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Detection of pulmonary embolism during pregnancy: comparing radiation doses of CTPA and pulmonary scintigraphy.
Nucl Med Commun 2014; 35(7):704-11NM

Abstract

OBJECTIVE

In pregnant patients pulmonary embolism is a common occurrence with potentially devastating outcomes, necessitating timely imaging diagnosis. In every patient, especially in pregnant patients, radiation exposure is an important consideration while selecting the best imaging modality.

MATERIALS AND METHODS

We performed a retrospective analysis comparing radiation doses of computed tomography pulmonary angiography (CTPA), perfusion scintigraphy, and perfusion/ventilation scintigraphy for suspected pulmonary embolism in 53 pregnant patients at our hospital between 2006 and 2012. Effective dose and breast-absorbed and uterus-absorbed doses for CTPA as well as effective dose and breast and fetus-absorbed doses for pulmonary scintigraphy were estimated using International Commission on Radiological Protection 103 weighting factors.

RESULTS

For CTPA and perfusion scintigraphy, average doses were estimated as effective doses of 21 and 1.04 mSv, breast-absorbed doses of 44 and 0.28 mGy, and uterus-absorbed dose of 0.46 mGy and fetal-absorbed dose of 0.25 mGy, respectively. With inclusion of the ventilation component of pulmonary scintigraphy, doses increased to an effective dose of 1.29 mSv, a breast-absorbed dose of 0.37 mGy, and a fetal-absorbed dose of 0.40 mGy.

CONCLUSION

Perfusion nuclear medicine study has a statistically significantly lower effective and breast-absorbed dose (P<0.0001) when compared with CTPA. Similarly, the fetal-absorbed dose for pulmonary scintigraphy has a statistically lower dose (P=0.0010) when compared with CTPA, even if the ventilation component of pulmonary scintigraphy is performed, although these values are so small that they are unlikely to be clinically significant.

Authors+Show Affiliations

Department of Radiology, Henry Ford Hospital, Detroit, Michigan, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

24743314

Citation

Astani, Seyed A., et al. "Detection of Pulmonary Embolism During Pregnancy: Comparing Radiation Doses of CTPA and Pulmonary Scintigraphy." Nuclear Medicine Communications, vol. 35, no. 7, 2014, pp. 704-11.
Astani SA, Davis LC, Harkness BA, et al. Detection of pulmonary embolism during pregnancy: comparing radiation doses of CTPA and pulmonary scintigraphy. Nucl Med Commun. 2014;35(7):704-11.
Astani, S. A., Davis, L. C., Harkness, B. A., Supanich, M. P., & Dalal, I. (2014). Detection of pulmonary embolism during pregnancy: comparing radiation doses of CTPA and pulmonary scintigraphy. Nuclear Medicine Communications, 35(7), pp. 704-11. doi:10.1097/MNM.0000000000000114.
Astani SA, et al. Detection of Pulmonary Embolism During Pregnancy: Comparing Radiation Doses of CTPA and Pulmonary Scintigraphy. Nucl Med Commun. 2014;35(7):704-11. PubMed PMID: 24743314.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Detection of pulmonary embolism during pregnancy: comparing radiation doses of CTPA and pulmonary scintigraphy. AU - Astani,Seyed A, AU - Davis,Leah C, AU - Harkness,Beth A, AU - Supanich,Mark P, AU - Dalal,Ishani, PY - 2014/4/19/entrez PY - 2014/4/20/pubmed PY - 2015/1/13/medline SP - 704 EP - 11 JF - Nuclear medicine communications JO - Nucl Med Commun VL - 35 IS - 7 N2 - OBJECTIVE: In pregnant patients pulmonary embolism is a common occurrence with potentially devastating outcomes, necessitating timely imaging diagnosis. In every patient, especially in pregnant patients, radiation exposure is an important consideration while selecting the best imaging modality. MATERIALS AND METHODS: We performed a retrospective analysis comparing radiation doses of computed tomography pulmonary angiography (CTPA), perfusion scintigraphy, and perfusion/ventilation scintigraphy for suspected pulmonary embolism in 53 pregnant patients at our hospital between 2006 and 2012. Effective dose and breast-absorbed and uterus-absorbed doses for CTPA as well as effective dose and breast and fetus-absorbed doses for pulmonary scintigraphy were estimated using International Commission on Radiological Protection 103 weighting factors. RESULTS: For CTPA and perfusion scintigraphy, average doses were estimated as effective doses of 21 and 1.04 mSv, breast-absorbed doses of 44 and 0.28 mGy, and uterus-absorbed dose of 0.46 mGy and fetal-absorbed dose of 0.25 mGy, respectively. With inclusion of the ventilation component of pulmonary scintigraphy, doses increased to an effective dose of 1.29 mSv, a breast-absorbed dose of 0.37 mGy, and a fetal-absorbed dose of 0.40 mGy. CONCLUSION: Perfusion nuclear medicine study has a statistically significantly lower effective and breast-absorbed dose (P<0.0001) when compared with CTPA. Similarly, the fetal-absorbed dose for pulmonary scintigraphy has a statistically lower dose (P=0.0010) when compared with CTPA, even if the ventilation component of pulmonary scintigraphy is performed, although these values are so small that they are unlikely to be clinically significant. SN - 1473-5628 UR - https://www.unboundmedicine.com/medline/citation/24743314/Detection_of_pulmonary_embolism_during_pregnancy:_comparing_radiation_doses_of_CTPA_and_pulmonary_scintigraphy_ L2 - http://Insights.ovid.com/pubmed?pmid=24743314 DB - PRIME DP - Unbound Medicine ER -