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Fetal Radiation Dose in Prophylactic Uterine Arterial Embolization

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Abstract

Purpose

The purpose of the study was to estimate the absorbed dose (AD) to the fetus for pregnant patients with placenta accreta undergoing fluoroscopy imaging during prophylactic catheterization and uterine artery embolization. We hypothesize that after optimizing the use of the radiation, this endovascular method is safe.

Methods

Catheterization was performed for seven women before their elective cesarean section. The correct position of the catheter was confirmed by a radiologist using a small bolus of contrast medium and optimized pulsed fluoroscopy imaging. For the AD measurements of the fetus, four radiophotoluminescence dosimeters were placed in the vaginal fornix. Dose area product (DAP), entrance skin exposure (ESE), fluoroscopy time (Tf), and dose rate also was recorded.

Results

The mean values of the radiation exposure for the seven patients were as follows: AD in the vaginal fornix was 11.2 (range 2.2–28.7) mGy, DAP 1,122 (648–2,001) cGy cm2, ESE 120 (63–184) mGy, Tf 7:31 (5:05–11:35) min:sec, and dose rate 15 (8–21) mGy/min, respectively.

Conclusions

This study revealed that the AD to the fetus due to the endovascular method can be reduced to be below the risk for developmental disorders when pulsed fluoroscopy with an optimized protocol is used without angiography exposures.

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Abbreviations

DAP:

Dose area product

ESE:

Entrance skin exposure

AD:

Absorbed dose

Tf :

Fluoroscopy time

LIH:

Last image hold

SID:

Source to image-receptor distance

FSD:

Focus to skin distance

RPLD:

Radiophotoluminescence dosimeter

ICRP:

International Commission on Radiological Protection

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Acknowledgments

The authors thank Oulu University Hospital in Finland for supporting this investigation.

Conflict of interest

Anna-Leena Manninen, Kati Ojala, Miika T. Nieminen, Jukka Perälä declare no conflict of interest.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Oulu University Hospital, POB 50, 90029, Oulu, Finland

    Anna-Leena Manninen, Miika T. Nieminen & Jukka Perälä

  2. Department of Obstetrics and Gynecology, Oulu University Hospital, POB 23, 90029, Oulu, Finland

    Kati Ojala

  3. Department of Radiology, University of Oulu, POB 5000, 90014, Oulu, Finland

    Miika T. Nieminen

Authors
  1. Anna-Leena Manninen
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  2. Kati Ojala
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  3. Miika T. Nieminen
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  4. Jukka Perälä
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Correspondence to Anna-Leena Manninen.

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Manninen, AL., Ojala, K., Nieminen, M.T. et al. Fetal Radiation Dose in Prophylactic Uterine Arterial Embolization. Cardiovasc Intervent Radiol 37, 942–948 (2014). https://doi.org/10.1007/s00270-013-0751-7

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  • DOI: https://doi.org/10.1007/s00270-013-0751-7

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