Requesting physicians’ knowledge of X-radiation exposure from computed tomography scan examinations: A case study of two Nigerian tertiary hospitals

2020 ◽  
Vol 3 ◽  
pp. 36-39
Author(s):  
Samson O. Paulinus ◽  
Benjamin E. Udoh ◽  
Bassey E. Archibong ◽  
Akpama E. Egong ◽  
Akwa E. Erim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ionizing Radiation ◽  
Ct Scan ◽  
Radiation Exposure ◽  
Work Experience ◽  
Radiation Risk ◽  
Radiological Protection ◽  
X Ray ◽  
Tertiary Hospitals ◽  
Medical Exposure

Objective: Physicians who often request for computed tomography (CT) scan examinations are expected to have sound knowledge of radiation exposure (risks) to patients in line with the basic radiation protection principles according to the International Commission on Radiological Protection (ICRP), the Protection of Persons Undergoing Medical Exposure or Treatment (POPUMET), and the Ionizing Radiation (Medical Exposure) Regulations (IR(ME)R). The aim is to assess the level of requesting physicians’ knowledge of ionizing radiation from CT scan examinations in two Nigerian tertiary hospitals. Materials and Methods: An 18-item-based questionnaire was distributed to 141 practicing medical doctors, excluding radiologists with work experience from 0 to >16 years in two major teaching hospitals in Nigeria with a return rate of 69%, using a voluntary sampling technique. Results: The results showed that 25% of the respondents identified CT thorax, abdomen, and pelvis examination as having the highest radiation risk, while 22% said that it was a conventional chest X-ray. Furthermore, 14% concluded that CT head had the highest risk while 9% gave their answer to be conventional abdominal X-ray. In addition, 17% inferred that magnetic resonance imaging had the highest radiation risk while 11% had no idea. Furthermore, 25.5% of the respondents have had training on ionizing radiation from CT scan examinations while 74.5% had no training. Majority (90%) of the respondents were not aware of the ICRP guidelines for requesting investigations with very little (<3%) or no knowledge (0%) on the POPUMET and the IR(ME)R respectively. Conclusion: There is low level of knowledge of ionizing radiation from CT scan examinations among requesting physicians in the study locations.

scholarly journals Patient Knowledge Regarding Radiation Exposure from Orthopaedic Foot and Ankle Imaging

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0015
Author(s):  
Daniel Bohl ◽  
Blaine Manning ◽  
George Holmes ◽  
Simon Lee ◽  
Johnny Lin ◽  
...  
Keyword(s):  
Ionizing Radiation ◽  
Ct Scan ◽  
Radiation Exposure ◽  
Cone Beam Ct ◽  
Plain Film ◽  
Ct Scans ◽  
Cone Beam ◽  
X Rays ◽  
Foot And Ankle ◽  
X Ray

Category: Other Introduction/Purpose: Foot and ankle surgeons routinely prescribe diagnostic imaging that exposes patients to potentially harmful ionizing radiation. The purpose of this study is to characterize patients’ knowledge regarding radiation exposure associated with common forms of foot and ankle imaging. Methods: A survey was administered to all new patients prior to their first foot and ankle clinic appointments. Patients were asked to compare the amount of harmful radiation associated with chest x-rays to that associated with various types of foot and ankle imaging. Results were tabulated and compared to actual values of radiation exposure from the published literature. Results: A total of 890 patients were invited to participate, of whom 791 (88.9%) completed the survey. The majority of patients believed that a foot x-ray, an ankle x-ray, a “low dose” CT scan of the foot and ankle (alluding to cone-beam CT), and a traditional CT scan of the foot and ankle all contain similar amounts of harmful ionizing radiation to a chest x-ray (Table 1). This is in contrast to the published literature, which suggests that foot x-rays, ankle x-rays, cone beam CT scans of the foot and ankle, and traditional CT scans of the foot and ankle expose patients to 0.006, 0.006, 0.127, and 0.833 chest x-rays worth of radiation. Conclusion: The results of the present study suggest that patients greatly over-estimate the amount of harmful ionizing radiation associated with plain film and cone-beam CT scans of the foot and ankle. Interestingly, their estimates of radiation associated with traditional CT scans of the foot and ankle were relatively accurate. Results suggest that patients may benefit from increased counseling by surgeons regarding the relatively low risk of radiation exposure associated with plain film and cone-beam CT imaging of the foot and ankle.

