CT Protocol Adaptation and Radiogenic Risk in Patients with Disabilities in Saudi Arabia: A Cross-Sectional Survey

Abstract

Exposure to ionizing radiation for medical purposes is the largest source of exposure to the general public. Patients with disabilities or special needs face unique physical, communication, and organizational barriers that may affect their radiation safety, image quality, and access to care. The objective of this study was to evaluate computed tomography (CT) imaging practices for patients with disabilities, examine the challenges encountered by radiology professionals, and offer evidence-based recommendations to improve clinical practice. A structured, expert-validated questionnaire evaluated facility readiness, protocol adjustments, immobilization methods, sedation use, staffing support, radiation dose optimization strategies, and specialized training. Data analysis involved descriptive statistics and chi-square tests, with a significance threshold at P < 0.05. There was a significant association between the use of customized positioning aids and the adoption of faster scanning protocols (χ 2 = 19.395, P = 0.022). A highly significant correlation was found between the number of immobilization devices and the reported challenges (χ 2 = 31.895, P < 0.001). No significant links were observed between faster scanning protocols and sedation, staffing, specialized training, or adaptive iterative reconstruction technology. CT practices for patients with disabilities differ across institutions. Some facilities employ positioning aids with motion-reduction protocols, but gaps remain in training standardization and in the implementation of dose optimization. Radiogenic risks from CT procedure increased due to the reparative exposure for patients with disabilities. Enhancing disability-specific education and standardizing protocols are crucial for safe, accessible, and equitable imaging services.