Low-dose paediatric cardiac and thoracic computed tomography with prospective triggering: Is it possible at any heart rate? |
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| Institution: | 1. Hôpital Universitaire Necker Enfants Malades, Service de Radiologie pédiatrique, 149, rue de Sèvres, 75743 Paris Cedex 15, France;2. Hôpital Universitaire Necker Enfants Malades, Unité Médico-Chirurgicale de Cardiologie Congénitale et Pédiatrique, 149, rue de Sèvres, 75743 Paris Cedex 15, France;3. Imagerie Cardiovasculaire, Centre Hospitalier Universitaire de Nantes, Blv Jacques Monod, 44093 Nantes, France;4. Unité Médico-Chirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de référence Malformations Cardiaques Congénitales Complexes – M3C, 149, rue de Sèvres, 75743 Paris Cedex 15, France;5. Université Paris Descartes, Sorbonne Paris Cité, France;6. Hôpital Universitaire Necker Enfants Malades, Service de Radiologie pédiatrique, 149, rue de Sèvres, 75743 Paris Cedex 15, France;7. Hôpital Universitaire Necker Enfants Malades, Service de Radiologie pédiatrique, Unité Médico-Chirurgicale de Cardiologie Congénitale et Pédiatrique, 149, rue de Sèvres, 75743 Paris Cedex 15, France;1. Center for Devices and Radiological Health, FDA, Silver Spring, Maryland;2. ACR, Reston, Virginia;3. Doshi Diagnostic Imaging, New York, New York;1. Department of Cardiology, Boston Children''s Hospital, Boston, MA, USA;2. Department of Pediatrics, Harvard Medical School, Boston, MA, USA;1. Department of Medical Imaging, St Michael’s Hospital, Toronto, Ontario, Canada;2. Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada;3. University of Toronto, Scarborough, Ontario, Canada;4. Keenan Research Centre, Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada;1. Institute of Medical Physics, University of Erlangen-Nürnberg, Germany;2. CT Imaging GmbH, Erlangen, Germany;3. Siemens AG Healthcare Sector, Forchheim, Germany |
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| Abstract: | ObjectiveTo 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.MethodsWe 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.ResultsFor 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).ConclusionSAS 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. |
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| Keywords: | Coronary CT angiography Paediatric Step and shoot Prospective triggering Congenital heart disease |
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