Submitted:
05 July 2026
Posted:
22 July 2026
You are already at the latest version
Abstract

Keywords:
Introduction
Materials and Methods
Study design and setting
Study participants and sampling
Study variables
Data collection tool and technique
Validity and reliability
Data analysis
Ethical considerations
Results
Participant recruitment
Participant characteristics
Knowledge of CT imaging and ionising radiation
Factors associated with adequate knowledge
Factors associated with high anxiety
| Qualitative theme | Illustrative quotation | Related quantitative finding |
| Professional trust | “I trusted the staff because they know what they are doing, even though I did not understand everything about the machine.” | Trust had the highest perception score: 4.18 ± 0.74. |
| Practical but limited technical knowledge | “I knew it takes pictures inside the body, but I did not know about the radiation part.” | Only 40.6% identified CT as using ionising radiation and 30.4% understood comparative dose. |
| Anxiety surrounding CT | “I was worried about the injection and what the results might show.” | First-time patients had higher odds of high anxiety: AOR = 2.37 (95% CI: 1.31–4.28). |
| Preference for simple information | “A simple explanation before the scan would help patients relax and know what to expect.” | Explanation before CT was associated with adequate knowledge and lower anxiety. |
Discussion
Implications for practice
Strengths and limitations
Conclusions
Competing interests
Authors’ contributions
Funding information
Data availability statement
Acknowledgments
References
- International Commission on Radiological Protection. Diagnostic reference levels in medical imaging. Ann. ICRP 2017, 46(1), 1–144. [Google Scholar] [CrossRef] [PubMed]
- United Nations Scientific Committee on the Effects of Atomic Radiation. Sources, effects and risks of ionizing radiation: UNSCEAR 2020/2021 report. Volume I, Scientific Annex A: Evaluation of medical exposure to ionizing radiation; United Nations: New York, 2022. [Google Scholar]
- Smith-Bindman, R.; Wang, Y.; Chu, P.; Chung, R.; Einstein, A.J.; Balcombe, J.; et al. International variation in radiation dose for computed tomography examinations: prospective cohort study. BMJ 2019, 364, k4931. [Google Scholar] [CrossRef] [PubMed]
- Sweetman, S.J.; Bernard, J. Patient knowledge and perception of radiation risk in diagnostic imaging: a cross-sectional study. J. Patient Exp. 2020, 7(1), 110–115. [Google Scholar] [CrossRef] [PubMed]
- Vassileva, J.; Zewde, N.T.; Reim, M.; Holmberg, O.; Rehani, M.M. Communication of radiation risk from imaging studies: an IAEA-coordinated international survey. J. Radiol. Prot. 2022, 42(2), 021524. [Google Scholar] [CrossRef] [PubMed]
- Ribeiro, A.; Husson, O.; Drey, N.; Murray, I.; May, K.; Thurston, J.; et al. Ionising radiation exposure from medical imaging: a review of patient’s (un)awareness. Radiography (Lond) 2020, 26(2), e25–e30. [Google Scholar] [CrossRef] [PubMed]
- Bastiani, L.; Paolicchi, F.; Faggioni, L.; Martinelli, M.; Gerasia, R.; Martini, C.; et al. Patient perceptions and knowledge of ionizing radiation from medical imaging. JAMA Netw. Open. 2021, 4(10), e2128561. [Google Scholar] [CrossRef] [PubMed]
- Alashban, Y.; Alghamdi, S.A. Patient perspectives on ionising radiation exposure from computed tomography in Saudi Arabia: a knowledge and perception study. Radiat. Prot. Dosim. 2024, 200(7), 687–692. [Google Scholar] [CrossRef] [PubMed]
