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To the Editor: In his Editorial, Dr Glassroth¹ suggests that during pregnancy ventilation-perfusion lung scanning is preferred to computed tomographic pulmonary angiography (CTPA) because radiation dosage is higher with CTPA. However, with respect to the fetus the opposite is true: CTPA exposes the fetus to less radiation.^2-3 The more important CTPA-related radiation risk during pregnancy is to the breasts,⁴ a risk that may be offset by the use of breast shields.⁵ In general, when pulmonary embolism is suspected during pregnancy, CTPA is the preferred study.

Financial Disclosures: None reported.

Mark D. Siegel, MD
mark.siegel@yale.edu
Yale University School of Medicine
New Haven, Connecticut

1. Glassroth J. Imaging of pulmonary embolism: too much of a good thing? JAMA. 2007;298(23):2788-2789. FREE FULL TEXT 2. Groves AM, Yates SJ, Win T; et al. CT pulmonary angiography versus ventilation-perfusion scintigraphy in pregnancy: implications from a UK survey of doctors' knowledge of radiation exposure. Radiology. 2006;240(3):765-770. FREE FULL TEXT 3. Winer-Muram HT, Boone JM, Brown HL, Jennings SG, Mabie WC, Lombardo GT. Pulmonary embolism in pregnant patients: fetal radiation dose with helical CT. Radiology. 2002;224(2):487-492. FREE FULL TEXT 4. Hurwitz LM, Reiman RE, Yoshizumi TT; et al. Radiation dose from contemporary cardiothoracic multidetector CT protocols with an anthropomorphic female phantom: implications for cancer induction. Radiology. 2007;245(3):742-750. FREE FULL TEXT 5. Hopper KD, King SH, Lobell ME, TenHave TR, Weaver JS. The breast: in-plane x-ray protection during diagnostic thoracic CT: shielding with bismuth radioprotective garments. Radiology. 1997;205(3):853-858. FREE FULL TEXT

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2008;299(14):1665.

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Imaging of Pulmonary Embolism: Too Much of a Good Thing?
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