A questionnaire survey reviewing radiologists' and clinical specialist radiographers' knowledge of CT exposure parameters

Latiff R, Mohamad M. Investigating knowledge of DRLs, image quality and radiation dose in PET/CT and CT imaging among medical imaging professionals

Objective

To investigate the knowledge of diagnostic reference levels (DRLs), image quality, radiation dose and protocol parameters among Jordanian medical imaging professionals (MIPs) involved in PET/CT and CT scan procedures.

Materials and methods

A questionnaire was designed and distributed to MIPs in Jordan. The survey comprised four sections: demographic data, MIP knowledge on dose/protocol parameters, image quality, and DRLs. Statistical analyses were performed utilizing Pearson's correlation, t-tests, ANOVA, and linear regression, with a significance level of 95 % and a p-value threshold of <0.05.

Results

The study involved 147 participants. Most respondents were male (76.2 %), and most were aged 26-35 years (44.2 %). Approximately 51 % held a bachelor's degree, and the most common range of experience was 3-5 years (28.6 %). Participants showed a moderate level of knowledge regarding dose and protocol parameters, with a mean score of 61.8 %. The mean scores for knowledge of image quality and DRLs were 45.2 % and 44.8 %, respectively. The age group of the MIPs and the total experience were found to have a significant impact on the knowledge of the dose and protocol parameters, as well as the DRLs. Additionally, experience was found to have a significant influence on knowledge of the dose and protocol parameters. The study revealed a positive and significant effect of MIPs' knowledge of dose/protocol parameters and image quality on their knowledge of DRLs.

Conclusions

This study indicates that professionals across five specialties who are engaged in PET/CT and CT imaging possess a moderate understanding of dosage and protocol parameters. However, there is a notable gap in knowledge regarding DRLs and image quality. To address this issue, it is recommended that MIPs actively engage in educational programs emphasizing exposure parameters and their impact on image quality. Additionally, access to comprehensive education and training programs will enable MIPs to grasp the complexities of DRLs and their implications, facilitating their implementation in clinical practice.

Knowledge of computed tomography dose optimisation and justification among CT users and referring physicians: A single hospital study

INTRODUCTION

Radiation dose associated with computed tomography (CT) remains a concern, and radiation risk does not receive the needed attention, especially in low and middle-income countries. This because the frequency of this high-dose examination is rapidly growing and systems for protocol optimisation and dose justification are yet to be provided in CT imaging.

OBJECTIVE

To determine radiographers' and radiologists' awareness and knowledge of CT dose optimisation. We also determined knowledge of dose justification and use of the referral guidelines amongst the referring physicians.

METHODS

Radiographers and radiologists were invited to complete a web-based questionnaire whilst the referring physicians completed a self-administered questionnaire. The returned questionnaires were analysed and a significant difference was determined using Yates corrected Chi-square, and a p-value of 0.05 was considered at the 95% confidence interval.

RESULTS

The response rates were 50% (17 out 34) and 35% (16 out 46) for radiographers and radiologists respectively while referring physicians had a response rate of 84% (92 out of 110). Overall, more radiographers (47.1%) than radiologists (18.8%) had good knowledge of CT doses and image quality, however, the difference in knowledge was not found to be significant (p = 0.167). In addition, knowledge of diagnostic reference levels (DRLs) was significantly (p = 0.033) higher amongst radiographers (52.9%) as compared to radiologists (12.5%). Meanwhile, physicians understood the principles of dose justification. However, their knowledge of referral guidelines was limited.

CONCLUSION

The study revealed that radiographers were more knowledgeable on matters relating to radiation dose and image quality as well as DRLs when compared to radiologists. Meanwhile, the concept of dose justification was understood among physicians, however, they had limited awareness and knowledge of referral guidelines.

Assessing the knowledge of CT radiographers regarding how CT parameters affect patient dose and image quality

PURPOSE

The objective of this study was to assess the current knowledge of CT radiographers regarding the optimization of CT parameters and their consequential effects on both patient dose and image quality.

METHOD

A nationwide, cross sectional study was conducted from the 2nd of January 2023 to 1st of March 2023 to evaluate CT radiographers' knowledge in managing CT parameters in Jordan. Recruitment involved convenience sampling where radiographers were invited to participate and complete the questionnaire. Descriptive statistics were used to report the normalized knowledge scores. Student's t-test and ANOVA were used to investigate and compare the outcomes between different subgroups. A forward stepwise linear regression was used to investigate the influence of a number of technologist related factors on the knowledge score.

