Abstract
Although imaging has become a standard tool of modern medicine, its widespread use has been paralleled by an increasing cumulative radiation dose to patients despite technological advancements and campaigns calling for better awareness and minimization of unnecessary exposures. To assess patients' knowledge about medical radiation and related risks. A survey study of hospitals in Italy was conducted; all patients in waiting rooms for medical imaging procedures before undergoing imaging examinations at 16 teaching and nonteaching hospitals were approached to take the survey. The survey was performed from June 1, 2019, to May 31, 2020. Survey respondents' basic knowledge of ionizing radiation levels and health risks, earlier imaging tests performed, and information and communication about radiation protection issues. Among 3039 patients invited to participate, the response rate was 94.3% (n = 2866). Participants included 1531 women (53.4%); mean (SD) age was 44.9 (17.3) years. Of the 2866 participants, 1529 (53.3%) were aware of the existence of natural sources of ionizing radiation. Mammography (1101 [38.4%]) and magnetic resonance imaging (1231 [43.0%]) were categorized as radiation-based imaging modalities. More than half of the 2866 patients (1579 [55.1%]; P = .03) did not know that chest computed tomography delivers a larger dose of radiation than chest radiography, and only 1499 (52.3%) knew that radiation can be emitted after nuclear medicine examinations (P = .004). A total of 667 patients (23.3%) believed that radiation risks were unrelated to age, 1273 (44.4%) deemed their knowledge about radiation risks inadequate, and 2305 (80.4%) preferred to be informed about radiation risks by medical staff. A better knowledge of radiation issues was associated with receiving information from health care professionals (odds ratio [OR], 1.71; 95% CI, 1.43-2.03; P < .001) and having a higher educational level (intermediate vs low: OR, 1.48; 95% CI, 1.17-1.88; P < .001; high vs low: OR, 2.68; 95% CI, 2.09-3.43; P < .001). The results of this survey suggest that patients undergoing medical imaging procedures have overall limited knowledge about medical radiation. Intervention to achieve better patient awareness of radiation risks related to medical exposures may be beneficial.
Highlights
Owing to the development and widespread availability of cross-sectional imaging, in the last several decades, radiology has become pivotal in the diagnosis and management of many diseases
More than half of the 2866 patients (1579 [55.1%]; P = .03) did not know that chest computed tomography delivers a larger dose of radiation than chest radiography, and only 1499 (52.3%) knew that radiation can be emitted after nuclear medicine examinations (P = .004)
A total of 667 patients (23.3%) believed that radiation risks were unrelated to age, 1273 (44.4%) deemed their knowledge about radiation risks inadequate, and 2305 (80.4%) preferred to be informed about radiation risks by medical staff
Summary
Owing to the development and widespread availability of cross-sectional imaging, in the last several decades, radiology has become pivotal in the diagnosis and management of many diseases. The use of medical imaging, including ionizing radiation-based modalities, continues to increase, raising concerns about patients’ radiation exposure,[1,2,3,4] with reported cumulative effective doses exceeding 100 mSv for single procedures.[5,6,7,8] accounting for only 17% of all medical examinations, multidetector computed tomography (CT) alone makes up approximately 50% of the total radiation burden for medical purposes, and a large multicenter trial by Rehani et al[9] revealed that more than 1% of patients undergoing multiple CT examinations over 1 to 5 years received a cumulative effective dose above 100 mSv. The European Council Directive 2013/59/Euratom has emphasized the need for “safety standards for protection against the dangers arising from exposure to ionizing radiation.”[10] Technical advances aimed to optimize radiation dose use, and awareness campaigns for health care professionals (including general practitioners, clinicians, radiologists, nuclear medicine physicians, and radiographers) and patients are the main ways to minimize unnecessary radiation exposure. Several studies have reported a lack of knowledge about medical radiation and related risks among both health care professionals and patients.[11,12,13,14,15,16] In particular, patients’ knowledge about medical radiation is limited, and the perception of radiation risks is variable depending on age and educational level.[17,18,19]
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