Introduction: Conventional radiography and computed tomography (CT) can result in different radiation doses to the foetus when pelvimetry needs to be performed before childbirth. New techniques in diagnostic imaging provide the basis for the optimization of radiation dose and create opportunities for higher measurement accuracy. The purpose of the study was to estimate the radiation dose to the foetus from pelvimetry performed using conventional radiography compared to different CT methods, namely: the topogram method, cross-sectional method, short-spiral method, standard-spiral method, and flashspiral method.Methods: An anthropomorphic phantom and thermoluminescent dosemeters (TLD) were used for the dose measurements. Bags with sodium chloride were placed on top of the phantom's abdomen and were used to simulate the last month of pregnancy. The foetal radiation dose was equated to the absorbed energy to the TLDs placed at the area of the birth canal (uterus). Results:The mean absorbed dose to the foetus was measured with conventional radiographic technique to 0.16mGy. The mean absorbed dose to the foetus with the various CT methods resulted in 0.17mGy (topogram), 0.21mGy (cross-sectional), 0.45mGy (shortspiral), 0.57mGy (standard-spiral), and 0.75mGy (flash-spiral). Conclusion: Although the absorbed dose to the foetus was higher in the CT pelvimetry methods, the dose levels are low. The CT spiral methods allowed adjustments in multiplane image reconstructions which could increase measurement accuracy. However, further studies are needed to investigate different CT pelvimetry methods in relation to measurement accuracy.
Background Different low-dose computed tomography (CT) pelvimetry methods can be used to evaluate the size of birth canal before delivery. CT pelvimetry might generate an acceptable low fetal radiation dose but its measurement accuracy is unknown. Purpose To investigate intra- and inter-rater measurement reliability of cross-sectional and two spiral CT pelvimetry methods: standard spiral and short spiral. Material and Methods Ten individuals (age ≥60 years, body mass index ≥30 kg/m 2 ) having a CT scan of the abdomen also had CT pelvimetry scans. Three radiologists made independent measurements of each pelvimetry method on two occasions and also in consensus for a reference pelvimetry computed from the standard-dose CT scan of the abdomen. Inter- and intra-rater reliability was analyzed by intraclass correlation coefficient. Results Measurements in the short spiral pelvimetry demonstrated excellent intra- and inter-rater reliability, intraclass correlation coefficient ≥0.93, and good to excellent 95% confidence interval 0.87–0.99. Corresponding results of the standard spiral and cross-sectional pelvimetry showed good to excellent intraclass correlation coefficient ≥0.85 and ≥0.76, and 95% confidence interval was least good and moderate 0.73–0.98 and 0.59–0.97, respectively. Intraclass correlation coefficient between reference pelvimetry and other CT methods showed analogous results. Conclusion The short spiral pelvimetry demonstrated high and best reliability in comparison to other methods. Standard spiral method showed also good measurement reliability but the short spiral pelvimetry generates lower fetal radiation dose. This method might be suitable for measurements at narrow pelvis. Patient acceptance and attitude to CT pelvimetry should be investigated.
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