Imaging for suspected pulmonary embolism in pregnancy-what about the fetal dose? A comprehensive review of the literature.

Insights Into Imaging
Tilo NiemannGeorg Bongartz

Abstract

OBJECTIVE: To give a comprehensive overview of fetal doses reported in the literature when imaging the pregnant woman with suspected pulmonary embolism (PE). METHODS: A comprehensive literature search in the PubMed, MEDLINE and EMBASE databases yielded a total of 1,687 papers that were included in the analysis and have been analysed with regard to fetal dose in suspected PE radiological imaging strategies. RESULTS: Fetal dose in chest computed tomography (CT) ranges between 0.013 and 0.026 mGy in early and 0.06-0.1 mGy in late pregnancy compared with 99mTc-MAA perfusion scintigraphy with a fetal dose of 0.1-0.6 mGy in early and 0.6-0.8 mGy in late pregnancy. (99m)Tc-aerosol ventilation scintigraphy results in 0.1-0.3 mGy. However, there is concern about female breast irradiation in CT, which is higher than in scintigraphy. CT radiation risks for breast tissue remain unclear. CONCLUSION: Knowledge of dosimetry and radiation risks is crucial in the radiological work-up of suspected PE in pregnancy. It is reasonable to reserve scintigraphy for pregnant patients with normal chest radiography findings and no history of asthma or chronic lung disease. Performing CT applying dose reduction instead of scintigraphy will minimise feta...Continue Reading

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Citations

Nov 22, 2014·Insights Into Imaging·Subramaniyan Ramanathan, John Ryan
Jun 20, 2019·The Medical Journal of Australia·Paul C KrugerGraeme J Hankey
Jun 3, 2020·Journal of Cardiac Surgery·Chandni PatelAmer Harky
Jun 20, 2020·Radiographics : a Review Publication of the Radiological Society of North America, Inc·William F SensakovicRebecca Vicenti
Aug 23, 2018·Internal Medicine Journal·M Peter Moore
May 31, 2014·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Kostas PerisinakisJohn Damilakis

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Methods Mentioned

BETA
imaging technique
X-ray

Software Mentioned

PIOPED

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