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International audience; OBJECTIVE: To evaluate the effects of ionizing radiation exposure during the first trimester of pregnancy in usual clinical situations.STUDY DESIGN: We conducted a prospective observational cohort study using data collected between 1987 and 2014. This database was authorized by the French "Commission Nationale de l'Informatique et des Libertés". The exposed group consisted of 319 pregnant women exposed to sub diaphragmatic ionizing radiations for diagnostic purposes, during the first trimester of pregnancy, and the control group consisted of 319 pregnant women without any exposure or exposed to non-teratogenic agents. Data on maternal history and radiations exposure were collected on first contact, and pregnancy outcomes were documented at follow-up. An univariate analysis was performed to compare both groups for the main outcomes.RESULTS: Exposure to sub diaphragmatic ionizing radiation for diagnosis purpose (median fetal dose of 3.1 mGy [0.2-130.0]) during the first trimester of pregnancy was not significantly associated with an increased risk of malformations (1.5% vs 1.8%, p = 1.00), miscarriage (7.8% vs 7.2%, p = 0.88), in utero fetal death (0.3% vs 0%, p = 1.00) or fetal growth restriction (5.4% vs 3.5%, p = 0.62).CONCLUSION: Pregnant women exposed to irradiant diagnostic procedures do not present a higher risk of malformations, miscarriage, in utero fetal death or fetal growth restriction and should be reassured, even if the examination focused on the pelvis.

International audience; PurposeThe objective of our study was to evaluate the impact of an automatic tube potential selection (ATPS) on the delivered dose and image quality in unenhanced head computed tomography (CT) scans of infants.Materials and methodsUnenhanced head CT scans were acquired before and after the introduction of an ATPS in full automatic mode in two groups of 20 patients under one year of age. The delivered dose (CDTIvol) as the quantitative (contrast-to-noise ratio) and qualitative (based on the European CT criteria) image quality were compared on the supra- and infratentorial regions by three senior pediatric radiologists. Mann–Whitney and Fisher exact tests were performed. An interobserver Fleiss's kappa agreement was calculated for each criterion.ResultsThe use of an ATPS allowed a significant reduction in the delivered dose (−21%, p = 0.0005) with no significant difference of the contrast-to-noise ratio in supra- (−5%, p = 0.21) and infratentorial regions (+16%, p = 0.96). In all cases, dose reduction was obtained with the same value of 100 kV. It maintained a good qualitative image quality (e.g., differentiation between gray and white matter in supra-tentorial region: p = 0.470). The interobserver Fleiss's kappa agreements were good to excellent.ConclusionATPS is a tool that can significantly reduce the delivered dose by choosing the most appropriate tube voltage while maintaining image quality in unenhanced head CT scans of infants.