ARRT Issues Statement on Gonadal and Fetal Shielding

ARRT has issued a statement on the issue of gonadal and fetal shielding in clinical practice:

Many reputable sources are considered for ARRT’s requirements of education, ethics, and examination. Professional societies, such as American Association of Physicists in Medicine (AAPM), are respected and appreciated for promoting radiation safety through published statements. These statements, notably recent changes in fetal and gonadal shielding recommendations, may be adopted in varying degrees at the state and institutional level and therefore cannot specifically be referenced in ARRT documents. Students should continue to receive instruction in their educational programs regarding shielding and the effects of fetal and gonadal radiation exposure. This instruction may be in greater detail than what would be found on the ARRT examination for certification and registration. Although fetal and gonadal shielding may not specifically be referenced, candidates for certification and registration can expect an examination that will include topics relevant to current clinical practice including topics relevant to patient radiation exposure and protection.  Finally, students and R.T.s have an ethical responsibility to act in a professional manner providing quality patient care while acting in the best interest of the patient. R.T.s are responsible to employ techniques and procedures appropriately in accordance with an accepted standard of practice.

In short, our positions are that:

• Health care institutions may adopt varying degrees of gonadal and fetal shielding recommendations.
• Schools with imaging programs should teach students about shielding and the effects of fetal and gonadal radiation exposure.
• ARRT’s exams may not specifically refer to gonadal and fetal shielding procedures, but they will include topics on patient radiation exposure and protection.
• Students and R.T.s have the ethical responsibility to act in the best interests of each patient.

What Others Have Done

Our statement comes as a result of the National Council on Radiation Protection and Measurements (NCRP) statement concluding that the shielding isn’t necessary during routine abdominal and pelvic radiography. The revision of NCRP’s recommendations was a result of American Association of Physicists in Medicine’s (AAPM) evidence-based recommendation to discontinue gonadal and fetal shielding. Other organizations, such as the American College of Radiology, endorsed AAPM’s position.

How ARRT Changed Our Position

Last summer, ARRT’s Radiography Practice Analysis Committee discussed shielding during our review of our proposed Radiography Task Inventory and initial revision of our Radiography Content Specifications. Some facilities and states have moved away from requiring shielding. ARRT made proposed radiography documents available for community comment in the fall.