One vendor, two centres, three generations of CT hardware - A decade of dose reduction in paediatric cardiothoracic CT

Congress:

EuroSafe Imaging 2017

Poster Number:

ESI-0008

Type:

EuroSafe Imaging

Keywords:

Technical aspects, Audit and standards, CT, Radioprotection / Radiation dose, Paediatric, Cardiac, Action 3 - Image quality assessment based on clinical indications, Action 2 - Clinical diagnostic reference levels (DRLs), Action 6 - Clinical audit tool for imaging, Action 4 - Quality of radiological equipment, Action 3 - Optimisation, diagnostic reference levels, image quality, Action 2 - Clinical audit, Technology assessment, Congenital, Education and training

Authors:

T. R. Semple, T. Minden, N. Gartland, I. Castellano, M. Holubinka, M. Rubens, S. P. G. Padley, E. Nicol, C. Owens

DOI:

10.1594/esi2017/ESI-0008

DOI-Link:

https://dx.doi.org/10.1594/esi2017/ESI-0008

Fig. 1: Volume rendered tomogram and planar reconstructions demonstrating a Sano shunt...

Fig. 2: The dual source scanner geometry, increasing rotation speed and temporal...

Fig. 3: Number of cardiothoracic examinations performed over time and clinical...

Fig. 4: Changing use of GA at a single institution.

Background/Introduction

More traditional adult cardiac CT requires advanced CT technology capable of freezing cardiac motion such that small, mobile coronary arteries are resolved with sufficient detail to allow non-invasive diagnosis of coronary disease. Heart rates are often lowered and coronary arterial caliber maximized via the administration of beta-blockers and sublingual nitrates respectively. Paediatric cardiac CT pushes this technology to the limits of its capability requiring smaller, faster moving structures such as neonatal coronary arteries and pulmonary veins to be frozen in time, often without the aid...

Description of activity and work performed

Both centers make use of automated dose recording / reporting software allowing comparison of three generations of dual source CT scanner; the Definition DS, Definition Flash and Definition Force (Siemens, Erlangen). Whilst clearly only a single vendor has been assessed, it should be noted that we have little to no experience with other CT vendors and similar stepwise innovation has been seen from many other cardiac CT manufacturers. We do not aim to endorse one vendor over another, merely to assess the impact of technologic...

Conclusion and Recommendations

The past 10 years has seen significant advancement in CT technology. In particular, the advent and rapid expansion of cardiac CT, with the ability to assess ever smaller and faster moving cardiac structures, continues to push CT technology to its limits. Step-wise improvements in image quality with ever-decreasing ionizing radiation exposure requirements has lead to a rapid increase in demand for cardiac CT in the paediatric population. The complexity of available cardiac scanning protocols and the particular difficulties of imaging children and young infants requires...

Personal/Organisational information

It is worth re-iterating the fact that we have little to no experience with other CT vendors and similar innovation has been seen from many other cardiac CT manufacturers. We do not aim to endorse one vendor over another, merely to demonstrate the impact of technologic advancement on radiation dose and medical imaging practice and the continued reduction in radiation dose that we believe is, in no small part, driven by close cooperation between radiologists and medical physics experts, jointly endeavoring to optimize technique whilst...

References

Kutanzi, K. R., Lumen, A., Koturbash, I. & Miousse, I. R. Pediatric Exposures to Ionizing Radiation: Carcinogenic Considerations. Int. J. Environ. Res. Public Health 13, (2016). Siemens. Dual Source CT Scanners. Siemens website (2017). Available at: https://www.healthcare.siemens.co.uk/computed-tomography/dual-source-ct. (Accessed: 23rd January 2017) McCollough, C. et al. Measurement of Temporal Resolution in Dual Source CT Using a Visually Intuative Technique. Med Phys. 35, 764–768 (2008).