Patients reveal anxiety over CT imaging

Patients undergoing CT imaging experienced anxiety over radiation exposure, claustrophobia and intravenous contrast, according to a study published online Sept. 16 in Academic Radiology.

Lead researcher Christoph M. Heyer, MD, of Ruhr University in Bochum, Germany, and colleagues, wrote that patients’ anxiety not only occurs before having an MRI but also before having a CT. “Its sources are manifold,” wrote Heyer and colleagues. Overall, the study showed that women experienced greater anxiety levels than men.

Researchers measured the anxiety of 852 patients who underwent CT during a nine-month study by using the standardized state-trait anxiety inventory (STAI) and identifying possible risk factors. The German STAI dates from 1981 and is based on an American version from the 1970s, the researchers said.

The average STAI was higher for women, while patients who received intravenous contrast also showed higher anxiety levels compared to patients who did not receive contrast.

Patients who had never received a CT scan before showed significantly greater anxiety levels than those with repeat studies. Women had greater fears concerning examination results, radiation exposure, administration of contrast and claustrophobia. Patients with known malignancies also had a significantly higher level of anxiety concerning their CT results.

Researchers asked the patients to respond positively or negatively to ten items specifically targeting anxiety about CT, as well as 20 questions about general anxiety. For example, patients responded to items related to CT imaging with statements such as: “I am afraid of the radiation" or ‘‘I am afraid of the narrowness of the scanner.” Patients responded with answers ranging from “no” to “very much so.”

Patients with CT scan of the extremities showed significantly lower values than those undergoing scans of the torso, spine, blood vessels or head, the authors wrote.  Trauma patients also showed significantly lower values than  patients receiving CT scans for primarily non-traumatic indications. Of all subgroups, tumor patients showed the highest level of anxiety, they said.

The study included 455 (53.4 percent) outpatients and 397 (46.6 percent) inpatient participants. Sixty-five percent (554) were assigned by the surgery department, 224 (26.3 percent) patients by the department of internal medicine, and 41 (4.8 percent) patients received primary neurologic treatment. For the remaining patients, 22, or 2.6 percent were referred for CT by orthopedic practices, and 11, or 1.3 percent, by the department of pain therapy.