title: Radiation dose reduction in paediatric coronary computed tomography: assessment of effective dose and image quality.
abstract: OBJECTIVE
  To assess the impact of different protocols on radiation dose and image quality for paediatric coronary computed tomography (cCT).
  
  
  METHODS
  From January-2012 to June-2014, 140 children who underwent cCT on a 64-slice scanner were included. Two consecutive changes in imaging protocols were performed: 1) the use of adaptive statistical iterative reconstruction (ASIR); 2) the optimization of acquisition parameters. Effective dose (ED) was calculated by conversion of the dose-length product. Image quality was assessed as excellent, good or with significant artefacts.
  
  
  RESULTS
  Patients were divided in three age groups: 0-4, 5-7 and 8-18 years. The use of ASIR combined to the adjustment of scan settings allowed a reduction in the median ED of 58 %, 82 % and 85 % in 0-4, 5-7 and 8-18 years group, respectively (7.3 ± 1.4 vs 3.1 ± 0.7 mSv, 5.5 ± 1.6 vs 1 ± 1.9 mSv and 5.3 ± 5.0 vs 0.8 ± 2.0 mSv, all p < 0,05). Prospective protocol was used in 51 % of children. The reduction in radiation dose was not associated with reduction in diagnostic image quality as assessed by the frequency of coronary segments with excellent or good image quality (88 %).
  
  
  CONCLUSIONS
  cCT can be obtained at very low radiation doses in children using ASIR, and prospective acquisition with optimized imaging parameters.
  
  
  CONCLUSIONS
  • Using ASIR allows 25 % to 41 % reduction in the ED. • Prospective protocol is used up to 51 % of children after premedication. • Low dose is possible using ASIR and optimized prospective paediatric cCT.
authors.affiliation: Direction de la qualité et de la gestion des risques, Hôpital Universitaire Necker Enfants Malades, 149, rue de Sèvres, 75743, Paris Cedex 15, France.
authors.forename: Bouchra
authors.initials: B
authors.lastname: Habib Geryes
authors.affiliation: Service de Radiologie pédiatrique, Hôpital Universitaire Necker Enfants Malades, 149, rue de Sèvres, 75743, Paris Cedex 15, France.|Sorbonne Paris Cité, Université Paris Descartes, Paris, France.
authors.forename: Raphael
authors.initials: R
authors.lastname: Calmon
authors.affiliation: Unité Médico-Chirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de référence Malformations Cardiaques Congénitales Complexes - M3C, 149, rue de Sèvres, 75743, Paris Cedex 15, France.|Sorbonne Paris Cité, Université Paris Descartes, Paris, France.
authors.forename: Diala
authors.initials: D
authors.lastname: Khraiche
authors.affiliation: Service de Radiologie pédiatrique, Hôpital Universitaire Necker Enfants Malades, 149, rue de Sèvres, 75743, Paris Cedex 15, France.|Sorbonne Paris Cité, Université Paris Descartes, Paris, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Boddaert
authors.affiliation: Unité Médico-Chirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de référence Malformations Cardiaques Congénitales Complexes - M3C, 149, rue de Sèvres, 75743, Paris Cedex 15, France.|Sorbonne Paris Cité, Université Paris Descartes, Paris, France.
authors.forename: Damien
authors.initials: D
authors.lastname: Bonnet
authors.affiliation: Service de Radiologie pédiatrique, Hôpital Universitaire Necker Enfants Malades, 149, rue de Sèvres, 75743, Paris Cedex 15, France. francesca.raimondi@nck.aphp.fr.|Unité Médico-Chirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de référence Malformations Cardiaques Congénitales Complexes - M3C, 149, rue de Sèvres, 75743, Paris Cedex 15, France. francesca.raimondi@nck.aphp.fr.|Sorbonne Paris Cité, Université Paris Descartes, Paris, France. francesca.raimondi@nck.aphp.fr.
authors.forename: Francesca
authors.initials: F
authors.lastname: Raimondi
mesh_terms: D000293:Adolescent; D016477:Artifacts; D002648:Child; D002675:Child, Preschool; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000592:standards
keywords: Angiography; Cardiac computed tomography; Iterative reconstructions and Optimization; Low radiation dose; Paediatrics