| Question 1: According to the AAPM CARES committee, when should X-ray technologists wear lead aprons? |
| Reference: | Ad Hoc Committee on Education and Implementation Efforts for Discontinuing the Use of Patient
Gonadal and Fetal Shielding (AHPGFS). “Patient Gonadal and Fetal Shielding in Diagnostic Imaging Frequently Asked Questions.” American Association of Physicists in Medicine, 2020. https://www.aapm.org/org/policies/documents/CARES_FAQs_Patient_Shielding.pdf. |
| Choice A: | Technologists should never wear a lead apron. |
| Choice B: | A technologist should only wear a lead apron if shielding is also provided for the patient. |
| Choice C: | A technologist should wear a lead apron if he or she is within 6 feet of the patient during
the exam. |
| Choice D: | A technologist should only wear a lead apron when operating fluoroscopy machines. |
| Question 2: With respect to abdominal entrance air Kerma values for a standard radiographic KUB examination
of the abdomen without gonadal shielding, all the following are true EXCEPT: |
| Reference: | Handloser JS, Love RA. Radiation doses from diagnostic studies. Radiology 57: 1951, pp. 252-4 Billings MS, Norman A, Greenfield MA. Gonad dose during routine Roentgenography 69: 1957m oo, 37-41.
Jeukens C, Kutterer G, Kicken PJ, et. al. Gonad shielding in pelvic radiography: modern optimized X-ray systems might allow its discontinuation. Insights Imaging. 2020; 11(1):15. |
| Choice A: | In the early 1950s, a single AP exposure for a newborn exceeded 1 mGy. |
| Choice B: | Pediatric doses have been approximately an order of magnitude less than adult doses since the
1950s. |
| Choice C: | The percent reduction of pediatric doses since the 1950s has been substantially less than adult
doses. |
| Choice D: | In general patient doses have decreased to less than 5% of their original values in the early
1950s. |
| Question 3: Which one of the following is most correct regarding radioprotective gonadal shielding of children during abdominopelvic radiography? |
| Reference: | Karami, Vahid, Mansour Zabihzadeh, Nasim Shams, and Amal Saki Malehi. “Gonad Shielding
during Pelvic Radiography: A Systematic Review and Meta-Analysis,” 2017; Archives of Iranian medicine 20(2):113-23
2. Guidance on using shielding on patients for diagnostic radiology applications. British Institue of Radiology 2020. https://www.bir.org.uk/media/414334/final_patient_shielding_guidance.pdf last accessed 4.15.20
3. DM, Black M, Schenk K et al (2009) Location of the ovaries in girls from newborn to 18 years of age: reconsidering ovarian shielding. Pediatr Radiol 39:253–259 |
| Choice A: | Due to visibility of scrotum, testes can be consistently localized. |
| Choice B: | Ovaries are more reliably localized centrally in the pelvis by external landmarks in prepubertal children. |
| Choice C: | There is more parental concern with need for shielding of younger children due to radiosensitivity of gonads. |
| Choice D: | Shielding can be used even if there is an impact on anatomic display. |
| Choice E: | Improper placement is usually due to lack of adherence to guidance (e.g., external landmarks). |
| Question 4: Which one of the following is most correct regarding automatic exposure control (AEC) and gonadal shielding in children? |
| Reference: | ICRP Publication 103; The 2007 Recommendations of the International Commission on Radiological Protection. Vol 37/2-4, Apr 2007, 334 pp https://www.icrp.org/publication.asp?id=ICRP%20Publication%20103 last accessed 04-15-20
2. Kaplan, Summer L., Dennise Magill, Marc A. Felice, Rui Xiao, Sayed Ali, and Xiaowei Zhu. “Female Gonadal Shielding with Automatic Exposure Control Increases Radiation Risks.” Pediatric Radiology 48, no. 2 (February 2018): 227–34. https://doi.org/10.1007/s00247-017- 3996-5.
3. Strauss, KJ. Pediatric interventional radiography equipment: safety considerations. Pediatric Radiol (2006) 36 Suppl 2: 126-35.
4. Kleinman PL, Strauss KJ, Zurakowski D, et. al. Patient size measured on CT images as a function of age at a tertiary care children’s hospital. AJR:194, June 2010, pp 1611-19. |
| Choice A: | AEC use is discouraged in young children (e.g., appx <3 yrs of age) |
| Choice B: | The shield in conjunction with AEC can cause the exposure to be terminated either before or after target image quality is achieved. |
| Choice C: | Gonadal shielding should never be used in pediatric age group with AEC. |
| Choice D: | Shielding in conjunction with AEC where detectors are partially covered may increase the overall exposure to the remaining unshielded organs all with higher ICRP tissue weighting
factors for radiosensitivity |
| Question 5: According to the presentation, which one of the following is most correct regarding approaches by technical staff for gonadal shielding of pediatric patients during abdominopelvic radiography? |
| Reference: | AAPM Position Statement on the Use of Patient Gonadal and Fetal Shielding. 4/2/19 Policy PP 32-A, https://www.aapm.org/org/policies/details.asp?id=468&type=PP last accessed 04.15.20
2. Marsh, Rebecca M., and Michael Silosky. “Patient Shielding in Diagnostic Imaging: Discontinuing a Legacy Practice.” American Journal of Roentgenology 212, no. 4 (January 23, 2019): 755–57
3. Strauss KJ, Gingold EL, Frush DP. Reconsidering the value of gonadal shielding during abdominal/pelvic radiography. J Am Coll Radiol 14(12):1635-1636, Dec 2017. PMID: 28739322.
4. Guidance on using shielding on patients for diagnostic radiology applications. British Institue of Radiology 2020. https://www.bir.org.uk/media/414334/final_patient_shielding_guidance.pdf last accessed 4.15.20 |
| Choice A: | The justifications for discontinuing routine shielding are the same in adults as in children. |
| Choice B: | Shielding should be discouraged when requested by the parent for chest radiography of their child. |
| Choice C: | The main resistance to routine shielding change is from the caregivers and public. |
| Choice D: | Technologists should defer all challenges to discontinuing shielding to the radiologist. |
| Choice E: | The recommendations to discontinue routine shielding are not largely based on poor technique by technologists. |
| Question 6: Despite understanding the science behind the discontinuation of gonadal shielding, a technologist may continue to use shielding because |
| Reference: | Radiography Curriculum - https://www.asrt.org/docs/default-
source/educators/curriculum/radiography/acad_curr_radcurrfinal2017_20170206.pdf?sfvrsn=2
ARRT Standards of Ethics - https://www.arrt.org/docs/default-source/governing-documents/arrt- standards-of-ethics.pdf?sfvrsn=c79e02fc_24
ARRT Radiography Examination Content Specifications - https://www.arrt.org/docs/default- source/discipline-documents/radiography/rad-content-specifications.pdf?sfvrsn=6dda01fc_32 |
| Choice A: | It is a state regulation. |
| Choice B: | It is a hospital policy. |
| Choice C: | It has Standards of Ethics ramifications. |
| Choice D: | It is in current educational curricula. |
| Choice E: | It is a patient expectation. |
| Choice F: | All of the above. |
