Fetal position and size data for dose estimation.

Abstract

In order to establish both positional and size data for estimation of fetal absorbed dose from radiological examinations, the depth from the mother's anterior surface to the mid-line of the fetal head and abdomen were measured from ultrasound scans in 215 pregnant women. Depths were measured along a ray path projected in the anteroposterior (AP) direction from the mother's abdomen. The fetal size was estimated from measurements of the fetal abdominal and head circumference, femur length and the biparietal diameter. The effects of fetal presentation, maternal bladder volume, placenta location, gestational age and maternal AP thickness on fetal depth and size were analysed. The fetal position from the anterior surface of the mother's abdomen is shorter for posterior placenta and empty bladder volume, but longer for anterior placenta and full bladder volume. Mean fetal depth (MFD) observed for all bladder volumes, fetal presentations and placenta locations increased from 6.5 +/- 0.5 cm to 10.2 +/- 0.7 cm over the duration of pregnancy. Similarly, mean fetal skull depth (FSD) increased from 6.6 +/- 0.6 cm to 9.8 +/- 0.6 cm over the period of pregnancy, but only from about 6.6 cm to 7.8 cm over the period (8-25 weeks) when damage to the developing brain has been observed to result in mental retardation. Using the range of mean fetal depth (4.7-13.9 cm) observed in this study and depth dose data at 75 kVp and 3.0 mmAl half value thickness (HVT), fetal absorbed dose would be overestimated by up to 66% or underestimated by up to 77% if the mean value of MFD (8.1 cm) is used rather than actual individual values. These errors increase with lower tube potential and filtration up to over 90% overestimation and up to 100% underestimation at 60 kVp and 1.0 mmAl filtration.