All Title Author
Keywords Abstract

Foetal Radiation Dose and Risk from Diagnostic Radiology Procedures: A Multinational Study

DOI: 10.5402/2013/318425

Full-Text   Cite this paper   Add to My Lib


In diagnostic radiology examinations there is a benefit that the patient derives from the resulting diagnosis. Given that so many examinations are performed each year, it is inevitable that there will be occasions when an examination(s) may be inadvertently performed on pregnant patients or occasionally it may become clinically necessary to perform an examination(s) on a pregnant patient. In all these circumstances it is necessary to request an estimation of the foetal dose and risk. We initiated a study to investigate fetal doses from different countries. Exposure techniques on 367 foetuses from 414 examinations were collected and investigated. The FetDoseV4 program was used for all dose and risk estimations. The radiation doses received by the 367 foetuses ranges: <0.001–21.9?mGy depending on examination and technique. The associated probability of induced hereditary effect ranges: <1 in 200000000 ( ) to 1 in 10000 ( ) and the risk of childhood cancer ranges <1 in 12500000 ( ) to 1 in 500 ( ). The data indicates that foetal doses from properly conducted diagnostic radiology examinations will not result in any deterministic effect and a negligible risk of causing radiation induced hereditary effect in the descendants of the unborn child. 1. Introduction In diagnostic radiology examinations, there is a benefit that the patient derives from the resulting diagnosis, provided that they are fully justified. However, given that so many examinations are performed each year, it is inevitable that there will be occasions when an examination will be performed on a woman who subsequently discovers that she was pregnant at the time of her examination(s). It may also occasionally become clinically necessary to perform a radiological examination(s) on a woman who is known to be pregnant. In the later case, there must be rigorous justification of the examination and the procedure itself must be optimized to minimise the foetal dose [1–3]. In order to avoid the former, some special rules have been developed to apply to the exposure of potentially pregnant women (who are or who may be pregnant) in which radiological examinations of such women are restricted to a certain period following menstruation [4–7]. For the protection of the foetus from occupational exposure of the pregnant worker, the International Commission on Radiological Protection (ICRP) [1, 2] considers that if a female worker has declared (i.e., notified her employer) that she is pregnant, additional controls have to be considered to protect the embryo/foetus. It is the Commission’s policy that the