RESULTS

Three hundred and fifty-seven radiographers participated in the study, with a mean knowledge score of 69.0%. Participants with an academic master's degree had a significantly higher score of 72.1% compared to the ones with a diploma degree, with a score of 66.8% (p = 0.026). No statistically significant difference was found between radiographers that received additional training and the ones that did not. Furthermore, when investigating the effects of academic education, working sector, additional training and years of experience, only education had a statistically significant impact on the knowledge score.

CONCLUSION

The results demonstrate that radiographers have an overall good understanding of CT parameters, with academic education having a significant influence on their performance.

How confident are UK radiographers at performing paediatric computed tomography trauma scans?

INTRODUCTION

Approximately 45% of paediatric deaths in the United Kingdom (UK) were as a result of trauma. Computed tomography (CT) provides time efficient and accurate diagnosis, increasing chances of survival. Whilst use of CT in evaluating paediatric trauma has been invaluable it carries significant radiation risks, largely because children have greater radiation sensitivity than adults. Although national paediatric trauma workload in the UK is proportionately low, the majority of paediatric patients are conveyed to hospitals which predominantly undertake CT scans on adult patients. This research aimed to determine the confidence levels of radiographers when performing paediatric CT trauma scans in three public hospitals in the UK, and whether a teaching intervention improved their perceived self-confidence.

METHODS

Individual questionnaires containing eight qualitative and quantitative questions were used to ascertain radiographers' perceived confidence levels. A teaching intervention was developed based on responses. A post-intervention questionnaire was used to determine whether radiographers' confidence levels had improved.

RESULTS

Radiographers (n = 45) reported a mean confidence score of 5.6 (standard deviation 2.2) and 8.0 (standard deviation 1.7) scanning paediatric trauma patients pre- and post-intervention respectively. A paired two group t-test found this difference to be statistically significant at p < .00001. Radiographers reported several factors which negatively influenced confidence levels, including limited experience and postgraduate education.

CONCLUSION

Radiographers reported to be less confident scanning paediatric CT trauma patients compared to adults, pre- and post-intervention, however this research does not clarify whether this is as a result of an increase in competence. Further research regarding this concept warrants investigation.

IMPLICATIONS FOR PRACTICE

Results suggest further training based on negative factors reported by radiographers can increase confidence when performing this type of scan, assisting radiographers in optimising paediatric patient doses.

Service evaluation of radiographer-led vetting and protocoling of Computed Tomography (CT) scan requests in a Singapore public healthcare institution

INTRODUCTION

A service improvement project involving the vetting and protocoling of Computed Tomography (CT) scan requests by qualified CT radiographers was initiated in 2018.

AIM

This study provides a comprehensive evaluation of how a radiographer-led initiative aims to ensure that the CT scan requests received by the Radiology department are clinically appropriate, which in turn will reduce interruptions to the interpretation and reporting of imaging examinations by radiologists, who might otherwise be required to attend to clinically inappropriate and wrongly protocolled CT scan requests.

METHOD

Outpatient CT scan requests received from July to October 2021 were vetted and protocolled by a qualified CT-trained radiographer for parameters which included the appropriateness of the clinical indication, adequacy of patient preparation for the scan, as well as the suitability of the requested examination protocol pertaining to the need for contrast media, multiple contrast-enhanced imaging phases, and the appropriateness of the scan range.

RESULTS

Poor patient preparation and insufficient or inaccurate clinical indications were the most common findings during the vetting process (71%). Out of the 64 CT scan requests with protocol errors, 77% were attributed to contrast media type errors. The odds of incorrect CT scan requests increased with the requesting clinician's rank, while there was no such significant correlation with the clinical specialty of the requesting clinician or the CT scan type.

CONCLUSION

The meticulous vetting of imaging requests helps to ensure that limited imaging hardware resources are allocated to more clinically appropriate cases, correct protocols are applied to requested imaging scans, and that patients undergoing imaging are adequately prepared, thereby enhancing overall patient care.

IMPLICATIONS FOR PRACTICE

Vetting of imaging requests by radiographers, who are capable to make appropriate clinical decisions related to their enhanced level of practice ensures patient safety and optimisation of Radiology resources.

