Evaluation of complex congenital heart disease in infants using low dose cardiac computed tomography

Dodge-Khatami, Jannika; Adebo, Dilachew A.

doi:10.1007/s10554-020-02118-7

Cited by 38 publications

(12 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…palliation with Dual Source, prospective ECG-gating, the median effective radiation dose for the computed tomographic angiography (CTA) was 0.32 mSv. Prior studies at our institute evaluating radiation parameters in congenital heart disease demonstrated median estimated effective radiation dose of 0.6 mSv, median total DLP of 13 mGy and median CTDI volume of 3.5 mGy 31. Orly Goitein and hisT A B L E 3 T A B L E 4Comparison of radiation dose parameters33 Our study demonstrates that cardiac CT can be safely used to evaluate perioperative single ventricle patients who are undergoing or have undergone Stage I palliation.…”

mentioning

confidence: 68%

Pre‐ and post‐operative cardiovascular CT in Stage I single ventricle palliation

John¹,

Schoeneberg²,

Greenleaf

et al. 2021

Journal of Cardiac Surgery

Self Cite

View full text Add to dashboard Cite

Objectives: The aim of this study is to describe clinical utility of low dose cardiac computed tomography (CT) in the evaluation of single ventricle physiology before and after Stage I palliation. Background: Despite the increased utilization of CT imaging and advancement of CT technology, there are limited studies describing the routine clinical use of cardiac CT and radiation dose parameters in the single ventricle Stage I palliation. Methods: This single center, retrospective study included 57 infants with single ventricle physiology who underwent cardiac CT scans between January 1, 2016 and November 30, 2020. Patients' demographic information, diagnosis, indication, total dose length product (DLP), computed tomographic dose index volume (CTDIvol), cardiac CT findings and intraoperative or intraprocedural findings were reviewed. Estimated effective radiation dose was calculated using a previously published conversion rate. Results: The studies were performed using different generations of CT scanners over the 4 years period: Somatom AS 128, Somatom definition edge, Somatom Force (Siemens Medical Solutions). The studies performed with dual source scanner with prospective gated technique have lower radiation dose exposure with median effective radiation dose of 0.32 mSv. Conclusion: Pre-and post-operative cardiovascular CT in Stage I single ventricle palliation using newer generation scanners with prospective gated technique can be done with minimal radiation exposure and good image quality. Cardiac CT is a powerful imaging modality for better management planning in this group of patients.

show abstract

mentioning

confidence: 68%

Pre‐ and post‐operative cardiovascular CT in Stage I single ventricle palliation

John¹,

Schoeneberg²,

Greenleaf

et al. 2021

Journal of Cardiac Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…DSCT allows the application of prospective ECG-gated CT in children with high heart rates >100 bpm (27,28). Prospective ECG-triggering CCT allows excellent image quality and high accuracy in a diagnosis of complex CHD for young infants with a sub-mSv effective dose (26,28,29).…”

Section: Discussionmentioning

confidence: 99%

“…We reported a mean effective radiation dose of 0.39 ± 1.2. Table 6 displays previously published radiation doses of CCT studies in young infants applying different ECG-gating techniques, using different scanners, and contrast-timing techniques in the context of our study dose (15,16,18,25–30). Our study’s suggested protocol achieved a low dose of radiation compared to previous studies.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of lower-dose cardiac CT in evaluating young infants with non-coronary complex congenital heart disease on a 64-slice multidetector CT scanner