Patient Knowledge Regarding Radiation Exposure From Foot and Ankle Imaging

2019 ◽  
Vol 13 (4) ◽  
pp. 324-329 ◽  
Author(s):  
Blaine T. Manning ◽  
Daniel D. Bohl ◽  
Alexander J. P. Idarraga ◽  
George B. Holmes ◽  
Simon Lee ◽  
...  
Keyword(s):  
Ionizing Radiation ◽  
Ct Scan ◽  
Radiation Exposure ◽  
Cone Beam Ct ◽  
Private Insurance ◽  
Cone Beam ◽  
X Rays ◽  
Foot And Ankle ◽  
X Ray ◽  
Imaging Results

Foot and ankle surgeons routinely prescribe diagnostic imaging that exposes patients to potentially harmful ionizing radiation. It is unclear how well patients understand the radiation to which they are exposed. In this study, 946 consecutive new patients were surveyed regarding medical imaging and radiation exposure prior to their first appointment. Respondents compared the amount of radiation associated with chest X-rays (CXRs) with various types of foot and ankle imaging. Results were compared with actual values of radiation exposure from the published literature. Of 946 patients surveyed, 841 (88.9%) participated. Most had private insurance (82.8%) and a bachelor’s degree or higher (60.6%). Most believed that foot X-ray, ankle X-ray, “low dose” foot and ankle computed tomography (CT) scan (alluding to cone-beam CT), and traditional foot and ankle CT scan contain similar amounts of ionizing radiation to CXR. This contradicts the published literature that suggests that the actual exposure to patients is 0.006, 0.006, 0.127, and 0.833 CXR equivalents of radiation, respectively. Of patients who had undergone an X-ray, 55.9% thought about the issue of radiation prior to the study, whereas 46.1% of those undergoing a CT scan considered radiation prior to the exam. Similarly, 35.2% and 27.6% reported their doctor having discussed radiation with them prior to obtaining an X-ray and CT scan, respectively. Patients greatly overestimate the radiation exposure associated with plain film X-rays and cone-beam CT scans of the foot and ankle, and may benefit from increased counseling regarding the relatively low radiation exposure associated with these imaging modalities. Level of Evidence: Level III: Prospective questionnaire

scholarly journals Physician’s Knowledge on X-ray Exposure from CT Scans in a Moroccan Hospital

2019 ◽  
pp. 1-6
Author(s):  
Bouchra Amaoui ◽  
Abdennasser El Kharras ◽  
Slimane Semghouli
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Radiation Exposure ◽  
Radiation Protection ◽  
Health Risks ◽  
Demographic Data ◽  
Radiation Doses ◽  
X Rays ◽  
Potential Health ◽  
X Ray

Background: Computed tomography (CT) is a major source of ionizing radiation exposure in medical diagnostic.  Patients more exposed related to radiation are supposed to be more susceptible to health risks. Purpose: The aim of this study was to assess physician’s knowledge of radiation doses and potential health risks of radiation exposure from CT. Materials and Methods: A standardized questionnaire was distributed to physicians. The questionnaire covered the demographic data of the prescriber, the frequency of referrals for CT scan examinations, the physicians’ knowledge of radiation doses, the potential health risks of radiation exposure from CT scan and training on patients’ radiation   protection. The data were analyzed using the Statistical Package for the Microsoft Office Excel 2007. Results: A total of 72 physicians (55%) completed the questionnaire. Ninety nine percent of the practitioners’ prescribe CT examinations for patients during their exercises but only 10% of physicians use the guideline during CT prescriptions. Thirty eight percent of prescribers took into account the ratio benefit/risk related to x-rays during radiological exam prescription. While 4% of prescribers’ explained the risk related to x-rays to the patients during radiological exam prescription, 14% of physicians have correctly estimated the effective dose received during an abdomen pelvic scan compared to the dose of a standard chest x-ray radiograph in an adult.  Fifty four percent of doctors underestimated the lifetime risk of fatal cancer attributable to a single computed tomography scan of the abdomen pelvic and 8% of practitioners have received formal training on risks to patients from radiation exposure. Conclusion: The present study showed the limited knowledge of radiation exposure for the Physicians. Recurrent training in advanced radiation protection of patients could lead to significant improvements in knowledge and practice of CT prescribers.