Assessment of diagnostic reference levels awareness and knowledge amongst CT radiographers

Background

Reports indicated that numerous factors, including inadequate personnel knowledge, contributes to insufficient patient data for setting up diagnostic reference levels (DRLs) in developing countries. This study aims to evaluate the knowledge of DRLs as an optimisation tool amongst computed tomography (CT) radiographers in northern Nigeria. This is a quantitative cross-sectional study. A structured questionnaire was devised and distributed on site to sixty-two CT radiographers in northern Nigeria. A total of fifteen questions were included in the questionnaire focusing on DRLs, dose optimisation and dose descriptors generating quantitative data concerning overall CT radiographers’ perceived knowledge and awareness about DRLs.

Results

A response rate of 77.4% (48/62) was achieved. About 83.3% of the participants declare DRLs awareness, and 37.5% carried out a local dose survey. The percentage correctly perceived knowledge of concepts; DRLs was 45.8%, dose optimisation (42%) and CT dose descriptor (39%). Radiographers with work experience ranging from 4-10 years had the highest score.

Conclusion

In this survey, deficiencies were noted in radiographers’ knowledge about DRLs with precise knowledge gap in the implementation of local dose survey for DRLs and optimisation. There is a need for continuous radiographers’ training with greater emphasis on dose optimisation and institutional based dose evaluation.

An assessment of Sri Lankan radiographer's knowledge and awareness of radiation protection and imaging parameters related to patient dose and image quality in computed tomography (CT)

INTRODUCTION

As computed tomography (CT) examinations have considerably risen, safe operation is essential to reduce the patients' dose. The main objective of this study was to evaluate the level of knowledge and awareness regarding the CT exposure parameters and radiation protection in CT imaging among Sri Lankan radiographers.

METHODS

An online survey-based study was devised and distributed among the Sri Lankan CT radiographers working in 63 CT units. Questions were divided into three subsections that collected data on the participants' demographic features, knowledge of the radiation protection, and imaging parameters.

RESULTS

Eighty-eight radiographers from 32 CT units (out of 63 CT units) distributed across 11 districts (out of 27 districts) participated in this survey.The percentages of correct responses for the questions related to radiation protection, imaging parameters, noise, Diagnostic Reference Level (DRL), and CT dosimetric parameters were 71%, 79%, 87%, 50%, and 66%, respectively. Although the years of experience did not influence any of above aspects, the level of education significantly impacted the knowledge about radiation protection, exposure parameters, and noise.

CONCLUSION

The radiographer's knowledge of radiation protection and most imaging parameters associated with patient safety and image quality is satisfactory. However, findings also show that participants should fill the knowledge gap in radiation-related risks, CT exposure parameters, dosimetric parameters, and DRL.

IMPLICATIONS FOR PRACTICE

The study suggests the necessity of initiating continuous education programs for radiographers in line with national radiation protection legislation requirements that can be linked with code of practice.

The importance of public health in radiology and radiation protection

The ionizing radiation belongs to the basic physical factors that can be measured. We forget often about its risks and the possible damage to our health. The imaging methods which use the ionizing radiation increase the diagnostics quality and they have become a certainty for many medical workers. Therefore, they are being used without rational thinking many times. With this is related to increasing the cumulative dose of patients. Next problem can be radiation safety knowledge of medical workers. The enormous increase in the use of sources ionizing radiation in medicine and rapid development, there may be a disproportionate acquisition of radiation safety knowledge of healthcare workers. At the same time, constant attention must be paid to the biological effects of radiation and realize epidemiology studies. In all the areas mentioned the public health has space. However, it is sad that presently, the radiation safety is not considered important enough in Public Health.  Based on many sources, it is safe to say that this is a major problem, because the public health itself can play an important role in radiation safety. It is important to point out, that safety and effectivity of using the source of ionizing radiation is one of the main components of Good Medical Practice.

An assessment of medical students' proficiency regarding the hazards of radiological examinations on the health of workers and patients: a cross-sectional study from Palestine

BACKGROUND

The use of radiological examination is increasing worldwide. Since radiation exposure can result in many health hazards, medical professionals, as well as medical students, should possess adequate knowledge regarding radiation and its related hazards to protect themselves and the patients. Many studies have assessed medical students' knowledge on this topic, but never in Palestine. In this study, we aimed to examine Palestinian medical students' awareness and knowledge regarding radiological examination modalities and their risks on themselves and their patients.

