National Survey on Computed Tomography Dose Reduction Awareness and Practices among Radiology Technologists in...

Computed tomography (CT) is a major source of medical radiation exposure, and radiologic technologists play a central role in applying dose-minimization principles. To date, no nationwide data exist on Moroccan technologists' knowledge, attitudes, and practices regarding CT dose optimization.

To assess awareness of dose-minimization concepts, implementation of optimization techniques, and perceived barriers among radiologic technologists in Morocco, and to identify educational and structural interventions to enhance radiation safety.

We conducted a cross-sectional, web-based survey from May 2025 to June 2025, targeting certified CT technologists across public and private hospitals in all 12 administrative regions of Morocco. The 22-item questionnaire covered demographics, familiarity with as low as reasonably achievable and dosimetric indices (CT dose index [CTDIvol], dose length product (DLP), size-specific dose estimate), use of dose-modulation techniques, adherence to diagnostic reference levels (DRLs), protocol adjustment practices (including pediatric and obese patients), and training needs. Data from 168 complete responses were analyzed using descriptive statistics and Chi-square tests (SPSS 21.0), with P < 0.05 denoting significance.

Of respondents, 66.9% were aged 25-35 years, 57% were female, and 50% had 1-5 years of experience. Although 82.6% reported familiarity with dose-minimization principles, only 46.1% understood dose-modulation technology, and 28.7% fully grasped CTDIvol/DLP metrics. Awareness of national DRLs was low (23.5%), with just 4.2% routinely comparing their practice to reference benchmarks. While 44.3% "always" considered dose reduction when selecting protocols, only 26.3% "regularly" modified exposure parameters. Key barriers included insufficient training (69.1%), technical limitations of existing CT scanners (53.3%), and high workload (39.4%). Half of the participants (50.9%) expressed a strong interest in further dose-optimization training.

This first national survey reveals substantial gaps between general awareness and practical mastery of CT dose minimization among Moroccan technologists. To strengthen patient protection, we recommend implementing structured continuous education programs, hands-on optimization workshops, integration of medical physicists for protocol auditing, and development of context-specific DRLs and standardized CT protocols. These measures will be critical for advancing radiation safety and ensuring compliance with international best-practice guidelines.