AAPM Challenges Findings Linking Pre-Pregnancy CT Scans to Adverse Outcomes
WASHINGTON, D.C. – The american Association of Physicists in Medicine (AAPM) has issued a response to a recent Annals of Internal Medicine study suggesting a link between CT scans performed before conception and increased risks of miscarriage and congenital anomalies. the AAPM argues that pre-existing health conditions, rather then radiation exposure, are more likely responsible for the observed outcomes.
The study, published alongside an accompanying editorial, concluded that exposure to CT imaging prior to conception was associated with a modestly elevated risk. However, the AAPM points out the study found similar results for both abdominal/pelvic CTs and head CTs - exposures delivering essentially zero radiation to the ovaries. “If head CT exams, with no ovary exposure, resulted in an increase in miscarriage and congenital anomalies, radiation dose to the ovaries does not explain their findings,” the AAPM stated in a press release.
The association highlighted substantially higher rates of comorbidities among women who underwent CT scans in the two years before conception, including obesity, diabetes mellitus, sexually transmitted infection, pelvic inflammatory disease, endometriosis, thyroid disorder, mental health conditions, and smoking - rates 50 to 100% higher than those who did not. The AAPM contends these underlying medical conditions, necessitating the CT scans in the first place, are a more plausible description for the observed outcomes.
The AAPM also took issue with the editorial accompanying the study, asserting it “dismisses the extensive research on this topic over the past nine decades.” The organization emphasized the long-standing commitment of radiologists, physicists, and other medical professionals to ensuring the safety of radiation exposure for both patients and future conceptions.
While acknowledging the Simard study’s results, the AAPM maintains they are not ”profound” and will not alter its existing recommendations.the association concluded the study’s findings do not provide sufficient evidence to suggest that having more than one to three CT scans before pregnancy impacts fetal outcomes.
The Annals of Internal medicine study is available at https://doi.org/10.7326/ANNALS-24-03479. The AAPM’s full response can be found at https://w3.aapm.org/media/releases/AAPM_response_Study_Annals.pdf and its critique of the editorial at https://w3.aapm.org/media/releases/AAPM_response_Study_Editorial.pdf.