METHODS

This was an observational, cross-sectional, population-based study, conducted to assess the awareness of radiation exposure and its risks among Palestinian medical students. An online questionnaire was implemented on medical students at An-Najah National University. A total knowledge score that ranged from 0 to 22 was calculated for each participant, with higher scores indicating better knowledge regarding radiation doses and the related hazards.

RESULTS

Two hundred eighty and seven students participated in our study, with a response rate of 71%. The average knowledge score of the participants was 10.97 ± 4.31 out of a maximum of 22 points. Male participants and participants in advanced study years achieved better knowledge scores (p-values were 0.034 and < 0.001, respectively). Perceived radiology knowledge was significantly associated with the actual knowledge score among the participants (p-value< 0.001). Receiving radiology lectures in fourth and fifth years significantly affected the participants' knowledge score (p-values were < 0.001).

CONCLUSIONS

We found a severe lack of knowledge regarding radiation doses and related risks among medical students. Therefore, we recommend that medical schools update and supplement their curriculum regarding knowledge on radiation.

Knowledge of CT exposure parameters among Norwegian student radiographers

BACKGROUND

Improvements in the competency levels of student radiographers in computed tomography examinations (CT) are important due to the increasing number of these examinations being undertaken in imaging departments. The present study assesses the knowledge of student radiographers regarding CT exposure parameters.

METHODS

The level of knowledge related to CT exposure parameters was evaluated using a twenty-one-item questionnaire that was distributed to final-year student radiographers. The questionnaire consisted of questions around CT exposure parameters and either allowed respondents to answer "true," or "false" or choose a response from a range of responses where only one answer was correct. Correct answers were given one mark, while no mark was given for an incorrect answer. The score out of possible 21 was converted to a percentage, with a higher percentage signifying greater knowledge.

RESULTS

Seventy-two students completed and returned the questionnaire, resulting in a 71% response rate. The mean score was 53%. Only 33% of students correctly identified that kilovoltage peak (kVp) should be increased when patients have metallic implants, and milliampere seconds (mAs) should be increased as body part thickness increases. No one answered all the questions correctly. There was no significant knowledge difference between students who had CT facilities on campus and those that did not.

CONCLUSION

Overall, student radiographers' knowledge of CT exposure parameters was reported to be satisfactory.

AUTOMATIC BRAIN DOSE ESTIMATION IN COMPUTED TOMOGRAPHY USING PATIENT DICOM IMAGES

This study aims to develop an Automatic Brain Dose Estimation (ABDE) methodology for head computed tomography examinations. The ABDE is to be applied first to an anthropomorphic Alderson phantom to obtain a Correction factor (Cf) between the ABDE and the direct absorbed brain dose using dosemeters positioned within the anthropomorphic phantom. Then, in order to estimate the correct brain dose for patient, the Cf was multiplied by the mean ABDE values for each patient. Results were compared to those registered with a mathematical simulation phantom using CT-Expo V 2.4 software. Results showed no significant difference between the correct ABDE values and the CT-Expo values with a mean percent difference of 2.54 ± 0.01%. In conclusion, ABDE yields a correct estimation of brain dose, taking into account the size and attenuation of the irradiated region. Thus, it is clinically recommended for accurate patient brain dose assessment.

Assessment of the professional practice knowledge of computed tomography preceptors

OBJECTIVES

This study aimed to assess the knowledge and practice of computed tomography (CT) clinical practice preceptors in terms of CT parameters affecting patient dose and image quality.

MATERIAL AND METHODS

A self-administered questionnaire that surveyed the participants' demographic information and knowledge about CT parameters and radiation doses was distributed to 60 CT preceptors.

RESULTS

The response rate of the invited technologists was 92 %. 38 (69 %) males and 17 (31 %) females aged between 24 and 59 years, with a mean age of 37.8. The participants' experience ranged between 2 and 24 years, with a mean of 15.5 years. The average knowledge score was 72.2 %, with a range of correct answers of 9-18 and a mean (±SD) of 13.1 ± 2.1. The participants showed a low awareness of diagnostic reference levels (DRLs). However, they demonstrated good overall knowledge, with a potential for improvement and confidence in practice.

CONCLUSIONS

Continuous medical education and professional development are a priority for improvement to ensure reliable delivery of health care and best practice. The findings of this study can be used by education institutes and health organizations when designing educational programs to ensure the highest training and performance of their technologists.

