Imaging Findings [34]. Pregnancy status and the method used to determine it should be included as part of the patient’s medical record in the radiology information system. If a fetal dose estimate is required, it should be performed by a Qualified Medical Physicist and appropriately documented. VII. QUALITY CONTROL AND IMPROVEMENT, SAFETY, INFECTION CONTROL, AND PATIENT EDUCATION Policies related to quality, patient education, infection control, and safety should be developed and implemented in accordance with the ACR Policy on Quality Control and Improvement, Safety, Infection Control, and Patient Education appearing under the heading Position Statement on QC & Improvement, Safety, Infection Control, and Patient Education on the ACR website (https://www.acr.org/Clinical-Resources/Practice-Parameters-andTechnical-Standards). Equipment performance monitoring should be in accordance with the ACR–AAPM Technical Standard for Diagnostic Medical Physics Performance Monitoring of Radiographic Equipment, ACR-AAPM Technical Standard for Diagnostic Medical Physics Performance Monitoring of Fluoroscopic Equipment and the ACR– AAPM Technical Standard for Diagnostic Medical Physics Performance Monitoring of Computed Tomography (CT) Equipment [35-37]. To provide foreknowledge of the potential radiation doses delivered, an evaluation of the likely doses delivered to the conceptus of a patient in early pregnancy by protocols involving diagnostic examination of the abdomen/pelvis should be performed to ensure that the delivered dose is within acceptable standards for that type of examination. For example, the conceptus dose from a CT protocol of the pelvis should not exceed 50 mGy and preferably should be below 30 mGy. (Note: testing a protocol requires that the cumulative dose from all exposures of the protocol be assessed, not just that from a single view, single procedure, or single phase of that protocol.) PRACTICE PARAMETER 12 Pregnant or Potentially Pregnant Patients ACKNOWLEDGEMENT This practice parameter was revised according to the process described under the heading The Process for Developing ACR Practice Parameters and Technical Standards on the ACR website (https://www.acr.org/Clinical-Resources/Practice-Parameters-and-Technical-Standards) by the Committee on Practice Parameters – General, Small, Emergency and/or Rural Practice of the Commission on General, Small, Emergency and/or Rural Practices and the Committee on Practice Parameters – Pediatric Radiology of the Commissions on Pediatric Radiology in collaboration with the SPR. Collaborative Committee Members represent their societies in the initial and final revision of this practice parameter. ACR SPR Padmaja A. Jonnalagadda, MD, Chair Einat Blumfield MD Kimberly E. Applegate, MD, MS, FACR T. Robin Goodman, MD Murray D. Becker, FACR, MD, PHD Riham H. El Khouli, MD, PHD Osama Mawlawi, PhD Tammam N. Nehme, MD Pallavi Sagar, MD Beth A. Schueler, PhD, FACR Committee on Practice Parameters – General, Small, Emergency and/or Rural Practices (ACR Committee responsible for sponsoring the draft through the process) Sayed Ali, MD, Chair Candice Johnstone, MD Marco A. Amendola, MD, FACR Padmaja A. Jonnalagadda, MD Lynn Broderick, MD, FACR Steven E. Liston, MD, MBA, FACR Resmi A. Charalel, MD Tammam Nehme, MD Brian D. Gale, MD, MBA Samir S. Shah, MD Carolyn A. Haerr, MD Jennifer L. Tomich, MD Charles E Johnson, MD Committee on Practice Parameters – Pediatric Radiology (ACR Committee responsible for sponsoring the draft through the process) Beverley Newman, MB, BCh, BSc, FACR, Chair Sue C. Kaste, DO Lorna P. Browne, MB, BCh Tal Laor, MD Timothy J. Carmody, MD, FACR Terry L. Levin, MD Brian D. Coley, MD, FACR Marguerite T. Parisi, MD, MS Lee K. Collins, MD Sumit Pruthi, MBBS Monica S. Epelman, MD Nancy K. Rollins, MD Lynn Ansley Fordham, MD, FACR Pallavi Sagar, MD Kerri A. Highmore, MD Robert S. Pyatt, Jr, MD, FACR, Chair, Commission on General, Small, Emergency and/or Rural Practice Marta Hernanz-Schulman, MD, FACR, Chair, Pediatric Commission Jacqueline Anne Bello, MD, FACR, Chair, Commission on Quality and Safety Matthew S. Pollack, MD, FACR, Chair, Committee on Practice Parameters & Technical Standards Comments Reconciliation Committee Eric Friedberg, MD, FACR, Chair Padmaja A. Jonnalagadda, MD Catherine Everett, MD, MBA, FACR, Co-Chair Paul A. Larson, MD, FACR Sayed Ali, MD Laurie R. Margolies, MD Jacqueline Anne Bello, MD, FACR Osama Mawlawi, PhD PRACTICE PARAMETER 13 Pregnant or Potentially Pregnant Patients Comments Reconciliation Committee Kimberly E. Applegate, MD, MS, FACR Tammam N. Nehme, MD Einat Blumfield MD Beverley Newman, MB, BCh, BSc, FACR Lindsay P. Busby, MD, MPH Matthew S. Pollack, MD, FACR Richard Duszak, Jr., MD Robert S. Pyatt Jr, MD, FACR Riham H. El Khouli, MD, PhD Pallavi Sagar, MD Richard A. Geise, PhD, FACR Beth A. Schueler, PhD, FACR T. Robin Goodman, MD Timothy L. Swan, MD, FACR, FSIR Mustapha R. Hatab, Ph.D, FACR Roland Wong, ScM Marta Hernanz-Schulman, MD, FACR REFERENCES 1. National Council on Radiation Protection and Measurements, NCRP Report No. 174. Preconception and Prenatal Radiation Exposure: Health Effects and Protective Guidance : Recommendations of the National Council on Radiation Pretection and Measurements,. Bethesda. Md,2013. 2. American College of Radiology. ACR manual on contrast media. 2016; Version 10.12. Available at: Available at: https://www.acr.org/Clinical-Resources/Contrast-Manual. Accessed February 20, 2017. 3. Expert Panel on MRS, Kanal E, Barkovich AJ, et al. ACR guidance document on MR safe practices: 2013. J Magn Reson Imaging. 2013;37(3):501-530. 4. International Commission on Radiological Protection. Pregnancy and Medical Radiation. ICRP Publication 84; 2000:1-43. 5. International Commission on Radiological Protection. Biological Effects After Prenatal Irradiation (Embryo and Fetus): ICRP Publication 90; 2003:1-200. 6. National Research Council.