Assessment of Knowledge and Awareness among Computed Tomography Technologists on Computed tomography radiation Exposure Parameters

Abstract

Background: Computed tomography (CT) plays a critical role in diagnostic imaging, but contributes substantially to cumulative radiation dose. The use of dose optimization strategies—such as Diagnostic Reference Levels (DRLs), Automatic Tube Current Modulation (ATCM), and individualized scanning protocols—is essential to minimize unnecessary exposure. Their application depends on CT technologists' knowledge, skills, and institutional environment. Despite several international studies, national-level data from Nepal are lacking.

Methods: A cross-sectional survey was conducted from April to June 2025 among CT technologists across Nepal using stratified random sampling. A validated self-administered questionnaire—developed through literature review and refined via expert consultation and pilot testing—covered demographics, technical knowledge, awareness of optimization principles, training, and institutional support. Data were analyzed in SPSS version 25 using descriptive statistics and chi-square tests.

Results:

Of the 197 CT technologists surveyed, most were aged 25–34 years (62.4%) and held a bachelor's degree (82.7%). Awareness of Diagnostic Reference Levels (DRLs) was high (79.7%), but only 46.2% reported applying them in practice. Although 98.5% were familiar with the ALARA principle, just 40.1% routinely used shielding. Confidence in adjusting CT parameters (73.6%) and communicating radiation risks (83.2%) was commonly reported, but only 20.8% had attended dose optimization training in the past two years. Just over half (52.8%) had access to dose-monitoring software, and fewer than 40% reported routine protocol review. Most respondents adjusted scan parameters for pediatric patients (90.4%) and screened women of childbearing age for pregnancy (91.9%). No demographic or professional factors were significantly associated with adequate knowledge.

Conclusion: CT technologists in Nepal understand basic radiation safety but inconsistently apply optimization strategies. The study highlights the need for targeted education, structured training, and institutional policies to enhance CT imaging safety and efficacy nationwide. Looking forward, national regulatory bodies such as the NHPC and other could play a critical role in standardizing training requirements, developing national DRLs, and enforcing institutional accountability across imaging facilities.