scholarly journals Patients’ perception of radiation safety of radiological investigations in urology

2020 ◽  
pp. 205141582096497
Author(s):  
Prakrit R Kumar ◽  
Stuart Irving
Keyword(s):  
Ct Scan ◽  
Radiation Exposure ◽  
Risk Score ◽  
Rank Order ◽  
Radiation Risk ◽  
University Teaching ◽  
Risk Scores ◽  
Level Of Evidence ◽  
X Ray ◽  
Perception Of Safety

Background: This study analyses patients’ knowledge of common radiological investigations. Methods: At a university teaching hospital, 100 patients attending urological clinics, who had had a plain X-ray of the kidney, ureter and bladder, magnetic resonance imaging (MRI), computed tomography (CT) or ultrasound scan (USS), completed a 14-item Likert scale questionnaire assessing patients’ perception of safety (both qualitatively and quantitatively) and the hazards of radiological investigations. Results: Using a radiation risk score, patients perceived the following investigations to be in rank order of increasing radiation risk: USS (0.84), MRI (1.4), CT (1.5) and plain X-ray (1.6). On the same scale (0–5), only 17% of patients correctly attributed a risk score of 3 or 4 for a CT scan, and 49% were able to identify a plain X-ray’s risk score correctly as 1 or 2. In addition, more patients identified CT (34%) as having a lower risk of 0 than an X-ray (24%). The mean (1.35 vs. 1.60), median (1 vs. 1) and mode (0 vs. 1) for the CT risk scores are less than those for a plain X-ray, demonstrating that patients perceived CT scans to be safer. Further, the majority of patients understood USS to have no radiation exposure (56%) but thought that MRI posed a radiation risk (62%). Patients were unable to quantify radiation exposure correctly: USS (37% correctly attributed – 0 mSv), MRI (22% – 0 mSv), X-ray (47% – 1 mSv) and CT scan (28% – 10 mSv). Conclusion: This demonstration of suboptimal patient awareness of radiation exposure of common radiological investigations highlights the need to educate patients in order to improve patient autonomy and possibly reduce the demand for unnecessary radiological investigations such as CT. Level of evidence: Level 2.

scholarly journals Establishing a quality assurance baseline for radiological protection of patients undergoing diagnostic radiology

2011 ◽  
Vol 15 (3) ◽  
pp. 70 ◽  
Author(s):  
Geoffrey K Korir ◽  
Jeska Sidika Wambani ◽  
Ian K Korir
Keyword(s):  
Quality Control ◽  
Quality Assurance ◽  
Image Quality ◽  
Radiation Exposure ◽  
High Speed ◽  
Quality Criteria ◽  
Patient Dose ◽  
Radiological Protection ◽  
X Ray ◽  
High Speed Film

Background. The wide use of ionising radiation in medical care has resulted in the largest man-made cause of radiation exposure. In recent years, diagnostic departments in Kenya have adapted the high-speed film/screen combination without well-established quality control, objective image quality criteria, and assessment of patient dose. The safety of patients in terms of justification and the as-low-as-reasonably-achievable (ALARA) principle is inadequate without quality assurance measures. Aim. This study assessed the level of film rejects, device performance, image quality and patient dose in 4 representative hospitals using high-speed film/screen combination. Results. The X-ray equipment quality control tests performance range was 67% to 90%, and 63% of the radiographs were of good diagnostic value. The measured prevalent chest examination entrance surface dose (ESD) showed levels above the international diagnostic reference levels (DRLs), while lumbar spine and pelvis examination was the largest source of radiation exposure to patients. Conclusion. The optimisation of patient protection can be achieved with optimally performing X-ray equipment, the application of good radiographic technique, and continuous assessment of radiographic image quality.