The pop-up research centre - Challenges and opportunities

OBJECTIVES

This article sets out to describe the concept of the "pop-up" research centre as a means to promote and develop radiography research locally, nationally and internationally, and to empower professional colleagues to set up similar initiatives in the future.

KEY FINDINGS

A detailed overview of the development and management of "pop-up" research is provided based on the experiences of the authors, including specific examples. Matters such as study design, approvals, equipment and software, environment, participant recruitment and management, research teams and activity costs are discussed. Quantifiable benefits of "pop-up" research such as resultant peer reviewed publications, development of researchers' skills and potential collaborations are described. A number of "soft skill" benefits are also apparent and include enhanced organisational profiles, team building and the development of leadership skills.

CONCLUSIONS

"Pop-up" research centres are a valuable option for conducting research and offer the radiography profession an achievable mechanism to increase and enhance research activity. However, careful planning and execution are essential.

Evaluation of radiographers’ and CT technologists’ knowledge regarding CT exposure parameters

Introduction: Since the CT operators play an important role in the diagnosis and treatment of diseases and exposing the patients to radiation exposure, they must be aware of all CT parameters which affect the image quality and patient dose and update their knowledge in parallel with the progresses in CT technology. Therefore, the knowledge of radiographers and CT technologists regarding the CT parameters was assessed in this study to identify and resolve any potential deficiencies.

Material and methods: This study was conducted in 2018 among 113 radiographers and 103 CT technologists in Khuzestan province using a three-part questionnaire containing demographic characteristics, general opinion on CT scan dose and questions assessing technologists’ knowledge of CT exposure parameters. Data were analyzed using SPSS software.

Results: Total knowledge scores of radiographers and CT technologists about CT exposure parameters were 36 and 42, respectively. The highest knowledge score among technologist was the knowledge of changing parameters based on patient characteristics and the lowest was in the field of awareness of noise index and diagnostic reference levels.

Conclusion: Total knowledge scores of radiographers and CT technologists about different scan parameters affecting dose and image quality was very low. Reviewing and updating the content of academic education and holding retraining courses are suggested.

Knowledge of radiation legislation and radiation exposure in common radiological investigations among final year medical students, foundation doctors, specialist radiology registrars and radiographers at a UK university teaching hospital

Objective:

Junior doctors routinely request radiological investigations for patients. Prior studies have noted that among this group there is a lack of knowledge on radiation legislation and radiation exposure in common radiological investigations. However, no studies have compared this against radiology trainees and radiographers. We compared knowledge of radiation legislation and radiation exposure in common radiological investigations among final year medical students (FYMS), foundation year doctors (FY1, FY2) against specialist radiology trainees (SRT) and radiographers (RG).

Methods:

A 12-question multiple choice questionnaire (MCQ) was distributed to FYMS, FY1, FY2, SRT and RG at a UK teaching hospital. Questions assessed knowledge of radiation legislation and radiation-dose estimates of common radiological investigations. Mean MCQ scores were compared using one-way ANOVA and Tukey post-test to determine statistical significance (p-value < 0.05).

Results:

127 participants were included in the study. Mean scores (%) for FYMS (49.3%), FY1 (52.6%) and FY2 (51.1%) were significantly lower compared to SRT (64.4%) and RG (66.3%) (p-value < 0.05). Mean test scores between FYMS, FY1 and FY2 did not significantly differ (p-value > 0.05).

Conclusion:

FYMS, FY1 and FY2 knowledge of radiation legislation and radiation exposure in common radiological investigations was poor compared to SRT and RG. Patients require knowledge of radiation risk to provide informed consent as per IRMER regulations, thus we propose formal teaching on the subject matter to promote radiation safety culture among medical undergraduates and postgraduates.

Advances in knowledge:

First study to compare knowledge of radiation legislation and radiation exposure in common radiological investigations between medical students and junior doctors to radiology trainees and radiographers.

Knowledge and practice of computed tomography exposure parameters amongst radiographers in Jordan

OBJECTIVE

To investigate the knowledge and practice of computed tomography (CT) radiographers working in Jordan.

MATERIALS AND METHODS

This Institutional Review Board (IRB) approved study disseminated a questionnaire via social media and recruited 54 Jordanian CT radiographers. The questionnaire comprised 36 questions divided into four sections: demographics; an evaluation of knowledge regarding CT exposure; modifications to CT exposure for paediatric patients; dose units and diagnostic reference levels (DRLs). Descriptive and inferential statistics including Chi-square tests, Mann-Whitney U tests, independent samples t-tests and Kruskal-Wallis H tests were employed. Statistical significance was considered below p < 0.05.

