Diagnostic imaging includes various modalities that use low-dose ionizing radiation. Modalities such as magnetic resonance imaging (MRI) and ultrasound (U/S) are non-ionizing. However, modalities such as x-ray (XR) and computed tomography (CT) are considered as carcinogenic as they feature low-dose ionizing radiation [1], [2]. The risk of cancer has been modelled via a linear, no-threshold (LNT) model and has been accepted by the Committee on the Biologic Effects of Ionizing Radiation (BEIR), the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), the International Committee on Radiological Protection (ICRP), and the National Council on Radiation Protection and Measurements (NCRP) [3]. The LNT model suggests that there is no safe quantity of radiation and the risk is cumulative throughout one’s life [4]. Although some counter that there may be a safe or even beneficial level of radiation [5], [6], [7], [8], there is currently insufficient evidence to reject the LNT model. Thus, avoiding unnecessary exposure to ionizing radiation is the best way to alleviate any risk.

Radiation risk assessment is only possible when assessing a patient’s cumulative dose throughout their lifetime [9], which patients themselves cannot do but should be able to [10]. Hence, there is a need for specific, personalized dose calculations [11].  The International Atomic Energy Agency (IAEA) calls for reliable and understandable communication of the potential health risks and benefits of patient exams [12] [13]. Physicians are expected to have the knowledge required to explain radiation risks to patients, but this is not always true. [3]

A survey was conducted to examine the current level of patient and physician communication of the risks of low-dose ionizing radiation, if and how the patient/physician dialogue is occurring and if not, discern how patients are seeking out information about low-dose radiation.

While patients have been identified as having an unsatisfactory level of radiation knowledge [3], patients strongly desire to be made aware of their

risk [14], [15], [16], [17], [18], [19]. A recent literature review conducted by Lam et al. [3] identified that many patients are unable to identify which

modalities use ionizing radiation, are unable to link ionizing radiation to its risk of cancer, and underestimate doses.

This is likely because patients are often not informed of risks associated with medical imaging by their referring physician [20], [21], [22]. Lee et al. [20] determined that 7% (5/76) of patients stated that they were informed of any risks associated with their CT scan.  However, patients may be misunderstanding what is being said to them as 22% (10/45) of the referring emergency department physicians reported they did

provide information. More literature review was necessary to be examined to further elucidate if patient knowledge has improved and identify where

patients are acquiring their information, as this was not addressed [3].