scholarly journals Post-mortem X-ray computed tomography (PMCT) identification using ante-mortem CT-scan of the sphenoid sinus

2019 ◽  
Vol 46 (4) ◽  
pp. 248-255 ◽  
Author(s):  
Lucile Deloire ◽  
Idris Diallo ◽  
Romain Cadieu ◽  
Mathieu Auffret ◽  
Zarrin Alavi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Sphenoid Sinus ◽  
Post Mortem ◽  
X Ray ◽  
X Ray Computed

scholarly journals Reducing radiation exposure in newborns with birth head trauma

2017 ◽  
Vol 5 (4) ◽  
pp. 24-30
Author(s):  
Irina A. Kriukova ◽  
Evgeniy Y. Kriukov ◽  
Danil A. Kozyrev ◽  
Semen A. Sotniкov ◽  
Dmitriy A. Iova ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Radiation Exposure ◽  
Head Trauma ◽  
Bone Structure ◽  
Bone Fractures ◽  
Diagnostic Methods ◽  
Cranial Bone ◽  
X Ray ◽  
Reduce Radiation Exposure ◽  
Risk Of Cancer

Background. Birth head trauma causing intracranial injury is one of the most common causes of neonatal mortality and morbidity. In case of suspected cranial fractures and intracranial hematomas, diagnostic methods involving radiation, such as x-ray radiography and computed tomography, are recommended. Recently, an increasing number of studies have highlighted the risk of cancer complications associated with computed tomography in infants. Therefore, diagnostic methods that reduce radiation exposure in neonates are important. One such method is ultrasonography (US). Aim. We evaluated US as a non-ionizing radiation method for diagnosis of cranial bone fractures and epidural hematomas in newborns with cephalohematomas or other birth head traumas. Material and methods. The study group included 449 newborns with the most common variant of birth head trauma: cephalohematomas. All newborns underwent transcranial-transfontanelle US for detection of intracranial changes and cranial US for visualization of bone structure in the cephalohematoma region. Children with ultrasonic signs of cranial fractures and epidural hematomas were further examined at a children’s hospital by x-ray radiography and/or computed tomography. Results and discussion. We found that cranial US for diagnosis of cranial fractures and transcranial-transfontanelle US for diagnosis of epidural hematomas in newborns were highly effective. In newborns with parietal cephalohematomas (444 children), 17 (3.8%) had US signs of linear fracture of the parietal bone, and 5 (1.1%) had signs of ipsilateral epidural hematoma. Epidural hematomas were visualized only when US was performed through the temporal bone and not by using the transfontanelle approach. Sixteen cases of linear fractures and all epidural hematomas were confirmed by computed tomography. Conclusion. The use of US diagnostic methods reduced radiation exposure in newborns with birth head trauma. US methods (transcranial-transfontanelle and cranial) can be used in screening for diagnosis and personalized monitoring of changes in birth head trauma as well as to reduce radiation exposure.

scholarly journals (F)utility of computed tomography of the chest in the presence of pleural effusion

2017 ◽  
Vol 2 (4) ◽  
pp. 181-186 ◽  
Author(s):  
Tilak Pathak ◽  
Malvinder S. Parmar
Keyword(s):  
Computed Tomography ◽  
Pleural Effusion ◽  
Ct Scan ◽  
Clinical Management ◽  
Chest Ct ◽  
X Ray ◽  
Contrast Enhanced ◽  
Plain Chest ◽  
Chest X Ray ◽  
Chest Ct Scan

