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Clinical Question Influence on Radiation Dose of Cardiac CT Scan in Children

. 2022 Aug 05 ; 9 (8) : . [epub] 20220805

Status PubMed-not-MEDLINE Language English Country Switzerland Media electronic

Document type Journal Article

Background: To assess the impact of different clinical questions on radiation doses acquired during cardiac computed tomography in children. Methods: A total of 116 children who underwent cardiac CT on a third-generation dual-source CT scanner were included. The clinical questions were divided into three main categories: the extent of scanning in the z-axis, coronary artery assessment and cardiac function assessment. Radiation dose values represented as a dose-length product (DLP) in mGy*cm were recorded from the CT scanner protocols. Results: There were significantly higher doses in cases with cardiac function assessment (median DLP 348 versus 59 mGy*cm, p < 0.01) and in cases with coronary artery assessment (median DLP 133 versus 71 mGy*cm, p < 0.01). Conclusion: The most important factor was the assessment of cardiac function, where the median radiation dose was 4.3× higher in patients with a request for cardiac function assessment. We strongly recommend that clinical requests for cardiac CT should be carefully considered in the paediatric population.

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Stocker T.J., Deseive S., Leipsic J., Hadamitzky M., Chen M.Y., Rubinshtein R., Heckner M., Bax J.J., Fang X.-M., Grove E.L., et al. Reduction in Radiation Exposure in Cardiovascular Computed Tomography Imaging: Results from the PROspective Multicenter Registry on RadiaTion Dose Estimates of Cardiac CT AngIOgraphy iN Daily Practice in 2017 (PROTECTION VI) Eur. Heart J. 2018;39:3715–3723. doi: 10.1093/eurheartj/ehy546. PubMed DOI PMC

Hosseini Nasab S.M.B., Deevband M.R., Shabestani-Monfared A., Hoseini Amoli S.A., Fatehi Feyzabad S.H. Organ Equivalent Dose and Lifetime Attributable Risk of Cancer Incidence and Mortality Associated with Cardiac Ct Angiography. Radiat. Prot. Dosim. 2020;189:213–223. doi: 10.1093/rpd/ncaa033. PubMed DOI

Williams M.C., Stewart C., Weir N.W., Newby D.E. Using Radiation Safely in Cardiology: What Imagers Need to Know. Heart. 2019;105:798–806. doi: 10.1136/heartjnl-2017-312493. PubMed DOI PMC

Alkadhi H., Leschka S. Radiation Dose of Cardiac Computed Tomography—What Has Been Achieved and What Needs to Be Done. Eur. Radiol. 2011;21:505–509. doi: 10.1007/s00330-010-1984-3. PubMed DOI

Halliburton S.S., Abbara S., Chen M.Y., Gentry R., Mahesh M., Raff G.L., Shaw L.J., Hausleiter J. SCCT Guidelines on Radiation Dose and Dose-Optimization Strategies in Cardiovascular CT. J. Cardiovasc. Comput. Tomogr. 2011;5:198–224. doi: 10.1016/j.jcct.2011.06.001. PubMed DOI PMC

Gimelli A., Achenbach S., Buechel R.R., Edvardsen T., Francone M., Gaemperli O., Hacker M., Hyafil F., Kaufmann P.A., Lancellotti P., et al. Strategies for Radiation Dose Reduction in Nuclear Cardiology and Cardiac Computed Tomography Imaging: A Report from the European Association of Cardiovascular Imaging (EACVI), the Cardiovascular Committee of European Association of Nuclear Medicine (EANM), and the European Society of Cardiovascular Radiology (ESCR) Eur. Heart J. 2018;39:286–296. doi: 10.1093/eurheartj/ehx582. PubMed DOI

Podberesky D.J., Angel E., Yoshizumi T.T., Toncheva G., Salisbury S.R., Alsip C., Barelli A., Egelhoff J.C., Anderson-Evans C., Nguyen G.B., et al. Radiation Dose Estimation for Prospective and Retrospective ECG-Gated Cardiac CT Angiography in Infants and Small Children Using a 320-MDCT Volume Scanner. Am. J. Roentgenol. 2012;199:1129–1135. doi: 10.2214/AJR.12.8480. PubMed DOI

Ghoshhajra B.B., Lee A.M., Engel L.-C., Celeng C., Kalra M.K., Brady T.J., Hoffmann U., Westra S.J., Abbara S. Radiation Dose Reduction in Pediatric Cardiac Computed Tomography: Experience from a Tertiary Medical Center. Pediatric Cardiol. 2014;35:171–179. doi: 10.1007/s00246-013-0758-5. PubMed DOI

