Fetal Dose Evaluation for Body CT Examinations of Pregnant Patients during all Stages of Pregnancy

2021 
Abstract Purpose CTDIvol-to-fetal-dose coefficients from Monte Carlo simulations are useful for fetal dose evaluations, but the available data is limited to the fetus being completely inside the abdominopelvic scan range. Whereas in a chest examination, the fetus is completely outside the scan range. In an abdominal examination, the fetus after 16 gestational weeks is partly in the scan region, and an earlier fetus is completely outside of it. This work proposes a practical approach to evaluate fetal dose for pregnant patients undergoing body CT examinations, without using Monte Carlo simulation. Methods The proposed method was based on the z-axis dose profile computed for a CT examination, considering CTDIvol, scan range, mA, and maternal WED (water equivalent diameter) at the fetus centroid. Fetal average dose was calculated over the fetus z-axis coverage. For validation, we considered a reference dataset of 24 pregnant patients, each underwent two abdominopelvic examinations (fixed mA, tube current modulation). WED was 30.1 ± 3.3 (25.3–35.6) cm [mean(range)]. Gestational age was Results The fetal dose difference between profile-based evaluations and Monte Carlo simulations was (5.9 ± 3.8)% for 24 fixed-mA examinations, (5.8 ± 4.6)% for 24 tube current modulated examinations, and (8.8 ± 5.9)% for the whole-body models in three scan ranges. Conclusions Profile-based fetal dose calculations can be performed for patients in body CT, considering maternal size, fetus size and location, and whether fetus is completely inside, partly inside, or outside scan ranges.
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