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Perfusion scintigraphy versus 256-slice CT angiography in pregnant patients suspected of pulmonary embolism: comparison of radiation risks.
J Nucl Med 2014; 55(8):1273-80JN

Abstract

One aim of the current study was to determine normalized dose data for maternal radiosensitive organs and embryo/fetus from 256-slice CT pulmonary angiography (CTPA) performed on pregnant patients suspected of having pulmonary embolism. A second aim was to provide reliable maternal and fetal doses and associated radiation cancer risk estimates from 256-slice CTPA and lung perfusion scintigraphy (LPS) for comparison.

METHODS

Mathematic anthropomorphic phantoms were generated to simulate the average woman at early pregnancy and at the third, sixth, and ninth months of gestation. In each phantom, 0-3 additional 1.5-cm-thick fat tissue layers were added to derive 4 phantoms representing pregnant women with different body sizes. Monte Carlo methods were used to simulate low-dose 256-slice CTPA exposures on each of the 16 generated phantoms. Normalized organ and embryo/fetal dose data were derived for exposures at 80, 100, and 120 kV. Maternal effective dose and embryo/fetal dose from 256-slice CTPA and associated lifetime attributable risks of radiation cancer were determined for different body sizes and gestational stages and compared with corresponding data from LPS.

RESULTS

For an average-sized pregnant patient at the first trimester, the 256-slice CTPA exposure resulted in a maternal effective dose of 1 mSv and an embryo/fetal dose of 0.05 mGy. However, maternal effective dose considerably increased with body size, whereas embryo/fetal dose increased with both body size and gestational stage. Compared with LPS, low-dose CTPA to an average-sized pregnant patient resulted in a 30% higher maternal effective dose but a 3.4-6 times lower embryo/fetal dose. Nevertheless, LPS was associated with less aggregated radiation risk for an average-sized pregnant patient, with the difference from CTPA being increased further for larger patients.

CONCLUSION

Compared with CTPA performed with a modern wide-area CT scanner, LPS remains comparatively more dose-efficient.

Authors+Show Affiliations

Department of Medical Physics, Medical School, University of Crete, Heraklion, Crete, Greece kostas.perisinakis@med.uoc.gr.Medical Diagnostic Center "Ayios Therissos," Nicosia, Cyprus Department of Medical Physics, Medical School, Democritus University of Thrace, Panepistimioupolis, Dragana, Alexandroupolis, Greece; and.Department of Medical Physics, University Hospital of Heraklion, Heraklion, Crete, Greece.Department of Medical Physics, Medical School, University of Crete, Heraklion, Crete, Greece.

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24876205

Citation

Perisinakis, Kostas, et al. "Perfusion Scintigraphy Versus 256-slice CT Angiography in Pregnant Patients Suspected of Pulmonary Embolism: Comparison of Radiation Risks." Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine, vol. 55, no. 8, 2014, pp. 1273-80.
Perisinakis K, Seimenis I, Tzedakis A, et al. Perfusion scintigraphy versus 256-slice CT angiography in pregnant patients suspected of pulmonary embolism: comparison of radiation risks. J Nucl Med. 2014;55(8):1273-80.
Perisinakis, K., Seimenis, I., Tzedakis, A., & Damilakis, J. (2014). Perfusion scintigraphy versus 256-slice CT angiography in pregnant patients suspected of pulmonary embolism: comparison of radiation risks. Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine, 55(8), pp. 1273-80. doi:10.2967/jnumed.114.137968.
Perisinakis K, et al. Perfusion Scintigraphy Versus 256-slice CT Angiography in Pregnant Patients Suspected of Pulmonary Embolism: Comparison of Radiation Risks. J Nucl Med. 2014;55(8):1273-80. PubMed PMID: 24876205.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Perfusion scintigraphy versus 256-slice CT angiography in pregnant patients suspected of pulmonary embolism: comparison of radiation risks. AU - Perisinakis,Kostas, AU - Seimenis,Ioannis, AU - Tzedakis,Antonis, AU - Damilakis,John, Y1 - 2014/05/29/ PY - 2014/01/24/received PY - 2014/04/25/accepted PY - 2014/5/31/entrez PY - 2014/5/31/pubmed PY - 2015/7/15/medline KW - CT pulmonary angiography KW - lung perfusion scintigraphy KW - patient dose KW - pulmonary embolism KW - radiation risk SP - 1273 EP - 80 JF - Journal of nuclear medicine : official publication, Society of Nuclear Medicine JO - J. Nucl. Med. VL - 55 IS - 8 N2 - UNLABELLED: One aim of the current study was to determine normalized dose data for maternal radiosensitive organs and embryo/fetus from 256-slice CT pulmonary angiography (CTPA) performed on pregnant patients suspected of having pulmonary embolism. A second aim was to provide reliable maternal and fetal doses and associated radiation cancer risk estimates from 256-slice CTPA and lung perfusion scintigraphy (LPS) for comparison. METHODS: Mathematic anthropomorphic phantoms were generated to simulate the average woman at early pregnancy and at the third, sixth, and ninth months of gestation. In each phantom, 0-3 additional 1.5-cm-thick fat tissue layers were added to derive 4 phantoms representing pregnant women with different body sizes. Monte Carlo methods were used to simulate low-dose 256-slice CTPA exposures on each of the 16 generated phantoms. Normalized organ and embryo/fetal dose data were derived for exposures at 80, 100, and 120 kV. Maternal effective dose and embryo/fetal dose from 256-slice CTPA and associated lifetime attributable risks of radiation cancer were determined for different body sizes and gestational stages and compared with corresponding data from LPS. RESULTS: For an average-sized pregnant patient at the first trimester, the 256-slice CTPA exposure resulted in a maternal effective dose of 1 mSv and an embryo/fetal dose of 0.05 mGy. However, maternal effective dose considerably increased with body size, whereas embryo/fetal dose increased with both body size and gestational stage. Compared with LPS, low-dose CTPA to an average-sized pregnant patient resulted in a 30% higher maternal effective dose but a 3.4-6 times lower embryo/fetal dose. Nevertheless, LPS was associated with less aggregated radiation risk for an average-sized pregnant patient, with the difference from CTPA being increased further for larger patients. CONCLUSION: Compared with CTPA performed with a modern wide-area CT scanner, LPS remains comparatively more dose-efficient. SN - 1535-5667 UR - https://www.unboundmedicine.com/medline/citation/24876205/Perfusion_scintigraphy_versus_256_slice_CT_angiography_in_pregnant_patients_suspected_of_pulmonary_embolism:_comparison_of_radiation_risks_ L2 - http://jnm.snmjournals.org/cgi/pmidlookup?view=long&pmid=24876205 DB - PRIME DP - Unbound Medicine ER -