Gonadal shielding protects a patient's reproductive organs - the testes, ovaries, or uterus - from radiation exposure during imaging. Typically, this is done by placing a 0.5mm lead-lined vest or cover over the area. How does it work? Radiation waves retract off these lead-lined areas, unable to reach vulnerable body regions.
In recent years, much debate has called into question the efficacy and necessity of gonadal shielding. Indeed, credible studies have supported arguments for and against its use, but it's still common practice for most states and companies.
What Is the Significance of Protecting the Gonadal Area of a Patient During Exposure?
And now, a brief refresher. Gonads contain reproductive cells: sperm in the testes and eggs in the ovaries. Mutations in these cells - such as those caused by radiation - can potentially cause congenital disabilities in a child conceived after exposure. This is the strongest argument behind gonadal shielding, although radiation-induced mutations could cause other health issues such as infertility and cancer.
It's important to note that modern X-ray machines produce around 95% lower absorbed radiation dose than similar machines of the 1950s when the practice began. Modern technologies include automatic exposure control (AEC) sensors that work to attenuate dosage. Here at Maven, we can help you find the best modern imaging equipment for your practice - made affordable by our convenient in-house financing.
When Should Gonadal Shielding Be Used?
Policies vary between states and medical practices, but a general rule of thumb is to use gonadal shielding on patients of reproductive age (45 and under) when imaging the abdominal or pelvic area - including hips and lumbar spine.
Should Gonadal Shielding Be Used for Female Patients?
Most policies prescribing gonadal shielding have requirements for both female and male patients. However, there may be more emphasis on using it for female patients. Why? Unlike males, who constantly produce new sperm, females are born with a finite amount of eggs - they can't make new eggs to replace damaged ones. Additionally, pregnant patients are especially likely to request shielding to protect their fetuses, even if not required by policy.
What Is the Argument for Discontinuing the Routine Use of Patient Gonadal and Fetal Shielding?
There are two main arguments for discontinuing routine gonadal shielding. The first is that it isn't needed; several organizations, including the American College of Radiology and the American College of Obstetricians and Gynecologists, have issued guidelines stating that radiation dosage from most standard imaging techniques is well below the threshold to cause harm. When gonadal shielding also has the potential to impact image quality, it may not be worth the cost of potentially having to repeat the exam.
The other argument is that in certain situations - namely when used with AECs - gonadal shielding may result in higher radiation doses to organs in unshielded areas, as shown in a 2018 study. Gonadal shielding also does not protect unshielded organs from internal X-ray scatter.
Frequently Asked Questions
As policies surrounding gonadal shielding continue to shift, we encourage you to stay updated on your state and local guidelines. Below are general questions our customers frequently have about gonad shields.
Is Gonadal Shielding Necessary?
This very much depends on your location and your practice. As more data becomes available, organizations of medical professionals are beginning to change their recommendations on gonadal shielding - especially with female patients. However, these recommendations may not yet be policy in your area. Clinics should be sure to educate patients on any changes in policy and data driving these changes.
Where Can I Buy Gonad Shields?
Maven offers male and female gonad shields in various sizes, including infant and child sizes. Our experts can help you find products that fit your needs and price range.
What About Breast Shields?
While breasts are not gonads - they do not contain any reproductive cells - breast shields are common practice. We offer several affordable breast shield options.
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