title: Image quality and radiation dose of dual-source CT cardiac angiography using prospective ECG-triggering technique in pediatric patients with congenital heart disease.
abstract: BACKGROUND
  All studies involving use of ionizing radiation should be performed in accordance with the ALARA (As Low As Reasonably Achievable) principle, especially in children. In this study, the prospective ECG triggering technique with low voltage was used in dual-source computed tomography (DSCT) angiography to investigate if image quality with low radiation dose could be satisfactory in pediatric patients with congenital heart disease.
  
  
  METHODS
  Sixty pediatric patients with suspected congenital cardiovascular anomalies were enrolled prospectively in the study. They were randomly assigned to two groups for DSCT angiography. Group A were scanned by prospective ECG-triggering computed tomography angiography (CTA) with 80 kV tube voltage, while group B by used non-ECG-gated CTA with the same tube voltage. The anomaly accuracy was evaluated based on the surgical and/or conventional cardiac angiography findings. The overall image quality was assessed on a five-point scale. And the diagnostic accuracy and radiation dose was evaluated in both groups.
  
  
  RESULTS
  There were 127 cardiovascular anomalies in Group A and 108 in Group B. The mean subjective image quality and diagnostic accuracy between these two groups were significantly different (P = 0.007 and 0.011, respectively). The mean effective dose in Group A and Group B was 0.38 ± 0.13 mSv and 0.35 ± 0.17 mSv, respectively. But there was no significant difference between two groups (P = 0.197).
  
  
  CONCLUSIONS
  The prospective ECG triggering technique in DSCT scan can offer better image quality and diagnostic accuracy with low radiation exposure in pediatric patients with congenital heart diseases. This technique has potential to become a new clinical routine in pediatric cardiac computed tomography (CT) imaging.
authors.affiliation: Department of Radiology, Xijing Hospital, Fourth Military Medical University, 169 West Changle Road, Xi'an, 710032, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Radiology, Xijing Hospital, Fourth Military Medical University, 169 West Changle Road, Xi'an, 710032, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Radiology, Xijing Hospital, Fourth Military Medical University, 169 West Changle Road, Xi'an, 710032, China.
authors.forename: Hongliang
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Siemens China Ltd., Shang Hai, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Jia
authors.affiliation: Department of Radiology, Xijing Hospital, Fourth Military Medical University, 169 West Changle Road, Xi'an, 710032, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Ren
authors.affiliation: Department of Radiology, Xijing Hospital, Fourth Military Medical University, 169 West Changle Road, Xi'an, 710032, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Radiology, Xijing Hospital, Fourth Military Medical University, 169 West Changle Road, Xi'an, 710032, China.
authors.forename: Yuewen
authors.initials: Y
authors.lastname: Hao
authors.affiliation: Department of Radiology, Xijing Hospital, Fourth Military Medical University, 169 West Changle Road, Xi'an, 710032, China. zhengmw2007@163.com.
authors.forename: Minwen
authors.initials: M
authors.lastname: Zheng
mesh_terms: D002675:Child, Preschool; D017023:Coronary Angiography / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011829:Radiation Dosage; D011856:Radiographic Image Enhancement / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Congenital heart disease; Dual-source CT; Radiation dose