RESULTS

The 54 participants had various qualifications, with the majority holding a Bachelor's degree (n = 35, 64.8%) and the rest holding a Diploma (n = 19, 35.2%). In order to pass the questionnaire, participants needed to score 13 correct answers. The overall number of radiographers who correctly passed the questionnaire was 48 (88.9%). None of the participants correctly stated all the DRL values for chest, abdomen and brain CT. However, four out of 54 respondents (7.4%) knew the chest DRL value, three (5.6%) participants correctly estimated the abdominal DRL value but only two (3.7%) knew the DRL for the brain.

CONCLUSION

Good general knowledge was found amongst radiographers regarding the relationship of each exposure parameter to the image quality and patient dose. However, there was poor knowledge of diagnostic reference levels and the order of the organ radiation sensitivity. The need for CT radiographers to undertake further education that focuses on radiation exposure in CT is highlighted.

Validation of the educational effectiveness of a mobile learning app to improve knowledge about MR image quality optimisation and artefact reduction

Aim

The aim was to design an app-based eLearning tool to provide radiographers with information about the physical basis of MR artefacts and practical elimination or/and minimisation strategies to optimise image quality, and to evaluate the impact of a smartphone app on radiographers’ knowledge.

Methods

The study used the comparison-experimental approach (pre- and post-test). Thirty-five MR radiographers independently reviewed a prepared series of MR images (n = 25). The participants were requested to identify image quality related errors, to specify error-correction strategies and to score how confident they were in their responses. Participants were then divided into experimental (n = 19) and control cohorts (n = 16). The app was provided to the experimental cohort for 3 months; after this period both cohorts re-reviewed the MR image datasets and repeated their identification of image quality errors.

Results

The results showed a statistically significant difference between control and experimental cohorts relative to participants’ pre- to post-test knowledge level. For the experimental cohort, years of experience, qualification and type of hospital were not associated with radiographer knowledge level and confidence in recognising the presence of an image quality error, naming the error and specifying appropriate correction strategies (p > 0.05).

Conclusion

The study identified the potential of the smartphone app as an effective educational tool to support MR radiographers’ knowledge in recognising and characterising MR image quality errors.

Key Points

• A high level of knowledge to optimise MR image quality is crucial.

• Ongoing education in image quality optimisation is required.

• The potential role of app as an effective educational tool is identified.

Assessment of organ dose and image quality in head and chest CT examinations: a phantom study

The purpose of this study is to assess dose for radiosensitive organs and image quality in head and chest computed tomography (CT) examinations. Our focus was in the brain, eye lens and lung organs using two protocols; one protocol with fixed mAs and filtered back projection (FBP) and another with tube current modulation (TCM) and sinogram affirmed iterative reconstruction (SAFIRE). Measurements were performed on a 128-slice CT scanner by placing thermoluminescent dosimeters (TLDs) in an anthropomorphic adult phantom. Results were compared to a CT-Expo software. Objective image quality was assessed in terms of signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). SPSS software was used for data analyses. Results showed that, using TCM, doses were reduced by 22.84%-25.06% for brain, by 21.82%-23.48% for eye lens and by 54%-53.22% for lung with TLD and CT-Expo respectively. The increased SNR and CNR values achieved for scans performed with TCM combined with iterative reconstruction techniques were 38.68%-58.81% and 38.91%-43.60% respectively. We conclude that, using TCM, a significant mean organ dose reduction is achieved for brain, eye lens and lung organs. Then, combined with iterative reconstruction, image quality was well maintained in terms of SNR and CNR. Thus it is highly recommended in clinical practice optimization in head and chest CT examinations.

Awareness and knowledge of radiation dose and associated risks among final year medical students in Norway

OBJECTIVES

The objective was to assess the knowledge of radiation dose and of the associated risks with ionising imaging examinations of medical students in their final year of training prior to graduating.

METHODS

An online questionnaire was sent to all final year medical students from two universities. The questionnaire consisted of radiation dose and risk related questions, with multiple choices, only one of these choices was the correct answer. A 'correct' answer was given one mark and no mark was given for 'incorrect/do not know' answers. The total mean score ranged from 0 to 11, with higher scores representing greater knowledge about radiation doses and the associated risks.

