Ultra‐low‐dose chest computed tomography without anesthesia in the assessment of pediatric pulmonary diseases

Abstract

ObjectiveTo evaluate the feasibility of using ultra‐low‐dose computed tomography of the chest with iterative reconstruction without anesthesia for assessment of pulmonary diseases in children. MethodsThis prospective study enrolled 86 consecutive pediatric patients (ranging from 1 month to 18 years) that underwent ultra‐low‐dose computed tomography due to suspicion of pulmonary diseases, without anesthesia and contrast. Parameters used were: 80kVp; 15–30mA; acquisition time, 0.5s; and pitch, 1.375. The adaptive statistical iterative reconstruction technique was used. Subjective visual evaluation and quantitative assessment of image quality were done using a 5‐point scale in 12 different structures of the chest. ResultsMean age was 66 months (interquartile range, 16–147). Final diagnosis was performed in all exams, and 44 (51.2%) were diagnosed with cystic fibrosis, 27 (31.4%) with bronchiolitis obliterans, and 15 (17.4%) with congenital pulmonary airways malformations. Diagnostic quality was achieved in 98.9%, of which 82.6% were considered excellent and 16.3% were slightly blurred but did not interfere with image evaluation. Only one case (1.2%) presented moderate blurring that slightly compromised the image, and previous examinations demonstrated findings compatible with bronchiolitis obliterans. Mean effective radiation dose was 0.39±0.15mSv. Percentages of images with motion artifacts were 0.3% for cystic fibrosis, 1.3% for bronchiolitis obliterans, and 1.1% for congenital pulmonary airways malformations. ConclusionChest ultra‐low‐dose computed tomography without sedation or anesthesia delivering a sub‐millisievert dose can provide image quality to allow identification of common pulmonary anatomy and diseases.