Low-dose paediatric cardiac CTA examinations and acceptable image quality - mission possible

Congress:

EuroSafe Imaging 2020

Poster Number:

ESI-12123

Type:

EuroSafe Imaging

Keywords:

Action 7 - Radiation protection of children, Cardiac, Paediatric, CT, Contrast agent-intravenous, Diagnostic procedure, Physics, Quality assurance, Prospective, Experimental, Performed at one institution

Authors:

D. Kostova-Lefterova, P. Ilieva, A. Partenova, V. Stoyanova, P. Popeski, B. Bogdanova , K. Genova

DOI:

10.26044/esi2020/ESI-12123

DOI-Link:

https://dx.doi.org/10.26044/esi2020/ESI-12123

Table 1: Set of structures established as diagnostic requirements to assess the...

Fig. 1: No proper sedation - movement during the CT examination. Axial view.

Fig. 2: Example for acceptable image quality with low-dose cardiac CTA. 3D...

Background/introduction

CT angiography (CTA) is modality able to provide excellent vascular diagnosis for paediatric patients with congenital heart diseases.This examination is important in cases of evaluation of patient’s pathology, for the purposes of the interventional and surgery planning and postoperative assessment.The radiation dose from such examinations and the adequate image quality are of a big concern.In contrast to adults, neonates and children aremore radiosensitive and have a longer lifetime to develop potential radiation injuries.Unfortunately, although the paediatric cardiology community has been constantly searching for less-harmful technology,...

Description of activity and work performed

Purpose: The purpose of the study was to develop low dose cardiac CTA (CCTA) protocols for paediatric examinations and achieve acceptable image quality for every single patient. Materials and Methods:Optimized CCTA protocol was continuously developed in the period 2015-2019 on a 64-slice CT scanner, Canon Aqulion, installed in 2008. The CT unit is used for both paediatric and adult examinations. Data for 86 paediatric patients was collected. For each patient the following information was collected: patient age, height and weight; protocol used; quantity and speed...

Conclusion and recommendations

Conclusions: After the implementation of the optimised protocol and the achieved adequate image quality, fewer number of paediatric patients are undergoing interventional CA procedures. The patients’ doses, number of sedations and the cases with patient’s support in the CT room were significantly reduced, A better representation of patient’s congenital heart malformations, for the purposes of the interventional and surgery planning and postoperative assessment have been achieved. Anatomically accurate patient-specific 3D models of congenital heart malformations were also segmented from CTA image data. Recommendations:The department performs...

Personal/organisational information

D. Kostova-Lefterova; Sofia/BG - nothing to disclose P. Ilieva; Sofia/BG - nothing to disclose A. Partenova; Sofia/BG - nothing to disclose V. Stoyanova; Sofia/BG - nothing to disclose B. Bogdanova; Sofia/BG - nothing to disclose P. Popeski; Sofia/BG - nothing to disclose K. Genova; Sofia/BG - nothing to disclose

References

1.Jonathan R. DillmanandRamiro J. Hernandez.Role of CT in the Evaluation of Congenital Cardiovascular Disease in Children.American Journal of Roentgenology. 2009;192: 1219-1231. 10.2214/AJR.09.2382 2.Young, C., Taylor, A.M. & Owens, C.M. Paediatric cardiac computed tomography: a review of imaging techniques and radiation dose consideration.Eur Radiol21,518–529 (2011) doi:10.1007/s00330-010-2036-8