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Study examines radiation dose estimates for pregnant women undergoing therapeutic ERCP
Date:4/28/2009

thod for the assessment of the fetal dose from ERCP procedures. Researchers examined 24 consecutive male and non-pregnant female patients who received therapeutic ERCP for conditions including cholangitis, choledocholithiasis, pancreatitis, stent extraction, and pancreatic and bile-duct tumors. It should be emphasized that none of these patients were pregnant or suspected of being pregnant, thus no measures to limit radiation exposure were taken. Based on the radiation exposure in these 24 non-pregnant patients, the radiation dose delivered to a theoretical fetus was then estimated. The estimation was performed using a Monte-Carlo-N-particle transport code, widely used to assess radiation dose distribution in the body by simulating radiologic examinations in mathematical phantoms.

Results

The radiation doses estimated for a theoretical fetus in these 24 ERCP procedures ranged from 3.4 to 55.9 mGy. The researchers provide tabulated data that then allow for calculation of the fetal radiation dose.

The data revealed that the fetal dose from ERCP procedures may occasionally exceed 10 mGy, a considerably greater value than previously reported. In cases with pregnant patients, special efforts should be made to minimize the fetal radiation burden. An accompanying editorial on this study by former ASGE Standards of Practice Committee Chair Todd H. Baron, MD, FASGE, division of gastroenterology and hepatology, and Beth A. Schueler, PhD, department of radiology, both from the Mayo Clinic College of Medicine, Rochester, Minn., appears in the April issue and offers a list of general rules for safe and effective fluoroscopy use to minimize radiation exposure during ERCP in pregnant women.

Researchers noted that limitations of the study included a source of error in the estimation of the fetal dose related to variations of fetus location and size from the average, especially during the second and third trimesters. Another limitation conc
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Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

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