2017
DOI: 10.1259/bjr.20160669
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A prospective evaluation of contrast and radiation dose and image quality in cardiac CT in children with complex congenital heart disease using low-concentration iodinated contrast agent and low tube voltage and current

Abstract: Compared with the standard dose protocol, the use of low tube voltage (80 kVp), low tube current (120 mA) and low-concentration iodinated contrast agent (270 mgI/ml) enables a reduction of 30% in iodine load and 22% in radiation dose while maintaining compatible image quality and diagnostic accuracy. Advances in knowledge: The new cardiac CT scanning protocol can largely reduce the adverse effects of radiation and contrast media to children. Meanwhile, it also can be used effectively to examine complex CHD.

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Cited by 18 publications
(11 citation statements)
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“…MRI and CT showed poorer sensitivity to identify native pulmonary arteries in our patients, and whilst the numbers were too small to allow for a comprehensive comparison, falling acquisition times and the use of CT and MRI imaging without anaesthesia continue to increase their attractiveness in a clinical setting [ 6 , 20 , 21 ]. CT in particular has shown promising results for infants with aortopulmonary collaterals [ 22 ], with the potential for a reduced radiation burden in modern systems [ 23 ]. The potential advantage of cross-sectional imaging providing an initial “roadmap” for subsequent catheterisation was, however, not clearly demonstrated in our series: the mean radiation dose when catheterisation was performed without prior CT/MRI was 87 mGy cm 2 (median 78 mGy cm 2 , range 62–122 mGy cm 2 , n = 3), and 152 mGy cm 2 (median 150 mGy cm 2 , 47–338 mGy cm 2 , n = 10) when cross-sectional imaging was available; the mean anaesthetic time was 110 min (median 108 min, range 40–181 min) versus 86 min (median 99 min, range 40–119 min), respectively ( p = 0.38).…”
Section: Discussionmentioning
confidence: 99%
“…MRI and CT showed poorer sensitivity to identify native pulmonary arteries in our patients, and whilst the numbers were too small to allow for a comprehensive comparison, falling acquisition times and the use of CT and MRI imaging without anaesthesia continue to increase their attractiveness in a clinical setting [ 6 , 20 , 21 ]. CT in particular has shown promising results for infants with aortopulmonary collaterals [ 22 ], with the potential for a reduced radiation burden in modern systems [ 23 ]. The potential advantage of cross-sectional imaging providing an initial “roadmap” for subsequent catheterisation was, however, not clearly demonstrated in our series: the mean radiation dose when catheterisation was performed without prior CT/MRI was 87 mGy cm 2 (median 78 mGy cm 2 , range 62–122 mGy cm 2 , n = 3), and 152 mGy cm 2 (median 150 mGy cm 2 , 47–338 mGy cm 2 , n = 10) when cross-sectional imaging was available; the mean anaesthetic time was 110 min (median 108 min, range 40–181 min) versus 86 min (median 99 min, range 40–119 min), respectively ( p = 0.38).…”
Section: Discussionmentioning
confidence: 99%
“…This represented the characteristic value as well as image noise for that particular region. For each region, the signal-to-noise ratio (SNR) was computed by dividing mean peak enhancement with the standard deviation of the mean peak enhancement of a given region 21 . Contrast-to-noise ratio (CNR) for a particular region was calculated with the following formula: [(mean peak enhancement of that region - mean peak muscle enhancement) / image noise measured in muscle regions] 22 .…”
Section: Methodsmentioning
confidence: 99%
“…Most children can be and should be scanned at lower tube potential (70 to 80 kV) and reduced tube current. 20,81 When information pertaining to cardiac function is not required or can be obtained with other imaging modalities, prospectively ECGtriggered axial or helical mode (such as high pitch on dualsource CT) should be used along with lower tube potential and IR techniques in order to reduce radiation dose. Most CCTA can be routinely obtained at sub-mSv radiation doses in children using prospective ECG-triggered high-pitch DSCT and iterative reconstruction to achieve consistent diagnostic scans.…”
Section: Pediatric Cardiac Computed Tomographymentioning
confidence: 99%
“…Most CCTA can be routinely obtained at sub-mSv radiation doses in children using prospective ECG-triggered high-pitch DSCT and iterative reconstruction to achieve consistent diagnostic scans. 20,69,75,81,82 When cardiac functional information is obligatory, either prospectively ECG-triggered acquisition with a widened acquisition window (also referred to as "padding") or retrospectively ECG-gated acquisition with an aggressive ECG-based tube current modulation should be used along with lower tube potential and optimal scan coverage. 69 …”
Section: Pediatric Cardiac Computed Tomographymentioning
confidence: 99%
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