Abstract
Background
: Imaging for diagnosis of suspected pulmonary embolism in pregnancy presents radiation
concerns for patient and fetus.
Objectives
: Estimate the risks of radiation-induced breast cancer and childhood leukemia from
common imaging techniques for the evaluation of suspected pulmonary embolism in pregnancy.
Methods
: Breast and uterine absorbed doses for various imaging techniques were input into
the National Cancer Institute Radiation Risk Assessment Tool to calculate excess risk
of breast cancer for the patient and childhood leukemia for the fetus. Absorbed doses
were obtained by synthesizing data from a recent systematic review and the International
Commission on Radiological Protection. Primary outcomes were the estimated excess
incidences of breast cancer and childhood leukemia per 100,000 exposures.
Results
: Excess risks of breast cancer for a 30-year-old woman were 0.003 and 0.275 for a
single and two-view chest radiograph, 20.6 and 9.53 for full and low-dose CT pulmonary
angiography, 2.54 and 0.616 for full and low dose perfusion scan, and 2.66 and 0.732
for full and low-dose ventilation perfusion scan. Excess risks of childhood leukemia
for a male fetus were 0.004 and 0.007 for a single and two-view chest radiograph,
0.490 and 0.069 for full and low-dose CT pulmonary angiography, 1.47 and 0.359 for
full and low-dose perfusion scan, and 1.97 and 0.856 for full and low-dose ventilation
perfusion scan.
Conclusion
: Excess cancer risks for all techniques were small relative to baseline cancer risks,
with CTPA carrying slightly higher risk of breast cancer for the patient and LS a
higher risk of childhood leukemia.
Keywords
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Article Info
Publication History
Accepted:
October 21,
2022
Received in revised form:
August 22,
2022
Received:
February 3,
2022
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
© 2022 Published by Elsevier Inc.
