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 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
Baseline incidences of breast cancer for a 30-year-old woman and childhood leukemia
for a male fetus were 13,341 and 939, respectively. Excess incidences of breast cancer
were 0.003 and 0.275 for a single and two-view chest radiograph, respectively, 9.53
and 20.6 for low- and full-dose computed tomography pulmonary angiography (CTPA),
respectively, 0.616 and 2.54 for low- and full-dose perfusion scan, respectively,
and 0.732 and 2.66 for low- and full-dose ventilation perfusion scan, respectively.
Excess incidences of childhood leukemia were 0.004 and 0.007 for a single and two-view
chest radiograph, respectively, 0.069 and 0.490 for low- and full-dose CTPA, respectively,
0.359 and 1.47 for low- and full-dose perfusion scan, respectively, and 0.856 and
1.97 for low- and full-dose ventilation perfusion scan, respectively.
Conclusion
Excess cancer risks for all techniques were small relative to baseline cancer risks,
with CTPA techniques carrying slightly higher risk of breast cancer for the patient
and ventilation perfusion techniques a higher risk of childhood leukemia.
Keywords
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Article info
Publication history
Published online: November 11, 2022
Accepted:
October 21,
2022
Received in revised form:
August 22,
2022
Received:
February 3,
2022
Publication stage
In Press Uncorrected ProofIdentification
Copyright
© 2022 Published by Elsevier Inc.
