James Daphne J, Cardew Paul, Warren-Forward Helen M
School of Health Sciences, University of Newcastle, New South Wales, Australia.
J Nucl Med Technol. 2013 Sep;41(3):216-22. doi: 10.2967/jnmt.113.123216. Epub 2013 Aug 12.
The ionizing radiation used in diagnostic nuclear medicine procedures has the potential to cause biologic harm to a fetus. Although the risks are relatively small, it is recommended that all female patients of childbearing age be questioned regarding their pregnancy status before administration of the radiopharmaceutical. This can be a sensitive situation especially for certain types of patients, such as teenagers. Currently, there are no guidelines that detail how to question the patient. Previous studies have revealed the lack of a consistent approach in this area. The aim of this study was to investigate current practice for pregnancy screening before diagnostic nuclear medicine procedures in Australia and New Zealand and to determine whether a standardized practice guideline is required.
An online survey was administered via SurveyMonkey from October to December 2011. Members of the Australian and New Zealand Society of Nuclear Medicine were invited to participate. The survey consisted of 30 questions divided into 4 sections: demographics, policy and regulations, current practice, and open-ended clinical scenarios.
Three hundred thirty-five responses were recorded from participants in all states and territories of Australia and New Zealand; 90% were nuclear medicine technologists. Participants reported a low awareness of radiation policy and regulations but demonstrated good knowledge of the relative risk to the fetus from commonly performed procedures. The most common minimum and maximum age to question patients was 12 y (32%) and 55 y (42%), respectively, although the range was from 10 to 60 y. Verbal questioning (44%) was the most commonly used approach. Pregnancy testing was used by 72%, usually if the patient indicated she was unsure of her pregnancy status. Responses to clinical scenarios were varied, and these will be discussed in a subsequent paper.
The survey revealed a lack of awareness of government regulations and departmental policy regarding radiation protection. The study demonstrated wide variety in pregnancy screening strategies used to determine the pregnancy status of patients before diagnostic nuclear medicine procedures, indicating that a standardized practice guideline is required for Australia and New Zealand.
诊断性核医学程序中使用的电离辐射有可能对胎儿造成生物伤害。尽管风险相对较小，但建议在给予放射性药物之前，对所有育龄期女性患者询问其妊娠状况。对于某些类型的患者，如青少年，这可能是一个敏感的情况。目前，没有详细说明如何询问患者的指南。先前的研究表明在这一领域缺乏一致的方法。本研究的目的是调查澳大利亚和新西兰在诊断性核医学程序前进行妊娠筛查的当前做法，并确定是否需要标准化的实践指南。
2011年10月至12月通过SurveyMonkey进行了一项在线调查。邀请澳大利亚和新西兰核医学协会的成员参与。该调查由30个问题组成，分为4个部分：人口统计学、政策与法规、当前做法以及开放式临床情景。
从澳大利亚和新西兰所有州和领地的参与者中记录到335份回复；90%是核医学技术人员。参与者报告对辐射政策和法规的认识较低，但对常见程序对胎儿的相对风险表现出良好的了解。询问患者的最常见最小和最大年龄分别为12岁（32%）和55岁（42%），尽管范围是10至60岁。口头询问（44%）是最常用的方法。72%的人使用妊娠测试，通常是在患者表示不确定自己的妊娠状况时。对临床情景的回复各不相同，这些将在后续论文中讨论。
调查显示对政府关于辐射防护的法规和部门政策缺乏认识。该研究表明在诊断性核医学程序前用于确定患者妊娠状况的妊娠筛查策略存在很大差异，这表明澳大利亚和新西兰需要标准化的实践指南。
