Effective Radiation Dose in Computed Tomographic Angiography of the Chest and Diagnostic Cardiac Catheterization in Pediatric Patients

2012 ◽  
Vol 34 (3) ◽  
pp. 518-524 ◽  
Author(s):  
Timotheus G. Watson ◽  
Eugene Mah ◽  
U. Joseph Schoepf ◽  
Lydia King ◽  
Walter Huda ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Cardiac Catheterization ◽  
Pediatric Patients ◽  
Computed Tomographic Angiography ◽  
Effective Radiation Dose ◽  
Computed Tomographic ◽  
Diagnostic Cardiac Catheterization ◽  
Tomographic Angiography ◽  
Effective Radiation

Preoperative Use of CT Angiography in Infants With Coarctation of the Aorta

2017 ◽  
Vol 8 (2) ◽  
pp. 196-202 ◽  
Author(s):  
Kirsten Rose-Felker ◽  
Joshua D. Robinson ◽  
Carl L. Backer ◽  
Cynthia K. Rigsby ◽  
Osama M. Eltayeb ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Surgical Approach ◽  
New Technology ◽  
Three Dimensional ◽  
Coarctation Of The Aorta ◽  
Computed Tomographic Angiography ◽  
Great Vessel ◽  
Z Score ◽  
Computed Tomographic ◽  
Tomographic Angiography

Background: Computed tomographic angiography (CTA) and echocardiography (echo) are used preoperatively in coarctation of the aorta to define arch hypoplasia and great vessel branching. We sought to determine differences in quantitative measurements, as well as surgical utility, between modalities. Methods: Infants (less than six months) with both CTA and echo prior to coarctation repair from 2004 to 2013 were included. Measurements were compared and correlated with surgical approach. Three surgeons reviewed de-identified images to predict approach and characterize utility. Computed tomographic angiography radiation dose was calculated. Results: Thirty-three patients were included. No differences existed in arch measurements between echo and CTA ( z-score: −2.59 vs −2.43; P = .47). No differences between modalities were seen for thoracotomy ( z-score: −2.48 [echo] vs −2.31 [CTA]; P = .48) or sternotomy ( z-score: −3.13 [echo] vs −3.08 [CTA]; P = .84). Computed tomographic angiography delineated great vessel branching pattern in two patients with equivocal echo findings ( P = .60). Surgeons rated CTA as far more useful than echo in understanding arch hypoplasia and great vessel branching in cases where CTA was done to resolve anatomical questions that remain after echo evaluation. Two of three surgeons were more likely to choose the surgical approach taken based on CTA (surgeon A, P = .02; surgeon B, P = .01). Radiation dose averaged 2.5 (1.6) mSv and trended down from 2.9 mSv (1.8 mSv; n = 20) to 1.6 mSv (0.5 mSv; n = 7) ( P = .06) with new technology. Conclusion: Although CTA and echo measurements of the aorta do not differ, CTA better delineates branching and surgeons strongly prefer it for three-dimensional arch anatomy. We recommend CTA for patients with anomalous arch branching patterns, diffuse or complex hypoplasia, or unusual arch morphology not fully elucidated by echo.

Radiation Dose Reduction with a Low-Tube Voltage Technique for Pediatric Chest Computed Tomographic Angiography Based on the Contrast-to-Noise Ratio Index

2018 ◽  
Vol 69 (4) ◽  
pp. 390-396
Author(s):  
Takanori Masuda ◽  
Yoshinori Funama ◽  
Takeshi Nakaura ◽  
Masahiro Tahara ◽  
Yukari Yamashita ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Computed Tomographic Angiography ◽  
Image Noise ◽  
Tube Voltage ◽  
Dose Length Product ◽  
Computed Tomographic ◽  
Low Tube Voltage ◽  
Pediatric Chest ◽  
The Mean ◽  
Tomographic Angiography

Introduction The aim of this study was to evaluate the radiation dose and image quality at low tube-voltage pediatric chest computed tomographic angiography (CTA) that applies the same contrast-to-noise ratio (CNR) index as the standard tube voltage technique. Materials and Methods Contrast-enhanced chest CTA scans of 100 infants were acquired on a 64-row multidetector computed tomography (MDCT) scanner. In the retrospective study, we evaluated 50 images acquired at 120 kVp; the image noise level was set at 25 Hounsfield units. In the prospective study, we used an 80-kVp protocol; the image noise level was 40 Hounsfield units because the iodine contrast was 1.6 times higher than on 120-kVp scans; the CNR was as in the 120-kVp protocol. We compared the CT number, image noise, CT dose index volume (CTDIvol), and the dose-length product on scans acquired with the 2 protocols. A diagnostic radiologist and a pediatric cardiologist visually evaluated all CTA images. Results The mean CTDIvol and the mean dose-length product were 0.5 mGy and 7.8 mGy-cm for 80- and 1.2 mGy and 20.8 mGy-cm for 120-kVp scans, respectively ( P < .001). The mean CTDIvol was 42% lower at 80 kVp than at 120 kVp, and there was no significant difference in the visual scores assigned to the CTA images ( P = .28). Conclusions With the CNR index being the same at 80-kVp and 120-kVp imaging, the radiation dose delivered to infants subjected to chest CTA can be reduced without degradation of the image quality.

