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Research ArticleClinical Investigation

Fetal Dose from PET and CT in Pregnant Patients

Christiane Sarah Burton, Kirk Frey, Frederic Fahey, Mark S. Kaminski, Richard K.J. Brown, Judith M. Pohlen and Barry L. Shulkin
Journal of Nuclear Medicine February 2023, 64 (2) 312-319; DOI: https://doi.org/10.2967/jnumed.122.263959
Christiane Sarah Burton
1St. Jude Children’s Research Hospital, Memphis, Tennessee;
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Kirk Frey
2Michigan Medicine, Ann Arbor, Michigan;
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Frederic Fahey
3Children’s Hospital, Boston, Massachusetts;
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Mark S. Kaminski
4University of Michigan, Ann Arbor, Michigan; and
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Richard K.J. Brown
5University of Utah School of Medicine, Salt Lake City, Utah
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Judith M. Pohlen
2Michigan Medicine, Ann Arbor, Michigan;
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Barry L. Shulkin
1St. Jude Children’s Research Hospital, Memphis, Tennessee;
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Abstract

When pregnancy is discovered during or after a diagnostic examination, the physician or the patient may request an estimate of the radiation dose received by the fetus as per guidelines and standard operating procedures. This study provided the imaging community with dose estimates to the fetus from PET/CT with protocols that are adapted to University of Michigan low-dose protocols for patients known to be pregnant. Methods: There were 9 patients analyzed with data for the first, second, and third trimesters, the availability of which is quite rare. These images were used to calculate the size-specific dose estimate (SSDE) from the CT scan portion and the SUV and 18F-FDG uptake dose from the PET scan portion using the MIRD formulation. The fetal dose estimates were tested for correlation with each of the following independent measures: gestational age, fetal volume, average water-equivalent diameter of the patient along the length of the fetus, SSDE, SUV, and percentage of dose from 18F-FDG. Stepwise multiple linear regression analysis was performed to assess the partial correlation of each variable. To our knowledge, this was the first study to determine fetal doses from CT and PET images. Results: Fetal self-doses from 18F for the first, second, and third trimesters were 2.18 mGy (single data point), 0.74–1.82 mGy, and 0.017–0.0017 mGy, respectively. The combined SSDE and fetal self-dose ranged from 1.2 to 8.2 mGy. These types of images from pregnant patients are rare. Conclusion: Our data indicate that the fetal radiation exposure from 18F-FDG PET and CT performed, when medically necessary, on pregnant women with cancer is low. All efforts should be made to minimize fetal radiation exposure by modifying the protocol.

  • PET/CT
  • radiation physics
  • MIRD
  • PET
  • fetal dose
  • imaging

Footnotes

  • Published online Sep. 8, 2022.

  • © 2023 by the Society of Nuclear Medicine and Molecular Imaging.
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Journal of Nuclear Medicine: 64 (2)
Journal of Nuclear Medicine
Vol. 64, Issue 2
February 1, 2023
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Fetal Dose from PET and CT in Pregnant Patients
Christiane Sarah Burton, Kirk Frey, Frederic Fahey, Mark S. Kaminski, Richard K.J. Brown, Judith M. Pohlen, Barry L. Shulkin
Journal of Nuclear Medicine Feb 2023, 64 (2) 312-319; DOI: 10.2967/jnumed.122.263959

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Fetal Dose from PET and CT in Pregnant Patients
Christiane Sarah Burton, Kirk Frey, Frederic Fahey, Mark S. Kaminski, Richard K.J. Brown, Judith M. Pohlen, Barry L. Shulkin
Journal of Nuclear Medicine Feb 2023, 64 (2) 312-319; DOI: 10.2967/jnumed.122.263959
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Keywords

  • PET/CT
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  • MIRD
  • PET
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  • imaging
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