic reference level, and the reduction in detriment-adjusted risk by shielding less than 1 × 10 −6 for women and 5 × 10 −6 for men. Conclusions: Assessment of pelvic doses revealed a large reduction in radiation risks facilitated by technological developments. Optimisation likewise contributed, but unfortunately, its potential was never adequately exploited. Today, using a modern and optimised X-ray system, gonad shielding can be safely discontinued for women. For men, there might be a marginal benefit, but potential negative side-effects may well dominate. Discontinuation of gonad shielding seems therefore justifiable.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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“… The highly attenuating material of the shielding may interfere with automatic exposure control systems and can lead to an increase rather than a decrease in patient dose [ 3 , 17 ]. Beam hardening or streak artefacts caused by the applied shielding can reduce the image quality and may lead to the requirement to repeat the exposure [ 18 ]. …”

Section: Evidence For Changementioning

confidence: 99%

“…Beam hardening or streak artefacts caused by the applied shielding can reduce the image quality and may lead to the requirement to repeat the exposure [ 18 ].…”

Section: Evidence For Changementioning

confidence: 99%

European consensus on patient contact shielding

et al. 2021

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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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“…Bu da, röntgende olduğu gibi daha etkili koruyucu önlemler alınmasına katkıda bulunacaktır. [24] Çıkar çakışması beyanı Yazarlar bu yazının hazırlanması ve yayınlanması aşamasında herhangi bir çıkar çakışması olmadığını beyan etmişlerdir.…”

Section: Gereç Ve Yöntemlerunclassified

Are there any adverse effects of static magnetic field from magnetic resonance imaging devices on bone health of workers?

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et al. 2014

Eklem Hastalik Cerrahisi

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Amaç: Bu çalışmada, manyetik rezonans görüntüleme (MRG) cihazlarının oluşturduğu statik manyetik alanın (SMA) MRG çalışanlarının kemik sağlığı üzerindeki etkileri araştırıldı. Gereç ve yöntemler: En az iki yıl boyunca 1.5 Tesla MRG cihazı ile çalışan 14 gönüllü MRG teknisyeni çalışmaya dahil edildi. Cinsiyet ve yaş eşleştirilmesi yapıldıktan sonra aynı kriterler gözetilerek, SMA'ya maruz kalmayan ve kapalı alanda çalışan 14 paramedikal gönüllü personelden kontrol grubu oluşturuldu. Tüm katılımcılara dual-enerji X-ray absopsiyometri (DXA) görüntülemesi uygulandı. Paratiroid hormon, kalsiyum, fosfor, alkalen fosfataz, 25-hidroksivitamin D3, ve 1.25-dihidroksivitamin D3 seviyeleri ölçüldü. Bulgular: MRG teknisyenlerinin vertebra ve femur boynu ortalama kemik mineral içeriği (KMİ) ve ortalama kemik mineral yoğunluğu (KMY) ile birlikte ortalama 25-hidroksivitamin D3 değerleri kontrol grubuna göre anlamlı oranda düşük bulundu (p<0.01). Referans sınırlarda olmasına rağmen MRG teknisyenlerinin kalsiyum düzeyleri, kontrol grubuna kıyasla, daha yüksek olarak tespit edildi (p<0.05). Ölçülen diğer parametrelerde gruplar arası istatistiksel olarak anlamlı bir farklılık görülmedi. Sonuç: Mevcut bilgilerimize göre, MRG cihazlarının oluş-turduğu SMA'nın çalışanların kemik sağlığı üzerinde olumsuz etkilerinin olduğu ilk kez saptandı. Ancak SMA'ya kronik maruziyetin kemik metabolizmasına etkisinin daha iyi anlaşı-labilmesi için çokmerkezli çalışmalara ve hayvan deneylerine gereksinim vardır.Anahtar sözcükler: Kemik yoğunluğu; manyetik alanlar; manyetik rezonans görüntüleme; mesleki etkilenim; vitamin D. Objectives:In this study, we aimed to evaluate the effects of static magnetic field (SMF) from magnetic resonance imaging (MRI) devices on the bone health of MRI workers. Materials and methods: Fourteen volunteer MRI technicians working with 1.5 Tesla MRI units at least for two years were included in the study. An age and sex-matched control group from indoor working 14 volunteer paramedical staff who were not exposed to SMF and met the identical criteria was formed. Dual-energy X-ray absorptiometry (DXA) scanning was performed in all participants. Parathyroid hormone, calcium, phosphorus, alkaline phosphatase, 25-hydroxyvitamin D3, and 1.25-dihydroxyvitamin D3 levels were measured. Results: The mean vertebral and femoral neck bone mineral content (BMC) and bone mineral density (BMD) as well as the mean 25-hydroxyvitamin D3 level of MRI technicians was found to be lower than the control group (p<0.01). Despite presenting within the normal range, the mean calcium level of MRI technicians was higher than the control group (p<0.05). There was no statistically significant difference in other variables between the groups. Conclusion: To the best of our knowledge, adverse effects of SMF from MRI devices on the bone health of MRI workers were detected for the first time. However, further multicenter studies and animal experiments are required to gain a better understanding of the mechanism that how the SMF affects bone health in chronic ...

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Efficacy of gonadal shielding in pediatric pelvis X-rays

Cited by 9 publications

References 5 publications

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

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

European consensus on patient contact shielding

Are there any adverse effects of static magnetic field from magnetic resonance imaging devices on bone health of workers?

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