CT pulmonary angiography versus ventilation-perfusion scintigraphy in pregnancy: Implications from a UK survey of doctors' knowledge of radiation exposure

Purpose: To prospectively investigate the fetal dosimetry knowledge of health care professionals involved in the management of pulmonary embolism. Materials and Methods: One hundred sixty-one health care professionals consented to participate in this study, which had ethical board approval. The individuals surveyed were from 14 hospitals (seven university and seven community hospitals) in the United Kingdom, and 68 trainees were included. These health care professionals included 102 radiologists, 13 nuclear physicians, seven dual-accredited radiologist-nuclear medicine physicians, 16 medical physicists, and 23 pulmonologists. The interview included eight questions. Two questions asked which examination-computed tomographic (CT) pulmonary angiography or ventilation-perfusion (V/Q) scintigraphy - gave (a) the larger radiation exposure (effective dose) to an adult and (b) the larger fetal dose. Two questions assessed the magnitude of the dose differences between these two tests. Four questions asked for an estimate of the dose to both adult and fetus from CT pulmonary angiography and scintigraphy. Subgroup analysis was performed by using the Fisher exact test. Results: Of the 161 professionals surveyed, 93 (58%) appreciated correctly that V/Q scintigraphy delivers a higher fetal dose than does CT pulmonary angiography. Three of 161 professionals were able to answer all eight questions correctly. In terms of the knowledge that V/Q scintigraphy has a higher fetal dose than does CT, there was no statistically significant difference in correct answers between specialties (P > .05), between university and community hospitals (P = .13), or between attending physicians and residents (P = .52). Conclusion: This survey reveals that there is a lack of knowledge of fetal dosimetry in the imaging of pregnant women suspected of having pulmonary embolism.