In pediatric radiography, which can be omitted to decrease patient dose?

• A. Collimation
• B. Filtration
• C. Gonadal shielding
• D. Grids

Answer: (D)

When thinking about dose reduction, consider how each item affects the amount of radiation the patient actually receives. A grid is used to improve image contrast by absorbing scatter, but because it also absorbs some of the primary beam, you must increase the exposure (mA, time, or kVp) to keep the image bright enough. In small pediatric patients, there’s relatively little scatter, so you can achieve acceptable image quality without a grid. Omitting the grid thus lowers the patient’s dose.

Collimation should not be omitted because narrowing the beam to the area of interest directly reduces patient exposure and minimizes unnecessary tissue irradiation. Filtration reduces dose by removing low-energy photons from the beam; removing filtration would increase patient dose and worsen beam quality. Gonadal shielding is intended to reduce dose to reproductive organs, but it does not reliably reduce overall patient dose and can obscure anatomy, potentially leading to repeats.