Diagnostic CT Scans: Assessment of Patient, Physician, and Radiologist Awareness of Radiation Dose and Possible Risks
Abstract
PURPOSE: To determine the awareness level concerning radiation dose and possible risks associated with computed tomographic (CT) scans among patients, emergency department (ED) physicians, and radiologists.
MATERIALS AND METHODS: Adult patients seen in the ED of a U.S. academic medical center during a 2-week period with mild to moderate abdominopelvic or flank pain and who underwent CT were surveyed after acquisition of the CT scan. Patients were asked whether or not they were informed about the risks, benefits, and radiation dose of the CT scan and if they believed that the scan increased their lifetime cancer risk. Patients were also asked to estimate the radiation dose for the CT scan compared with that for one chest radiograph. ED physicians who requested CT scans and radiologists who reviewed the CT scans were surveyed with similar questions and an additional question regarding the number of years in practice. The χ2 test of independence was used to compare the three respondent groups regarding perceived increased cancer risk from one abdominopelvic CT scan.
RESULTS: Seven percent (five of 76) of patients reported that they were told about risks and benefits of their CT scan, while 22% (10 of 45) of ED physicians reported that they had provided such information. Forty-seven percent (18 of 38) of radiologists believed that there was increased cancer risk, whereas only 9% (four of 45) of ED physicians and 3% (two of 76) of patients believed that there was increased risk (χ22 = 41.45, P < .001). All patients and most ED physicians and radiologists were unable to accurately estimate the dose for one CT scan compared with that for one chest radiograph.
CONCLUSION: Patients are not given information about the risks, benefits, and radiation dose for a CT scan. Patients, ED physicians, and radiologists alike are unable to provide accurate estimates of CT doses regardless of their experience level.
© RSNA, 2004
References
- 1 Dixon AK, Goldstone KE. Abdominal CT and the Euratom Directive. Eur Radiol 2002; 12:1567-1570. Crossref, Medline, Google Scholar
- 2 Mettler FA, Jr, Wiest PW, Locken JA, Kelsey CA. CT scanning: patterns of use and dose. J Radiol Prot 2000; 20:353-359. Crossref, Medline, Google Scholar
- 3 Golding SJ, Shrimpton PC. Commentary. Radiation dose in CT: are we meeting the challenge? Br J Radiol 2002; 75:1-4. Google Scholar
- 4 Haaga JR. Radiation dose management: weighing risk versus benefit. AJR Am J Roentgenol 2001; 177:289-291. Crossref, Medline, Google Scholar
- 5 Pierce DA, Preston DL. Radiation-related cancer risks at low doses among atomic bomb survivors. Radiat Res 2000; 154:178-186. Crossref, Medline, Google Scholar
- 6 Brenner D, Elliston C, Hall E, Berdon W. Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR Am J Roentgenol 2001; 176:289-296. Crossref, Medline, Google Scholar
- 7 Gower-Thomas K, Lewis MH, Shiralkar S, Snow M, Galland RB, Rennie A. Doctors’ knowledge of radiation exposures is deficient (letter). BMJ 2002; 324:919. Crossref, Google Scholar
- 8 Jessen KA, Shrimpton PC, Geleijns J, Panzer W, Tosi G. Dosimetry for optimisation of patient protection in computed tomography. Appl Radiat Isot 1999; 50:165-172. Crossref, Medline, Google Scholar
- 9 Dixon AK, Dendy P. Spiral CT: how much does radiation dose matter? Lancet 1998; 352:1082-1083. Crossref, Medline, Google Scholar
- 10 Trott KR. Radiation risks from imaging of intestinal and abdominal inflammation. Scand J Gastroenterol Suppl 1994; 203:43-47. Medline, Google Scholar
- 11 Donnelly LF, Frush DP. Fallout from recent articles on radiation dose and pediatric CT. Pediatr Radiol 2001; 31:388; discussion 389-391. Crossref, Google Scholar
- 12 Linton OW, Mettler FA, Jr. National conference on dose reduction in CT, with an emphasis on pediatric patients. AJR Am J Roentgenol 2003; 181:321-329. Crossref, Medline, Google Scholar
- 13 Lewis C. Full-body CT scans: what you need to know. FDA Consum 2001; 35:10. Google Scholar
- 14 Thomas RH, Lindell B. In radiological protection, the protection quantities should be expressed in terms of measurable physical quantities. Radiat Prot Dosimetry 2001; 94:287-292. Crossref, Medline, Google Scholar
- 15 Nickoloff E. Current adult and pediatric CT doses. Pediatr Radiol 2002; 32:250-260. Crossref, Medline, Google Scholar
- 16 Earnest F, Swensen SJ, Zink FE. Respecting patient autonomy: screening at CT and informed consent. Radiology 2003; 226:633-634. Link, Google Scholar