20.500.12556/RUL-182946 Vpliv uporabe radiofarmakov na plod v času nosečnosti diplomsko delo The effect of the use of radiopharmaceuticals on the fetus during pregnancy - literature review diploma work Uvod: Nuklearna medicina uporablja radiofarmake, ki oddajajo ionizirajoče sevanje. Med nosečnostjo je uporaba teh postopkov možna le, kadar korist za mater in plod presega tveganje. Plod je zaradi povečane radiosenzitivnosti občutljiv, zato je pomembno oceniti prenose in biokinetiko radiofarmakov ter sevalno dozo na plod. Tveganje za plod je odvisno od gestacijske starosti, vrste uporabljenega radiofarmaka in količine sevanja, ki ga plod prejme med preiskavo. Namen: Namen diplomske naloge je s sistematičnim pregledom literature raziskati vpliv radiofarmakov na plod med nosečnostjo ter opisati njihovo upravičeno uporabo, možne učinke na plod in obdobje največje občutljivosti na ionizirajoče sevanje. Metode dela: Uporabili smo deskriptivno metodo s sistematičnim pregledom literature v mednarodnih podatkovnih bazah PubMed, ScienceDirect, Wiley Online Library, Google Scholar in European Journal of Medical Physics. Članke smo iskali med letoma 2010 in 2026, v angleškem jeziku, s ključnimi besedami: pregnant women, pregnancy, fetus, fetal dose, radiopharmaceuticals, nuclear medicine in molecular imaging. Pri analizi smo upoštevali metode, rezultate in ugotovitve, ki se nanašajo na dozo na plod, varno uporabo radiofarmakov in ukrepe za zmanjšanje tveganja. Rezultati: Po pregledu podatkovnih baz smo v analizo vključili 12 relevantnih člankov. Pregledali smo njihove metode, rezultate in ugotovitve glede doze na plod, občutljivosti ploda in varne uporabe radiofarmakov. Ugotovitve kažejo, da je plod najbolj občutljiv v prvem trimesečju, da večina uporabljenih radiofarmakov povzroča nizke doze, ki so pod pragom determinističnih učinkov, ter da lahko ustrezni ukrepi, kot so zmanjšan odmerek, hidracija in spodbujanje izločanja urina, dodatno zmanjšajo tveganje. Razprava in zaključek: Ugotovili smo, da je plod najbolj občutljiv na ionizirajoče sevanje v zgodnji nosečnosti, zlasti med organogenezo. Povprečne doze na plod pri standardnih diagnostičnih preiskavah, kot sta pozitronska emisijska tomografija z računalniško tomografijo z uporabo fluorodeoksiglukoze, označene s 18fluorom, ali scintigrafija z 99m-tehnecijem, ostajajo nizke in ne presegajo pragov za deterministične učinke. Uporaba radiofarmakov je upravičena le, kadar diagnostični izid neposredno vpliva na materino zdravljenje, pri čemer je ključno upoštevati načelo čim nižje razumno dosegljive izpostavljenosti, optimizirati protokole, zmanjšati aplicirano aktivnost ter spodbujati hidracijo in pogosto praznjenje mehurja. Najpogosteje uporabljeni diagnostični radiofarmaki so spojine 99m-tehnecija in fluorodeoksiglukoza, označena s 18fluorom, medtem ko je terapevtska uporaba radiofarmakov, zlasti 131joda, med nosečnostjo skoraj vedno odsvetovana. Pravilno načrtovana uporaba radiofarmakov med nosečnostjo je tako lahko varna in omogoča diagnostično korist ob minimalnem tveganju za plod. Introduction: Nuclear medicine uses radiopharmaceuticals that emit ionizing radiation. During pregnancy, these procedures are performed only when the benefit for the mother and the fetus outweigh the potential risk. Due to increased radiosensitivity, the fetus is particularly vulnerable, therefore it is important to evaluate the transfer and biokinetics of radiopharmaceuticals as well as the fetal radiation dose. The risk to the fetus depends on gestational age, the type of radiopharmaceutical used, and the amount of radiation received during the examination. Purpose: The aim of this thesis is to examine the effects of radiopharmaceuticals on the fetus during pregnancy and to describe their justified use, possible effects on the fetus, and the period of greatest sensitivity to ionizing radiation through a systematic literature review. Methods: A descriptive method with a systematic literature review was used. Literature was searched in international databases such as PubMed, ScienceDirect, Wiley Online Library, Google Scholar, and the European Journal of Medical Physics. Articles published between 2010 and 2026 in English were included. The following keywords were used: pregnant women, pregnancy, fetus, fetal dose, radiopharmaceuticals, nuclear medicine, and molecular imaging. In the analysis, we considered the methods, results, and findings related to fetal dose, safe use of radiopharmaceuticals, and risk-reduction measures. Results: After reviewing the databases, 12 relevant articles were included in the analysis. Their methods, results, and findings regarding fetal dose, fetal sensitivity, and the safe use of radiopharmaceuticals were examined. The findings show that the fetus is most sensitive during the first trimester, that most commonly used radiopharmaceuticals result in low doses below the threshold for deterministic effects, and that appropriate measures such as reduced administered activity, hydration, and frequent urination can further reduce the risk. Discussion and conclusion: We found that the fetus is most sensitive to ionizing radiation in early pregnancy, particularly during organogenesis. The average fetal doses in standard diagnostic procedures, such as positron emission tomography combined with computed tomography using 18fluorine fluorodeoxyglucose or scintigraphy with 99m-technetium, remain low and do not exceed the thresholds for deterministic effects. The use of radiopharmaceuticals is justified only when the diagnostic outcome directly affects the mother’s treatment. In such cases, it is essential to follow the principle of keeping radiation exposure as low as reasonably achievable, optimize protocols, reduce the administered activity, and encourage hydration and frequent bladder emptying. The most commonly used diagnostic radiopharmaceuticals are 99m-technetium compounds and 18fluorine fluorodeoxyglucose, whereas therapeutic use of radiopharmaceuticals, especially 131iodine, is almost always discouraged during pregnancy. Properly planned use of radiopharmaceuticals during pregnancy can therefore be safe and can provide diagnostic benefit with minimal risk to the fetus. diplomska dela radiološka tehnologija radiofarmaki nuklearna medicina plod nosečnost doza na plod diploma theses radiologic technology radiopharmaceuticals nuclear medicine fetus pregnancy fetal dose true false false [R. Skubic : N. Škoberne] Slovenski jezik Angleški jezik Diplomsko delo/naloga 2026-05-29 07:45:38 2026-05-29 07:45:58 2026-05-30 04:58:32 0000-00-00 00:00:00 2026 0 Ljubljana 0 Ljubljana X, 37 str. 0000-00-00 NiDoloceno NiDoloceno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616-07 159935 279766787 59138.pdf 59138.pdf 1 2C54B12BD78DC253B68902DC47E79BA7 02bc6e647d517b28c64d1a280e3268cfb5dffb24fbe87986338c57c10708a8e1 5233571e-5b21-11f1-b0ab-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=234642 Zdravstvena fakulteta 0 0 0