Have you noticed recently that you don’t always have a lead apron draped across your lap when you get a quick X-ray? It’s not a mistake, it’s progress.

Thanks to advances in imaging technology, modern X-ray machines are safer and smarter than they used to be. The machines now use far lower doses of radiation and target the area being scanned more precisely. This means international safety protocols and standards have also evolved over time – lead aprons are used far more selectively than in the past.

Here’s what’s changed:

• Less radiation, more safety
  Today’s X-ray machines are far more efficient, exposing you to a fraction of the radiation used in the past.
• Improved precision
  The radiation beam is now more tightly focused on the area of concern, minimising what we call radiation “scatter” and exposure to other areas of the body.
• The help-hindrance ratio
  Lead aprons can actually block part of an image or cause unnecessary discomfort for the patient, sometimes leading to retakes. Ironically, this exposes the patient to more radiation overall.
• New research
  Scientific evidence shows that shielding reproductive organs routinely during X-rays doesn’t make a meaningful difference to patients’ health. Shielding the reproductive organs is only considered in specific circumstances, and if it won’t interfere with the quality of the image.
• ALARA in action
  When choosing the protocols or “settings” on the X-ray equipment, radiographers follow the ALARA principle: ‘As Low As Reasonably Achievable’ to make sure radiation doses are kept to the absolute minimum.

What if you are pregnant?

Although the possibility of an X-ray causing harm to a foetus is relatively small, radiology staff are extra careful when a patient is pregnant. Generally, doctors will consider whether X-rays are essential, if alternative imaging such as ultrasound can be used instead, and how far along the patient is in her pregnancy. If the benefits of the X-ray still outweigh the risks, staff will follow meticulous steps to limit radiation risk to the foetus to the very minimum.

What if the patient is a child?

Even for children, lead shielding isn’t universally recommended anymore. International recommendations for children are much the same as for adults, shielding the reproductive organs when it’s practical and doesn’t interfere with image quality.

So why do radiographers and radiologists often wear aprons?

Good question. The key difference is that radiographers and radiologists may be frequently exposed to scatter radiation – small amounts of radiation that bounce around during imaging. This is especially true during fluoroscopy or interventional procedures when staff need to stay close to the patient while a CT scan or continuous X-ray beam is emitted. The right quality lead apron can reduce the effect of scatter radiation by more than 90%.

What about caregivers?

Whenever possible, caregivers should be outside the room during the X-ray or scan. If a parent needs to stay with a child or hold them on the X-ray table, the same rules that apply to radiographers apply to them – wearing lead protection to shield them from scatter radiation.

The bottom line?

For patients, not using a lead apron is not about cutting corners – it’s about smarter, safer scanning.

.

• This article is part of a series aimed at decoding radiology jargon for patients. Visit our news section for more.
• The article is intended to create awareness and none of the information it contains should replace the need for seeking personal advice from a qualified medical practitioner.
• Apart from selected screening examinations, all radiology procedures are performed upon referral from a qualified medical professional.