Download Handy dose Chart

ExamswherefetusisNOTinx-raybeam
ExamswherefetusisINthex-raybeam
•
•
•
Fetalexposureisfromscatteredradiation.3
Forexamsabovethediaphragmsorbelowthepelvis,patient
shouldbereassuredthatthereisnoscientificevidencethat
theexamwillresultinanydetectableharmtothefetus12.
• Dosesarecumulative.
• CTA(PE)versusV/Qscan:slightlyhigherfetaldosewithV/Q
scan(CTdoseincreasesduringpregnancyduetosizeoffetus
anditsproximitytothechest),butsignificantlyhigherdose
tobreasttissuewithCTAchest.13,14
EstimatedFetalDose
Radiography3
(mGy)
Extremityradiographs
<0.001
(Skull,C-spine,ankle,
shoulder,femur,etc.)
ThoracicSpine(AP,Lateral)
<0.003
ChestX-ray(PAandLateral)
0.002
3
EstimatedFetalDose
CT (mGy)
Head/Neck
0
Chest
0.02-0.2
Chest(PEstudy)*
0.02-0.2
EstimatedFetalDose
Other13,14
(mGy)
V/Qscan
0.1-1
*AlgorithmfortheworkupofsuspectedPEinapregnantpatient
shouldincludeaPACXRandDopplerUSforDVTpriortoCTAor
V/Qscan10
•
•
Forradiographyexamwherefetusisinthex-raybeam
estimatedfetaldoseisgenerally<3mGy.3
ForCTexamwherefetusisinthex-raybeam,estimatedfetal
doseisgenerally10-34mGy.3Alwaysusedosereduction
techniques.
Dosesarecumulative.
Radiography3
EstimatedFetalDose(mGy)
LumbarSpine
KUB(Lateral)
KUB(Upright)
Pelvis(AP)
<1
<1
<1
1-3
EstimatedFetalDose(mGy)
CT3
Abdomen
Abdomen/Pelvis
Abdomen/Pelvis(stone)
1.3-4
13-34
10
Note:Radiationdosetothefetusincreaseswithincreasing
patientthickness(i.e.,increasinggestationalage,obesity)
PatientThickness
(cm)
14-15
APview
(mGy)
1.0
Lateralview
(mGy)
0.7
20-23
2.1
1.5
27-30
4.3
3.0
References:
1. ACOGCommitteeonObstetricPractice.Guidelinesfor
DiagnosticImagingDuringPregnancy.ACOGCommittee
OpinionNo.299,September2004(ReplacesNo.158,
September1995).ObstetGynecol.2004;104:647-651.
2. NationalCouncilonRadiationProtectionandMeasurements.
Medicalradiationexposureofpregnantandpotentially
pregnantwomen.NCRPreportno.54.Bethesda,Md:National
CouncilonRadiationProtectionsandMeasurements,1977.
3. McColloughCH,SchuelerBA,AtwellTD,etal.Radiation
exposureandpregnancy:Whenshouldwebeconcerned?
Radiographics.2007;27:909–917;discussion917–908.
4. WagnerLK,LesterRG,SaldanaLR.Exposureofthepregnant
patienttodiagnosticradiations.AguidetoMedical
Manangement.Madison,Wis:MedicalPhysicsPublishing;
1997.
5. CentersforDiseaseControlandPrevention.Emergency
PreparednessandResponse.RadiationandPregnancy:AFact
SheetforClinicians.
http://bt.cdc.gov/radiation/prenatalphysician.asp.Reviewed
11/29/2011.
6. InternationalCommissiononRadiologicalProtection.
Pregnancyandmedicalradiation.AnnICRP2000;30:1-43.
7. UnitedNationsScientificCommitteeoftheEffectsofAtomic
Radiation,SourcesandEffectsofIonizingRadiation,United
NationsScientificCommitteeontheEffectsofAtomic
Radiation2000ReporttotheGeneralAssemblywithScientific
Annexes.NewYork:UnitedNationsPublications;2000.
8. WagnerLK,HaymanLA.Pregnancyandwomenradiologists.
Radiology1982;145:559-562.
9. BrentRL.Utilizationofdevelopmentalbasicscienceprinciples
intheevaluationofreproductiverisksfrompre-and
postconceptionenvironmentalradiationexposure.Teratology
59:182;1999.
10. WieselerKM,BhargavaP,KanalKM,etal.Imaginginpregnant
patients:Examinationappropriateness.Radiographics.2010;
30:1215–1229;discussion1230–1213.
11. ACR-SPRPracticeGuidelinesforImagingPregnantor
PotentiallyPregnantAdolescentsandWomenwithIonizing
12.
13.
14.
15.
Radiation.AmericanCollegeofRadiologyWebsite:
http://www.acr.org/~/media/ACR/Documents/PGTS/guideli
nes/Pregnant_Patients.pdf.Published2008(resolution26).
Revised2013(resolution48).
TremblayE,TherasseE,Thomassin-NaggaraI,etal.Guidelines
forUseofMedicalImagingduringPregnancyandLactation.
Radiographics.2012;32:897-911.
PahadeJK,LitmanovichD,PedrosaI,etal.ImagingPregnant
PatientswithSuspectedPulmonaryEmbolism:Whatthe
RadiologistNeedstoKnow.Radiographics.2009;29:639-654.
SchembriGP,MillerAE,SmartR.RadiationDosimetryand
SafetyIssuesintheInvestigationofPulmonaryEmbolism.
SeminNuclMed.2010;40:442-454.
AmericanCollegeofRadiology.ACRcommitteeondrugsand
contrastmedia.ACRManualonContrastMedia.9thed.Reston,
VA:AmericanCollegeofRadiology,2013.