Do urologists actually comply with the ALARA principle in pediatric urolithiasis management?

Abstract

The purpose of the study was to determine the urologists' knowledge of ionizing radiation and the frequency of CT scan utilization for pediatric patients with urolithiasis. The second aim is to examine the factors that affect the choice of the CT imaging method in these patients. We sent a quantitative online questionnaire to urologists and pediatric urologists in various regions and practice settings of Turkey via a web survey database in June 2022. The survey consisted of 22 items in a multiple-choice or yes/no format and was divided into three sections: participant characteristics, knowledge, and current practice. One hundred and fifty-four participants fully completed this questionnaire. Forty-two participants (27.3%) correctly stated the radiation dose of an abdominal CT scan. Thirty of the participants (19.5%) thought that there was no relationship between exposure to radiation and cancer development. In addition, 76 participants (49.4%) were aware of any scientific literature about this relationship. Ninety-eight participants (63.6%) think that they did not receive adequate training on imaging methods for pediatric patients during their residency program. The choice of CT scans as the first imaging method was increased with age. Even if the choice of imaging method is mostly decided according to the guidelines, various factors such as medicolegal causes, long ultrasound appointment dates, poor quality of assessment, and clinical experiences are inevitable facts that guide the choice of computed tomography. Urologists are responsible for knowing the effects of ionizing radiation and the ALARA principle. Our findings emphasize the lack of knowledge about ionizing radiation. Encouragement of the literature, provision of the mandatory curriculum, and supervision of the use of ionizing radiation will contribute to the elimination of the deficiency in this area.