2022

View full text Add to dashboard Cite

Background Redoable precise and non-invasive diagnostic imaging modality with the least radiation dose is essential for infants with congenital heart disease (CHD) . Purpose To investigate the accuracy and estimate the radiation dose of our cardiac computed tomography (CCT) protocol. Material and Methods A total of 82 infants with CHD underwent non-ECG-gated CCT without contrast timing scanning techniques and were retrospectively studied. The image quality and radiation dose were estimated. The radiation dose was compared statistically to virtual retrospective ECG-gated and prospective ECG-triggering scanning modes. The diagnostic accuracy was assessed assuming the surgical results as the diagnostic gold standard. Results Most exams showed a high quality with low radiation doses compared to previous studies. The mean effective dose (ED) was 0.39 ± 1.2, significantly lower than that of the virtual retrospective ECG-gated and prospective ECG-triggering scanning and lower than in previous studies. Our CCT protocol has achieved a diagnostic accuracy of 99.52% with a sensitivity of 94.83% and specificity of 99.91%. Conclusion Non-ECG-gated CCT without contrast timing techniques can detect the non-coronary cardiovascular defects of CHD in infants with an ultralow radiation dose and a high diagnostic accuracy.

show abstract

“…Over the past decade, our field has also seen significant advances in the quality of post-natal diagnosis. Technological advances in post-natal imaging has been dramatically improved by the introduction of threedimensional echocardiography (16,17), by accurate anatomic definition of congenital heart defects lesions through low radiation dose computed tomography (18)(19)(20), and by the functional assessment of flows and myocardial function with magnetic resonance imaging (21,22). Modern imaging techniques have also allowed for more precise clinical decision-making and planning related to the performance of interventional catheter-based procedures as well as for surgical repair through enhanced imaging techniques with segmentation of the heart structures to facilitate three-dimensional rendering or printing of complex heart anatomy (23,24).…”

Section: Review Methodsmentioning

confidence: 99%

A narrative review of modern approach and outcomes evaluation in congenital heart defects

Corno¹,

LaPar²,

Wen³

et al. 2021

Transl Pediatr

View full text Add to dashboard Cite

Objective: The purpose of this review is to highlight critical advances and innovative approaches to the most challenging clinical situations in congenital heart surgery, to establish a new perspective from which to evaluate current clinical practice patterns and contemporary United States program ranking systems. Background:The past decades have witnessed substantial advances in the treatment of congenital heart defects. New strategies are deeply rooted in calculated risk-taking innovations. Pioneer surgeons developed, improved and refined critical operative skills and techniques to optimize cardiovascular physiology, decrease operative mortality and improve clinical outcomes.Methods: Unfortunately, in the modern surgical era, supportive environments to allow surgeons to make similar gains and innovative contributions remain scarce. In the current practice, overall procedure volume is prioritized to safeguard quality metrics, including hospital survival and length of stay, surgical complications, and neurocognitive outcomes. As a result, exceptional surgical results have become translated and defined by public ranking systems such as the US News and World Report Best Children's Hospital National Ranking (USNWR) and the Congenital Heart Surgery Database of the Society for Thoracic Surgeons (CHSD-STS), primary based upon early post-operative mortality. This reality places surgeons in a vulnerable position where pressure to achieve a high clinical ranking contrasts with a surgeon definition of "acceptable" surgical risk. Currently, the most frequently used risk stratification tools do not factor in important differences in strategies, such as staged palliation versus complete repair, or bi-ventricular versus uni-ventricular physiology. This favors hospitals pursuing multistage surgical approaches, even if the result is worse long-term morbidity, mortality and increased resource utilization. This economy of ranking-based decision-making causes surgeons either avoid operating altogether or accept less advantageous multi-staged treatment strategies for patients with elevated expected mortality. Such an environment also might present much farther-reaching negative impacts on the growth and development of junior surgeons and trainees, as well as on the pursuit of new surgical innovations to aid future generations of patients.Conclusions: Risk aversive surgical behavior is creating an environment not favorable for the children born with truly complex congenital heart defects.

show abstract

Evaluation of complex congenital heart disease in infants using low dose cardiac computed tomography

Cited by 38 publications

References 22 publications

Pre‐ and post‐operative cardiovascular CT in Stage I single ventricle palliation

Pre‐ and post‐operative cardiovascular CT in Stage I single ventricle palliation

Diagnostic accuracy of lower-dose cardiac CT in evaluating young infants with non-coronary complex congenital heart disease on a 64-slice multidetector CT scanner

A narrative review of modern approach and outcomes evaluation in congenital heart defects

Contact Info

Product

Resources

About