Fetal dosimetry for 18F-FDG PET Imaging during pregnancy: a comparative Monte Carlo study

Document Type : Original Paper

Authors

1 Physics Department, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, Iran.

2 Physics Department, Faculty of Science, Sahand University of Technology, Tabriz, Iran

Abstract

Introduction: Current reported values of fetal doses from 18F Fluorodeoxyglucose (FDG) in pregnant women imaged with PET scan showed a significant variation. This study aimed to evaluate fetal radiation doses using the last generation of computational pregnant phantoms and also to shed light on one of the uncertainty components of the fetal dose.
Material and Methods: In this respect, we used a boundary representation (BREP) series of computational pregnant phantoms to evaluate radiation doses to the fetus. We also reviewed available data on fetal time-integrated activities and evaluated the confidence and prediction (95%) intervals for the existing data. By doing this, the uncertainty of fetal Biokinetic data was taken into account in fetal dose calculations.
Results: The fetal doses of 2.30E-02, 1.53E-02, and 1.02E-02 mGy/MBq at 3, 6 and 9 months of gestation were estimated. The results also showed the contributions of source organs to the fetal doses. The maternal “urinary bladder contents” and “other organs and tissues” are the main source regions contributing to fetal dose. We also indicated that the Biokinetic variation caused a large uncertainty on fetal dose (with a prediction interval from 1.73E-02 to 3.93E-02 mGy/MBq) at the first trimester of pregnancy, while it is much lower at second and third trimesters. Furthermore, it is indicated that variations on fetal dose outside the determined intervals may be related to the geometrical differences of used computational phantoms.
Conclusion: Since the fetal dose is much higher and the radiation exposure is more deterministic at the first trimester of pregnancy, attempting to evaluate the fetal dose is relevant at this stage accurately.

