The large use of Computed Tomography Scan (CT scan) is a principal cause of increasing medical ionizing radiation exposure. Children are considered a population at risk for the occurrence of radiation-induced pathologies, and the implementation of radiation protection measures relies on the knowledge and skills of healthcare professionals. This analytical cross-sectional study aimed to assess the knowledge of Moroccan physicians prescribing pediatric CT scan examinations on the radiation protection of patients, radiation doses, and potential health risks of radiation exposure from CT scan. A questionnaire was distributed to all clinicians on the medical staff who prescribe pediatric CT examinations in five Moroccan pediatric hospitals. The questions have a focusing on prescribers’ practices and their knowledge of patient radiation protection, radiation doses, the potential health risks of radiation exposure from CT scan, and training on radiation protection. One hundred and ninety-two questionnaires were submitted to prescribers and among them, 88% responded. The data were analyzed using the Statistical Package of Microsoft Office Excel. Knowledge gaps regarding CT scan radiation doses and associated health risks among Moroccan physicians are evident from this study results, initial and continuing training of health care staff and the implementation of referral guidelines for medical imaging could lead to improve practitioners’ knowledge of patient radiation protection.
In Morocco, the radiation protection of patients undergoing medical imaging examinations using ionizing radiation sources is now governed by specific provisions of Chapter VII of Law no142-12 (Loi no142-12 – AMSSNuR, 2015). The principle of justification of procedures and the principle of optimization of doses delivered constitute the basis of the legislation governing medical exposure. DRLs are considered as an important optimization tool encouraging healthcare professionals to optimize their practice and assure a better patient safety. In this survey, Local Diagnostic Reference Levels (LDRLs) were established for the eight most frequent examinations in Morocco. Data from 1747 patients were collected from seven regional hospitals. The proposed LDRLs were defined as the 75th percentile of the mean entrance surface dose distribution (ESD) in mGy using the indirect dosimetry method according to the IAEA Report Series No. 457. The LDRLs values reported in this study were for the eight examinations: skull (PA) 2.8 mGy, chest (PA) 0.51 mGy, abdomen (AP) 7.6 mGy, pelvis (AP) 6.45 mGy, lumbar (AP) 7.8 mGy, lumbar (Lat) 10.7 mGy, cervical (AP) 2.2 mGy, and cervical (Lat) 2.4 mGy. The DRLs reported in Morocco were compared with those of international authorities and other countries: IRSN (France), NRPB (UK), Japan, Sudan, and Iran. The present work assesses the local DRLs in Morocco and constitutes a starting point that will provide professionals with a tool to help them optimize the doses delivered to patients. Furthermore, the definition of national DRLs by radiography is an essential step in the process of optimizing medical exposures.
Digital Mammography is used as a screening tool to discover breast cancer at an early stage, the benefits and harms of this techniques is under scrutiny hence and Moroccan regulations governing radiation protection of patients have been strengthened, the need to investigate the dose received during screening mammography and the risk associated. This study is consisted of examining 126 mammography projections, for 63 women. All examinations were performed with a full digital mammography machine, technical and exposure parameters were recorded, statistical analysis was carried out using Microsoft Excel in order to calculate local DRLs and compare them with international standards. Cancer risk has been estimated using BEIR VII report methods. The mean glandular dose MGD was 1,09±0, 45 mGy and 1,26±0,74 mGy for craniocaudal (CC) and mediolateral oblique (MLO) respectively, DRLs were 1,34 for CC view and 1,36 for MLO view. Of the 100,000 women exposed, Lifetime Attributable Risk of cancer incidence has been found to be 0,76 for CC examination, 0.88 for MLO, and 1,64 for the full mammography protocol. Established local DRLs in this study are lower compared to that of United Kingdom and France and higher compared to that of Nigeria and Australia. A potential risk of radiation-induced carcinogenesis exists, and there is a need for optimization of screening mammography practices.
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