title: High-pitch computed tomography of the lung in pediatric patients: an intraindividual comparison of image quality and radiation dose to conventional 64-MDCT.
abstract: OBJECTIVE
  The aim of this study was to investigate frequencies of typical artifacts in low-dose pediatric lung examinations using high-pitch computed tomography (HPCT) compared to MDCT, and to estimate the effective radiation dose (Eeff).
  
  
  METHODS
  Institutional review board approval for this retrospective study was obtained. 35 patients (17 boys, 18 girls; mean age 112 ± 69 months) were included and underwent MDCT and follow-up scan by HPCT or vice versa (mean follow-up time 87 days), using the same tube voltage and current. The total artifact score (0 - 8) was defined as the sum of artifacts arising from movement, breathing or pulsation of the heart or pulmonary vessels (0 - no; 1 - moderate; 2 - severe artifacts). Eeff was estimated according to the European Guidelines on Quality Criteria for Multislice Computed Tomography. The Mann-Whitney U test was used to analyze differences between the patient groups. The Spearman's rank correlation coefficient was used for correlation of ordinal variables.
  
  
  RESULTS
  The scan time was significantly lower for HPCT compared to MDCT (0.72 ± 0.13 s vs. 3.65 ± 0.81s; p < 0.0001). In 28 of 35 (80 %) HPCT examinations no artifacts were visible, whereas in MDCT artifacts occurred in all examinations. The frequency of pulsation artifacts and breathing artifacts was higher in MDCT compared to HPCT (100 % vs. 17 % and 31 % vs. 6 %). The total artifact score significantly correlated with the patient's age in MDCT (r = - 0.42; p = 0.01), but not in HPCT (r = - 0.32; p = 0.07). The estimated Eeff was significantly lower in HPCT than in MDCT (1.29 ± 0.31 vs. 1.47 ± 0.37 mSv; p < 0.0001).
  
  
  CONCLUSIONS
  Our study indicates that the use of HPCT has advantages for pediatric lung imaging with a reduction of breathing and pulsation artifacts. Moreover, the estimated Eeff was lower. In addition, examinations can be performed without sedation or breath-hold without losing image quality.
  
  
  CONCLUSIONS
  • Fewer artifacts in pediatric lung imaging with HPCT• Reduced Eeff in HPCT• HPCT without sedation or breath-hold without loss of image quality.
authors.affiliation: Diagnostic and Interventional Radiology, University Hospital of Tuebingen.
authors.forename: I
authors.initials: I
authors.lastname: Tsiflikas
authors.affiliation: Diagnostic and Interventional Radiology, University Hospital of Tuebingen.
authors.forename: C
authors.initials: C
authors.lastname: Thomas
authors.affiliation: Diagnostic and Interventional Radiology, University Hospital of Tuebingen.
authors.forename: D
authors.initials: D
authors.lastname: Ketelsen
authors.affiliation: Pediatric Surgery, University Hospital of Tuebingen.
authors.forename: G
authors.initials: G
authors.lastname: Seitz
authors.affiliation: Pediatric Surgery, University Hospital of Tuebingen.
authors.forename: S
authors.initials: S
authors.lastname: Warmann
authors.affiliation: Diagnostic and Interventional Radiology, University Hospital of Tuebingen.
authors.forename: C D
authors.initials: CD
authors.lastname: Claussen
authors.affiliation: Diagnostic and Interventional Radiology, University Hospital of Tuebingen.
authors.forename: J F
authors.initials: JF
authors.lastname: Schäfer
mesh_terms: D000293:Adolescent; D016477:Artifacts; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000295:instrumentation / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D007223:Infant; D008171:Lung Diseases / Q000000981:diagnostic imaging*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D061330:Multidetector Computed Tomography / Q000295:instrumentation / Q000379:methods*; D056888:Patient Positioning / Q000295:instrumentation / Q000379:methods; D011829:Radiation Dosage; D012680:Sensitivity and Specificity