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CTPA versus V-Q lung scan in pregnant women
Table 5. Overview of studies on radiation exposure from CTPA or V-Q lung scanning in phantom studies.
Study
Chatterson et al. 2014 Chatterson et al. 2011 Doshi et al. 2008
Hurwitz et al. 2006 Litmanovitch et al. 2011
Winer-Muran et al. 2002 *** Perisinakis et al. 2014 ***
Phantom studies with CTPA Foetal/uterus absorbed dose (mGy)
1st trimester 2nd trimester 3rd trimester
0.05 NP 0.13
0.11 0.3 0.5 0.06*
Maternal effective dose (mSv)
100k Vp
100k Vp
100k Vp 120k Vp** 140k Vp 100k Vp 120k Vp‡ 120k Vp 100k Vp
0.10-0.23*
NP NP
0.084* 0.023-0.140*
0.008-0.077 0.051-0.131 NP NP
NP NP
NA NA
NA NA
< 0.01
0.02 0.08 0.18 0.09 0.2 0.47
0.28 0.73 0.57
1st trimester
NP
NP
NP
NP
NA
NA
NP NP NP
NP
2nd trimester
2.5
4.9 NP NP
NP NP
NP
NP
NA
NA
NP NP NP
NP
3rd trimester
NP
NP
NA
NA
NP NP NP
NP
0.024-0.07
0.003-0.020 NP
120kVp NP Iballetal.2008 NA NA
Kennedy et al. 2007 Motavalli et al. 2017***
Isodoro et al. 2017
NA NA
80 kVp 100kVp 120kVp
100 kVp
<0.02 0.04
CTPA: computed tomography pulmonary angiography: Vp: kilovolt protocol; NP: not provided; NA: not applicable. *mean fetal absorbed dose;** two different CTPA protocols with 120 kV were assessed; ‡ three different CTPA protocols with 120kV were assessed; *** Monte Carlo simulation.
Figure 2. Meta-analysis of false negative tests after a first negative ventilation-per- fusion lung scan and comput- ed tomography pulmonary angiography in pregnant patients with suspected acute pulmonary embolism. A false negative test is defined by a first negative computed tomography pul- monary angiography (CTPA) or ventilation-perfusion (V-Q) lung scan in a woman who had a pulmonary embolism (PE) diagnosed during the 3 months of follow-up. Three patients had a PE during the follow up.37,55 The type of imaging test performed to diagnose the PE was not pro- vided.
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