[1]  International Commission on Radiological Protection (ICRP), “The 2007 Recommendations of the ICRP,” ICRP Publication 103, Elsevier, 2007, Annals of the ICRP.
[2]  International Commission on Radiological Protection (ICRP), “1990 Recommendations of the ICRP,” ICRP Publication 60, Pergamon Press, Oxford, UK, 1991, Annals of the ICRP 21, no. 1–3.
[3]  International Commission on Radiological Protection, “Radiological protection and safety in medicine,” ICRP Publication 73, Pergamon Press, Oxford, UK, 1990, Annals of the ICRP 26.
[4]  National Radiological Protection Board, “Statement by the National Radiological Protection Board: diagnostic medical exposures: advice on exposure to ionizing radiation during pregnancy,” Documents of the NRPB, vol. 4, no. 4, pp. 1–3, 1993.
[5]  National Radiological Protection Board, “Diagnostic medical exposures: exposure to ionizing radiation of pregnant women: biological Basis of the Board's Statement,” Documents of the NRPB, vol. 4, no. 4, pp. 7–14, 1993.
[6]  National Radiological Protection Board, “Estimates of late radiation risks to the UK population. Chapter 6: Irradiation in utero,” Documents of the NRPB, vol. 4, pp. 105–125, 1993.
[7]  K. L. Wagner, R. G. Lester, and L. R. Saldana, Exposure of the Pregnant Patient to Diagnostic Radiations: A Guide to Medical Management, Medical Physics Publishing, Madison, Wis, USA, 1997.
[8]  E. K. Osei, J. B. Darko, K. Faulkner, and C. J. Kotre, “Software for the estimation of foetal radiation dose to patients and staff in diagnostic radiology,” Journal of Radiological Protection, vol. 23, no. 2, pp. 183–194, 2003.
[9]  E. K. Osei and K. Faulkner, “Fetal position and size data far dose estimation,” British Journal of Radiology, vol. 72, pp. 363–370, 1999.
[10]  E. K. Osei and C. J. Kotre, “Equivalent dose to the fetus from occupational exposure of pregnant staff in diagnostic radiology,” British Journal of Radiology, vol. 74, no. 883, pp. 629–637, 2001.
[11]  E. K. Osei and K. Faulkner, “Fetal doses from radiological examinations,” British Journal of Radiology, vol. 72, pp. 773–780, 1999.
[12]  D. Hart, D. C. Jones, and B. F. Wall, “Normalized organ doses for medical x-ray examinations calculated using Monte Carlo techniques,” NRPB SR262, NRPB, Madison, Wis, USA, 1991.
[13]  M. Rosenstein, Handbook of Selected Organ Doses for Projections Common in Diagnostic Radiology, Department of Health, Education and Welfare, Rockville, Md, USA, 1976.
[14]  IPSM, National Protocol for Patient Dose Measurements in Diagnostic Radiology, Dosimetry Working Party of the Institute of Physical Sciences in Medicine (IPSM), New York, NY, USA, 1992.
[15]  C. J. Martin, B. Farquhar, E. Stockdale, and S. MacDonald, “A study of the relationship between patient dose and size in paediatric radiology,” British Journal of Radiology, vol. 67, no. 801, pp. 864–871, 1994.
[16]  C. L. Chapple, D. A. Broadhead, and K. Faulkner, “A phantom based method for deriving typical patient doses from measurements of dose-area product on populations of patients,” British Journal of Radiology, vol. 68, no. 814, pp. 1083–1086, 1995.
[17]  D. G. Jones and P. C. Shrimpton, “Normalized organ doses for X-ray CT calculated using monte Carlo techniques,” NRPB Software Report 250, NRPB, 1993.
[18]  E. Angel, C. V. Wellnitz, M. M. Goodsitt et al., “Radiation dose to the fetus for pregnant patients undergoing multidetector CT imaging: Monte carlo simulations estimating fetal dose for a range of gestational age and patient size1,” Radiology, vol. 249, no. 1, pp. 220–227, 2008.
[19]  S. K. Doshi, I. S. Negus, and J. M. Oduko, “Fetal radiation dose from CT pulmonary angiography in late pregnancy: a phantom study,” British Journal of Radiology, vol. 81, no. 968, pp. 653–658, 2008.
[20]  Health Protection Agency (HPA), “Protection of pregnant patients during diagnostic medical exposures to ionising radiation: advice from the health protection agency,” Documents of the Health Protection Agency: Radiation, Chemical and Environmental Hazards RCE 9, The Royal College of Radiologists and the College of Radiographers, 2009.
[21]  M. Otake, W. J. Schull, Y. Fujikoshi, and H. Yoshimaru, “Effect on school performance of prenatal exposure to ionising radiation in Hiroshima,” Tech. Rep. RERF TR2-88, Radiation Effects Research Foundation, Hiroshima, Japan, 1988.
[22]  M. Otake, W. J. Schull, and H. Yoshimaru, “A review of forty-five years study of Hiroshima and Nagasaki atomic bomb survivors. Brain damage among the prenatally exposed,” Journal of Radiation Research, vol. 32, supplement, pp. 249–264, 1991.
[23]  R. L. Brent, “Utilization of developmental basic science principles in the evaluation of reproductive risks from pre- and postconception environmental radiation exposures,” Teratology, vol. 59, no. 4, pp. 182–204, 1999.
[24]  R. Brent, Pregnancy and Radiation Exposure, Health Physics Society, 2012,


comments powered by Disqus

Contact Us


微信:OALib Journal