AbstractBackgroundPleural effusion is common and can cause significant morbidity. The chest X-ray is often the initial radiological test, but additional tests may be required to reduce uncertainty and to provide additional diagnostic information. However, additional exposure and unnecessary costs should be prevented. The objective of the study was to assess the clinical benefit of an additional chest computed tomography (CT) scan over plain chest X-ray alone in the management of patients with pleural effusion.MethodsRetrospective analysis in 94 consecutive patients with pleural effusion who underwent chest X-ray and CT scan over an 18-month period in a single institution. All chest X-ray and CT scan reports were compared and correlated with clinical parameters in order to assess their utility in the clinical management. No blinding was applied.ResultsIn 75 chest CT scan reports (80 %), information provided by the radiologist did not change clinical management when compared to plain chest X-ray alone and did not provide any additional information over chest X-ray. Only 2/49 (4 %) of the native chest CT scan reports provided clinically relevant information as compared to 17/45 (38 %) contrast-enhanced chest CT scan reports (p<0.001).ConclusionsIn this retrospective cohort of patients with pleural effusion, an additional chest CT scan was not useful in the majority of patients. However, if a chest CT scan is required, then a contrast-enhanced study after pleural aspiration should be performed. Further prospective studies are required to confirm these findings.

Occupational Radiation Exposure of Anesthesia Providers: A Summary of Key Learning Points and Resident-Led Radiation Safety Projects

2017 ◽  
Vol 21 (2) ◽  
pp. 165-171 ◽  
Author(s):  
Rachel R. Wang ◽  
Amanda H. Kumar ◽  
Pedro Tanaka ◽  
Alex Macario
Keyword(s):  
Occupational Exposure ◽  
Ionizing Radiation ◽  
Radiation Exposure ◽  
Radiation Safety ◽  
Radiological Protection ◽  
Dose Equivalent ◽  
Occupational Radiation Exposure ◽  
Anesthesia Providers ◽  
Occupational Radiation ◽  
Learning Points

Anesthesia providers are frequently exposed to radiation during routine patient care in the operating room and remote anesthetizing locations. Eighty-two percent of anesthesiology residents (n = 57 responders) at our institution had a “high” or “very high” concern about the level of ionizing radiation exposure, and 94% indicated interest in educational materials about radiation safety. This article highlights key learning points related to basic physical principles, effects of ionizing radiation, radiation exposure measurement, occupational dose limits, considerations during pregnancy, sources of exposure, factors affecting occupational exposure such as positioning and shielding, and monitoring. The principle source of exposure is through scattered radiation as opposed to direct exposure from the X-ray beam, with the patient serving as the primary source of scatter. As a result, maximizing the distance between the provider and the patient is of great importance to minimize occupational exposure. Our dosimeter monitoring project found that anesthesiology residents (n = 41) had low overall mean measured occupational radiation exposure. The highest deep dose equivalent value for a resident was 0.50 mSv over a 3-month period, less than 10% of the International Commission on Radiological Protection occupational limit, with the eye dose equivalent being 0.52 mSv, approximately 4% of the International Commission on Radiological Protection recommended limit. Continued education and awareness of the risks of ionizing radiation and protective strategies will reduce exposure and potential for associated sequelae.

Can a CT be Omitted in Pediatric Minor Head Trauma?

2017 ◽  
Vol 16 (01) ◽  
pp. 001-007
Author(s):  
Maria Sinzig ◽  
Eveline Achatz ◽  
Günter Fasching ◽  
Christoph Arneitz
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Radiation Exposure ◽  
Head Trauma ◽  
Neurological Status ◽  
Ct Scans ◽  
Minor Head Trauma ◽  
Pediatric Ct ◽  
Ct Protocol ◽  
In Infants And Children

AbstractThis study aimed to evaluate the need for radiation exposure in pediatric minor head trauma. Symptomatic patients after minor head trauma were observed for at least 24 hours in a 13-month period. A computed tomography (CT) scan was performed on children with a depressed neurological status. Two hundred fourteen patients with a mean age of 9.3 years were included. An intracranial hemorrhage (ICH) was diagnosed in three (1.4%) patients. The overall CT rate was 10.7%. The study concluded that neuro-observation without initial CT scans is safe in infants and children following minor head trauma. Special pediatric CT protocol can limit radiation exposure.

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