Prospective ECG-triggering cardiac CT for infants with complex congenital heart disease using low-dose contrast medium, low tube voltage, and adaptive statistical iterative reconstruction

Wang, S.-Y.; Gao, Wei; Zhong, Yu; Sun, Aimin; Wang, Q.; Hu, Liwei; Qiu, Hai-Sheng; Li, J.-Y.

doi:10.1016/j.crad.2017.01.017

Cited by 10 publications

(7 citation statements)

References 27 publications

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“…Similarly, Pache et al [ 12 ] enrolled 64 infants for MDCTs at 80 kV and 60–120 mAs, with a mean CTDIvol, DLP, and ED of 2.1 ± 0.4 mGy, 24.7 ± 5.9 mGy*cm, and 1.6 ± 0.3 mSv, respectively. In addition, Wang et al [ 25 ] found that performing cardiac CTs at 80 kVp and 120 mAs resulted in a mean ED of 0.55 ± 0.10 mSv. In line with previous studies [ 26 , 27 ], we found that diagnostic quality is not impaired if automated tube-current modulation is used.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Validity and Reliability of Low-Dose Prospective ECG-Triggering Cardiac CT in Preoperative Assessment of Complex Congenital Heart Diseases (CHDs)

et al. 2022

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For the precise preoperative evaluation of complex congenital heart diseases (CHDs) with reduced radiation dose exposure, we assessed the diagnostic validity and reliability of low-dose prospective ECG-gated cardiac CT (CCT). Forty-two individuals with complex CHDs who underwent preoperative CCT as part of a prospective study were included. Each CCT image was examined independently by two radiologists. The primary reference for assessing the diagnostic validity of the CCT was the post-operative data. Infants and neonates were the most common age group suffering from complex CHDs. The mean volume of the CT dose index was 1.44 ± 0.47 mGy, the mean value of the dose-length product was 14.13 ± 5.4 mGy*cm, and the mean value of the effective radiation dose was 0.58 ± 0.13 mSv. The sensitivity, specificity, PPV, NPV, and accuracy of the low-dose prospective ECG-gated CCT for identifying complex CHDs were 95.6%, 98 %, 97 %, 97%, and 97% for reader 1 and 92.6%, 97%, 95.5%, 95.1%, and 95.2% for reader 2, respectively. The overall inter-reader agreement for interpreting the cardiac CCTs was good (κ = 0.74). According to the results of our investigation, low-dose prospective ECG-gated CCT is a useful and trustworthy method for assessing coronary arteries and making a precise preoperative diagnosis of complex CHDs.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Validity and Reliability of Low-Dose Prospective ECG-Triggering Cardiac CT in Preoperative Assessment of Complex Congenital Heart Diseases (CHDs)

et al. 2022

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“…Previous studies have shown that exposure to ionizing radiation has a significant effect on the growth of children 24,25 . Importantly, compared with adults, children are more sensitive to radiation and have a greater number of remaining years of life to develop potential radiation injuries 26 . Epidemiological data suggest that the lowest dose of radiation for exists of increased risks in human populations is 10 to 50 mSv for an acute exposure and 50 to 100 mSv for a protracted exposure.…”

Section: Discussionmentioning

confidence: 99%

“…24,25 Importantly, compared with adults, children are more sensitive to radiation and have a greater number of remaining years of life to develop potential radiation injuries. 26 Epidemiological data suggest that the lowest dose of radiation for exists of increased risks in human populations is 10 to 50 mSv for an acute exposure and 50 to 100 mSv for a protracted exposure. The fact that risks cannot be directly estimated at doses below 5 mSv, and it does not imply any conclusion as to whether risks actually exist at these lower doses.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of Cardiac Computed Tomography for the Evaluation of Ventricular Function in Postoperative Children With Congenital Heart Disease: Comparison With Cardiac Magnetic Resonance Imaging

