Evaluating the Justification of Computed Tomography (CT) Scan Requests to Reduce the Risk of Radiation-Induced Cancers

Abstract

Background: Ionizing radiation used in computed tomography (CT) has a carcinogenic risk. The aim of this study was to evaluate the justification of CT scan requests by physicians in Kashani hospital, Isfahan, Iran. Methods: Patients' data including the gender, age, type of CT scan, the cause of the request, the specialty of the requesting physician, and the test report were collected. The percentage of positive or abnormal cases for each test was obtained based on radiologist reports. The percentage of positive cases was also determined in term of the specialty of the requesting physicians. Findings: The data of 888 patients were analyzed. The number of CT scans of the brain, abdomen, chest, spine, facial bones, pelvis, upper limbs, and lower limbs was 601, 13, 31, 76, 53, 29, 19, and 66, respectively. The lowest and highest percentages of positive results were related to brain (18.64%) and upper extremity (36.84%) CT scan, respectively. The highest percentage of normal results was related to patients referred to the CT scan by general practitioners, general surgeons, and emergency medicine specialists. Conclusion: Totally, in all tests, 78.38% of the reports were normal, and less than 22% of the tests were indicative of pathological cases. Therefore, it is necessary to reduce the requests without indication to reduce the radiation dose of the community. The knowledge of the physicians about the suitable justification of the CT scan tests should be increased based on clinical guidelines, as well.

Keywords

• Diagnostic imaging
• Computed X-ray tomography
• Radiation-induced neoplasms