Keywords

Main Subjects


  1. Mankoff DA, Dehdashti F, Shields AF. Characterizing tumors using metabolic imaging: PET imaging of cellular proliferation and steroid receptors. Neoplasia. 2000 Jan 1;2(1-2):71-88.
  2. Bruzzi JF, Munden RF, Truong MT, Marom EM, Sabloff BS, Gladish GW, Iyer RB, Pan TS, Macapinlac HA, Erasmus JJ. PET/CT of esophageal cancer: its role in clinical management. Radiographics. 2007 Nov;27(6):1635-52.
  3. Chung HH, Jo H, Kang WJ, Kim JW, Park NH, Song YS, Chung JK, Kang SB, Lee HP. Clinical impact of integrated PET/CT on the management of suspected cervical cancer recurrence. Gynecologic oncology. 2007 Mar 1;104(3):529-34.
  4. Groheux D, Espié M, Giacchetti S, Hindié E. Performance of FDG PET/CT in the clinical management of breast cancer. Radiology. 2013 Feb;266(2):388-405.
  5. Leide-Svegborn S. Radiation exposure of patients and personnel from a PET/CT procedure with 18F-FDG. Radiation protection dosimetry. 2010 Apr 1;139(1-3):208-13.
  6. Ishiguro T, Nishikawa N, Ishii S, Yoshihara K, Haino K, Yamaguchi M, Adachi S, Watanabe T, Soeda S, Enomoto T. PET/MR imaging for the evaluation of cervical cancer during pregnancy. BMC Pregnancy and Childbirth. 2021 Dec;21(1):1-7.
  7. Zanotti-Fregonara P, Stabin MG. New Fetal Radiation Doses for 18F-FDG Based on Human Data. Journal of Nuclear Medicine. 2017 Nov 1;58(11):1865-6.
  8. Rafat-Motavalli L, Miri-Hakimabad H, and Hoseinian-Azghadi E. Fetal and maternal dose assessment for diagnostic scans during pregnancy. Phys Med Biol. 2016;61(9):3596–3608
  9. Rafat-Motavalli L, Miri-Hakimabad H, Hoseinian-Azghadi E. Hybrid pregnant reference phantom series based on adult female ICRP reference phantom. Radiation Physics and Chemistry. 2018 Mar 1;144:386-95.
  10. Hoseinian Azghadi E, Rafat Motavalli L, and Miri Hakimabad H. Development of a 9-month pregnant hybrid phantom and its internal dosimetry for thyroid agents. J Radiat Res. 2014a;55(4):730–747
  11. ICRP, 2002. Basic Anatomical and Physiological Data for Use in Radiological Protection Reference Values. ICRP Publication 89. Ann. ICRP 32 (3-4).
  12. Bolch WE, Eckerman KF, Sgouros G, Thomas SR. MIRD pamphlet no. 21: a generalized schema for radiopharmaceutical dosimetry—standardization of nomenclature. Journal of Nuclear Medicine. 2009 Mar 1;50(3):477-84.
  13. Hendricks JS, McKinney GW, Fensin ML, James MR, Johns RC, Durkee JW, Finch JP, Pelowitz DB, Waters LS, Johnson MW, Gallmeier FX. MCNPX 2.6. 0 Extensions. Los Alamos National Laboratory. 2008 Apr 11.
  14. ICRP, 2008. Nuclear Decay Data for Dosimetric Calculations. ICRP Publication 107. Ann. ICRP 38 (3).
  15. ICRP, 2015. Radiation Dose to Patients fromRadiopharmaceuticals: A Compendium of Current Information Related to Frequently Used Substances. ICRP Publication 128. Ann. ICRP 44(2S).
  16. Zanotti-Fregonara P, Chastan M, Edet-Sanson A, Ekmekcioglu O, Erdogan EB, Hapdey S, Hindie E, Stabin MG. New fetal dose estimates from 18F-FDG administered during pregnancy: standardization of dose calculations and estimations with voxel-based anthropomorphic phantoms. Journal of Nuclear Medicine. 2016 Nov 1;57(11):1760-3.
  17. Stabin MG. Proposed addendum to previously published fetal dose estimate tables for 18F-FDG. Journal of Nuclear Medicine. 2004 Apr 1;45(4):634-5.
  18. Zanotti-Fregonara P, Champion C, Trébossen R, Maroy R, Devaux JY, Hindié E. Estimation of the β+ dose to the embryo resulting from 18F-FDG administration during early pregnancy. Journal of Nuclear Medicine. 2008 Apr 1;49(4):679-82.
  19. Zanotti-Fregonara P, Jan S, Champion C, Trébossen R, Maroy R, Devaux JY, Hindié E. In vivo quantification of 18F-FDG uptake in human placenta during early pregnancy. Health physics. 2009 Jul 1;97(1):82-5.
  20. Zanotti-Fregonara P, Jan S, Taieb D, Cammilleri S, Trébossen R, Hindié E, Mundler O. Absorbed 18F-FDG dose to the fetus during early pregnancy. Journal of Nuclear Medicine. 2010 May 1;51(5):803-5.
  21. Zanotti-Fregonara P, Koroscil TM, Mantil J, Satter M. Radiation dose to the fetus from [18F]-FDG administration during the second trimester of pregnancy. Health physics. 2012 Feb;102(2):217.
  22. Benveniste H, Fowler JS, Rooney WD, Moller DH, Backus WW, Warner DA, Carter P, King P, Scharf B, Alexoff DA, Ma Y. Maternal-fetal in vivo imaging: a combined PET and MRI study. Journal of Nuclear Medicine. 2003 Sep 1;44(9):1522-30.
  23. Xie T, Zaidi H. Development of computational pregnant female and fetus models and assessment of radiation dose from positron-emitting tracers. European journal of nuclear medicine and molecular imaging. 2016 Dec 1;43(13):2290-300.
  24. Xie T, Zaidi H. Fetal and maternal absorbed dose estimates for positron-emitting molecular imaging probes. Journal of Nuclear Medicine. 2014 Sep 1;55(9):1459-66.
  25. Doll R, Wakeford R. Risk of childhood cancer from fetal irradiation. The British journal of radiology. 1997 Feb;70(830):130-9.
Volume 18, Issue 6
November and December 2021
Pages 461-467
  • Receive Date: 24 September 2020
  • Revise Date: 19 December 2020
  • Accept Date: 26 December 2020