RESULTS

Ninety-nine students completed and returned the questionnaire yielding a response rate of 45%. The total mean score was 3.91 out of possible 11. Only eighteen students scored more than five points (50%). Students who reported moderate confidence in their knowledge about radiation dose and risks, scored significantly higher than students who reported no confidence (p = 0.003). There was a moderate positive correlation between students that reported moderate confidence and radiation knowledge scores (rho = .301, p = .002).

CONCLUSION

Overall medical students' knowledge of radiation dose and the risks associated with ionising imaging examinations was reported to be low.

MAIN MESSAGES

• Medical students' knowledge about radiation and associated risk is poor • Students are not aware of radiation doses for common radiological procedures • The majority of students underestimated radiation doses for specific examinations • Students with confidence reported greater knowledge than students with no confidence.

An investigation of Saudi Arabian MR radiographers' knowledge and confidence in relation to MR image-quality-related errors

OBJECTIVE

To investigate MR radiographers' current knowledge base and confidence level in relation to quality-related errors within MR images.

METHOD

Thirty-five MR radiographers within 16 MRI departments in the Kingdom of Saudi Arabia (KSA) independently reviewed a prepared set of 25 MR images, naming the error, specifying the error-correction strategy, scoring how confident they were in recognising this error and suggesting a correction strategy by using a scale of 1-100. The datasets were obtained from MRI departments in the KSA to represent the range of images which depicted excellent, acceptable and poor image quality.

RESULTS

The findings demonstrated a low level of radiographer knowledge in identifying the type of quality errors and when suggesting an appropriate strategy to rectify those errors. The findings show that only (n = 7) 20% of the radiographers could correctly name what the quality errors were in 70% of the dataset, and none of the radiographers correctly specified the error-correction strategy in more than 68% of the MR datasets. The confidence level of radiography participants in their ability to state the type of image quality errors was significantly different (p < 0.001) for who work in different hospital types.

CONCLUSION

The findings of this study suggest there is a need to establish a national association for MR radiographers to monitor training and the development of postgraduate MRI education in Saudi Arabia to improve the current status of the MR radiographers' knowledge and direct high quality service delivery.

Assessment of radiation protection awareness and knowledge about radiological examination doses among Italian radiographers

Objectives

To evaluate radiation protection basic knowledge and dose assessment for radiological procedures among Italian radiographers

Methods

A validated questionnaire was distributed to 780 participants with balanced demographic characteristics and geographic distribution.

Results

Only 12.1 % of participants attended radiation protection courses on a regular basis. Despite 90 % of radiographers stating to have sufficient awareness of radiation protection issues, most of them underestimated the radiation dose of almost all radiological procedures. About 5 % and 4 % of the participants, respectively, claimed that pelvis magnetic resonance imaging and abdominal ultrasound exposed patients to radiation. On the contrary, 7.0 % of the radiographers stated that mammography does not use ionising radiation. About half of participants believed that radiation-induced cancer is not dependent on age or gender and were not able to differentiate between deterministic and stochastic effects. Young radiographers (with less than 3 years of experience) showed a higher level of knowledge compared with the more experienced radiographers.

Conclusions

There is a substantial need for radiographers to improve their awareness of radiation protection issues and their knowledge of radiological procedures. Specific actions such as regular training courses for both undergraduate and postgraduate students as well as for working radiographers must be considered in order to assure patient safety during radiological examinations.

Main messages

• Radiographers should improve their knowledge on radiation protection issues.

• Only 12.1 % of participants attended radiation protection courses on a regular basis.

• Specific actions must be considered in order to increase knowledge and awareness.

Dose tracking and radiology department management

The purpose of this work was to review the reasonable measures that should be implemented as part of a routine practice in the process of managing CT radiation risks in a typical average radiology department. Based on 6 y of experience in the management of a general radiology department and the newly implemented supportive software for dose tracking, analysing and reporting, the approach towards radiation risk reduction is presented. Thanks to this approach, some problems have been resolved, and reasonable measures have been introduced into daily practice.

Radiation risks knowledge in resident and fellow in paediatrics: a questionnaire survey

BACKGROUND

Analyse through a multi-choice anonymous questionnaire the knowledge's level in paediatric residents and fellows in two different main Italian hospital, looking mainly to the information to patients and relatives related to risks of ionizing radiation used in common radiological investigations in children.

