We analyzed the US Nuclear Regulatory Commission event notifications related to unplanned exposure to fetus or embryo for events that occurred between 1 January 2005 and 31 December 2024. A total of 39 events were identified, 28 related to therapeutic and 11 to diagnostic nuclear medicine; no events related to brachytherapy or gamma teletherapy were found. The number of events fell during the study period (2005-2009: 15; 2020-2024: 6). The radioisotope in most (71.8 %) of the events was 131 I. A pregnancy test was performed in 21/28 therapy events and in 0/11 diagnostic events. The estimated age of the fetus ranged from 1 to 26 wk (mean 5.7 wk); in two therapy events, conception occurred after the administration of the radiopharmaceutical. The mean reported estimated dose to the fetus was 260 mSv (SD: 190; range 20–860) for the therapy events and 17 mSv (SD: 6; range 10–26) for the diagnostic events. Unplanned fetal exposures are occurring; for therapy events, the estimated dose to the fetus is often high enough that adverse effects are possible. We suggest institutions review their policies on patient consent and pregnancy testing.
Sillanpaa et al. (Tue,) studied this question.