Fetal dose assessment in diagnostic and interventional radiology: a systematic review and European survey on methods, tools and dose ranges
Abstract
Background: An increasing number of pregnant patients undergo radiological examinations or procedures each year, raising concerns about fetal radiation exposure. Several methods for fetal dose (FD) estimation are available. Within the EU-funded SONORA project, this study aims to identify, evaluate, and synthesize existing FD estimation methods used in diagnostic and interventional radiology (DIR). The objective is to compare evidence from the literature with real-world clinical practices across Europe, identifying discrepancies and areas requiring harmonization.
Materials and methods: A systematic review of PubMed and Embase databases (2000-2025) was conducted following PRISMA guidelines, including 75 original studies. In parallel, a survey was distributed across European countries to investigate current FD estimation practices, tools, reported dose ranges, and optimization strategies. Fifty-two valid responses, mainly from Medical Physicists, were analyzed.
Results: Literature and survey data identified three main FD estimation approaches: Monte Carlo simulations, physical phantom measurements, and software tools, the latter being most used in clinical practice. Reported FD values varied by imaging modality: 10-60 mGy for abdominal or pelvic CT, 100 mGy) for interventional procedures. While strong agreement was observed on technical optimization strategies-such as collimation, tube current modulation, and reduction of CT acquisition phases-substantial variability persists…
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