Prof Mark McEntee
Professor McEntee said placing of a lead shield takes “very little effort” but as the risk is the patient’s and not the radiographer’s, patients should have a choice in this risk – something that is still “absent from the guidelines.” He said: “While doses may have decreased for clinical examination, the number of examinations that people are having has increased. In 1996, 149 out of 1000 patients entering hospital had a CT scan, but by 2012 that had tripled and tripled again by 2020. Now, about a third of patients that enter hospital have a CT exam. These examinations are also getting more complex, and common examinations now exceed 50 mSv.” He also pointed out that even low doses are dangerous and not all patients are the same.
In addition, there are patients that are at increased risk of diagnostic radiology, such as carriers of BRCA1/2 mutations, where radiation can be harmful, and children. He said that during CTA (computed tomography angiography), the breast may receive up to 24.3 milligrays (mGys) of radiation, compared to 4mGys with a mammogram. “If we displaced the breast and add lead on top of that, we can reduce dose to the breast by 10 mGys. If I was a patient with that mutation, I would want that protection but we just don’t know who those patients are. Lead shielding, correctly placed outside the field of view and away from the AEC, can help reduce these harms.” He pointed to ‘hundreds of papers’ that demonstrate that lead shielding can reduce dose to patient. “The evidence against using lead shielding is very weak,” he added. “As a profession, we need to carry out our own randomized controlled trials and do our own systematic reviews. Shielding in radiography is not outdated. If it is used outside of the field, it reduces dose and it protects patients.”
Source: Healthcare in Europe
