Low-dose paediatric cardiac and thoracic computed tomography with prospective triggering: Is it possible at any heart rate?. (May 2018)

• Record Type: Journal Article
• Authors: Habib Geryes, Bouchra; Calmon, Raphael; Donciu, Victoria; Khraiche, Diala; Warin-Fresse, Karine; Bonnet, Damien; Boddaert, Nathalie; Raimondi, Francesca
• Is Part Of: Physica medica. Volume 49(2018)
• Page Start: 99
• Page End: 104
• Publication Date: 2018-05
• Subjects: ASIR Adaptive Statistical Iterative Reconstruction -- BPM Beats per Minute -- BSA Body Surface Area -- CCTA Cardiac Computed Tomography Angiography -- CTDIvol Computed Tomography Dose Index to the volume -- DLP Dose Length Product -- ECG Electrocardiogram -- ED Effective Dose -- Group D image reconstruction at mid-diastole -- Group S image reconstruction at end-systole -- Group NG not gated scan acquisition -- HR Heart Rate -- IQR Interquartile Range -- SAS Step-And-Shoot -- SD Standard Deviation -- SSDE Size-Specific Dose Estimates; Coronary CT angiography -- Paediatric -- Step and shoot -- Prospective triggering -- Congenital heart disease; Medical physics -- Periodicals; Biophysics -- Periodicals; Biophysics -- Periodicals; Imagerie médicale -- Périodiques; Radiothérapie -- Périodiques; Rayons X -- Sécurité -- Mesures -- Périodiques; Physique -- Périodiques; Médecine -- Périodiques; 610.153
• DOI: 10.1016/j.ejmp.2018.05.015
• Languages: English
• ISSNs: 1120-1797

Abstract

Highlights: CCTA with SAS mode is feasible in children with heart rates greater than 65 bpm. SAS mode is feasible with low dose for thoracic vascular anatomy studies. Radiation dose is less in SAS mode compared to non-gated scans. Abstract: Objective: To demonstrate that the use of step-and-shoot (SAS) mode in paediatric cardiac CT angiography (CCTA) is possible at heart rates (HR) greater than 65 bpm, allowing low-dose acquisition with single-source 64-slices CT. Methods: We retrospectively included 125 paediatric patients (0–6 years). CCTA was performed with SAS at diastolic phase in 31 patients (group D, HR < 65 bpm), at systolic phase in 45 patients (group S, HR ≥ 65 bpm) and with non-gated mode in 49 patients (group NG). Effective dose (ED) and image quality using a 3-grade scoring scale (1, excellent; 2, moderate; 3, insufficient) of group S were compared with group D for coronary examinations and group NG for entire thorax vascular anatomy. Results: For coronary indications, median ED was 0.6 mSv in group D versus 0.9 mSv in group S (p < 0.01). For whole thorax indications, median ED was 2.7 mSv in group NG versus 1.1 mSv in group S (p < 0.001). The mean image quality score was (1.4 ± 0.6) points in group D, (1.4 ± 0.7) in group S for coronary indications (p = 0.9), (1.3 ± 0.6) in group S for whole thorax indications and (2.0 ± 0.0) in group NG (p < 0.001). Conclusion: SAS mode is feasible in children with HR greater than 65 bpm allowing low-dose CCTA. It provided comparable image quality in systole, compared to diastole. SAS at the systolic phase provided better image quality with less radiation dose compared to non-gated scans for whole thorax examinations.