Editing Radiography (section)

==Radiation dose==
The dosage of radiation applied in radiography varies by procedure. For example, the effective dosage of a chest x-ray is 0.1&nbsp;mSv, while an abdominal CT is 10&nbsp;mSv.<ref>{{cite web |title=Reducing Radiation from Medical X-rays |url=https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm095505.htm#HowMuch |website=FDA.gov |access-date=9 September 2018}}</ref> The [[American Association of Physicists in Medicine]] (AAPM) have stated that the "risks of medical imaging at patient doses below 50&nbsp;mSv for single procedures or 100&nbsp;mSv for multiple procedures over short time periods are too low to be detectable and may be nonexistent." Other scientific bodies sharing this conclusion include the [[International Organization for Medical Physics|International Organization of Medical Physicists]], the [[United Nations Scientific Committee on the Effects of Atomic Radiation|UN Scientific Committee on the Effects of Atomic Radiation]], and the [[International Commission on Radiological Protection]]. Nonetheless, radiological organizations, including the [[Radiological Society of North America]] (RSNA) and the [[American College of Radiology]] (ACR), as well as multiple government agencies, indicate safety standards to ensure that radiation dosage is as low as possible.<ref>{{cite journal |last1=Goldberg |first1=Jeanne | name-list-style = vanc |title=From the Spectral to the Spectrum |journal=[[Skeptical Inquirer]] |date=September–October 2018 |volume=42 |issue=5}}</ref>

===Shielding===
{| class="wikitable floatright" style = "text-align:center"
|-
!X-rays generated by<br />peak voltages below !! Minimum thickness<br /> of lead (depending on machine)
|-
|75&nbsp;kV || 1.0&nbsp;mm
|-
|100&nbsp;kV || 1.5&nbsp;mm
|-
|125&nbsp;kV || 2.0&nbsp;mm
|-
|150&nbsp;kV || 2.5&nbsp;mm
|-
|175&nbsp;kV || 3.0&nbsp;mm
|-
|200&nbsp;kV || 4.0&nbsp;mm
|-
|225&nbsp;kV || 5.0&nbsp;mm
|-
|300&nbsp;kV || 9.0&nbsp;mm
|-
|400&nbsp;kV || 15.0&nbsp;mm
|-
|500&nbsp;kV || 22.0&nbsp;mm
|-
|600&nbsp;kV || 34.0&nbsp;mm
|-
|900&nbsp;kV ||51.0&nbsp;mm
|}

[[Lead]] is the most common shield against X-rays because of its highdensity (11,340&nbsp;kg/m<sup>3</sup>), stopping power, ease of installation and low cost. The maximum range of a high-energy photon such as an X-ray in matter is infinite; at every point in the matter traversed by the photon, there is a probability of interaction. Thus there is a very small probability of no interaction over very large distances. The shielding of photon beam is therefore exponential (with an [[attenuation length]] being close to the [[radiation length]] of the material); doubling the thickness of shielding will square the shielding effect.

Starting in the 1950s, personal lead shielding began to be used on [[Radiation protection of patients#Lead shielding during routine X-rays and CT scans|directly on patients]] during all X-rays over the abdomen to intending to protect the [[gonads]] (reproductive organs) or a [[fetus]] if the patient was pregnant. [[Dental radiography |Dental X-rays]] would also typically additionally use lead shielding to protect the [[thyroid]]. However, a consensus was reached between 2019<ref>{{Cite web |title=AAPM Position Statement on the Use of Patient Gonadal and Fetal Shielding |url=https://www.aapm.org/org/policies/details.asp?id=2552 |access-date=5 April 2025 |website= www.aapm.org}}</ref><ref>{{Citation |title=Patient Gonadal and Fetal Shielding in Diagnostic Imaging |url=https://www.aapm.org/org/policies/documents/CARES_FAQs_Patient_Shielding.pdf |publisher=[[American Association of Physicists in Medicine]]}}</ref><ref name=":1">{{Cite journal |last=Benavides |first=Erika |last2= Krecioch |first2=Joseph R. |last3=Connolly |first3=Roger T. |last4=Allareddy |first4=Trishul |last5=Buchanan |first5=Allison |last6=Spelic |first6=David |last7= O’Brien |first7= Kelly K. |last8=Keels |first8=Martha Ann |last9=Mascarenhas |first9=Ana Karina |last10=Duong |first10=Mai-Ly |last11=Aerne-Bowe |first11=Mickie J. |last12= Ziegler |first12= Kathleen M. |last13=Lipman |first13=Ruth D. |date=April 2024 |title=Optimizing radiation safety in dentistry |url=https://linkinghub.elsevier.com/retrieve/pii/S0002817723007341 |journal=The Journal of the American Dental Association |volume=155 |issue=4 |pages=280–293.e4 |doi=10.1016/j.adaj.2023.12.002}}</ref> and 2021<ref>{{Cite journal |last=Fujibuchi |first=Toshio |last2=Matsubara |first2=Kosuke |last3=Hamada |first3=Nobuyuki |date=1 October 2021 |title=NCRP statement No. 13 "NCRP recommendations for ending routine gonadal shielding during abdominal and pelvic radiography" and its accompanying documents. Underpinnings and recent developments |url=https://inis.iaea.org/records/4c577-gzv77 |language=Japanese |volume=56 |issue=3 |pages=107–115 |doi=10.5453/jhps.56.107 |issn=1884-7560|doi-access=free |journal = Hoken Butsuri}}</ref><ref>https://ncrponline.org/wp-content/themes/ncrp/PDFs/Statement13.pdf</ref> that lead shielding for routine diagnostic X-rays is not necessary and may in some cases be harmful. Personal shielding for medical professionals and other people in the room is still recommended.

