Strategies for Dose-Optimized Imaging in Pediatric Cardiac Dual Source CT

Kuettner, Axel; Gehann, B; Spolnik, J; Koch, Andreas; Achenbach, Stephan; Weyand, Michael; Dittrich, Sven; Uder, Michael; Staatz, Gundula

doi:10.1055/s-0028-1109293

Cited by 27 publications

(8 citation statements)

References 32 publications

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“…21 Another study investigating the diagnostic accuracy of prospective electrocardiogram-triggered cardiac computed tomography in 35 children generated a median effective dose of 0.36 (0.25-0.58) millisieverts. 23 Kuettner et al 24 have published effective doses ranging from 0.6 to 3.2 millisieverts in 12 paediatric gated cardiac computed tomography cases, using a dual source scanner. These are marginally lower doses than in this report and may reflect the lower tube voltage (80 kilovolts peak) used in all examinations.…”

Section: Discussionmentioning

confidence: 99%

Cardiac computed tomography and conventional angiography in the diagnosis of congenital cardiac disease in children: recent trends and radiation doses

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Cardiac computed tomography and conventional angiography in the diagnosis of congenital cardiac disease in children: recent trends and radiation doses

et al. 2011

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“…To date, there are few studies that have evaluated the image quality and radiation dose of ECG-gated DSCT protocols in pediatric patients with congenital heart disease [11][12][13]. In this study, we have compared the image quality and radiation dose of ECGgated thoracic DSCT angiography in pediatric patients with congenital heart disease with using two different protocols: (1) an retrospective ECGgated helical scan (the ECG-pulsing protocol) and (2) a prospective ECG-triggering non-helical scan (the step and shoot mode).…”

Section: Introductionmentioning

confidence: 99%

Retrospective versus prospective ECG-gated dual-source CT in pediatric patients with congenital heart diseases: comparison of image quality and radiation dose

Jin

Park

Shin

et al. 2010

Int J Cardiovasc Imaging

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We wanted to compare the image quality and radiation dose of retrospective versus prospective ECG-gated dual-source CT imaging in pediatric patients with congenital heart diseases. We retrospectively evaluated 44 thorax CT images that were obtained using two different protocols (retrospective helical ECG-gated [n = 22] versus prospective non-helical ECG-triggering [n = 22]) in patients younger than 5 years. Two radiologists evaluated the image quality, using a 3- or 4-point scale, in terms of the degree of homogeneity of vascular enhancement, the stair-step artifacts, the subjective image noise and the overall subjective image quality. We compared the mean score of image quality, the frequency of marked stair-step artifact and the estimated radiation dose. The mean score of the homogeneity of vascular enhancement and the stair-step artifacts tended to be higher for the patients in the retrospective group than that for the patients in the prospective group, but this did not reach statistical significance. However, marked stair-step artifacts were significantly more frequent in the prospective scan group than that in the retrospective scan group (25.8 vs. 7.6%, respectively, P < 0.01). The mean scores for subjective image noise and the overall image quality were better in the retrospective group than those scores in the prospective group (P < 0.01). The mean estimated effective dose was higher for the retrospective ECG-gated helical scan than that for the prospective non-helical scan (0.79 vs. 0.21 mSv, respectively, P < 0.01). Retrospective ECG-gated helical dual-source CT using aggressive ECG pulsing can be obtained with an acceptable radiation dose and superior image quality, as compared to the prospective ECG-triggering technique, for the evaluation of congenital heart diseases in pediatric patients who are younger than 5 years old.

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“…First results of use and feasibility of paediatric cardiac DSCT were presented by Kuettner et al [14] in 2008 with good image quality, even in two neonates. In 2009, Ben Saad et al presented a study, in which 110 babies with CHD were enrolled by DSCT.…”

Section: Discussionmentioning

confidence: 99%

Preoperative assessment of the aortic arch in children younger than 1 year with congenital heart disease: utility of low-dose high-pitch dual-source computed tomography. A single-centre, retrospective analysis of 62 cases

Glöckler

Halbfass

Koch

et al. 2013

European Journal of Cardio-Thoracic Surgery

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OBJECTIVES: To evaluate the feasibility, image quality and impact of 3D imaging in low-dose high-pitch dual-source computed tomography (DSCT) to assess arbitrary anatomical malformations of the aortic arch in children <1 year of age with congenital heart disease (CHD). METHODS:Between January 2010 and May 2013, DSCT was performed to assess the aortic arch anatomy in a total of 62 consecutive patients with CHD (aged 0-348 days). DSCT was used whenever conventional echocardiography was not sufficient to display the complex anatomy entirely. Image data acquisition was realized within a single cardiac cycle using prospective ECG triggering. 3D reconstruction for surgical planning was performed. Image quality was assessed retrospectively, using a 4-point scale from '1 = no artefacts' to '4 = uninterpretable'. The accuracy and impact of the 3D reconstructions was compared with intraoperative findings using a 5-point scale (from '1 = essential' to '5 = misleading'). Administered radiation exposure was evaluated. RESULTS:Imaging was successful in all patients, image quality was rated 1.34 on the 4-point scale and the impact of the 3D reconstructions for surgical planning was 2.05 on the 5-point scale. Mean dose-length product was 6.8 ± 2.6 mGy cm, and the effective dose was 0.45 ± 0.13 mSv (0.21-0.74).CONCLUSIONS: DSCT is a fast and appropriate imaging modality in the preoperative assessment of the aortic arch for surgical planning in CHD.

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Strategies for Dose-Optimized Imaging in Pediatric Cardiac Dual Source CT

Abstract: The present study shows that dual source cardiac CT is a potential diagnostic alternative in children with congenital heart disease without excessive radiation exposure or contrast media application.

Cited by 27 publications

References 32 publications

Cardiac computed tomography and conventional angiography in the diagnosis of congenital cardiac disease in children: recent trends and radiation doses

Cardiac computed tomography and conventional angiography in the diagnosis of congenital cardiac disease in children: recent trends and radiation doses

Retrospective versus prospective ECG-gated dual-source CT in pediatric patients with congenital heart diseases: comparison of image quality and radiation dose

Preoperative assessment of the aortic arch in children younger than 1 year with congenital heart disease: utility of low-dose high-pitch dual-source computed tomography. A single-centre, retrospective analysis of 62 cases

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