title: Subjective and objective image differences in pediatric computed tomography cardiac angiography using lower iodine concentration.
abstract: BACKGROUND
  Several recent studies showed the optimal contrast enhancement with a low-concentration and iso-osmolar contrast media in both adult and pediatric patients. However, low contrast media concentrations are not routinely used due to concerns of suboptimal enhancement of cardiac structures and small vessels.
  
  
  OBJECTIVE
  To evaluate the feasibility of using iso-osmolar contrast media containing a low iodine dose for CT cardiac angiography at 80 kilovolts (kVp) in neonates and infants.
  
  
  METHODS
  The iodixanol 270 group consisted of 79 CT scans and the iopromide 370 group of 62 CT scans in patients ≤1 year old. Objective measurement of the contrast enhancement was analyzed and contrast-to-noise ratios of the ascending aorta and left ventricle were calculated. Regarding subjective measurement, a four-point scale system was devised to evaluate degrees of contrast enhancement, image noise, motion artifact and overall image quality of each image set. Reader performance for correctly differentiating iodixanol 270 and iopromide 370 by visual assessment was evaluated.
  
  
  RESULTS
  Group objective and subjective measurements were nonsignificantly different. Overall sensitivity, specificity and diagnostic accuracy for correctly differentiating iodixanol 270 and iopromide 370 by visual assessment were 42.8%, 59%, and 50%, respectively.
  
  
  CONCLUSIONS
  The application of iodixanol 270 achieved optimal enhancement for performing pediatric cardiac CT angiography at 80 kVp in neonates and infants. Objective measurements of contrast enhancement and subjective image quality assessments were not statistically different in the iodixanol 270 and iopromide 370 groups.
authors.affiliation: Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea.|Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Geumo-ro 20, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea.
authors.forename: Jae-Yeon
authors.initials: JY
authors.lastname: Hwang
authors.affiliation: Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea. kschoo0618@naver.com.
authors.forename: Ki Seok
authors.initials: KS
authors.lastname: Choo
authors.affiliation: Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea.
authors.forename: Yoon Young
authors.initials: YY
authors.lastname: Choi
authors.affiliation: Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea.
authors.forename: Jin Hyeok
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea.
authors.forename: Hwaseong
authors.initials: H
authors.lastname: Ryu
authors.affiliation: Division of Biostatistics, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Geumo-ro 20, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea.
authors.forename: Junhee
authors.initials: J
authors.lastname: Han
authors.affiliation: Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea.
authors.forename: Yong-Woo
authors.initials: YW
authors.lastname: Kim
authors.affiliation: Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea.
authors.forename: Ung Bae
authors.initials: UB
authors.lastname: Jeon
authors.affiliation: Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea.
authors.forename: Kyung Jin
authors.initials: KJ
authors.lastname: Nam
mesh_terms: D016477:Artifacts; D000072226:Computed Tomography Angiography; D003287:Contrast Media / Q000008:administration & dosage*; D017023:Coronary Angiography; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007472:Iohexol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D008297:Male; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014283:Triiodobenzoic Acids / Q000008:administration & dosage*
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; D007472:Iohexol; C038192:iopromide; C044834:iodixanol
keywords: Computed tomography cardiac angiography; Heart; Infant; Iodixanol; Iopromide; Multidetector computed tomography; Newborn; Radiographic contrast media