Evaluation of non-radiologist physicians' knowledge on aspects related to ionizing radiation in imaging

Madrigano, Renata Rodrigues; Abrão, Karen Cristine; Puchnick, Andrea; Regacini, Rodrigo

doi:10.1590/0100-3984.2013.1840

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Sumário

ORIGINAL ARTICLES • Radiol Bras 47 (4) • Jul-Aug 2014 • https://doi.org/10.1590/0100-3984.2013.1840 copy

Evaluation of non-radiologist physicians' knowledge on aspects related to ionizing radiation in imaging^* * Study developed at Escola de Medicina da Universidade Anhembi Morumbi, São Paulo, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

To assess the non-radiologist physicians' knowledge on the use of ionizing radiation in imaging.

Materials and Methods:

Cross-sectional study utilizing an anonymous questionnaire responded by physicians in clinical and surgical specialties, divided into two parts as follows: one including questions about the physicians' characteristics, frequency of imaging studies requests and participation in professional updating events, and another part including multiple choice questions approaching general knowledge about radiation, optimization principles and radioprotection.

Results:

From a total of 309 questionnaires, 120 (38.8%) were responded, 50% by physicians in surgical specialties and 50% in clinical specialties; respectively 45% and 2.5% of physicians responded that magnetic resonance imaging and ultrasonography use ionizing radiation. Overall, the average grade was higher for surgical specialists with no significant difference, except for the question about exposure in pregnant women (p = 0.047). Physicians who are professionally updated, particularly those attending clinical meetings (p = 0.050) and participating in teaching activities (p = 0.047), showed statistically superior knowledge about ionizing radiation as compared with others.

Conclusion:

The non-radiologist physicians' knowledge is heterogeneous and in some points needs to be improved. Multidisciplinary clinical meetings and teaching activities are important ways to disseminate information on the subject.

Ionizing radiation; Knowledge; Physicians; Imaging diagnosis; Radiation protection; Questionnaire

	n	%
Medical practice	20	33.3
Cardiology	7	11.7
Nephrology	1	1.7
Pneumology	1	1.7
Family medicine	2	3.3
Psychiatry	1	1.7
Homeopathy	1	1.7
Endocrinology	2	3.3
Occupational medicine	2	3.3
Dermatology	4	6.7
Geriatrics	1	1.7
Pediatrics	15	25.0
Anesthesiology	3	5.0
Total	60	100

	n	%
Vascular surgery	6	10.0
Gynecology & obstetrics	19	31.7
Orthopedics	4	6.7
Otolaryngology	1	1.7
Urology	7	11.7
Gastrointestinal surgery	2	3.3
Pediatric surgery	3	5.0
General surgery	13	21.7
Plastic surgery	2	3.3
Coloproctology	1	1.7
Head and neck surgery	1	1.7
Cardiac surgery	1	1.7
Total	60	100

	n	%
Angiography	97	80.8
Bronchoscopy	2	1.7
Scintigraphy	66	55.0
Colonoscopy	1	0.8
Colposcopy	0	0.0
Dacryocystography	36	30.0
Defecography	26	21.7
Bone densitometry	72	60.0
Echocardiography	1	0.8
High digestive endoscopy	0	0.0
Opaque enema	86	71.7
Fluoroscopy	57	47.5
Esophagus, stomach and duodenum	53	44.2
Hysterosalpingography	65	54.2
Mammography	101	84.2
PET/CT	102	85.0
Conventional radiography	114	95.0
Magnetic resonance imaging	54	45.0
Sialography	38	31.7
Computed tomography	120	100.0
Intestinal transit time test	68	56.7
Ultrasonography	3	2.5
Videofluoroscopic swallowing study	33	27.5

		n	%
How many chest radiographs (anterior and lateral views) correspond to a chest CT?
	From 1 to 50..........................................................	16	13.3
	From 60 to 120....................................................	39	32.5
	From 150 to 350....................................................	47	39.2
	From 400 to 600...................................................	18	15.0
Is the radiation dose absorbed by the tissues during a unilateral leg CT (with both legs inside the apparatus) the same as in bilateral leg CT?
	Yes........................................................................	59	49.2
	No........................................................................	61	50.8

