Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, T12 AK54, Ireland.
Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, T12 AK54, Ireland.
J Med Imaging Radiat Sci. 2023 Sep;54(3):415-420. doi: 10.1016/j.jmir.2023.07.006. Epub 2023 Jul 28.
Lead contact shielding has been a crucial component of patient radiation protection since it was first introduced in the early 1900s. Concerns surrounding the hereditary effects of ionising radiation were a driver for using lead shielding. Recently the American Association of Physics in Medicine (AAPM) and the British Institute of Radiology (BIR) have published position papers that suggest that lead contact shielding is no longer needed due to reduced radiation doses for x-ray examinations. This work examines radiographers' opinions on these position papers.
An online survey with quantitative and qualitative elements was designed to explore knowledge and attitudes toward the BIR and AAPM position papers. The population for this survey was all qualified radiographers.
The majority (59%) of participants are aware of the AAPM guidance, and 76% are aware of the BIR guidance. Given the changes in the gonad tissue weighting factor, 66% believed additional emphasis should be placed on protecting organs and tissues with higher tissue weighting factors. The vast majority (87%) believed lead shielding is not the primary dose reduction strategy, with 82% agreeing that lead shielding may interfere with the AEC.
This study identifies a perception that lead protection may still play a role in patient protection, particularly for children and pregnant patients. However, it is not considered the primary mechanism of protection. More specific guidance and information are needed to incorporate the guidance for radiographers into working practice, improving patient care.
Lead shielding remains a tool for radiation protection in particular examinations, however, its role has diminished in clinical practice.
Additional research is required into the number of repeat x-rays associated with the use of lead shielding and the actual dose saving for shielding outside the field of view. Additional education and specific clarification on when to use and not use lead contact shielding is required.
自 20 世纪初首次引入以来，铅接触屏蔽一直是患者辐射防护的重要组成部分。人们对电离辐射遗传效应的担忧是使用铅屏蔽的驱动因素。最近，美国医学物理学家协会（AAPM）和英国放射学会（BIR）发表了立场文件，认为由于 X 射线检查的辐射剂量降低，不再需要使用铅接触屏蔽。这项工作研究了放射技师对这些立场文件的看法。
设计了一份包含定量和定性元素的在线调查，以探讨对 BIR 和 AAPM 立场文件的知识和态度。该调查的对象是所有合格的放射技师。
大多数（59%）参与者了解 AAPM 指南，76%的人了解 BIR 指南。考虑到性腺组织权重系数的变化，66%的人认为应该更加重视保护具有更高组织权重系数的器官和组织。绝大多数（87%）人认为铅屏蔽不是主要的剂量降低策略，82%的人同意铅屏蔽可能会干扰 AEC。
这项研究表明，人们认为铅保护可能仍然在患者保护中发挥作用，特别是对于儿童和孕妇。然而，它不被认为是主要的保护机制。需要更具体的指导和信息，将指南纳入放射技师的工作实践中，以改善患者护理。
铅屏蔽仍然是特定检查中辐射防护的一种工具，但其在临床实践中的作用已经减弱。
需要进一步研究使用铅屏蔽与重复 X 射线数量之间的关系，以及屏蔽视野外的实际剂量节省。需要进行更多的教育，并明确何时使用和不使用铅接触屏蔽。
