The goal of all medical imaging that uses ionizing radiation, including radiography, is to manage the radiation dose (exposure) to the patient to be commensurate with the medical purpose. Radiography is the most commonly performed imaging procedure in children [1, 2] (Figure 1) and the use of gonadal shielding during these procedures should be re-evaluated.
Usage of gonadal shielding: Past and Present
In the U.S., gonadal shielding recommendations, which date back to 1950s [3-7], were based on what was understood at that time about potential...
Description of activity and work performed
National Council on Radiation Protection and Measurements SC 4-11 is currently preparing statement on routine use of gonadal shielding during abdominopelvic radiography.Image Gently chair and co-chair head this committee
American Association of Physicists in Medicine CARES (Communicating Advances in Radiation Exposure during Shielding) Committee developed responses to FAQs for technologists/radiographers and parents/caregivers . (Figure 7)
Image Gently and Image Wisely endorsed the AAPM Position Statement  on gonadal shielding as well as the CARES Committee project
Conclusion and recommendations
To these ends, practices/institutions should
1.understand current regulations, recommendations, guidelines from relevant authorities (with ongoing efforts such as through NCRP to facilitate review and modification as needed)
2.develop/revise policies and/or procedural practices for gonadal shielding that are harmonious with current scientific evidence and updated recommendations
3.provide appropriate level and depth of information for sufficient clarity for patients and radiographers/technologists to be able to understand and discuss the current practice and reasons for any modifications
one strategy can be message mapping 
include key messages, talking...
D. P. Frush; Durham, NC/US - nothing to disclose K. J. Strauss; Cincinnati, OH, OH/US - nothing to disclose S. McKenney; Stanford, CA/US - nothing to disclose D. Gress; Reston/US - nothing to disclose R. Marsh; Aurora, CO/US - nothing to disclose M. M. Rehani; Boston, MA/US - nothing to disclose E. K. Fishman; Baltimore, MD/US - nothing to disclose B. Schueler; Rochester/US - nothing to disclose
2.Mettler FA, Mahesh M, Chatfield MB, Elee JG, Milano MT, Royal HD, Chambers CE, Frush DP, Miller DL, Spelic DC and Technical Advisors (November 2019). NCRP Report from SC4-9 Medical Exposures of Patients in the United States
3.Magnusson, Wolfgang. “A Device for the Protection of the Testicle in Roentgen Examinations of Adjacent Organs and Bones.” Acta Radiologica 1952; 37 (3–4):288–90
4.Abram E, Wilkinson DM, Hodson CJ. Gonadal protection from X radiation for the female. Br J Radiol 1958; 31(366):335-6
5.Adran GM, Kemp FH. Protection...