It surprised some imaging professionals when a recent analysis published in the American Journal of Roentgenology called for the decades-old practice of patient shielding during medical imaging examinations to come to an end. To learn more about the proposal, Radiology Business spoke with that article’s two co-authors, Rebecca M. Marsh, PhD, and Michael Silosky, MS, who are both medical physicists at the University of Colorado School of Medicine in Aurora, Colorado.

Read below for the full conversation:

Is patient shielding a topic that has been on your radar for a long time now?

Michael Silosky: Our interest developed over the last five years or so, mainly based on conversations we had with other healthcare professionals and physicists. For example, we have some technologist training programs in the area, and those students occasionally visit our facility. We typically get a lot of questions about patient shielding during x-rays, and one student asked me specifically what difference it makes if we are already collimating. I replied that it makes very little difference, or none at all, and the representative from the training program was taken aback that I said that. We spent some time talking about it, and I realized how ingrained the practice is into technologist training. It’s at odds with how the medical physics community views the subject, and it started making me want to look into it a bit further.

Rebecca M. Marsh, PhD

What is the biggest argument in favor of abandoning the practice of patient shielding?

Rebecca M. Marsh: I want to start my answer by reminding everyone that the overarching goal of any diagnostic imaging is to generate images that can guide the clinical care of the patient. We have to look at patient shielding in that context. The single biggest argument in favor of abandoning the practice is that it provides no benefit to the patient, but increases the risk that we’ll fail to meet that underlying goal of producing a quality image.

Patient shielding increases the risk that an exam will need to be repeated—which means additional radiation exposure—or that the image quality will be degraded. What’s even more problematic is that shielding can cover up anatomy the physician may need to see. If there were no benefits and no associated risks, then one could argue that patient shielding doesn’t harm anyone. But there are a lot of things that can happen, and we need to address the risks associated with this practice.