Abstract
BackgroundThe aims of this study were to investigate the image quality and radiation exposure of pediatric protocols for cardiac CT angiography (CTA) in infants under one year of age.Methodology/Principal FindingsCardiac CTA examinations were performed using an anthropomorphic phantom representing a 1-year-old child scanned with non-electrocardiogram-gated (NG), retrospectively electrocardiogram-gated helical (RGH) and prospectively electrocardiogram-gated axial (PGA) techniques in 64-slice and 256-slice CT scanners. The thermoluminescent dosimeters (TLD) were used for direct organ dose measurement, while dose-length product and effective mAs were also used to estimate the patient dose. For image quality, noise and signal-to-noise-ratio (SNR) were assessed based on regions-of-interest drawn on the reconstructed CT images, and were compared with the proposed cardiac image quantum index (CIQI). Estimated dose results were in accordant to the measured doses. The NG scan showed the best image quality in terms of noise and SNR. The PGA scan had better image quality than the RGH scan with 83.70% dose reduction. Noise and SNR were also corresponded to the proposed CIQI.Conclusions/SignificanceThe PGA scan protocol was a good choice in balancing radiation exposure and image quality for infant cardiac CTA. We also suggested that the effective mAs and the CIQI were suitable in assessing the tradeoffs between radiation dose and image quality for cardiac CTA in infants. These results are useful for future implementation of dose reduction strategies in pediatric cardiac CTA protocols.
Highlights
Congenital heart disease (CHD) is the most common birth abnormality and the leading cause of death for infants under one year of age
We suggested that the effective mAs and the cardiac image quantum index (CIQI) were suitable in assessing the tradeoffs between radiation dose and image quality for cardiac CT angiography (CTA) in infants
The purpose of this study was to investigate the image quality and radiation dose resulting from various pediatric cardiac CTA techniques, including nonelectrocardiogram-gated (NG), retrospectively electrocardiogram-gated helical (RGH) and prospectively electrocardiogram-gated axial (PGA), performed with 64-slice and 256-slice CT for 1-year old infants
Summary
Congenital heart disease (CHD) is the most common birth abnormality and the leading cause of death for infants under one year of age. With advances in the multi-detector computed tomography (MDCT), the improvement in spatial and temporal resolution has allowed non-invasive evaluation of intrathoracic vessels, airways, cardiac anatomy and coronary arteries in infants with CHD [1]. Infant cardiac computed tomography angiography (CTA) has evolved to play a key role in evaluating complex CHD. Radiation exposure with CTA has become an important issue due to the increased risk of cancer induction [2,3,4,5]. The aims of this study were to investigate the image quality and radiation exposure of pediatric protocols for cardiac CT angiography (CTA) in infants under one year of age
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