Beyond Guesswork: Addressing the Wide Variability in Pediatric Iodinated Contrast Media Delivery from an International Perspective

Background: Radiographers play a crucial role in ensuring the safe and effective delivery of iodinated contrast media (ICM) in pediatric CT imaging. However, practice variability across institutions raises concerns about consistency, patient safety, and diagnostic quality. This study examines the range of real-world practices in pediatric ICM administration, focusing on protocol adherence and variations in technique. Methods: An international cross-sectional survey was conducted among 103 CT radiographers. The online questionnaire assessed demographic data, clinical practices, protocol modification behaviors, and institutional procedures. Data were collected over a nine-week period and analyzed using descriptive and comparative statistics to identify trends and practice variability. Results: The findings revealed considerable variability in ICM administration practices, including differences in injection rates, contrast volumes, catheter gauge selection, and use of saline flush techniques. Although 93.2% of participants reported confidence in modifying contrast protocols, knowledge assessments showed that 75.7% of radiographers scored in the "Poor" category, with no participants achieving an "Excellent" score. Additionally, many respondents reported relying on experience-based practices rather than standardized institutional guidelines, contributing to inconsistent contrast delivery approaches. No significant associations were found between demographic factors and reported practices, suggesting variability exists across all levels of education and experience. Conclusion: The study highlights inconsistencies in pediatric ICM delivery practices among CT radiographers, emphasizing the need for standardized protocols and structured training programs. Addressing these inconsistencies is crucial for improving diagnostic quality, patient safety, and promoting consistency in best practices across clinical settings.