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

Main Article Content

Bouchra Amaoui
Abdennasser El Kharras
Slimane Semghouli

Abstract

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.

Keywords:
CT scan examinations, patients’ radiation protection, X-ray risks.

Article Details

How to Cite
Amaoui, B., Kharras, A., & Semghouli, S. (2019). Physician’s Knowledge on X-ray Exposure from CT Scans in a Moroccan Hospital. Journal of Advances in Medicine and Medical Research, 30(7), 1-6. https://doi.org/10.9734/jammr/2019/v30i730215
Section
Original Research Article

References

Merzenich H, Krille L, Hammer G, Kaiser M, Yamashita S, Zeeb H. Paediatric CT scan usage and referrals of children to computed tomography in Germany-a cross-sectional survey of medical practice and awareness of radiation related health risks among physicians. BMC Health Services Research. 2012;12:47.
DOI: 10.1186/1472-6963-12-47

Ron E. Cancer risks from medical radiation. Health Phys. 2003;85:47-59.

Mather R. The physics of CT dose. Toshiba America Medical Systems Inc.

Griffey RT, Sodickson A. Cumulative radiation exposure and cancer risk estimates in emergency department patients undergoing repeat or multiple CT. AJR Am J Roentgenol. 2009;192(4):887- 92.
Doi:10.2214/AJR.08.1351

Gervaise A, Esparbe-Vigneau E, Pernin M, Naulet T, Porton Y, Lampierre CM. Evaluation of knowledge prescribing CT examinations on the radiation protection of patients. Radiology Journal, 2011;92:671-678.

Einstein AJ, Henzlova MJ, Rajagopalan S. Estimated risk of cancer with radiation exposure from 64-slice computed tomography coronary angiography. JAMA. 2007;298:317-323.

Shiralkar S, Rennie A, Snow M, et al. Doctors’ knowledge of radiation exposure: Questionnaire Study. BMJ. 2003;327.
DOI: https://doi.org/10.1136/bmj.327.7411.371

Health Physics Society. ALARA.
Available:http://www.hps.org/public information/radterms/radfact1.html [Accessed Mar 2019]

Cember H. Introduction to health physics. McGraw-Hill: 3rd edition; 1996.

Semghouli S, Amaoui B, El Kharras A, Bouykhlaf K, Hakam OK, Choukr A. Evaluation of radiation risks during CT brain procedures for adults. Perspectives in Science Journal (in press); 2019.
DOI: 10.1016/j.pisc.2019.100407

Semghouli S, Amaoui B, Hakam OK, Choukri A. Radiation exposure during pelvimetry CT procedures in Ibn Sina Children's Hospital of Rabat. Radiation Physics and Chemistry (in press); 2018.
DOI: 10.1016/j.radphyschem.2018.12.007

Semghouli S, Amaoui B, Maamri. Estimated radiation exposure from medical imaging for patients of radiology service of Al Faraby Hospital, Oujda Morocco. International Journal of Cancer Therapy and Oncology. 2015;3(3):3325.

Semghouli S, Amaoui B, El Kharras, Shaim A, Choukri A, Hakam A. Physicians knowledge of radiation risk in prescribing CT imaging in Moroccan hospitals. Br.J. Appl. Sci. Technol. 2017;20(3):1.

Council Directive 97/43/EURATOM/ of 30 June 1997 on Health protection of individuals against the dangers of ionizing radiation in relation to medical exposure and repealing Directive 84/466/Euratom. (OJ L-180 of 9 July 1997).

Semghouli S, Amaoui B, El Fahssi M, Choukri A, Hakam OK. Practitioners’ Knowledge on Patients’ Radioprotection in Emergency and Radiology Services of Hassan II Hospital Agadir Morocco. International Journal of Modern Physics and Applications. 2015;1(5):205-209.

Faragai RA, Ugwu CA, Hassan M, Mohammed S. How Knowledgeable are Non-Radiology Doctors on Ionizing Radiation? J Rad & Radiat Sci. 2019;33(1): 17–20.

Lee CI, Haims AH, Monico EP, Brink JA, Forman HP. Diagnostic CT scans: Assessment of patient, physician, and radiologist awareness of radiation dose and possible risks. Radiology Journal. 2004;231(2):393-8.

Board on Radiation Effects Research Division on Earth and Life Studies, Committee to Assess Health Risks from Exposure to Low Levels of Ionizing Radiation. Health Risks From Exposure To Low Levels of Ionizing Radiation Beir Vii Phase 2. National Research Council of The National Academies Press, Washington, DC; 2006.

BrennerDJ , Doll R, Goodhead DT, Salle EJ, Terre CE, Little JB, Lubin JH, Preston DL, Preston RJ, Puskin J, Ron E, Sachs RK,Samet JM, Setlow RB, Zaider M. Cancer risks attributable to low doses of ionizing radiation: Assessing what we really know. Proc Natl Acad Sci USA. 2003;25:100(24): 13761-6.

Jacob K, Vivian G, Stell JR. X ray dose training: Are we exposed to enough? Clin Radiology. 2004;59:928–934.

Rice HE, Frush DP, Harker MJ, Farmer D, Waldhausen JH. Peer assessment of pediatric surgeons for potential risks of radiation exposure from computed tomo-graphy scans. J Pediatr Surg. 2007;42(7): 1157-64.
DOI: 10.1016/j.jpedsurg.2007.02.007

Gerben B Keijzers, Charles J Britton. Doctors’ knowledge of patient radiation exposure from diagnostic imaging requested in the emergency department. Medical Journal of Australia. 2010; 193(8):450-3.