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General Updates | Diagnosing and staging hematologic malignancies in pregnancy

Daan Dierickx, MD, PhD, KU Leuven and University Hospitals Leuven, Leuven, Belgium, discusses adjustments to the diagnostic workup when a hematologic malignancy is suspected in a pregnant patient, noting that PET-CT scans are avoided due to radiation concerns. Prof. Dierickx notes that magnetic resonance imaging (MRI) is used instead for staging lymphomas, as it does not involve radiation, and that bone marrow punctures can be safely performed in pregnant patients when necessary. This interview took place virtually.

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Transcript

So for lymphomas, in particular, we do PET-CT scan in non-pregnant patients as a staging device, but the problem is that, of course, this is associated with radiation. So in pregnant patients, we don’t use PET or CT for staging. In pregnant patients, we use MRI, so magnetic resonance imaging, which is not based on radiation, but is based on magnetic resonance, as the name itself says...

So for lymphomas, in particular, we do PET-CT scan in non-pregnant patients as a staging device, but the problem is that, of course, this is associated with radiation. So in pregnant patients, we don’t use PET or CT for staging. In pregnant patients, we use MRI, so magnetic resonance imaging, which is not based on radiation, but is based on magnetic resonance, as the name itself says. And with this tool, you can also stage the whole body and see in which stage the lymphoma is at the moment of diagnosis. 

For leukemia, we can do a bone marrow puncture. So if it’s necessary to do a bone marrow puncture, you can do it safely in a pregnant patient. For lymphoma and for myeloma, for example, we do those magnetic resonance imaging as it’s not associated with radiation, with ionizing radiation, to the patient.

 

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