Prospective ECG-gated high-pitch dual-source cardiac CT angiography in the diagnosis of congenital cardiovascular abnormalities: Radiation dose and diagnostic efficacy in a pediatric population

Koplay, Mustafa; Kızılca, Özgür; Çimen, Derya; Sivri, Mesut; Erdoğan, Hasan; Güvenç, Osman; Öç, Mehmet; Oran, Bülent

doi:10.1016/j.diii.2016.03.014

Cited by 23 publications

(9 citation statements)

References 23 publications

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“…Coronary computed tomography angiography (CCTA) is the first-line diagnostic imaging method for children with coronary artery diseases (1)(2)(3), such as those of abnormal origin (4) and coronary aneurysm (5). Reducing radiation and contrast medium doses while providing acceptable image quality (6,7), eliminating motion artifacts (8,9), and maintaining fast and easy operation remains the research focuses.…”

Section: Introductionmentioning

confidence: 99%

Performance evaluation of using shorter contrast injection and 70 kVp with deep learning image reconstruction for reduced contrast medium dose and radiation dose in coronary CT angiography for children: a pilot study

Sun¹,

Li²,

Li³

et al. 2021

Quant Imaging Med Surg

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Background: Iterative reconstruction algorithms are often used to reduce image noise in low-dose coronary computed tomography angiography (CCTA) but encounter limitations. The newly introduced deep learning image reconstruction (DLIR) algorithm may provide new opportunities. We assessed the image quality and diagnostic performance of DLIR in low radiation dose and contrast medium dose CCTA of pediatric patients with 70 kVp and a shortened injection protocol.Methods: This was a prospective study. A total of 27 consecutive arrhythmic pediatric patients were enrolled in the study group and underwent CCTA using a prospective ECG-triggered single-beat protocol: tube voltage 70 kVp, automatic tube current modulation for a noise index (NI) of 22, and contrast dose of 0.4-0.6 mL/kg. Images were reconstructed with DLIR. They were compared with 27 matched patients in the control group scanned with 80 kVp, a lower NI setting (NI =19), and a higher contrast dose (0.8-1.2 mL/kg).The images in the control group were reconstructed using the adaptive statistical iterative reconstruction (ASIR-V) algorithm. The image contrast, image quality, and diagnostic confidence were assessed by 2 experienced radiologists using a 5-point scale (1: nondiagnostic and 5: excellent). The CT value and standard deviation of the aorta and perivascular tissue were measured, and the contrast-to-noise ratio (CNR) for the aorta was calculated. The contrast medium and radiation doses were compared. Results: The study and control groups had similar image contrast scores (4.75±0.57 vs. 4.78±0.42), image quality scores (3.67±0.47 vs. 3.44±0.51), and diagnostic confidence (4.74±0.44 vs. 4.74±0.45) (all P>0.05). There was an adequate enhancement in the aorta (614.74±127.73 vs. 705.89±111.20 HU) and similar CNR (20.34±4.64 vs. 20.99±4.14) in both groups. The image noise of the study group was lower in the aorta (30.61±3.88 vs. 34.77±3.49) and similar in perivascular tissue (27.66±6.24 vs. 27.55±3.33) compared with the control group. The study group reduced the total contrast medium dose by 53% to 15.07±3.68 ml and radiation dose by 36% to 0.57±0.31 mSv. Conclusions:The DLIR algorithm in CCTA for children using 70 kVp tube voltage with a shortened contrast medium injection protocol maintains image quality and diagnostic confidence while significantly reducing contrast medium dose and radiation dose compared with the use of the conventional CCTA protocol.

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Section: Introductionmentioning

confidence: 99%

Performance evaluation of using shorter contrast injection and 70 kVp with deep learning image reconstruction for reduced contrast medium dose and radiation dose in coronary CT angiography for children: a pilot study

Sun¹,

Li²,

Li³

et al. 2021

Quant Imaging Med Surg

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“…Cardiac computed tomography is an excellent imaging modality in patients with CHD, which could reliably visualize pulmonary arterial supply (13,14). Additionally, dual-source computed tomography (DSCT) broadens its application range because of its lower radiation dose and higher density and spatial resolution (15). However, only a few studies explored the value of DSCT for diagnosing PA focusing only on PA with ventricular septal defect (VSD) and MAPCAs (16,17).…”

Section: Introductionmentioning

confidence: 99%

Assessment of Intracardiac and Extracardiac Anomalies in Patients with Various Types of Pulmonary Atresia by Low-dose Dual-source Computed Tomography

Qian

Zhou

Shi

et al. 2021

Preprint

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Background: pulmonary atresia (PA) is a group of heterogeneous complex congenital heart disease which need more than one study modality to get correct diagnoses. This study aims to investigate the diagnostic power of low-dose dual-source computed tomography (DSCT) for all intracardiac and extracardiac anomalies in patients with PA compared with transthoracic echocardiography (TTE).Materials and methods: This retrospective study enrolled 73 patients and divided them into three groups according to their main diagnosis. All associated malformation and clinical information, including treatments, were recorded and compared among the three groups. The diagnostic power of DSCT and TTE on all associated anomalies were compared. The surgical index (McGoon ratio, pulmonary arterials index (PAI), and total neopulmonary arterial index) and radiation dose were calculated on the basis of DSCT.Results: Of the patients, 29, 29, and 15 were divide into the groups of PA with ventricular septal defect (VSD), PA with VSD and major aortopulmonary collateral arteries, and PA with other major malformations, respectively. Consequently, 178, 144, and 12 intracardiac, extracardiac, and other major anomalies were diagnosed, respectively. Moreover, DSCT showed a better diagnostic performance in extracardiac anomalies (137 vs 100, p = 0.000), whereas TTE could diagnose intracardiac anomalies better (158 vs 134, p = 0.001). The McGoon ratio, PAI, and treatment methods were significantly different among the three groups (p = 0.027, p = 0.035, and p = 0.041, respectively).Conclusion: More than one imaging modality should be used to make a correct diagnosis when clinically suspecting PA. DSCT is superior to TTE in diagnosing extracardiac anomalies and could be used to roughly calculate surgical indices to optimize treatment strategy.

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“…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%

“…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%

Recent advances in cardiac computed tomography dose reduction strategies: a review of scientific evidence and technical developments

et al. 2017

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Abstract. Cardiac imagers worldwide are bracing for increased utilization of cardiac computed tomography (CT) in clinical practice. This expanding opportunity brings along a responsibility to produce diagnostic quality images with optimized radiation dose. The following review aims to address the dose reduction strategies in cardiac CT in light of recent scientific evidence and technical developments.

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Prospective ECG-gated high-pitch dual-source cardiac CT angiography in the diagnosis of congenital cardiovascular abnormalities: Radiation dose and diagnostic efficacy in a pediatric population

Cited by 23 publications

References 23 publications

Performance evaluation of using shorter contrast injection and 70 kVp with deep learning image reconstruction for reduced contrast medium dose and radiation dose in coronary CT angiography for children: a pilot study

Performance evaluation of using shorter contrast injection and 70 kVp with deep learning image reconstruction for reduced contrast medium dose and radiation dose in coronary CT angiography for children: a pilot study

Assessment of Intracardiac and Extracardiac Anomalies in Patients with Various Types of Pulmonary Atresia by Low-dose Dual-source Computed Tomography

Recent advances in cardiac computed tomography dose reduction strategies: a review of scientific evidence and technical developments

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