Abstract
CT is a ubiquitous, efficient, and cost-effective method to evaluate pediatric ventricular size, particularly in patients with CSF shunt diversion who often need emergent imaging. We therefore sought to determine the minimum dose output or CT dose index required to produce clinically acceptable examinations. Using a validated noise insertion method and CT projection data from 22 patients, standard pediatric head CT images were reconstructed with weighted filtered back-projection and sinogram-affirmed iterative reconstruction corresponding to routine, 25%, and 10% dose. Reconstructed images were then evaluated by 3 neuroradiologists (blinded to dose and reconstruction method) for ventricular size, diagnostic confidence, image quality, evidence of hemorrhage, and shunt tip location, and compared with the reference standard. There was no significant difference in the ventricular size ranking, and the sensitivity for moderate to severe hydrocephalus was 100%. There was no significant difference between the full-dose level and the ventricular size rankings at the 25% or the 10% dose level for either reconstruction kernel (P > .979). Diagnostic confidence was maintained across doses and kernel. Hemorrhage was more difficult to identify as image quality degraded as dose decreased but was still seen in a majority of cases. Shunts were identified by all readers across all doses and reconstruction methods. CT images having dose reductions of 90% relative to routine head CT examinations provide acceptable image quality to address the specific clinical task of evaluating ventricular size.
Highlights
BACKGROUND AND PURPOSECT is a ubiquitous, efficient, and cost-effective method to evaluate pediatric ventricular size, in patients with CSF shunt diversion who often need emergent imaging
There was no significant difference between the full-dose level and the ventricular size rankings at the 25% or the 10% dose level for either reconstruction kernel (P Ͼ .979)
Using validated, reduced dose compared with standard simulation techniques,14 our study demonstrated that a 90% reduction in dose relative to a routine head CT examination was clinically acceptable for the evaluation of ventricular size
Summary
Using a validated noise insertion method and CT projection data from 22 patients, standard pediatric head CT images were reconstructed with weighted filtered back-projection and sinogram-affirmed iterative reconstruction corresponding to routine, 25%, and 10% dose. Minnesota Research Authorization was obtained for each study subject. This study used CT projection data from pediatric head CT using 1 of 2 emergency department CT scanners at our institution. This study was in complete compliance with the Health Insurance Portability and Accountability Act. Patient Population Twenty-two pediatric subjects who underwent noncontrast head CT studies at our institution from August 2012 to March 2013 were included in this study. Patients were excluded if CT projection data were deleted off the scanner image reconstruction system before archiving or if the patient was without the Minnesota Research Authorization. Some of our study subjects had a ventriculostomy device to treat hydrocephalus
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
