Advances in CT technology and application to pediatric imaging

The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, 601 N. Caroline St., Baltimore, MD 21287-0856, USA.
Pediatric Radiology (Impact Factor: 1.57). 09/2011; 41 Suppl 2(S2):493-7. DOI: 10.1007/s00247-011-2169-1
Source: PubMed


The use of imaging in both hospital and non-hospital settings has expanded to more than 70 million CT procedures in the United States per year, with nearly 10% of procedures performed on children. The availability of multiple-row detector CT (MDCT) systems has played a large part in the wider usage of CT. This rapid increase in CT utilization combined with an increasing concern with regard to radiation exposure and associated risk demands the need for optimization of MDCT protocols. This manuscript will briefly discuss how technology has changed in regard to MDCT protocols, helping to reduce radiation dose in CT, especially in pediatric imaging.

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    • "The “ALARA” (as low as reasonable achievable) principle has to be considered thoroughly before each examination for children. Several dose reduction strategies, such as reduced tube voltage, automated tube current modulation, weight-adjusted tube current, minimization of z-axis coverage as well as use of the prospective ECG-triggering sequential mode and high-pitch mode, have been successfully implemented into paediatric cardiac CT angiography and have been shown to effectively lower the radiation dose [1]–[3], [4]–[8]. "
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    ABSTRACT: To compare the image quality and diagnostic accuracy between sinogram affirmed iterative reconstruction (SAFIRE) algorithm and filtered back projection (FBP) reconstruction algorithm at 70 kVp-tube-voltage DSCT angiography in children with congenital heart disease (CHD). Twenty-eight patients (mean age: 13 months; range: 2-48 months; male: 16; female: 12; mean weight: 8 kg) with CHD underwent 70 kVp DSCT angiography. Imaging data were reconstructed with both FBP and SAFIRE algorithms. Subjective image quality was evaluated on a five-point scale. The parameters of image noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) on the objective image quality were compared for the two reconstruction algorithms. Surgery was performed in 20 patients, whereas conventional cardiac angiography (CCA) was performed in 8 patients. The diagnostic accuracy was evaluated on the surgical and/or CCA findings. The effective radiation doses were calculated. Compared to FBP algorithm, SAFIRE algorithm had significantly higher scores for subjective image quality (P<0.05), and lower image noise (P<0.05) as well as higher SNR &CNR values (P<0.05). There was no significant difference in the diagnostic accuracy between the FBP and SAFIRE algorithm (χ2 = 1.793, P>0.05). The mean effective dose for 70 kVp DSCT angiography was 0.30±0.13 mSv. The SAFIRE algorithm can significantly reduce image noise and improve the image quality at 70 kVp DSCT angiography for the assessment of CHD in children.
    PLoS ONE 03/2014; 9(3):e91123. DOI:10.1371/journal.pone.0091123 · 3.23 Impact Factor
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    • "Pediatric radiation exposure from medical imaging, and its implications for long-term development of cancer, remains a major international health concern [11]. Most estimates have been extrapolated from atomic bomb survivors in Hiroshima and Nagasaki, a cohort strikingly dissimilar from today's standard pediatric patients undergoing CT scans [11]. In our series, several steps were undertaken to ensure low levels of radiation, including weight-based radiation dosing and retroverted CT slices. "
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    ABSTRACT: Diagnosis of lower gastrointestinal bleeding (LGIB) represents a significant diagnostic and therapeutic challenge for any physician. While CT enterography (CTE) has been applied in adults with occult LGIB, its use in children has been limited to evaluation of Crohn's disease. We reviewed 6 patients ages 4-15 who underwent CTE for LGIB at a tertiary pediatric institution. In sum, CTE appears to be a valuable tool for localizing the source of LGIB prior to surgical or endoscopic intervention. However, rapid lesion identification must be weighed against the increased radiation exposure and patient discomfort due to bowel distention associated with this diagnostic technique.
    Journal of Pediatric Surgery 03/2013; 48(3):681-684. DOI:10.1016/j.jpedsurg.2013.01.002 · 1.39 Impact Factor
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    Pediatric Radiology 02/2012; 42(4):397-8. DOI:10.1007/s00247-011-2315-9 · 1.57 Impact Factor
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