Having a V/Q scan or CTPA scan of your lungs whilst pregnant

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1 Having a V/Q scan or CTPA scan of your lungs whilst pregnant Department of Radiology Information for Patients i Radiology Leaflet No. 93 University Hospitals of Leicester NHS Trust

2 Introduction This leaflet has been written to give you information about two different types of lung scan used within the hospital so that you are informed about the amount of radiation, and the associated risks, that you and your unborn baby will receive when you have one of these scans. Your doctor, together with a radiologist (doctor specialising in imaging), will decide which type of scan is most appropriate for you to have. They will take into account your medical history and the stage of your pregnancy. Depending on the results of the first scan it is possible that you will go on to have a second scan. Why do I need a lung scan? Your doctor has requested a scan to look at your lungs. This scan will show whether or not there is a blood clot in your lungs. There are two types of scan that can be performed to look at your lungs: The first is called a ventilation/perfusion scan (V/Q scan) and is performed in the nuclear medicine department. The second type of scan is called a computed tomography (CTPA) scan and is performed in the radiology department. Both scans involve the use of ionising radiation. Please read this information leaflet for an overview of each type of scan. You may also receive another leaflet that describes the scan you are to have in more detail. 2

3 The benefits and risks of examinations that use ionising radiation Examinations that use radiation are only performed when absolutely necessary. This means the clinical benefit to you (and therefore also your unborn child) of having the examination outweighs the risks of not having it. In this particular situation the risks (to you and your baby) of NOT having a lung scan are as follows: You could have a blood clot in your lungs. If this is not found and therefore not treated, it could lead to conditions such as pulmonary hypertension, stroke or even death. By not having a scan, you could be treated for a blood clot when you do not need to be treated. The request for a lung scan has been discussed with a Consultant Radiologist (who specialises in scans involving radiation) and the senior medical team looking after you. They consider that: The risks to you and your baby from a lung scan are very small. The benefits from knowing what is wrong with you outweigh the risk. You should be fully informed of all risks and benefits involved with the procedure. 3

4 What are the radiation risks to me? The radiation doses from both examinations are small. The only known effect to the exposed individual at these low doses is a very slight increase in the chance of cancer occurring, many years or even decades after radiation exposure. To put this into context it is important to realise that there are risks in every day life, and the extra risks by having medical radiation are low when compared to these existing risks. For example: Around 25 % (1 in 4) of people die from cancer*. A CT scan of the chest will increase the risk that we will die from cancer over a normal lifetime by about 0.05 %. Another way of saying this would be that following the CT scan the risk would rise from 500 in 2000 to 501 in *(NRPB Publication: Diagnostic Medical Exposures Advice on exposure to ionising radiation during pregnancy (ISBN X [Pub. 1998]). What are the radiation risks to my baby? The risks to your baby from the small amount of radiation are extremely low. The table below gives an idea of the size of the risks involved compared to the natural risks (with no scan performed). 4

5 What are the radiation risks to my baby? (continued) What is the risk of causing cancer in childhood? What is the risk of causing significant hereditary disease (a disease that can be passed down to future generations of the same family)? V/Q Scan CTPA Scan Natural Risk Very small (1 in 100,000 to 1 in 10,000) Very small (About 1 in 435,000) Very small (1 in 1,000,000 to 1 in 100,000) Very small (About 1 in 5,500,000) About 1 in 500 About 1 in 50 Data from HPA report: Protection of Pregnant Patients during Diagnostic Medical Exposures to Ionising Radiation, March 2009 How much radiation is involved? Whole body radiation dose is measured in units called millisieverts (msv): We are all exposed to natural background radiation every day of our lives. This comes from the ground and building materials around us, the air we breathe, the food we eat and even from outer space. The average background radiation dose per year from naturally occurring radiation in the UK is 2mSv, but it is up to 10mSv in some parts of the country. A CTPA scan gives a radiation dose to you of 3mSv and a dose to your baby of 0.04mSv. A V/Q Scan gives a radiation dose to you of approximately 1.1 msv and a dose to your baby of 0.46mSv. As you can see, the radiation dose from either scan is small. 5

6 Is one test better than the other? Although both tests can show whether there is a blood clot on your lungs, they each have advantages and disadvantages that will be taken into account when the doctor decides which test you will have. CTPA scans are not suitable for everyone. If you have previously had a reaction to x-ray contrast agents, are allergic to iodine, or have poorly functioning kidneys, a CTPA scan may be less suitable for you. V/Q scans are not suitable for everyone. If you currently have other problems with your chest that might make the V/Q scan difficult to interpret then a V/Q scan may not be suitable for you. However, V/Q scans are often preferred during pregnancy because they give a lower radiation dose to your breast tissue (which is more sensitive than usual to radiation during pregnancy). Who can I contact for further information? If you have further questions about your condition or treatment you can ask the medical and nursing staff looking after you. If you want to ask questions about the scan itself, or about the radiation risks, ask a member of the medical or nursing staff to contact the Nuclear Medicine department (for V/Q scans) or the Radiology department (for CTPA scans). A member of staff from those departments will be happy to come and talk to you. 6

7 Websites For information about the effects of X-rays read the NRPB publication: X-rays how safe are they, on the Health Protection Agency website: Any questions? If you have any questions write them down here to remind you what to ask when you speak to your consultant or radiologist. 7

8 Today s research is tomorrow s care We all benefit from research. Leicester s Hospitals is a research active Trust so you may find that research is happening when you visit the hospital or your clinic. If you are interested in finding out how you can become involved in a clinical trial or to find out more about taking part in research, please speak to your clinician or GP. If you would like this information in another language or format, please contact the service equality manager on Produced by: Imaging and Medical Physics Patient Information Group. Edition 1. Date implemented: April Review date: April (Mear) KR IMA

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