Rooms where X-rays are performed are lined with lead. The table in this section shows the recommended thickness of lead shielding for a room where X-rays are performed as function of X-ray energy, from the Recommendations by the Second International Congress of Radiology.<ref>Alchemy Art Lead Products – [https://web.archive.org/web/20031115052741/http://www.alchemycastings.com/pdf/SheetLead.pdf Lead Shielding Sheet Lead For Shielding Applications]. Retrieved 7 December 2008.</ref>

===Campaigns===
In response to increased concern by the public over radiation doses and the ongoing progress of best practices, The Alliance for Radiation Safety in Pediatric Imaging was formed within the [[Society for Pediatric Radiology]]. In concert with the [[American Society of Radiologic Technologists]], the [[American College of Radiology]], and the [[American Association of Physicists in Medicine]], the Society for Pediatric Radiology developed and launched the Image Gently campaign which is designed to maintain high quality imaging studies while using the lowest doses and best radiation safety practices available on pediatric patients.<ref>{{cite web|url=http://www.pedrad.org/associations/5364/ig/?page=365 |title=IG new: The Alliance &#124; image gently |publisher=Pedrad.org |access-date=16 August 2013 |url-status=dead |archive-url=https://web.archive.org/web/20130609063515/http://www.pedrad.org/associations/5364/ig/?page=365 |archive-date=9 June 2013 }}</ref> This initiative has been endorsed and applied by a growing list of various professional medical organizations around the world and has received support and assistance from companies that manufacture equipment used in radiology.

Following upon the success of the Image Gently campaign, the American College of Radiology, the Radiological Society of North America, the American Association of Physicists in Medicine, and the American Society of Radiologic Technologists have launched a similar campaign to address this issue in the adult population called Image Wisely.<ref>{{cite web|url=http://www.imagewisely.org/ |title=Radiation Safety in Adult Medical Imaging |publisher=Image Wisely |access-date=16 August 2013}}</ref> The [[World Health Organization]] and [[International Atomic Energy Agency]] (IAEA) of the United Nations have also been working in this area and have ongoing projects designed to broaden best practices and lower patient radiation dose.<ref>{{cite web |url=http://new.paho.org/hq10/index.php?option=com_content&task=view&id=3365&Itemid=2164 |title=Optimal levels of radiation for patients – Pan American Health Organization – Organización Panamericana de la Salud |publisher=New.paho.org |date=24 August 2010 |access-date=16 August 2013 |url-status=dead |archive-url=https://web.archive.org/web/20130525051814/http://new.paho.org/hq10/index.php?option=com_content&task=view&id=3365&Itemid=2164 |archive-date=25 May 2013 }}</ref><ref>{{cite web|url=https://rpop.iaea.org/RPOP/RPoP/Content/index.htm |title=Radiation Protection of Patients |publisher=Rpop.iaea.org |date=14 March 2013 |access-date=16 August 2013}}</ref><ref>{{cite web|url=https://www.who.int/ionizing_radiation/about/GI_TM_Report_2008_Dec.pdf |archive-url=https://web.archive.org/web/20131029171805/http://www.who.int/ionizing_radiation/about/GI_TM_Report_2008_Dec.pdf |archive-date=29 October 2013 |url-status=live |title=Global Initiative on Radiation Safety in Healthcare Settings: Technical Meeting Report |publisher=[[World Health Organization]] |access-date=16 August 2013}}</ref>

===Provider payment===
Contrary to advice that emphasises only conducting radiographs when in the patient's interest, recent evidence suggests that they are used more frequently when dentists are paid under fee-for-service.<ref>{{cite journal | vauthors = Chalkley M, Listl S | title = First do no harm - The impact of financial incentives on dental X-rays | journal = Journal of Health Economics | volume = 58 | issue = March 2018 | pages = 1–9 | date = March 2018 | pmid = 29408150 | doi = 10.1016/j.jhealeco.2017.12.005 | doi-access = free | hdl = 2066/190628 | hdl-access = free }}</ref>