Chest CT in infants and children

Lobo, Luísa; Antunes, Dulce

doi:10.1016/j.ejrad.2011.12.006

Cited by 23 publications

(13 citation statements)

References 49 publications

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“…Recently, effective diameter and cross-sectional dimension have been considered as more accurate indicators of body size and habitus [5][6][7]. Also, awareness about variation of organ radiosensitivity across the child age range as well as between genders has been increased [2,4,[23][24][25][26]. The following sections discuss individual scan parameters and other technical considerations for developing protocols specific to age, body size, and composition.…”

Section: Protocols Specific To Age Body Size and Compositionmentioning

confidence: 98%

Pediatric Computed Tomography Dose Optimization Strategies: A Literature Review

Mahrooqi

Sun

2015

Journal of Medical Imaging and Radiation Sciences

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Introduction: Computed tomography (CT) dose optimization is an important issue in radiography because CT is the largest contributor to medical radiation dose and its use is increasing. However, CT dose optimization for pediatric patients could be more challenging than their adult counterparts. The purpose of this literature review was to identify and discuss the current pediatric CT dose saving techniques. Optimized pediatric protocols were also proposed.Methods: A comprehensive literature search was conducted using the Medline, ProQuest Health and Medical Complete, PubMed, ScienceDirect, Scopus, Springer Link, and Web of Science databases and the keywords CT, pediatric, optimization, protocol, and radiation dose to identify articles focusing on pediatric CT dose optimization strategies published between 2004 and 2014.Results and Summary: Seventy-seven articles were identified in the literature search. Strategies for optimizing a range of scan parameters and technical considerations including tube voltage and current, iterative reconstruction, diagnostic reference levels, bowtie filters, scout view, pitch, scan collimation and time, overscanning, and overbeaming for pediatric patients with different ages and body sizes and compositions were discussed. An example of optimized pediatric protocols specific to age and body size for the 64-slice CT scanners was devised. It is expected that this example could provide medical radiation technologists, radiologists, and medical physicists with ideas to optimize their pediatric protocols.

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Section: Protocols Specific To Age Body Size and Compositionmentioning

confidence: 98%

Pediatric Computed Tomography Dose Optimization Strategies: A Literature Review

Mahrooqi

Sun

2015

Journal of Medical Imaging and Radiation Sciences

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“…T echnical developments in multidetector row computed tomography (CT) have enabled the coverage of larger volumes with higher spatial resolution and lower noise, thus greatly improving the ability to image respiratory diseases such as pulmonary infection, bronchial foreign bodies, and congenital airway malformations in the pediatric population. However, infants and young children cannot hold their breath and restrict movement voluntarily, resulting in motion and breathing artifacts that may lead to difficulties in diagnosis (1,2).…”

Section: Patient Informationmentioning

confidence: 99%

Imaging the Infant Chest without Sedation: Feasibility of Using Single Axial Rotation with 16-cm Wide-Detector CT

Zhu

et al. 2018

Radiology

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Purpose To compare image quality, patient preparation time, and radiation dose using a single axial rotation with 16-cm wide-detector computed tomography (CT) in imaging the infant chest without sedation with those in infants examined by using a 64-row CT and sedation. Materials and Methods Thirty-two infants (group 1) were prospectively enrolled to undergo nonenhanced chest CT without sedation using a single axial rotation on a 16-cm wide-detector CT scanner. Patients were imaged with automatic tube current modulation and tube voltages of 80 kVp for patients weighing 5 kg or less and 100 kVp for patients weighing more than 5 kg. Patient preparation time, CT dose index (CTDI), dose-length product (DLP), and image quality were compared with those in a historical control group consisting of 30 infants (group 2) who underwent conventional helical scanning with sedation performed by using a 64-row volume CT scanner. The Student t test for independent samples was used to assess continuous variables. The Mann-Whitney rank test and the κ test were used to evaluate image quality. Results There was no statistically significant difference in body weight, age, mean CT attenuation value, image noise, and subjective image quality score between the two groups. However, compared with the group scanned by using a 64-row volume CT scanner (group 2), group 1 experienced significantly reduced scan time by 83% (0.35 second vs 2.01 seconds ± 0.21 [standard deviation]), preparation time by 57% (41.25 minutes ± 103.78 vs 96.5 minutes ± 151.77), CTDI by 42% (2.03 mGy ± 0.4 vs 3.52 mGy ± 0.03), and DLP by 52% (27.07 mGy·cm ± 6.97 vs 55.84 mGy·cm ± 6.46) (P< .05 for all). Conclusion Compared with conventional 64-row helical CT with sedation, use of a single axial rotation with 16-cm wide-detector CT in imaging the infant chest without sedation can reduce radiation dose, preparation time, and total scan time, while providing comparable image quality. RSNA, 2017.

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“…In the last decades, computed tomography (CT) has emerged as a basic diagnostic tool in the evaluation of thoracic disease in many clinical subgroups of children. It plays a significant role in the characterization of various pulmonary and mediastinal pathologies and pleural and chest wall anomalies [1][2][3]. Therefore, there is no doubt about the efficacy of pediatric chest CT [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…As an essential factor, numerous studies have been published dealing with technical aspects, radiation exposure, or specific chest pathologies in children [3,15,16]. However, no study has analyzed the effectiveness of pediatric chest CT considering the relevance of findings with respect to the referring question to the best of our knowledge.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Chest CT in Children: CT Findings in Relation to the Clinical Question

Esser

Tsiflikas

Kraus

et al. 2021

Rofo

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Purpose To estimate the effectiveness and efficiency of chest CT in children based on the suspected diagnosis in relation to the number of positive, negative, and inconclusive CT results. Materials and Methods In this monocentric retrospective study at a university hospital with a division of pediatric radiology, 2019 chest CT examinations (973 patients; median age: 10.5 years; range: 2 days to 17.9 years) were analyzed with regards to clinical data, including the referring department, primary questions or suspected diagnosis, and CT findings. It was identified if the clinical question was answered, whether the suspected diagnosis was confirmed or ruled out, and if additional findings (clinically significant or minor) were detected. Results The largest clinical subgroup was the hematooncological subgroup (n = 987), with frequent questions for inflammation/pneumonia (66 % in this subgroup). Overall, CT provided conclusive results in 97.6 % of all scans. In 1380 scans (70 %), the suspected diagnosis was confirmed. In 406/2019 cases (20 %), the CT scan was negative also in terms of an additional finding. In 8 of 9 clinical categories, the proportion of positive results was over 50 %. There were predominantly negative results (110/179; 61 %) in pre-stem cell transplant evaluation. In the subgroup of trauma management, 81/144 exams (57 %) showed positive results, including combined injuries (n = 23). 222/396 (56 %) of all additional findings were estimated to be clinically significant. Conclusion In a specialized center, the effectiveness of pediatric chest CT was excellent when counting the conclusive results. However, to improve efficiency, the clinical evaluation before imaging appears crucial to prevent unnecessary CT examinations. Key Points: Citation Format

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Chest CT in infants and children

Cited by 23 publications

References 49 publications

Pediatric Computed Tomography Dose Optimization Strategies: A Literature Review

Pediatric Computed Tomography Dose Optimization Strategies: A Literature Review

Imaging the Infant Chest without Sedation: Feasibility of Using Single Axial Rotation with 16-cm Wide-Detector CT

Effectiveness of Chest CT in Children: CT Findings in Relation to the Clinical Question

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