title: Imaging Pregnant and Lactating Patients.
abstract: As use of imaging in the evaluation of pregnant and lactating patients continues to increase, misperceptions of radiation and safety risks have proliferated, which has led to often unwarranted concerns among patients and clinicians. When radiologic examinations are appropriately used, the benefits derived from the information gained usually outweigh the risks. This review describes appropriateness and safety issues, estimated doses for imaging examinations that use iodizing radiation (ie, radiography, computed tomography, nuclear scintigraphy, and fluoroscopically guided interventional radiology), radiation risks to the mother and conceptus during various stages of pregnancy, and use of iodinated or gadolinium-based contrast agents and radiotracers in pregnant and lactating women. Maternal radiation risk must be weighed with the potential consequences of missing a life-threatening diagnosis such as pulmonary embolus. Fetal risks (ie, spontaneous abortion, teratogenesis, or carcinogenesis) vary with gestational age and imaging modality and should be considered in the context of the potential benefit of medically necessary diagnostic imaging. When feasible and medically indicated, modalities that do not use ionizing radiation (eg, magnetic resonance imaging) are preferred in pregnant and lactating patients. Radiologists should strive to minimize risks of radiation to the mother and fetus, counsel patients effectively, and promote a realistic understanding of risks related to imaging during pregnancy and lactation.
authors.affiliation: From the Department of Radiology, George Washington University Hospital, 900 23rd St NW, Washington, DC 20037 (N.T., N.J.K., E.A.A., R.K.Z.); and Department of Diagnostic Radiology, University of Maryland Medical Center and R Adams Cowley Shock Trauma Center, Baltimore, Md (D.D).
authors.forename: Nikki
authors.initials: N
authors.lastname: Tirada
authors.affiliation: From the Department of Radiology, George Washington University Hospital, 900 23rd St NW, Washington, DC 20037 (N.T., N.J.K., E.A.A., R.K.Z.); and Department of Diagnostic Radiology, University of Maryland Medical Center and R Adams Cowley Shock Trauma Center, Baltimore, Md (D.D).
authors.forename: David
authors.initials: D
authors.lastname: Dreizin
authors.affiliation: From the Department of Radiology, George Washington University Hospital, 900 23rd St NW, Washington, DC 20037 (N.T., N.J.K., E.A.A., R.K.Z.); and Department of Diagnostic Radiology, University of Maryland Medical Center and R Adams Cowley Shock Trauma Center, Baltimore, Md (D.D).
authors.forename: Nadia J
authors.initials: NJ
authors.lastname: Khati
authors.affiliation: From the Department of Radiology, George Washington University Hospital, 900 23rd St NW, Washington, DC 20037 (N.T., N.J.K., E.A.A., R.K.Z.); and Department of Diagnostic Radiology, University of Maryland Medical Center and R Adams Cowley Shock Trauma Center, Baltimore, Md (D.D).
authors.forename: Esma A
authors.initials: EA
authors.lastname: Akin
authors.affiliation: From the Department of Radiology, George Washington University Hospital, 900 23rd St NW, Washington, DC 20037 (N.T., N.J.K., E.A.A., R.K.Z.); and Department of Diagnostic Radiology, University of Maryland Medical Center and R Adams Cowley Shock Trauma Center, Baltimore, Md (D.D).
authors.forename: Robert K
authors.initials: RK
authors.lastname: Zeman
mesh_terms: D001940:Breast / Q000528:radiation effects; D003287:Contrast Media / Q000009:adverse effects; D003952:Diagnostic Imaging / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D005260:Female; D005333:Fetus / Q000187:drug effects / Q000528:radiation effects; D006801:Humans; D007258:Informed Consent; D007774:Lactation; D061214:Patient Safety; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000209:etiology; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000009:adverse effects; D019275:Radiopharmaceuticals / Q000009:adverse effects
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals