Assessment of Knowledge, Attitude and Utilization of Nuclear Medicine Imaging among Clinical and Radiation Oncologists in Nigeria

Abstract

Background: Optimal decision-making regarding the diagnosis, initial staging, restaging, treatment response monitoring, detection of recurrence or metastasis, and adequate post-treatment follow-up and monitoring of patients with cancer requires appropriate knowledge of imaging modalities and proper utilization among Clinical and radiation oncologists. The aim of this study was to assess the knowledge, attitudes, and reported practices regarding the utilization of nuclear medicine imaging among clinical and radiation oncologists in Nigeria. Method: Self-administered survey of physicians in radiation oncology in Nigeria on knowledge, attitudes, and practices regarding the utilisation of Nuclear Medicine (NM) imaging was conducted between June and October 2018. In consultation with Nuclear medicine experts, 20 questions were developed, including 10, 7, and 3 questions for each of the following domains: knowledge, attitudes, and practices respectively. For each domain, we created a score equal to the number of questions correctly answered out of the number of questions available. Results: Fifty-two oncologists participated in the study. The age range of participants was between 26 and 68 years. The survey response rate was 51.4% in a sample of 101 radiation oncologists from the database. Thirty-nine percent of respondents were consultants and 61% were residents. Approximately 46.2% of the participants had 5 to 10 years of working experience. All of the respondents were involved in the diagnosis and treatment of cancer. On average, 83.1% of participants had adequate cumulative knowledge of nuclear medicine imaging applications in oncology practice, 90.4% had a positive attitude to the use of NM imaging and the referral of patients for NM imaging was poor with those with more years of experience more likely to refer. However, there was no significant difference in NM practice with the age of participants. The most important factors responsible for poor utilization include a shortage of functional NM imaging centers and poor accessibility of existing ones. Potential facilitators may include providing adequate NM facilities and improving access to the usage. Conclusion: Our study shows that clinicians involved in the treatment of patients with cancer in Nigeria have good knowledge and attitude towards the use of nuclear medicine imaging and its application. However, availability and accessibility drive the utilisation.