Perioperative Anomalous Pulmonary Venous Return Evaluation With Low-Dose Cardiac Computed Tomography

2021 ◽  
Vol 12 (4) ◽  
pp. 529-534
Author(s):  
Li Xiong ◽  
Mehul D. Patel ◽  
Gurur Biliciler-Denktas ◽  
Ali Dodge-Khatami ◽  
Jorge Salazar ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Low Dose ◽  
Cardiac Ct ◽  
Venous Return ◽  
Venous Anatomy ◽  
Effective Radiation Dose ◽  
Computed Tomographic ◽  
Anomalous Pulmonary Venous Return ◽  
Effective Radiation ◽  
In Infants And Children

Background: Low-dose multidetector computed tomographic angiography (MDCTA) is playing an increasingly larger role in the diagnosis of anomalous pulmonary venous return (APVR). Despite advances in new computed tomographic (CT) techniques with radiation dose reduction, there are limited studies describing radiation dose parameters to allow routine use of cardiac CT in infants and children with APVR. This study compares cardiac CT findings with intraoperative findings and describes comprehensive radiation exposure parameters. Methods: A retrospective analysis of 27 patients compared MDCTA and intraoperative or cardiac catheterization findings of the pulmonary venous anatomy. Results: A total of 32 MDCTA studies were performed on these 27 patients. Of the 28 studies with subsequent intervention, MDCTA accurately diagnosed the anomalous pulmonary venous anatomy in 27 (96.4%) patients. Narrowing of the pulmonary venous confluence entrance to the coronary sinus was missed on cardiac CT in one patient due to motion artifact, but it was noted intraoperatively. Median estimated effective radiation dose was 0.98 mSv (range: 0.39-3.2 mSv), and mean estimated effective radiation dose was 1.1 ± 0.68 mSv. Median total dose length product (DLP) was 25 mGy cm (range: 10-83 mGy cm), and mean total DLP was 28 ± 18 mGy cm. Median CTDI volume was 3.8 mGy (range: 2.5-14.6 mGy), and mean CTDI volume was 5.0 ± 3.2 mGy. Conclusions: We conclude that modern cardiac MDCTA is the best imaging modality to guide management in both preintervention and postintervention APVR patients. In this study, we describe comprehensive radiation exposure parameters in infants and children with APVR.

scholarly journals Total Anomalous Pulmonary Venous Connection in Children: Preoperative Evaluation with Low-Dose Multidetector Computed Tomographic Angiography

2017 ◽  
Vol 44 (2) ◽  
pp. 120-126 ◽  
Author(s):  
Aysel Turkvatan ◽  
Hasan Tahsin Tola ◽  
Pelin Ayyildiz ◽  
Erkut Ozturk ◽  
Yakup Ergul ◽  
...  
Keyword(s):  
Pediatric Population ◽  
Preoperative Evaluation ◽  
Computed Tomographic Angiography ◽  
Imaging Method ◽  
Effective Radiation Dose ◽  
Computed Tomographic ◽  
Dual Source ◽  
Tomographic Angiography ◽  
Anomalous Pulmonary Venous Connection ◽  
Cardiovascular Anomalies

We report the results of our retrospective evaluation, from February 2011 through August 2014, of the anatomic features of total anomalous pulmonary venous connection (TAPVC) and its associated cardiovascular anomalies in a pediatric population. In all 43 patients under study (23 female; average age, 9 mo [range, 4 d–7.1 yr]), these examinations had been performed with a dual-source 256-detector scanner. The type of TAPVC, the presence of obstruction, and the association with other cardiovascular anomalies were investigated and recorded. In accordance with the absence or presence of these accompanying anomalies, patients were subdivided into 2 groups: isolated and complex. In the 43 patients, 22 (51%) TAPVCs were supracardiac, 10 (23%) were cardiac, 6 (14%) were infracardiac, and 5 (12%) were mixed. Obstruction was detected in 7 patients. Seventeen patients were in the isolated group and 26 in the complex group. The diagnostic agreements between multidetector computed tomographic angiographic and surgical results were 100% in both the isolated and complex groups. The overall average effective radiation dose was 0.66 mSv (range, 0.15–1.11 mSv); and it was 0.52 mSv (range, 0.12–0.72 mSv) in patients younger than 1 year of age. We conclude that computed tomographic angiography with a dual-source 256-slice multidetector scanner is a reliable imaging method that enables, despite lower radiation doses, the detailed and comprehensive anatomic imaging of TAPVC in neonates and children.

Effect of a Standardized Quality-Improvement Protocol on Radiation Dose in Coronary Computed Tomographic Angiography

2010 ◽  
Vol 106 (11) ◽  
pp. 1663-1667 ◽  
Author(s):  
Troy M. LaBounty ◽  
James P. Earls ◽  
Jonathon Leipsic ◽  
Brett Heilbron ◽  
G.B. John Mancini ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Radiation Dose ◽  
Computed Tomographic Angiography ◽  
Coronary Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Tomographic Angiography
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