- Mkoloma, S.S.; Motto, J.A.; Muhogora, W.E. Knowledge, attitude and awareness of the community about medical radiation in Tanzania. Health Phys. 2026, 130(2), 188–201. [Google Scholar] [CrossRef] [PubMed]
- Lambertova, A.; Harsa, P.; Lambert, L.; Kuchynka, P.; Briza, J.; Burgetova, A. Patient awareness, perception and attitude to contrast-enhanced CT examination: implications for communication and compliance with patients’ preferences. Adv. Clin. Exp. Med. 2019, 28(7), 923–929. [Google Scholar] [CrossRef] [PubMed]
- Salerno, S.; Nardi, C.; Pace, M.; Rabiolo, L.; Flammia, F.; Loverre, F.; et al. Communicating radiation dose in medical imaging: how to best inform our patients? Acta Radiol. Open. 2023, 12(4), 20584601231168967. [Google Scholar] [CrossRef] [PubMed]
| Characteristic | Category | n | Percentage |
| Age group | 18–30 years | 42 | 18.8 |
| 31–45 years | 71 | 31.7 | |
| 46–60 years | 63 | 28.1 | |
| >60 years | 48 | 21.4 | |
| Sex | Male | 118 | 52.7 |
| Female | 106 | 47.3 | |
| Education | No formal/primary | 52 | 23.2 |
| Secondary | 96 | 42.9 | |
| College/university | 76 | 33.9 | |
| Patient type | Outpatient | 155 | 69.2 |
| Inpatient | 69 | 30.8 | |
| Residence | Urban | 143 | 63.8 |
| Rural | 81 | 36.2 | |
| Previous CT experience | Yes | 83 | 37.1 |
| No | 141 | 62.9 | |
| Explanation before CT | Yes | 150 | 67.0 |
| No | 74 | 33.0 | |
| Main source of explanation | Radiographer | 96 | 42.9 |
| Physician/referring clinician | 34 | 15.2 | |
| Nurse | 20 | 8.9 | |
| No explanation | 74 | 33.0 | |
| Asked questions before CT | Yes | 71 | 31.7 |
| No | 153 | 68.3 | |
| Contrast used | Yes | 132 | 58.9 |
| No | 92 | 41.1 |
| Knowledge item | n | Percentage |
| CT produces cross-sectional images | 147 | 65.6 |
| CT uses ionising radiation | 91 | 40.6 |
| CT generally delivers a higher radiation dose than plain chest radiography | 68 | 30.4 |
| Pregnancy status is important before selected CT examinations | 165 | 73.7 |
| Contrast administration may require allergy or kidney-function screening | 122 | 54.5 |
| Patients can ask questions before examination | 136 | 60.7 |
| Knowledge measure | Category/statistic | n | percentage | Mean | SD |
| Overall knowledge score | Mean score | — | — | 4.8 | 2.1 |
| Knowledge level | Low | 98 | 43.8 | — | — |
| Moderate | 85 | 37.9 | — | — | |
| High | 41 | 18.3 | — | — |
| Perception domain | Mean ± SD |
| Anxiety before CT | 3.42 ± 0.96 |
| Fear of radiation | 2.88 ± 1.03 |
| Concern about contrast administration or injection | 3.35 ± 1.01 |
| Trust in healthcare providers | 4.18 ± 0.74 |
| Clarity of explanation | 3.64 ± 0.89 |
| Overall CT experience | 3.91 ± 0.81 |
| Outcome | Predictor | Reference category | AOR | 95% CI | P value |
| Adequate knowledge | Explanation before CT | No explanation | 3.12 | 1.74–5.60 | <0.001 |
| College/university education | Secondary or below | 2.45 | 1.36–4.41 | 0.003 | |
| Previous CT experience | No previous CT | 1.83 | 1.02–3.29 | 0.043 | |
| High anxiety | Female sex | Male | 2.05 | 1.17–3.59 | 0.012 |
| First CT examination | Previous CT experience | 2.37 | 1.31–4.28 | 0.004 | |
| Explanation before CT | No explanation | 0.46 | 0.25–0.83 | 0.010 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.