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Predictors of radiation dose for CT pulmonary angiography in pregnancy across a multihospital integrated healthcare network.
Eur J Radiol. 2019 Dec; 121:108721.EJ

Abstract

PURPOSE

There is a large range of published effective radiation dose for CTPA during pregnancy. The purpose of our study is to determine the mean effective radiation dose and predictors of mean effective radiation dose for CTPA in pregnant patients across a multihospital integrated healthcare network.

METHODS

This retrospective study evaluates pregnant women who had a CTPA as the first primary advanced imaging test for evaluation of PE in a multihospital integrated healthcare network from January 2012-April 2017. Patient and CT-related data were obtained from the electronic health record and Radimetrics server (Radimetrics Inc, Bayer). DLP was recorded and effective radiation dose in mSv was determined using a conversation factor of 0.014 mSv·mGy-¹·cm-¹. Patient size was determined by water equivalent diameter. Bivariate and multivariate analysis were performed for effective radiation dose based on patient and CT factors.

RESULTS

In the 534 CTPA exams, the mean effective radiation dose was 3.96 mSv. Bivariate analysis showed significant differences in radiation dose by trimester, p = 0.042: first trimester 4.52 mSv, second trimester 3.73 mSv, and third trimester 3.95 mSv. Multivariable analysis demonstrated CTPA during first trimester, increasing mAs, kVp, scan length, patient size, and use of mAs modulation, as well as decreasing pitch, to be predictive of higher effective radiation dose.

CONCLUSION

Mean effective radiation dose was on the lower end of published studies. Trimester was a statistically significant predictor of effective radiation dose when accounting for known predictors of radiation dose.

Authors+Show Affiliations

Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States; Northwell Health Imaging, Manhasset, NY, United States; Imaging Clinical Effectiveness & Outcomes Research Program at Northwell Health, Manhasset NY, United States; Feinstein Institute for Medical Research at Northwell Health, Manhasset NY, United States. Electronic address: slcohen@northwell.edu.Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States; Imaging Clinical Effectiveness & Outcomes Research Program at Northwell Health, Manhasset NY, United States; Feinstein Institute for Medical Research at Northwell Health, Manhasset NY, United States.Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States.Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States; Northwell Health Imaging, Manhasset, NY, United States; Imaging Clinical Effectiveness & Outcomes Research Program at Northwell Health, Manhasset NY, United States; Feinstein Institute for Medical Research at Northwell Health, Manhasset NY, United States.Georgia Institute of Technology, Atlanta GA, United States.Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States; Northwell Health Imaging, Manhasset, NY, United States.Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States; Northwell Health Imaging, Manhasset, NY, United States; Imaging Clinical Effectiveness & Outcomes Research Program at Northwell Health, Manhasset NY, United States; Feinstein Institute for Medical Research at Northwell Health, Manhasset NY, United States.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31711025

Citation

Cohen, Stuart L., et al. "Predictors of Radiation Dose for CT Pulmonary Angiography in Pregnancy Across a Multihospital Integrated Healthcare Network." European Journal of Radiology, vol. 121, 2019, p. 108721.
Cohen SL, Wang JJ, Chan N, et al. Predictors of radiation dose for CT pulmonary angiography in pregnancy across a multihospital integrated healthcare network. Eur J Radiol. 2019;121:108721.
Cohen, S. L., Wang, J. J., Chan, N., Feizullayeva, C., McCandlish, J. A., O'Connell, W., & Sanelli, P. (2019). Predictors of radiation dose for CT pulmonary angiography in pregnancy across a multihospital integrated healthcare network. European Journal of Radiology, 121, 108721. https://doi.org/10.1016/j.ejrad.2019.108721
Cohen SL, et al. Predictors of Radiation Dose for CT Pulmonary Angiography in Pregnancy Across a Multihospital Integrated Healthcare Network. Eur J Radiol. 2019;121:108721. PubMed PMID: 31711025.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of radiation dose for CT pulmonary angiography in pregnancy across a multihospital integrated healthcare network. AU - Cohen,Stuart L, AU - Wang,Jason J, AU - Chan,Nicholas, AU - Feizullayeva,Chinara, AU - McCandlish,John Austin, AU - O'Connell,William, AU - Sanelli,Pina, Y1 - 2019/10/25/ PY - 2019/03/08/received PY - 2019/10/08/revised PY - 2019/10/21/accepted PY - 2019/11/12/pubmed PY - 2019/11/12/medline PY - 2019/11/12/entrez KW - CT pulmonary angiography KW - Pregnancy KW - Pulmonary embolism KW - Radiation dose SP - 108721 EP - 108721 JF - European journal of radiology JO - Eur J Radiol VL - 121 N2 - PURPOSE: There is a large range of published effective radiation dose for CTPA during pregnancy. The purpose of our study is to determine the mean effective radiation dose and predictors of mean effective radiation dose for CTPA in pregnant patients across a multihospital integrated healthcare network. METHODS: This retrospective study evaluates pregnant women who had a CTPA as the first primary advanced imaging test for evaluation of PE in a multihospital integrated healthcare network from January 2012-April 2017. Patient and CT-related data were obtained from the electronic health record and Radimetrics server (Radimetrics Inc, Bayer). DLP was recorded and effective radiation dose in mSv was determined using a conversation factor of 0.014 mSv·mGy-¹·cm-¹. Patient size was determined by water equivalent diameter. Bivariate and multivariate analysis were performed for effective radiation dose based on patient and CT factors. RESULTS: In the 534 CTPA exams, the mean effective radiation dose was 3.96 mSv. Bivariate analysis showed significant differences in radiation dose by trimester, p = 0.042: first trimester 4.52 mSv, second trimester 3.73 mSv, and third trimester 3.95 mSv. Multivariable analysis demonstrated CTPA during first trimester, increasing mAs, kVp, scan length, patient size, and use of mAs modulation, as well as decreasing pitch, to be predictive of higher effective radiation dose. CONCLUSION: Mean effective radiation dose was on the lower end of published studies. Trimester was a statistically significant predictor of effective radiation dose when accounting for known predictors of radiation dose. SN - 1872-7727 UR - https://www.unboundmedicine.com/medline/citation/31711025/Predictors_of_radiation_dose_for_CT_pulmonary_angiography_in_pregnancy_across_a_multihospital_integrated_healthcare_network_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0720-048X(19)30371-7 DB - PRIME DP - Unbound Medicine ER -
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