Patient radiation awareness in diagnostic imaging across Arab healthcare systems: A multicenter cross-sectional study.

INTRODUCTION: Effective patient communication regarding radiation exposure has become increasingly important in contemporary diagnostic imaging practice. This study evaluated patient radiation awareness and communication-related awareness deficiencies across diagnostic imaging pathways in Arab healthcare systems and identified factors associated with adequate awareness. METHODS: A multicenter cross-sectional survey was conducted between February and July 2025 across imaging departments in Egypt, Saudi Arabia, and Jordan. A culturally adapted Arabic questionnaire assessed awareness related to X-ray, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and nuclear medicine. Awareness scores were normalized to a 0-5 scale, with adequate awareness predefined as ≥3. Multivariable logistic regression and repeated-measures generalized estimating equation analyses were performed. RESULTS: Adequate awareness was uncommon across all participating cohorts, occurring in 5.7% of participants in Egypt, 5.5% in Saudi Arabia, and 7.2% in Jordan. Awareness scores remained below the predefined adequacy threshold across all evaluated imaging pathways, with only limited modality-level separation after adjustment. Prior radiation-related information was the factor most consistently associated with adequate awareness (adjusted OR = 39.48, 95% CI: 17.19-90.67; p < 0.001). CONCLUSION: Patient radiation awareness remained low across the surveyed Arab healthcare settings, supporting the need for structured, culturally accessible, patient-centered communication strategies in diagnostic imaging practice. IMPLICATIONS FOR PRACTICE: Radiographers and frontline imaging professionals may help improve patient understanding through structured pre-imaging communication and accessible radiation-awareness education.