Examining the Decision of Radiographers in the Selection of Computed Tomography Scan Radiation Doses

Abstract

Medical radiation is a controllable source and should be applied on individualized basis to determine whether each patient fits the appropriate criteria for the diagnostic procedure. Appropriate justification of requested CT examinations should ensure that benefits outweigh the risk. CT scan protocols and radiation doses vary greatly across countries and are primarily attributable to local choices regarding technical parameters, rather than the patient, institution, or machine characteristics. These variations call for optimization of doses to consistent standards. This was a mixed methods study, with quantitative and qualitative approaches, undertaken in Uganda. This study involved radiographers scoring the effects of various CT best-practices on dose selection using a Likert scale. The qualitative component explored factors influencing CT scan technical parameter selection, the barriers, and facilitators to best practices to CT radiation protection. The male to female ratio was 3.5: 1 and the average age was 30 years with a range of 21 – 40 years. The respondents either agreed or strongly agreed that Diagnostic Reference Levels were important in dose selection. Key factors influencing the selection of CT scan doses included CT scan machine, examination time, age and body size. Key barriers to best practices were the type or level of health facility, radiographer, and government level related and the facilitators to best practices also included type or level health facility, radiographer and regulator related. Based on the findings, Diagnostic Reference Levels (DRLs), the make, model and year of manufacture of the CT equipment were important in dose selection. Radiographers had limited training on DRLs, and majority were concerned about the lack of these DRLs. Regular training will be designed and implemented for the radiographers through the professional bodies and the regulator to educate the radiographers about CT radiation scan dose selection to optimize patient radiation dose and image quality.