Patient-specific fetal radiation dosimetry for pregnant patients undergoing abdominal and pelvic CT imaging

Background: Accurate estimation of fetal radiation dose is crucial for risk-benefit analysis of radiological imaging, while the radiation dosimetry studies based on individual pregnant patient are highly desired. Purpose: To use Monte Carlo calculations for estimation of fetal radiation dose from abdominal and pelvic computed tomography (CT) examinations for a population of patients with a range of variations in patients’ anatomy, abdominal circumference, gestational age (GA), fetal depth (FD), and fetal development. Methods: Forty-four patient-specific pregnant female models were constructed based on CT imaging data of pregnant patients, with gestational ages ranging from 8 to 35 weeks. The simulation of abdominal and pelvic helical CT examinations was performed on three validated commercial scanner systems to calculate organ-level fetal radiation dose. Results: The absorbed radiation dose to the fetus ranged between 0.97 and 2.24 mGy, with an average of 1.63 ± 0.33 mGy. The CTDI_vol-normalized fetal dose ranged between 0.56 and 1.30, with an average of 0.94 ± 0.25. The normalized fetal organ dose showed significant correlations with gestational age, maternal abdominal circumference (MAC), and fetal depth. The use of ATCM technique increased the fetal radiation dose in some patients. Conclusion: A technique enabling the calculation of organ-level radiation dose to the fetus was developed from models of actual anatomy representing a range of gestational age, maternal size, and fetal position. The developed maternal and fetal models provide a basis for reliable and accurate radiation dose estimation to fetal organs.