title: Radiation Dose and Image Quality in Pediatric Cardiac Computed Tomography: A Comparison Between Sequential and Third-Generation Dual-Source High-Pitch Spiral Techniques.
abstract: The aim of this study was to investigate whether there is a reduction in radiation dose and improvement in image quality of pediatric cardiac computed tomography scans performed using the high-pitch spiral technique on a new third-generation dual-source 2 × 192-slice scanner (group B) compared with scans performed using the sequential technique on a single-source 256-slice scanner (group A). We performed a retrospective observational study on 40 patients aged ≤18 years who underwent prospectively electrocardiogram-triggered cardiac computed tomography. Image quality was assessed by pre-defined objective indices and a four-point subjective score. Apart from a higher mean heart rate in group A (P = 0.016), there were otherwise no significant inter-group differences in patient characteristics. The median effective dose was 4.41 mSv (interquartile range 2.58-5.90 mSv) in group A and 0.52 mSv (interquartile range 0.39-0.59 mSv) in group B (P < 0.001), representing a 88 % reduction. Subjective image quality score was significantly better in group B (4 = excellent with no artifact, mode 57.1 %) than in group A (3 = good with mild artifact, mode 57.9 %) (P < 0.001). Noise index, signal-to-noise ratio and contrast-to-noise ratio between both groups were not statistically significant. New third-generation dual-source high-pitch spiral scan technique can deliver excellent image quality with low radiation dose. Our results suggest that it should be considered as a first-choice technique for performing cardiac computed tomography in the pediatric population.
authors.affiliation: Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore.
authors.forename: Huiliang
authors.initials: H
authors.lastname: Koh
authors.affiliation: Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore.
authors.forename: Ching Ching
authors.initials: CC
authors.lastname: Ong
authors.affiliation: Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore.
authors.forename: Yun Song
authors.initials: YS
authors.lastname: Choo
authors.affiliation: Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore.
authors.forename: Chong Ri
authors.initials: CR
authors.lastname: Liang
authors.affiliation: Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore.
authors.forename: Grace Hui Zhen
authors.initials: GH
authors.lastname: Tan
authors.affiliation: Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore.
authors.forename: Terence Chee Wen
authors.initials: TC
authors.lastname: Lim
authors.affiliation: Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore.
authors.forename: Swee Chye
authors.initials: SC
authors.lastname: Quek
authors.affiliation: Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore.
authors.forename: Shankar
authors.initials: S
authors.lastname: Sriram
authors.affiliation: Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore. lynette_ls_teo@nuhs.edu.sg.
authors.forename: Lynette Li San
authors.initials: LL
authors.lastname: Teo
mesh_terms: D002648:Child; D017023:Coronary Angiography; D004562:Electrocardiography; D006331:Heart Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D011829:Radiation Dosage; D012189:Retrospective Studies; D036542:Tomography, Spiral Computed; D014057:Tomography, X-Ray Computed
keywords: Computed tomography; Congenital heart disease; Image quality; Pediatrics; Radiation