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Pediatric providers and radiology examinations: knowledge and comfort levels regarding ionizing radiation and potential complications of imaging

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Abstract

Background

Pediatric providers should understand the basic risks of the diagnostic imaging tests they order and comfortably discuss those risks with parents. Appreciating providers’ level of understanding is important to guide discussions and enhance relationships between radiologists and pediatric referrers.

Objective

To assess pediatric provider knowledge of diagnostic imaging modalities that use ionizing radiation and to understand provider concerns about risks of imaging.

Materials and methods

A 6-question survey was sent via email to 390 pediatric providers (faculty, trainees and midlevel providers) from a single academic institution. A knowledge-based question asked providers to identify which radiology modalities use ionizing radiation. Subjective questions asked providers about discussions with parents, consultations with radiologists, and complications of imaging studies.

Results

One hundred sixty-nine pediatric providers (43.3% response rate) completed the survey. Greater than 90% of responding providers correctly identified computed tomography (CT), fluoroscopy and radiography as modalities that use ionizing radiation, and ultrasound and magnetic resonance imaging (MRI) as modalities that do not. Fewer (66.9% correct, P<0.001) knew that nuclear medicine utilizes ionizing radiation. A majority of providers (82.2%) believed that discussions with radiologists regarding ionizing radiation were helpful, but 39.6% said they rarely had time to do so. Providers were more concerned with complications of sedation and cost than they were with radiation-induced cancer, renal failure or anaphylaxis.

Conclusion

Providers at our academic referral center have a high level of basic knowledge regarding modalities that use ionizing radiation, but they are less aware of ionizing radiation use in nuclear medicine studies. They find discussions with radiologists helpful and are concerned about complications of sedation and cost.

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Author information

Authors and Affiliations

  1. Department of Radiology, Duke University Hospital, 2301 Erwin Road, Durham, NC, 27710, USA

    Benjamin Wildman-Tobriner & Charles M. Maxfield

  2. Department of Pediatrics, Duke University Hospital, Durham, NC, USA

    Victoria M. Parente

Authors
  1. Benjamin Wildman-Tobriner
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  2. Victoria M. Parente
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  3. Charles M. Maxfield
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Corresponding author

Correspondence to Benjamin Wildman-Tobriner.

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Conflicts of interest

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Appendix

Appendix

  • Q1. Who are you?

    • ❍ Attending

    • ❍ Fellow

    • ❍ Resident

    • ❍ Nurse Practitioner

    • ❍ Physician Assistant

    • ❍ Other ____________________

  • Q2. What is your pediatric subspecialty?

    • ❍ Allergy/Immunology

    • ❍ Cardiology

    • ❍ Critical Care

    • ❍ Endocrinology

    • ❍ Gastroenterology

    • ❍ Healthy Lifestyles

    • ❍ Hematology-Oncology

    • ❍ Hospital and Emergency Medicine

    • ❍ Infectious disease

    • ❍ Medical Genetics

    • ❍ Medicine-Pediatrics

    • ❍ Nephrology

    • ❍ Neonatology

    • ❍ Neurology

    • ❍ Primary Care

    • ❍ Pulmonary

    • ❍ Rheumatology

    • ❍ Surgery

    • ❍ Other ____________________

  • Q3. Which of the following imaging examinations use ionizing radiation?

 

Yes

No

Not Sure

Computed Tomography (CT)

❍

❍

❍

Fluoroscopy

❍

❍

❍

Magnetic Resonance Imaging (MRI)

❍

❍

❍

Nuclear Medicine

❍

❍

❍

Ultrasound

❍

❍

❍

X-Ray

❍

❍

❍

  • Q4. What is your level of comfort when discussing the risks of ionizing radiation with parents?

    • ❍ Very uncomfortable

    • ❍ Somewhat uncomfortable

    • ❍ Neutral

    • ❍ Somewhat comfortable

    • ❍ Very comfortable

  • Q5. Do you find it helpful to discuss the risks of ionizing radiation with a radiologist?

    • ❍ Yes

    • ❍ Yes but I rarely have time for such a discussion

    • ❍ No

    • ❍ I have not discussed radiation risks with a radiologist

  • Q6. When ordering imaging studies for your patients, please characterize your level of concern for each of the following potential complications/issues:

 

No concern

Minimal concern

Moderate concern

Greatly concerned

Anaphylaxis (contrast reaction)

❍

❍

❍

❍

Complications of sedation

❍

❍

❍

❍

Cost

❍

❍

❍

❍

Radiation-induced cancer

❍

❍

❍

❍

Renal failure

❍

❍

❍

❍

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Cite this article

Wildman-Tobriner, B., Parente, V.M. & Maxfield, C.M. Pediatric providers and radiology examinations: knowledge and comfort levels regarding ionizing radiation and potential complications of imaging. Pediatr Radiol 47, 1730–1736 (2017). https://doi.org/10.1007/s00247-017-3969-8

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  • DOI: https://doi.org/10.1007/s00247-017-3969-8

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