Utilization of Imaging in Pregnant Patients: 10-year Review of 5270 Examinations in 3285 Patients—1997–2006

Lazarus, Elizabeth; DeBenedectis, Carolynn M.; North, David L.; Spencer, Patricia K.; Mayo-Smith, William W.

doi:10.1148/radiol.2512080736

Cited by 111 publications

(64 citation statements)

References 7 publications

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“…Between 2001 and 2010, the annual number of PET scans performed in the United States increased nearly 7-fold (from ;250,000 to .1.7 million) (1), and 18 F-FDG is used for most PET examinations. As a consequence, an ever-increasing number of pregnant women are injected with radiopharmaceuticals (2). Fetal radiation exposure may be accidental if the pregnancy is unknown at the time of the PET scan (3)(4)(5)(6) or may be the consequence of a diagnostic workup for cancer in the mother (7)(8)(9).…”

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confidence: 99%

Fetal Radiation Dose from ¹⁸F-FDG in Pregnant Patients Imaged with PET, PET/CT, and PET/MR

2015

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The fetal radiation dose from 18 F-FDG was estimated in a series of pregnant women who underwent a PET scan during a clinical workup for malignancies. Methods: Six pregnant patients were injected with 18 F-FDG (activity range, 296-385 MBq). Three patients were scanned during the first trimester (1 with PET and 2 with PET/CT), 2 were scanned during the second trimester (with PET/MR imaging), and 1 was scanned during the third trimester (with PET). The time-integrated activity coefficients were derived from the fetal radioactivity concentrations measured on the images for all but 1 patient (in early pregnancy [5 wk]), in whom the activity in the uterus was used as a proxy. The coefficients of the mother's organs were derived from standard values (from the International Commission on Radiological Protection). Results: Fetal doses ranged from 6.29E-03 to 2.46E-02 mGy/MBq. An earlier bladder voiding reduced these doses by 25%-45%. The 2 patients who underwent PET/MR imaging-in whom fetal contours could be accurately delineated-displayed the lowest fetal absorbed dose, likely because of more accurate region drawing, with the inclusion of areas of both low and high fetal uptake. Moreover, PET/MR imaging did not necessitate additional radiation for attenuation correction. The placenta, delineated on a PET/MR imaging scan, concentrated 0.27% of the injected activity. Conclusion: Fetal radiation doses are higher in early pregnancy than in late pregnancy, and there can be considerable intersubject variability. However, the total absorbed dose is always well below the threshold for noncancer health effects throughout pregnancy. PET/MR imaging is the optimal PET procedure for imaging pregnant women because it is not associated with radiation for attenuation correction and allows more accurate dosimetric calculations.

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Fetal Radiation Dose from ¹⁸F-FDG in Pregnant Patients Imaged with PET, PET/CT, and PET/MR

2015

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“…Additionally, as more women delay childbearing, cancers that have an increasing incidence with age should be expected to be more frequently encountered during pregnancy (3)(4)(5). Not only has the use rate of imaging in the general patient population grown dramatically over the past few decades, but radiologic imaging in pregnant patients has also increased (6). 18 F-FDG PET and PET/CT have now become the standard of care for evaluation and workup of many neoplasms, including most of the malignancies that can occur in pregnant patients.…”

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¹⁸F-FDG PET in Pregnancy and Fetal Radiation Dose Estimates

et al. 2011

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“…A recent study on the utilization of radiologic imaging in pregnant patients from 1997 to 2006 has shown that the number of CT examinations during pregnancy has increased by an average of 25% per year ( 1 ). In such intentional exposures, estimation of radiation dose to the unborn baby is needed.…”

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Radiation Dose to the Conceptus from Multidetector CT during Early Gestation: A Method That Allows for Variations in Maternal Body Size and Conceptus Position

Damilakis

Perisinakis²,

Tzedakis³

et al. 2010

Radiology

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Purpose:To develop a method for estimating the radiation dose to the conceptus from multidetector computed tomography (CT) of the abdomen and pelvis in pregnant patients during the fi rst 7 weeks of gestation. Materials and Methods:This study was approved by the institutional review board and informed consent was obtained. A CT simulation software package was used to (a) develop voxelized models on the basis of image data from 117 nonpregnant patients who underwent abdominal and pelvic multidetector CT and (b) calculate dose at a position of the uterus assumed to be the position of the conceptus in case of pregnancy during the fi rst 7 weeks of gestation. Regression analysis was carried out to establish the relationship among conceptus dose, patient body size, and distance from the conceptus to the anterior skin surface. Results:Normalized conceptus doses calculated by using the software package ranged from 0.335 to 0.785 mGy per absorbed dose to air. Conceptus dose showed a signifi cant correlation with maternal body size and conceptus depth ( R 2 = 0.793, P , .001). A multivariable correlation of conceptus dose normalized to the free-in-air CT dose index (CTDI F ) with conceptus depth and patient perimeter was produced for estimating conceptus dose from abdominal and pelvic multidetector CT. Conceptus dose data provided for a specifi c scanner can be applied to other scanners by using correction factors based on ratios between the weighted CT dose index and CTDI F , resulting in inaccuracies in the estimation of conceptus dose of less than 12%. Conclusion:The radiation dose to the conceptus from abdominal and pelvic multidetector CT can be estimated with a method that allows for variations in maternal body size and conceptus position.q RSNA, 2010

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Utilization of Imaging in Pregnant Patients: 10-year Review of 5270 Examinations in 3285 Patients—1997–2006

Cited by 111 publications

References 7 publications

Fetal Radiation Dose from ¹⁸F-FDG in Pregnant Patients Imaged with PET, PET/CT, and PET/MR

Fetal Radiation Dose from ¹⁸F-FDG in Pregnant Patients Imaged with PET, PET/CT, and PET/MR

¹⁸F-FDG PET in Pregnancy and Fetal Radiation Dose Estimates

Radiation Dose to the Conceptus from Multidetector CT during Early Gestation: A Method That Allows for Variations in Maternal Body Size and Conceptus Position

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Utilization of Imaging in Pregnant Patients: 10-year Review of 5270 Examinations in 3285 Patients—1997–2006

Cited by 111 publications

References 7 publications

Fetal Radiation Dose from 18F-FDG in Pregnant Patients Imaged with PET, PET/CT, and PET/MR

Fetal Radiation Dose from 18F-FDG in Pregnant Patients Imaged with PET, PET/CT, and PET/MR

18F-FDG PET in Pregnancy and Fetal Radiation Dose Estimates

Radiation Dose to the Conceptus from Multidetector CT during Early Gestation: A Method That Allows for Variations in Maternal Body Size and Conceptus Position

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Fetal Radiation Dose from ¹⁸F-FDG in Pregnant Patients Imaged with PET, PET/CT, and PET/MR

Fetal Radiation Dose from ¹⁸F-FDG in Pregnant Patients Imaged with PET, PET/CT, and PET/MR

¹⁸F-FDG PET in Pregnancy and Fetal Radiation Dose Estimates