		n	%
What should the approach be in the event of a skull CT in a child victim of cranioencephalic trauma, with artifacts on few images which the radiologist considered as a normal study?
	The scan should be repeated until all images are acquired without any artifact........................................	7	5.8
	It is not necessary to repeat the scan.................	86	71.7
	The child should be referred for MRI...........................	3	2.5
	The child should be sedated in order to repeat the scan without moving........................................................	24	20.0
Should a radiological study be interrupted when the clinical doubt is solved, even in the event the protocol is not completed?
	Yes........................................................................	85	70.8
	No.........................................................................	35	29.2
With digital radiology, is it possible to reduce exposure to radiation by acquiring images from a comprehensive area of the body and then edit them on the computer, selecting only the region of interest?
	Yes........................................................................	78	65.0
	No.........................................................................	42	35.0
Should patients who will undergo multiple scans in their lifetime preferably be followed-up by means of other non-radiation emitting imaging methods, even in cases where such methods are not the gold standard?
	Yes.........................................................................	105	87.5
	No........................................................................	15	12.5

		n	%
Is it forbidden in cases of gestational age < 3 months?
	Yes.....................................................................	89	74.2
	No......................................................................	31	25.8
Can pregnant women be submitted to skull CT only?
	Yes.....................................................................	10	8.3
	No......................................................................	110	91.7
Is it an absolute contraindication at any gestational age?
	Yes......................................................................	21	17.5
	No......................................................................	99	82.5
Can pregnant women be submitted to diagnostic or screening mammography?
	Yes......................................................................	48	40.0
	No.......................................................................	72	60.0
Should every woman in childbearing age be submitted to a pregnancy test before being submitted to radiography of the pelvis?
	Yes......................................................................	52	43.3
	No......................................................................	68	56.7

		n	%
Is there a dose threshold below which the exposure is safe?
	Yes.......................................................................	81	67.5
	No.......................................................................	39	32.5
Does the risk for developing cancer increase with the dose value and may be present even with a single exposure?
	Yes.........................................................................	93	77.5
	No.......................................................................	27	22.5
The time interval during which the total amount of radiation was received does not influence the risk for cancer development. Is this right or wrong?
	Right....................................................................	25	20.8
	Wrong.................................................................	95	79.2
Are there organs or tissues more sensitive to radiation than others?
	Yes......................................................................	113	94.2
	No........................................................................	7	5.8

		n	%
Should any activity involving radiation be justified in relation to available alternatives?
	Yes......................................................................	111	92.5
	No.......................................................................	9	7.5
Should all exposures to radiation be maintained as low as reasonably achievable (ALARA)?
	Yes......................................................................	114	95.0
	No........................................................................	6	5.0
CNEN has established the annual dose threshold of 20 mSv for workers involved with radiation. Should such a threshold be also respected for patients being submitted to diagnostic procedures?
	Yes......................................................................	77	64.2
	No......................................................................	43	35.8
Should physicians and technicians who perform procedures utilizing ionizing radiation always be protected with shielding equipment and keep themselves as far as possible from the radiation source?
	Yes......................................................................	119	99.2
	No.......................................................................	1	0.8

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[1] Mailing Address: Dr. Rodrigo Regacini. Universidade Anhembi Morumbi - Coordenação de Medicina. Rua Doutor Almeida Lima, 1134, Brás. São Paulo, SP, Brazil, 03164-000. E-mail: regacini@gmail.com.

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Evaluation of non-radiologist physicians' knowledge on aspects related to ionizing radiation in imaging* * Study developed at Escola de Medicina da Universidade Anhembi Morumbi, São Paulo, SP, Brazil.

Objective:

Materials and Methods:

Results:

Conclusion:

Evaluation of non-radiologist physicians' knowledge on aspects related to ionizing radiation in imaging^* * Study developed at Escola de Medicina da Universidade Anhembi Morumbi, São Paulo, SP, Brazil.