Evaluation of fetal absorbed doses from computed tomography examinations of pregnant patients: A systematic review

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BACKGROUND: Currently, no systematic data are available on fetal radiation exposure as a result of radiographic studies during pregnancy. Consequently, there are no approved methods of its calculation that can be used in clinical practice. It is especially relevant for computed tomography scans as it is a widely used and highly informative method of diagnostic imaging associated with high exposure levels.

AIM: to systematize currently available data on radiation dose absorbed by the fetus from computed tomography scans in pregnant women.

MATERIALS AND METHODS: The search for publications in Russian and English was conducted in PubMed/Medline, Google Scholar and еLibrary. The final analysis included 12 papers including 8 studies using human body phantoms, 3 retrospective studies and one prospective clinical study.

RESULTS: Abdominal and pelvic computed tomography scans as well as whole-body scans were found to be associated with the highest fetal radiation exposure. However, in none of the publications the fetal exposure limit was exceeded.

CONCLUSION: Clinically indicated non-contrast-enhanced computed tomography scans in pregnant women are not likely to be associated with the fetal absorbed doses that exceed the limit of 100 mGy regardless of the scanned area. However, this limit might be exceeded in case of performing multiple studies or if multiphase abdominal or pelvic computed tomography scans, or whole-body computed tomography scans are performed in patients with multiple trauma. In these cases, a decision regarding the need for these investigations should be made by a multi-disciplinary team (including radiation safety specialists, diagnostic radiologists and clinicians) based on the results of additional risk assessment.

Sobre autores

Aleksandr Vodovatov

Saint-Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev

Email: vodovatoff@gmail.com
ORCID ID: 0000-0002-5191-7535
Código SPIN: 4560-8978

Cand. Sci. (Biol.)

Rússia, Saint Petersburg

Olga Golchenko

City polyclinic № 19

Email: breakerxolyga@yandex.ru
ORCID ID: 0000-0003-4614-9241
Rússia, Saint Petersburg

Irina Mashchenko

Almazov National Medical Research Centre

Email: mashchenko_ia@almazovcentre.ru
ORCID ID: 0000-0002-4949-8829
Código SPIN: 5154-7080

MD, Cand. Sci. (Med.), Leading Researcher, Assistant Professor

Rússia, Saint Petersburg

Darya Alekseeva

Almazov National Medical Research Centre

Email: darja-karpova@yandex.ru
ORCID ID: 0000-0001-9528-9377
Código SPIN: 6484-4327

Assistant Lecturer

Rússia, Saint Petersburg

Larisa Chipiga

Saint-Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev; Almazov National Medical Research Centre

Email: larisa.chipiga@gmail.com
ORCID ID: 0000-0001-9153-3061
Código SPIN: 3920-7798

Cand. Sci. (Engin.), Research Associate, Assistant Professor

Rússia, Saint Petersburg; Saint Petersburg

Ivan Khutornoy

Lomonosov Moscow State University

Email: mcdm.avk@gmail.com
ORCID ID: 0000-0002-5405-603X
Código SPIN: 8020-0222

Graduate Student

Rússia, Moscow

Polina Kozlova

Almazov National Medical Research Centre

Email: apollinaria@bk.ru
ORCID ID: 0000-0002-3240-7038
Código SPIN: 3555-0410

Assistant Lecturer

Rússia, Saint Petersburg

Gennady Trufanov

Almazov National Medical Research Centre

Email: trufanovge@mail.ru
ORCID ID: 0000-0002-1611-5000
Código SPIN: 3139-3581

MD, Dr. Sci. (Med.)

Rússia, Saint Petersburg

Polina Druzhinina

Saint-Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev

Email: druzhininapauline@gmail.com
ORCID ID: 0000-0003-2921-067X
Código SPIN: 9003-3234

Junior Research Associate

Rússia, Saint Petersburg

Sergey Ryzhov

Research and Practice Center of Diagnostics and Telemedicine Technologies

Email: mosrg@mail.ru
ORCID ID: 0000-0002-0640-7368
Código SPIN: 6595-4011

Research Associate

Rússia, Moscow

Ilia Soldatov

Research and Practice Center of Diagnostics and Telemedicine Technologies

Autor responsável pela correspondência
Email: SoldatovIV2@zdrav.mos.ru
ORCID ID: 0000-0002-4867-0746
Código SPIN: 4065-6048
Rússia, Moscow

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2. Fig. 1. Study design in the PRISMA scheme.

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3. Fig. 2. Summary results of fetal dosimetry in chest CT (led by Vodovatov [8] and Gu [13]) and abdominal CT (led by Kelaranta [14] and Angel [15]) with LOESS regression line modeling and 95% confidence interval.

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Este artigo é disponível sob a Licença Creative Commons Atribuição–NãoComercial–SemDerivações 4.0 Internacional.

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