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Radiography 17 (2011) 88

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Radiography

journal homepage: www.elsevier .com/locate/radi

Letter to the Editor

Gonad protection for lumbar spine radiography – Have we proved anything?

Sir,

I readwith interest the recent article byClancyet al. “The effect ofpatient shield position on gonad dose during lumbar spine radiog-raphy. Radiography (2010) 16, 131–135. It must be said that articlesconcerning general radiography are few and far between nowadays.

The work compared doses to the gonads of both sexes with andwithout gonad protection. This was done for both the AP andLateral projections. In the male this gave the result that doseswere reduced for the AP projection but were unaffected in thelateral projection. Thus the conclusion was drawn that a consider-able dose reduction could be obtained when a tube side apronwas used to cover the testes for the AP projection but no benefitwas shown when the apron was used for the lateral projection.When the same technique was applied to the female it was foundthat no dose benefit was obtained in either projection. Thus itwould seem logical that there is no benefit to the female patientin using gonad protection for lumbar spine radiography.

I then read on to the Discussion/Conclusion section and wassomewhat surprised to read that, despite there being no benefitto the female for either projection, it was deemed appropriate tocontinue its use as a routine as it would somehow allay theconcerns of worried female patients surrounding the radiationdose from lumbar spine radiography.

The only thing that this conclusion does is to reinforce the ideathat gonad protection is used by some to protect the mind and notthe gonads. The article set out to highlight when it is correct touse gonad protection and when it is useless. If we are expected to

1078-8174/$ – see front matter � 2010 The College of Radiographers. Published by Elsedoi:10.1016/j.radi.2010.09.004

work to evidence based guidelines thenwe should be using researchto change the dated ideas of the past. Research gives us the confi-dence to know that our practise and advice has the backing of scien-tific proof. The public should be able to trust us as a profession toknow what is best for themwhilst in our care.

What is the point of this article if it concludes that we shouldignore the evidence that it has produced and return to the statusquo? What was wrong with making the recommendation that, asthere was no benefit to the female then its use should be aban-doned? What we need as a profession is a definitive answer onceand for all from the experts what we should do. The only way ofimproving public relations concerning radiation protection isa set of strict guidelines that we all follow consistently and iscommon to all undergraduate training. One reason for the publicconcerns is that gonad protection is not consistently used anddiffers from one site to another.

Adrian Turner*Radiology Department,

Kettering General Hospital,Rothwell Road, Kettering,

Northants NN16 8UZ, United Kingdom* Tel.: þ44 (0) 1536492494;

fax: þ44 (0) 1536492473.E-mail address: adrian.turner@kgh.nhs.uk

9 July 2010Available online 28 October 2010

vier Ltd. All rights reserved.