Multiphase abdomen-pelvis CT in women of childbearing potential (WOCBP): Justification and radiation dose

To assess justification and radiation doses of abdomen-pelvis CT in women of childbearing potential (WOCBP) scanned in 2 tertiary hospitals in Qatar. The local ethical committee approved retrospective study of 451 WOCBP (14–55 years) who underwent abdomen-pelvis CT examinations. Patients’ age, clinical indications for ordered CT, scanner types and vendors, number and type of scan phases (non-contrast, arterial, portal venous, and/or delayed phases), and radiation dose descriptors (CT dose index volume - CTDIvol and dose length product- DLP) were recorded. Patients undergoing simultaneous chest-abdomen-pelvis CT were excluded. We classified the clinical indications for all 451 CT into indicated and unindicated based on the ACR Appropriateness Criteria. Information regarding the date of last menstrual period, likelihood of pregnancy, and if available, results of the pregnancy test were recorded. Data were analyzed with descriptive statistics (median and inter-quartile range) and analysis of variance (ANOVA). None of the patients were pregnant at the time of their scanning. Amongst the 673 phases acquired for multiphase abdomen-pelvis CT in 451 patients, the 47% unindicated phases (315/673) included non-contrast (122/673, 18%), arterial (33/673, 5%), portal venous (125/673, 19%) and delayed (35/673, 5%) phases. The respective median DLP for indicated and unindicated phases were 266 and 758 mGy.cm (P < .0001). Multiphase abdomen-pelvis CT exams are frequent but seldom justified in WOCBP. They lead to a substantial increase in unindicated radiation dose compared to a single-phase CT.