Xie

Guo

et al. 2021

J Comput Assist Tomogr

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ObjectiveWe explored the feasibility of cardiac computed tomography (CCT) to evaluate postoperative ventricular function in children with congenital heart disease (CHD) and evaluated the accuracy and reproducibility of CCT using cardiac magnetic resonance (CMR) as a reference.MethodsThirty-two postoperative children with CHD (20 boys and 12 girls) who underwent CMR and CCT were enrolled. Left and right ventricular ejection fraction, end-diastolic volume, end-systolic volume, stroke volume, and cardiac index were measured using cardiac function analysis software. Cardiac function data were compared between CMR and CCT. The agreement between the 2 modalities was assessed using a Bland-Altman analysis. Intraclass correlation coefficients were used to assess intraobserver and interobserver reproducibility in CCT functional measurements.ResultsAll functional parameters showed no significant difference (P > 0.05) and were well-correlated (r > 0.5, P < 0.05) between CMR and CCT. The mean values of all ventricular function parameters in CCT were higher compared with CMR. As indicated by 95% limits of agreement, left ventricular function parameters showed a better level of agreement compared with right ventricular function parameters between the 2 modalities. Intraobserver and interobserver reproducibility were excellent in CCT measurements for all functional parameters (intraclass correlation coefficient > 0.9).ConclusionsCompared with the criterion standard of CMR, CCT is feasible for assessing postoperative ventricular function with sufficient diagnostic accuracy and reproducibility in children with CHD. In addition to its important role regarding anatomical characterization, CCT is a suitable alternative and convenient follow-up tool that can be used to functional evaluation in children who are intolerant with CMR or have contraindications to CMR.

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“…Goo[6] used cardiac CT (CCT) to explore the visibility of the coronary arteries in children with Kawasaki disease at different ages. Wang [7] reported that electrocardiogram (ECG)triggered CCT combined with a low tube voltage, low-dose contrast agent, and adaptive statistical iterative reconstruction (ASIR) resulted in a radiation dose of less than 1 mSv for CCT examinations in infants. Reports on new-generation CT with lower radiation and contrast dose for coronary artery disease in neonates are few.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of using sub-milliSievert prospective electrocardiogram-triggered cardiac CT for imaging neonatal coronary arteries

nie,

he,

wang

et al. 2024

Preprint

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Objectives: To evaluate the feasibility of imaging coronary arteries in neonates with congenital heart disease (CHD) using sub-mSv prospective electrocardiogram (ECG)-triggered coronary CT. Materials & Methods: We retrospectively reviewed neonatal coronary CT images performed on a 16cm-wide detector CT system at a single center from March 2021 to March 2022. Low-dose prospective ECG-triggering coronary CT was performed, and images were reconstructed using an adaptive statistical iterative reconstruction algorithm. Subjective image quality was assessed using a five-point grading scale. Objective image quality was assessed using the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) of the aortic root and beam hardening artifacts. Images were compared among neonates of different groups according to weight, birth history, pulmonary infection, and tracheal intubation. Results: Sixty-one participants were included. The incidence of coronary artery anomalies in neonates was 4.92% (3/61). The effective dose was 0.42±0.06mSv, and most images were acceptable for diagnosis, with good agreement between reviewers (κ=0.55–0.67). The visualization rate for the proximal vessel segments and all vessel segments was 90.98% and 81.79%, respectively. Aortic root SNR, CNR were adequately high at 17.33±5.32HU and 22.41±4.31 HU, respectively, and beam hardening artifacts were low at 26.22±11.24 HU. No significant difference in the image quality of the coronary arteries was found between patients of different groups (P>0.05). Conclusion: Sub-millisievert prospective ECG-triggered coronary CT provides excellent coronary visualization in neonates with CHD and may confirm the diagnosis of coronary anomalies. Image quality was not affected by weight, birth history, pulmonary infection, or intubation. Clinical Relevance Statement: sub-millisievert electrocardiograph-triggered cardiac CT provides excellent coronary visualization in neonates with CHD and confirm the diagnosis of coronary anomalies.

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Prospective ECG-triggering cardiac CT for infants with complex congenital heart disease using low-dose contrast medium, low tube voltage, and adaptive statistical iterative reconstruction

Cited by 10 publications

References 27 publications

Diagnostic Validity and Reliability of Low-Dose Prospective ECG-Triggering Cardiac CT in Preoperative Assessment of Complex Congenital Heart Diseases (CHDs)

Diagnostic Validity and Reliability of Low-Dose Prospective ECG-Triggering Cardiac CT in Preoperative Assessment of Complex Congenital Heart Diseases (CHDs)

Feasibility of Cardiac Computed Tomography for the Evaluation of Ventricular Function in Postoperative Children With Congenital Heart Disease: Comparison With Cardiac Magnetic Resonance Imaging

Feasibility of using sub-milliSievert prospective electrocardiogram-triggered cardiac CT for imaging neonatal coronary arteries

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