When should you use a thyroid shield during an X-ray? Thyroid shields, also called thyroid collars, are commonly used by healthcare professionals who work near active X-ray equipment during procedures involving scattered radiation, such as fluoroscopy and interventional radiology.
A properly fitted thyroid collar helps reduce radiation exposure to the covered neck area. However, not every imaging procedure requires thyroid shielding, and the recommendations for patients differ from those for healthcare professionals.
For patients undergoing routine diagnostic imaging, the decision to use a thyroid shield depends on the examination and current professional guidance. In particular, the American Dental Association no longer recommends routine thyroid collars during dental X-rays.
At Barrier Technologies, we manufacture radiation protection equipment designed for appropriate clinical applications. This guide explains when thyroid shields are used, when they are not recommended, and what to consider when choosing a protective collar.
The Importance of a Thyroid Collar
The thyroid gland is located at the front of the neck and produces hormones that regulate metabolism, growth, and other important body functions. Exposure to sufficiently high doses of ionizing radiation can affect thyroid health, with particular concerns following significant exposure during childhood.
Healthcare professionals working around fluoroscopy, interventional radiology, and other procedures involving scattered X-rays may require thyroid protection as part of their occupational radiation safety equipment.
A thyroid collar contains lead or lead-equivalent material designed to attenuate scattered radiation reaching the covered neck area. It is commonly used alongside a properly fitted lead apron when indicated by the procedure.
Thyroid collars support the ALARA principle, which means keeping radiation exposure As Low As Reasonably Achievable. The three fundamental protective measures are minimizing exposure time, increasing distance from the radiation source, and using appropriate shielding.
Wearing a thyroid shield does not eliminate radiation exposure or justify extending the amount of time spent near an active radiation source. It should be used alongside appropriate imaging protocols, protective barriers, and occupational radiation monitoring.
For more information about the thyroid’s response to radiation, read our article on why the thyroid gland is sensitive to radiation.
When to Use a Thyroid Shield During an X-Ray
Whether a thyroid shield is appropriate depends on the imaging procedure, expected radiation exposure, and whether the individual is a healthcare professional or patient.
1. Thyroid Shields for Healthcare Professionals
Healthcare professionals may need thyroid protection when working near active X-ray equipment during procedures that generate scattered radiation.
Common situations include fluoroscopy, interventional radiology, cardiac catheterization, and certain image-guided surgical procedures.
In these environments, a properly fitted thyroid collar can help reduce scattered X-ray exposure to the covered neck area.
A thyroid shield should be selected according to the procedure, expected exposure, and the facility’s radiation safety requirements. It should complement protective aprons, barriers, appropriate positioning, and dose monitoring.
2. Thyroid Shields During Mammograms
Routine thyroid shielding is not recommended during mammography.
The thyroid receives very little scattered radiation during a properly performed mammogram. A thyroid collar may also interfere with patient positioning or create imaging artifacts that could require additional examinations.
According to Mayo Clinic’s guidance on thyroid guards during mammograms, thyroid shielding is generally unnecessary for this examination.
Patients concerned about radiation exposure should discuss their questions with the mammography team rather than using shielding that may interfere with image quality.
3. Thyroid Shields During CT Scans and Diagnostic X-Rays
The need for patient thyroid shielding during CT scans and other diagnostic X-ray examinations depends on the specific procedure and current professional guidance.
Routine contact shielding is not recommended for many diagnostic examinations because protective material can obscure important anatomy or interfere with automatic exposure control systems.
Modern radiation protection focuses on clinically justified examinations, appropriate dose settings, limiting the imaging area, and avoiding unnecessary repeat scans.
For healthcare professionals who must remain inside the imaging room during certain CT-guided interventions, thyroid collars may be appropriate as part of occupational protective equipment.
The decision to use shielding should follow the facility’s imaging protocols and guidance from qualified radiation safety personnel.
4. Thyroid Shields During Dental X-Rays
The American Dental Association updated its radiation protection recommendations in February 2024.
Under the current guidance, routine thyroid collars and lead abdominal aprons are no longer recommended for patients undergoing dental radiography, including children and pregnant patients.
The recommendation applies to routine dental imaging, including examinations using cone-beam computed tomography (CBCT).
Patient protection instead focuses on clinically necessary imaging, appropriate beam collimation, correct positioning, and suitable equipment settings.
However, dental practices must continue to follow applicable state and local radiation safety regulations.
For additional details, read our article on whether lead aprons are required for dental X-rays.
You can also review the ADA’s updated dental radiation safety recommendations.
Understanding Your Thyroid Shield’s Efficacy
Choosing an appropriate thyroid shield involves evaluating protective coverage, lead equivalence, fit, comfort, and maintenance requirements.
Important factors include:
- Thyroid coverage: The collar should cover the intended thyroid region without leaving significant gaps. Coverage should be evaluated with the wearer in their usual working positions.
- Lead equivalence: Check the manufacturer’s stated protection rating and the relevant X-ray energy range. A higher rating does not eliminate the need for other radiation safety measures.
- Proper fit: The shield should sit securely around the neck while allowing reasonable head and neck movement.
- Garment construction: Inspect the protective material, seams, and closures for damage or areas that may compromise intended coverage.
- Cleaning and maintenance: Choose materials that can be cleaned and disinfected according to the manufacturer’s instructions and the facility’s infection control procedures.
- Ease of use: Closures should allow the wearer to put on, remove, and adjust the collar appropriately without compromising the fit.
A thyroid shield should be selected for the actual wearer and clinical procedure, rather than appearance or comfort alone.
Barrier Technologies Thyroid Shield Options
Barrier Technologies offers thyroid shield collars in different protective materials, designs, and covering fabrics to accommodate clinical requirements.
Core Material
Available material options include traditional lead, Lead-Lite composite, and lead-free shielding materials.
Barrier Technologies lists 0.5 mm Pb equivalent protection for its thyroid shield products. The appropriate material should be selected according to shielding performance, weight, wearer comfort, and the facility’s requirements.
Covering Fabric
Our thyroid shields are available with different covering materials, including UltraFlex™, a proprietary fabric designed for durability, comfort, and easier cleaning.
Facilities should review the recommended cleaning and disinfection procedures for the selected material.
Design
Barrier Technologies offers different thyroid collar configurations:
- Boomerang Thyroid Shield: A standard collar design intended for everyday clinical use.
- Visor Thyroid Shield: Provides an extended protective design for applications requiring additional neck coverage.
- Disposable Thyroid Shield: An available option for certain short-term or rotating personnel requirements.
The preferred design depends on protective coverage, individual fit, and the clinical application.
Closure
Our patented MagnaGuard magnetic closure system provides a Velcro-free fastening option for compatible thyroid collars.
MagnaGuard is designed to simplify fastening and cleaning while supporting comfortable daily use.
Regardless of closure design, thyroid shields should be maintained and disinfected according to the manufacturer’s instructions and facility hygiene procedures.
Conclusion: When Should You Use a Thyroid Shield?
Thyroid shields are an important form of occupational radiation protection for healthcare professionals who work near scattered X-rays during appropriate procedures.
However, routine patient thyroid shielding is no longer recommended for many diagnostic examinations, particularly dental X-rays and mammography. The correct approach depends on the examination, current professional guidance, and applicable regulations.
For healthcare facilities, selecting the right thyroid collar involves considering protective coverage, lead equivalence, comfort, and maintenance requirements.
Barrier Technologies manufactures thyroid shields and other radiation protection equipment for medical environments.
To learn more about choosing an appropriate thyroid shield for your team, contact Barrier Technologies.