METHODS

65 multi choice questionnaires were distributed to paediatric residents and fellows of two different hospitals, an University Hospital (A.O.U.P. "P. Giaccone"- University of Palermo) and a national reference centre for paediatrics (Ospedale Pediatrico Bambino Gesù - Rome). The questionnaire included twelve multiple-choice questions with the aim of analyzing the knowledge about ionizing radiation related risks in infants and children who undergo common diagnostic radiology investigations. The data obtained were processed using software Stata/MP version 11.2. In order to measure the level of expertise of each interviewee a binary indicator was built. The value 1 was assigned if the percentage of correct answers exceeds the median of the distribution and 0 for values not exceeding the median. The association between the level of competence and demographic characteristics (gender, age) and training experience was measured by means of α(2) test.

RESULTS

51/65 questionnaires were completed, returned and analysed (87.7%). Only 18 surveyed (35%), (95% IC = [22%-48%]) can be defined as competent in radiation risk knowledge for common radiological investigations, considering the percentage of correct answers at least of 50% (sufficient knowledge was given with a minimum score of 8 correct answers out of 12).

CONCLUSIONS

The study demonstrates an urgent need to implement the radiation protection knowledge in the training programme of paediatricians, that improve if just a short targeted training is performed.

Radiation awareness among radiology residents, technologists, fellows and staff: where do we stand?

OBJECTIVES

To investigate and compare the knowledge of radiation dose and risk incurred in common radiology examinations among radiology residents, fellows, staff radiologists and technologists.

METHODS

A questionnaire containing 17 multiple choice questions was administered to all residents, technologists, fellows and staff radiologists of the department of medical imaging through the hospital group mailing list.

RESULTS

A total of 92 responses was received. Mean score was 8.5 out of 17. Only 48 % of all participants scored more than 50 % correct answers. Only 23 % were aware of dose from both single-view and two-view chest X-ray; 50-70 % underestimated dose from common studies; 50-75 % underestimated the risk of fatal cancer. Awareness about radiation exposure in pregnancy is variable and particularly poor among technologists. A statistically significant comparative knowledge gap was found among technologists.

CONCLUSIONS

Our results show a variable level of knowledge about radiation dose and risk among radiology residents, fellows, staff radiologists and technologists, but overall knowledge is inadequate in all groups. There is significant underestimation of dosage and cancer risk from common examinations, which could potentially lead to suboptimal risk assessment and excessive or unwarranted studies posing significant radiation hazard to the patient and radiology workers.

MAIN MESSAGES

• Knowledge of radiation dose and risk is poor among all radiology workers. • Significant knowledge gap among technologists compared to residents, fellows and staff radiologists. • Significant underestimation of radiation dose and cancer risk from common examinations.

Radiographers' professional knowledge regarding parameters and safety issues in plain radiography: a questionnaire survey

OBJECTIVE

To review the knowledge of radiographers and examine the possible sociodemographic and situational contributors to this knowledge.

METHODS

A questionnaire survey was devised and distributed to a cohort of 120 radiographers. Each questionnaire contained two sections. In the first section, background data, including sex, age, highest academic level, grade point average (GPA), length of time from graduation, work experience as a radiographer and the status of previous refresher course(s), were collected. The second section contained 17 multiple-choice questions concerning radiographic imaging parameters and safety issues.

RESULTS

The response rate was 63.8%. In univariate analytic model, higher academic degree (p < 0.001), higher GPA (r(2) = 0.11; p = 0.001), academic workplace (p = 0.04) and taking previous refresher course(s) (p = 0.01) were significantly associated with higher knowledge score. In multivariate analytic model, however, higher academic degree (B = 1.62; p = 0.01), higher GPA (B = 0.50; p = 0.01) and taking previous refresher course(s) (B = -1.26; p = 0.03) were independently associated with higher level of knowledge. Age, sex, length of time from graduation and work experience were not associated with the respondents' knowledge score.

CONCLUSION

Academic background is a robust indicator of a radiographer's professional knowledge. Refresher courses and regular knowledge assessments are highly recommended.

ADVANCES IN KNOWLEDGE

This is the first study in the literature that examines professional knowledge of radiographers in terms of technical and safety issues in plain radiography. Academic degree, GPA and refresher courses are independent predictors of this knowledge. Regular radiographer professional knowledge checks may be recommended.