The Evolution of radiation dose management in CT: Moving Beyond physical shielding

Abstract

This literature review explores the evolving role of shielding in computed tomography (CT) imaging, with a focus on its impact on patient radiation dose. Traditionally, physical shielding methods, such as bismuth and lead shields were used to protect radiosensitive organs from ionizing radiation. However, recent technological advancements, such as automatic exposure control (AEC) and tube current modulation (TCM), have raised questions about the continued necessity of shielding. While early studies demonstrated the efficacy of shielding in dose reduction, later research highlighted its drawbacks, including interference with modern CT systems, image artifacts, and, in some cases, increased radiation exposure. This review traces the historical use of shielding, its limitations, and the rise of alternative dose-reduction technologies. By examining clinical studies and technological advancements, this review suggests that modern imaging practices can achieve optimal radiation dose reduction without relying on physical shields.