Congress:
EuroSafe Imaging 2018
Keywords:
Radiation safety, Radiation effects, Fluoroscopy, CT, Emergency, Action 2 - Clinical diagnostic reference levels (DRLs), Action 3 - Optimisation, diagnostic reference levels, image quality, Obstetrics
Authors:
A. Morasca, M. Gentile, M. Latini, A. Guidi, P. Polidori, L. Indovina, R. Manfredi, L. Bonomo
DOI:
10.1594/esi2018/ESI-0082
Conclusion and recommendations
The most recent scientific research tells us that for doses lower than 0.100 Sv at the embryo / fetus there is no evidence of teratogenic effects; in line with what we observed, in scientific publication and in the dose assessments carried in our population of study,
no diagnostic procedure currently in use exceeds 0.05 Sv.
Concerning the risk of occurrence of leukemia or other malignant neoplasms in the embryos / fetuses who underwent irradiation,
the most recent studies assert that for a dose of 0.001 Sv the risk of having a tumor in the child within 15 years of age is 0.006%(1).
The results of this analysis were below the mentioned threshold (0.100 Sv),
albeit we have to pursue a series of targeted actions to maintain the lowest obtainable dose level,
compatibly with the achievement of the desired diagnostic information.
In conclusion,
the main actions that we should apply in women in fertile age (2):
- to choose imaging procedures not associated with radiation ionizing (eg.
ultrasound,
MR),
when possible;
- to create dedicated procedures;
- to perform the radiological scan of the abdomen within in the first 10 days of the menstrual cycle;
- to set up dose tracking systems;
- Performing Radiology examinations of body other than the abdomen and the lumbosacral spine,
(if they are medically justified) can be done in pregnant women,
because it is well know that the irradiation of the embryo or fetus is negligible.
In view of the current legislation and our experience,
we want to propose the flow chart (fig.2) below concerning an approach to the problem of "pregnancy and ionizing radiation".
Therefore "exposures with dose values lower than 0.100 Sv at the embryo/ fetus should not be considered a reason to terminate early pregnancy" (ICRP103).