Diagnostic accuracy of lower-dose cardiac CT in evaluating young infants with non-coronary complex congenital heart disease on a 64-slice multidetector CT scanner
Restricted accessResearch articleFirst published online May, 2023
Diagnostic accuracy of lower-dose cardiac CT in evaluating young infants with non-coronary complex congenital heart disease on a 64-slice multidetector CT scanner
Redoable precise and non-invasive diagnostic imaging modality with the least radiation dose is essential for infants with congenital heart disease (CHD) .
Purpose
To investigate the accuracy and estimate the radiation dose of our cardiac computed tomography (CCT) protocol.
Material and Methods
A total of 82 infants with CHD underwent non-ECG-gated CCT without contrast timing scanning techniques and were retrospectively studied. The image quality and radiation dose were estimated. The radiation dose was compared statistically to virtual retrospective ECG-gated and prospective ECG-triggering scanning modes. The diagnostic accuracy was assessed assuming the surgical results as the diagnostic gold standard.
Results
Most exams showed a high quality with low radiation doses compared to previous studies. The mean effective dose (ED) was 0.39 ± 1.2, significantly lower than that of the virtual retrospective ECG-gated and prospective ECG-triggering scanning and lower than in previous studies. Our CCT protocol has achieved a diagnostic accuracy of 99.52% with a sensitivity of 94.83% and specificity of 99.91%.
Conclusion
Non-ECG-gated CCT without contrast timing techniques can detect the non-coronary cardiovascular defects of CHD in infants with an ultralow radiation dose and a high diagnostic accuracy.
ChanFP. MR and CT imaging of the pediatric patient with structural heart disease. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu2009;99–105.
4.
NtsinjanaHNHughesMLTaylorAM. The role of cardiovascular magnetic resonance in pediatric congenital heart disease. J Cardiovasc Magn Reson2011;13:51.
5.
FratzSChungTGreilGF, et al.Guidelines and protocols for cardiovascular magnetic resonance in children and adults with congenital heart disease: SCMR expert consensus group on congenital heart disease. J Cardiovasc Magn Reson2013;15:51.
6.
PrakashAPowellAJGevaT. Multimodality noninvasive imaging for assessment of congenital heart disease. Circ Cardiovasc Imaging2010;3:112–125.
7.
PodbereskyDJAngelEYoshizumiTT, et al.Radiation dose estimation for prospective and retrospective ECG-gated cardiac CT angiography in infants and small children using a 320-MDCT volume scanner. AJR Am J Roentgenol2012;199:1129–1135.
8.
GooHWParkI-SKoJK, et al.Computed tomography for the diagnosis of congenital heart disease in pediatric and adult patients. Int J Cardiovasc Imaging2005;21:347–365.
9.
HallEJ. Lessons we have learned from our children: cancer risks from diagnostic radiology. Pediatr Radiol2002;32:700–706.
10.
BrennerDJEllistonCDHallEJ, et al.Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR Am J Roentgenol2001;176:289–296.
11.
GooHWSuhDS. Tube current reduction in pediatric non-ECG-gated heart CT by combined tube current modulation. Pediatr Radiol2006;36:344–351.
12.
SaakeMLellMMRompelO, et al.Contrast medium application in pediatric high-pitch cardiovascular CT angiography: manual or power injection?J Cardiovasc Comput Tomogr2014;8:315–322.
13.
RaimondiFWarin-FresseK. Computed tomography imaging in children with congenital heart disease: indications and radiation dose optimization. Arch Cardiovasc Dis2016;109:150–157.
14.
AntónioM. New-generation multidetector computed tomography technology for the management of congenital heart disease in children: now we can!Rev Port Cardiol2021;40:591–593.
15.
SchindlerPKehlH-GWildgruberM, et al.Cardiac CT in the preoperative diagnostics of neonates with congenital heart disease: radiation dose optimization by omitting test bolus or bolus tracking. Acad Radiol2020;27:e102–e108.
16.
JadhavSPGolrizFAtwehLA, et al.CT angiography of neonates and infants: comparison of radiation dose and image quality of target mode prospectively ECG-gated 320-MDCT and ungated helical 64-MDCT. AJR Am J Roentgenol2015;204:W184–W191.
17.
ThomasKEWangB. Age-specific effective doses for pediatric MSCT examinations at a large children's hospital using DLP conversion coefficients: a simple estimation method. Pediatr Radiol2008;38:645–656.
18.
GoiteinOSalemYJacobsonJ, et al.The role of cardiac computed tomography in infants with congenital heart disease. Isr Med Assoc J2014;16:147–152.
19.
AndreassiMG. Radiation risk from pediatric cardiac catheterization: friendly fire on children with congenital heart disease. Circ J2009;120:1847–1849.
20.
PearceMSSalottiJALittleMP, et al.Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet2012;380:499–505.
21.
MathewsJDForsytheAVBradyZ, et al.Cancer risk in 680,000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians. BMJ2013;346:f2360.
22.
GooHW. State-of-the-art CT imaging techniques for congenital heart disease. Korean J Radiol2010;11:4–18.
23.
HiraiNHoriguchiJFujiokaC, et al.Prospective versus retrospective ECG-gated 64-detector coronary CT angiography: assessment of image quality, stenosis, and radiation dose. Radiology2008;248:424–430.
24.
YoungCTaylorAMOwensCM. Paediatric cardiac computed tomography: a review of imaging techniques and radiation dose consideration. Eur Radiol2011;21:518–529.
25.
Ben SaadMRohneanASigal-CinqualbreA, et al.Evaluation of image quality and radiation dose of thoracic and coronary dual-source CT in 110 infants with congenital heart disease. Pediatr Radiol2009;39:668–676.
26.
GaoWZhongYMSunAM, et al.Diagnostic accuracy of sub-mSv prospective ECG-triggering cardiac CT in young infant with complex congenital heart disease. Int J Cardiovasc Imaging2016;32:991–998.
27.
LiuYLiJZhaoH, et al.Image quality and radiation dose of dual-source CT cardiac angiography using prospective ECG-triggering technique in pediatric patients with congenital heart disease. J Cardiovasc Surg2016;11:47.
28.
ChengZWangXDuanY, et al.Low-dose prospective ECG-triggering dual-source CT angiography in infants and children with complex congenital heart disease: first experience. Eur Radiol2010;20:2503–2511.
29.
Dodge-KhatamiJAdeboDA. Evaluation of complex congenital heart disease in infants using low dose cardiac computed tomography. Int J Cardiovasc Imaging2021;37:1455–1460.
30.
CannaoPMSecchiFAlìM, et al.High-quality low-dose cardiovascular computed tomography (CCT) in pediatric patients using a 64-slice scanner. Acta Radiol2018;59:1247–1253.
31.
GooHWYangDH. Coronary artery visibility in free-breathing young children with congenital heart disease on cardiac 64-slice CT: dual-source ECG-triggered sequential scan vs. single-source non-ECG-synchronized spiral scan. Pediatr Radiol2010;40:1670–1680.
32.
TsaiICLeeTChenMC, et al.Visualization of neonatal coronary arteries on multidetector row CT: ECG-gated versus non-ECG-gated technique. Pediatr Radiol2007;37:818–825.
