Radiation dose and image quality of 70 kVp functional cardiovascular computed tomography imaging in congenital heart disease

Lesser, Andrew M.; Newell, Marc C.; Samara, Michael A.; Gornick, Charles C.; Grant, Katharine L.; Garberich, Ross; Han, Bo

doi:10.1016/j.jcct.2015.12.009

Cited by 10 publications

(5 citation statements)

References 24 publications

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“…A mean radiation dose of 7.6 mSv was reported in an adult congenital heart disease population comparing quantitative assessment of right ventricular volumes between 256-slice CT and 3-Tesla MRI in 33 patients with surgically repaired Tetralogy of Fallot [24]. A recent study reported a median radiation dose of approximately 1.1 mSv for ventricular function analysis when using a tube potential of 70 kV and tube current modulation [34]. However, the study group did not represent consecutive patients undergoing cardiac CT.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of low radiation dose retrospectively-gated cardiac CT for functional analysis in adult congenital heart disease

Groves

Olivieri

Shanbhag

et al. 2017

International Journal of Cardiology

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Section: Discussionmentioning

confidence: 99%

Feasibility of low radiation dose retrospectively-gated cardiac CT for functional analysis in adult congenital heart disease

Groves

Olivieri

Shanbhag

et al. 2017

International Journal of Cardiology

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“…They found a good correlation to echocardiography at a DLP of 157 mGycm. Lesser et al [9] achieved a DLP of 95 mGycm in 18 adult patients with congenital heart disease, using a similar approach on a Somatom FLASH, but without comparing functional results to any reference. Even though the scanners used in those studies were similar to those used in the present study, they differed in that the full dose was applied in either ED or ES phases, dependent on heart rate.…”

Section: Discussionmentioning

confidence: 99%

“…To be acceptable in clinical practice, a CT-LVEF protocol must be designed to keep the radiation dose as low as reasonably achievable (ALARA) without compromising the accuracy of LVEF measurements. Several studies have described relatively low-dose functional CT protocols [6][7][8][9] for LVEF measurement. These were performed on relatively small cohorts, and where a reference standard was employed, results were compared to other modalities.…”

Section: Introductionmentioning

confidence: 99%

Potential for Dose Reduction in CT-Derived Left Ventricular Ejection Fraction: A Simulation Study

Kusk,

Hess,

Gerke

et al. 2023

Tomography

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Background: Measuring left ventricular ejection fraction (LVEF) is important for detecting heart failure, e.g., in treatment with potentially cardiotoxic chemotherapy. MRI is considered the reference standard for LVEF, but availability may be limited and claustrophobia or metal implants still present challenges. CT has been shown to be accurate and would be advantageous, as LVEF could be measured in conjunction with routine chest–abdomen–pelvis oncology CT. However, the use of CT is not recommended due to the excessive radiation dose. This study aimed to explore the potential for dose reduction using simulation. Using an anthropomorphic heart phantom scanned at 13 dose levels, a noise simulation algorithm was developed to introduce controlled Poisson noise. Filtered backprojection parameters were iteratively tested to minimise differences in myocardium-to-ventricle contrast/noise ratio, as well as structural similarity index (SSIM) differences between real and simulated images at all dose levels. Fifty-one clinical CT coronary angiographies, scanned with full dose through end-systolic and -diastolic phases, were located retrospectively. Using the developed algorithm, noise was introduced corresponding to 25, 10, 5 and 2% of the original dose level. LVEF was measured using clinical software (Syngo.via VB50) with papillary muscles in and excluded from the LV volume. At each dose level, LVEF was compared to the 100% dose level, using Bland–Altman analysis. The effective dose was calculated from DLP using a conversion factor of 0.026 mSv/mGycm. Results: In the clinical images, mean CTDIvol and DLP were 47.1 mGy and 771.9 mGycm, respectively (effective dose 20.0 mSv). Measurements with papillary muscles excluded did not exhibit statistically significant LVEF bias to full-dose images at 25, 10 and 5% simulated dose. At 2% dose, a significant bias of 4.4% was found. With papillary muscles included, small but significant biases were found at all simulated dose levels. Conclusion: Provided that measurements are performed with papillary muscles excluded from the LV volume, the dose can be reduced by a factor of 20 without significantly affecting LVEF measurements. This corresponds to an effective dose of 1 mSv. CT can potentially be used for LVEF measurement with minimal excessive radiation.

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“…A lower tube potential provides the dual advantage of not only providing a higher contrast-to-noise ratio that accentuates iodinated cardiovascular contrast enhancement in CT, but can also be used to lower contrast amounts and radiation dose [139]. Generally 80 kV (or 70 kV if available) is adequate for scanning most infants and children through the first decade of life [140–142]. 100 kV may be needed for larger children or adolescents, especially if examining subtle details such as coronary artery stenosis.…”

Section: Pediatric Cardiac Ct Technique Optimizationmentioning

confidence: 99%

Radiation dose management for pediatric cardiac computed tomography: a report from the Image Gently ‘Have-A-Heart’ campaign

et al. 2018

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Children with congenital or acquired heart disease can be exposed to relatively high lifetime cumulative doses of ionizing radiation from necessary medical imaging procedures including radiography, fluoroscopic procedures including diagnostic and interventional cardiac catheterizations, electrophysiology examinations, cardiac computed tomography (CT) studies, and nuclear cardiology examinations. Despite the clinical necessity of these imaging studies, the related ionizing radiation exposure could pose an increased lifetime attributable cancer risk. The Image Gently "Have-A-Heart" campaign is promoting the appropriate use of medical imaging studies in children with congenital or acquired heart disease while minimizing radiation exposure. The focus of this manuscript is to provide a comprehensive review of radiation dose management and CT performance in children with congenital or acquired heart disease.

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Radiation dose and image quality of 70 kVp functional cardiovascular computed tomography imaging in congenital heart disease

Cited by 10 publications

References 24 publications

Feasibility of low radiation dose retrospectively-gated cardiac CT for functional analysis in adult congenital heart disease

Feasibility of low radiation dose retrospectively-gated cardiac CT for functional analysis in adult congenital heart disease

Potential for Dose Reduction in CT-Derived Left Ventricular Ejection Fraction: A Simulation Study

Radiation dose management for pediatric cardiac computed tomography: a report from the Image Gently ‘Have-A-Heart’ campaign

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