Meinel F.G., Henzler T., Schoepf U.J., Park P.W., Huda W., Spearman J.V., Dyer K.T., Rao A.G., Hlavacek A.M. ECG-Synchronized CT Angiography in 324 Consecutive Pediatric Patients: Spectrum of Indications and Trends in Radiation Dose. Pediatric Cardiol. 2015;36:569–578. doi: 10.1007/s00246-014-1051-y. PubMed DOI

Liu Y., Li J., Zhao H., Jia Y., Ren J., Xu J., Hao Y., Zheng M. Image Quality and Radiation Dose of Dual-Source CT Cardiac Angiography Using Prospective ECG-Triggering Technique in Pediatric Patients with Congenital Heart Disease. J. Cardiothorac. Surg. 2016;11:47. doi: 10.1186/s13019-016-0460-9. PubMed DOI PMC

Koplay M., Kizilca O., Cimen D., Sivri M., Erdogan H., Guvenc O., Oc M., Oran B. Prospective ECG-Gated High-Pitch Dual-Source Cardiac CT Angiography in the Diagnosis of Congenital Cardiovascular Abnormalities: Radiation Dose and Diagnostic Efficacy in a Pediatric Population. Diagn. Interv. Imaging. 2016;97:1141–1150. doi: 10.1016/j.diii.2016.03.014. PubMed DOI

Barrera C.A., Otero H.J., White A.M., Saul D., Biko D.M. Image Quality and Radiation Dose of ECG-Triggered High-Pitch Dual-Source Cardiac Computed Tomography Angiography in Children for the Evaluation of Central Vascular Stents. Int. J. Cardiovasc. Imaging. 2019;35:367–374. doi: 10.1007/s10554-019-01539-3. PubMed DOI

Hou Q.-R., Gao W., Sun A., Wang Q., Qiu H., Wang F., Hu L., Li J., Zhong Y. A Prospective Evaluation of Contrast and Radiation Dose and Image Quality in Cardiac CT in Children with Complex Congenital Heart Disease Using Low-Concentration Iodinated Contrast Agent and Low Tube Voltage and Current. Br. J. Radiol. 2017;90:20160669. doi: 10.1259/bjr.20160669. PubMed DOI PMC

European Commission . European Guidelines on Diagnostic Reference Levels for Paediatric Imaging. Publications Office of the European Union; Luxembourg: 2018. Radiation Protection; p. 185.

Vañó E., Miller D.L., Martin C.J., Rehani M.M., Kang K., Rosenstein M., Ortiz-López P., Mattsson S., Padovani R., Rogers A., et al. ICRP Publication 135: Diagnostic Reference Levels in Medical Imaging. Ann. ICRP. 2017;46:1–144. doi: 10.1177/0146645317717209. PubMed DOI

The 2007 Recommendations of the International Commission on Radiological Protection. ICRP Publication 103. Ann. ICRP. 2007;37:1–332. doi: 10.1016/j.icrp.2007.10.003. PubMed DOI

Patient Dosimetry for x Rays Used in Medical Imaging. J. ICRU. 2005;5:1–113. doi: 10.1093/jicru/ndi018. PubMed DOI

Trattner S., Chelliah A., Prinsen P., Ruzal-Shapiro C.B., Xu Y., Jambawalikar S., Amurao M., Einstein A.J. Estimating Effective Dose of Radiation From Pediatric Cardiac CT Angiography Using a 64-MDCT Scanner: New Conversion Factors Relating Dose-Length Product to Effective Dose. Am. J. Roentgenol. 2017;208:585–594. doi: 10.2214/AJR.15.15908. PubMed DOI PMC

Rompel O., Glöckler M., Janka R., Dittrich S., Cesnjevar R., Lell M.M., Uder M., Hammon M. Third-Generation Dual-Source 70-KVp Chest CT Angiography with Advanced Iterative Reconstruction in Young Children: Image Quality and Radiation Dose Reduction. Pediatric Radiol. 2016;46:462–472. doi: 10.1007/s00247-015-3510-x. PubMed DOI

Habib Geryes B., Calmon R., Khraiche D., Boddaert N., Bonnet D., Raimondi F. Radiation Dose Reduction in Paediatric Coronary Computed Tomography: Assessment of Effective Dose and Image Quality. Eur. Radiol. 2016;26:2030–2038. doi: 10.1007/s00330-015-4032-5. PubMed DOI

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