title: Trends in the utilization of computed tomography and cardiac catheterization among children with congenital heart disease.
abstract: OBJECTIVE
  Pediatric cardiac computed tomography (CT) is a noninvasive imaging modality used to clearly demonstrate the anatomical detail of congenital heart diseases. We investigated the impact of cardiac CT on the utilization of cardiac catheterization among children with congenital heart disease.
  
  
  METHODS
  The study sample consisted of 2648 cardiac CT and 3814 cardiac catheterization from 1999 to 2009 for congenital heart diseases. Diagnoses were categorized into 11 disease groups. The numbers of examination, according to the different modalities, were compared using temporal trend analyses. The estimated effective radiation doses (mSv) of CT and catheterization were calculated and compared.
  
  
  RESULTS
  The number of CT scans and interventional catheterizations had a slight annual increase of 1.2% and 2.7%, respectively, whereas that of diagnostic catheterization decreased by 6.2% per year. Disease groups fell into two categories according to utilization trend differences between CT and diagnostic catheterization. The increased use of CT reduces the need for diagnostic catheterization in patients with atrioventricular connection disorder, coronary arterial disorder, great vessel disorder, septal disorder, tetralogy of Fallot, and ventriculoarterial connection disorder. Clinicians choose either catheterization or CT, or both examinations, depending on clinical conditions, in patients with semilunar valvular disorder, heterotaxy, myocardial disorder, pericardial disorder, and pulmonary vein disorder. The radiation dose of CT was lower than that of diagnostic cardiac catheterization in all age groups.
  
  
  CONCLUSIONS
  The use of noninvasive CT in children with selected heart conditions might reduce the use of diagnostic cardiac catheterization. This may release time and facilities within the catheterization laboratory to meet the increasing demand for cardiac interventions.
authors.affiliation: Institute of Biomedical Engineering, College of Engineering and College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan; College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Medical Imaging, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan; Department of Radiology, National Taiwan University Hospital, Chu-Tung Branch, Hsinchu, Taiwan.
authors.forename: Justin Cheng-Ta
authors.initials: JC
authors.lastname: Yang
authors.affiliation: College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Ming-Tai
authors.initials: MT
authors.lastname: Lin
authors.affiliation: Institute of Biomedical Engineering, College of Engineering and College of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Fu-Shan
authors.initials: FS
authors.lastname: Jaw
authors.affiliation: Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: james_5586@hotmail.com.
authors.forename: Shyh-Jye
authors.initials: SJ
authors.lastname: Chen
authors.affiliation: College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Jou-Kou
authors.initials: JK
authors.lastname: Wang
authors.affiliation: Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Tiffany Ting-Fang
authors.initials: TT
authors.lastname: Shih
authors.affiliation: College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Mei-Hwan
authors.initials: MH
authors.lastname: Wu
authors.affiliation: Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Yiu-Wah
authors.initials: YW
authors.lastname: Li
mesh_terms: D000293:Adolescent; D006328:Cardiac Catheterization / Q000706:statistics & numerical data* / Q000639:trends*; D002648:Child; D002675:Child, Preschool; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D005260:Female; D006330:Heart Defects, Congenital / Q000145:classification / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D013624:Taiwan; D062606:Tertiary Care Centers; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data* / Q000639:trends*
keywords: cardiac catheterization; children; congenital heart disease; multidetector computed tomography; utilization