Patient Shielding in Computed Tomography: Analysis of Influencing Factors and a Conceptual Framework for Decision-Making

Background: Although lead shielding during computed tomography (CT) examinations has served as routine clinical practice, its actual efficacy and execution remain controversial, showing noticeable divergences across national policies and international clinical guidelines. This discrepancy highlights a disconnect between clinical habits and evolving technical evidence. Methods: This narrative review examines the operational, institutional, legal, and cognitive constraints sustaining these divergent practices. Results: Rather than offering empirical data, this work synthesizes existing literature to propose a preliminary conceptual framework integrating these multi-dimensional factors. Conclusions: Unlike prior studies focusing narrowly on dosimetric outcomes, this framework incorporates transitional stages in CT technology and institutional capacities, offering a scalable, context-specific perspective to inform professional discussions and support localized evaluations regarding radiation protection.