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

Abstract

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.

Hip Imaging in Children With Cerebral Palsy

“…Recently, LDCT techniques have been successfully applied to many pediatric and adult populations for various clinical indications 36–42 . The newest CT dose reduction technology is based on photon counting, which has been gaining popularity and is being introduced into the clinical arena by simultaneously touting the additional advantages of high spatial resolution and high contrast-to-noise ratio 43–47 .…”

“…Recently, LDCT techniques have been successfully applied to many pediatric and adult populations for various clinical indications. [36][37][38][39][40][41][42] The newest CT dose reduction technology is based on photon counting, which has been gaining popularity and is being introduced into the clinical arena by simultaneously touting the additional advantages of high spatial resolution and high contrast-to-noise ratio. [43][44][45][46][47] Thus, a potential future line of inquiry would be to investigate the use of photon counting CT for imaging hip surveillance in children with CP, with the hopes of further lowering the radiation exposure to a level comparable to radiography while providing important 3D anatomical details of the hips for diagnosis and presurgical planning.…”

Narrative review of single ventricle: where are we after 40 years?

“…Over the past decade, the field has also seen significant advances in the quality of postnatal diagnosis. The introduction of technological innovations such as three-dimensional echocardiography ( 48 , 49 ) and global longitudinal strain analysis of single ventricle physiology ( 50 ) using low radiation-dose computed tomography ( 51 - 53 ) can provide accurate anatomic delineation of congenital heart defects. Functional assessment of myocardial function, in addition to the echocardiographic investigations, with magnetic resonance imaging ( 54 , 55 ) and the introduction of techniques merging different diagnostic imaging modalities ( 56 ) facilitate operative decision-making, together with 3-D modeling and printing of the heart structures ( 57 , 58 ), as well as computational design of the planned surgical procedure with evaluation of the obtainable sizes of ventricular inflows/outflows and ventricular volumes ( 59 ).…”