Multi-institution assessment of the use and risk of cardiovascular computed tomography in pediatric patients with congenital heart disease

Nunes, Mariana De Oliveira; Witt, Dawn; Casey, Susan A.; Rigsby, Cynthia K.; Hlavacek, Anthony M.; Chowdhury, Shahryar M; Nicol, Edward; Semple, Thomas; Lesser, John R.; Storey, Katelyn; Kunz, Miranda; Schmidt, Christian; Stanberry, Larissa; Han, Bo

doi:10.1016/j.jcct.2021.01.003

Cited by 18 publications

(7 citation statements)

References 26 publications

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“…This study demonstrates the significant decreased radiation dosage for newer generation scanners, now much lower than cardiac catheterization studies and on par with paediatric head CTs [14]. There were no major adverse effects during rapid acquisition and sedation was required in only 19% of cases [13 ▪▪ ]. All participating institutions used dual-source CT scanners, which limit reproducibility to all paediatric centres; however, this work highlights the decreased current radiation dosage and the importance of CCT as an imaging modality in a number of clinical situations.…”

Section: Cardiac Magnetic Resonance Imaging and Cardiac Computed Tomo...mentioning

confidence: 79%

“…The most common clinical indication was abnormality of the great vessels followed by coronary artery abnormalities. The median time to complete the CT scan was 5 min and the median effective radiation dose was 1 mSV [13 ▪▪ ]. This study demonstrates the significant decreased radiation dosage for newer generation scanners, now much lower than cardiac catheterization studies and on par with paediatric head CTs [14].…”

Section: Cardiac Magnetic Resonance Imaging and Cardiac Computed Tomo...mentioning

confidence: 82%

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Use of advanced cardiac imaging in congenital heart disease: growth, indications and innovations

Steele

Moore

Lang

2021

Current Opinion in Pediatrics

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Purpose of review Significant improvements in the diagnosis and management of patients with congenital heart disease (CHD) have led to improved survival. These patients require life-long noninvasive evaluation. The use of advanced imaging such as cardiac magnetic resonance imaging (CMR) and cardiac computed tomography (CCT) has increased to support this need. The purpose of this review is to discuss the basics of advanced cardiac imaging, indications and review the recent innovations. Recent findings Recent literature has demonstrated the increasing reliance of advanced imaging for CHD patients. In addition, research is focusing on CMR techniques to shorten scan time and address previous limitations that made imaging younger and sicker patients more challenging. CCT research has involved demonstrating high-quality images with low radiation exposure. Advances in digital technology have impacted the interactivity of 3D imaging through the use of virtual and augmented reality platforms. With the increased reliance of advanced imaging, appropriate use criteria have been developed to address possible under or over utilization. Summary The utilization of advanced cardiac imaging continues to increase. As CMR and CCT continue to grow, increased knowledge of these modalities and their usage will be necessary for clinicians caring for CHD patients.

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Section: Cardiac Magnetic Resonance Imaging and Cardiac Computed Tomo...mentioning

confidence: 79%

Section: Cardiac Magnetic Resonance Imaging and Cardiac Computed Tomo...mentioning

confidence: 82%

Use of advanced cardiac imaging in congenital heart disease: growth, indications and innovations

Steele

Moore

Lang

2021

Current Opinion in Pediatrics

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“…Modern scanners have been shown to have far lower radiation exposure than historical standards when used in centers with expertise imaging CHD patients. 79 , 80 Two studies documented 85% to 90% dose reduction in the CHD patient population with adoption of dose optimization and newer scanner platforms. 81 , 82 A recent multi-institutional study of CCT performed in patients of all ages with CHD showed low radiation dose across the age range even for functional CT imaging.…”

Section: Cardiovascular Computed Tomography Scan Acquisition Recommen...mentioning

confidence: 99%

Technical Recommendations for Computed Tomography Guidance of Intervention in the Right Ventricular Outflow Tract: Native RVOT, Conduits, and Bioprosthetic Valves

Han,

Garcia,

Aboulhosn

et al. 2023

World J Pediatr Congenit Heart Surg

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This consensus document for the performance of cardiovascular computed tomography (CCT) to guide intervention in the right ventricular outflow tract (RVOT) in patients with congenital heart disease (CHD) was developed collaboratively by pediatric and adult interventionalists, surgeons, and cardiac imagers with expertise specific to this patient subset. The document summarizes definitions of RVOT dysfunction as assessed by multimodality imaging techniques and reviews existing consensus statements and guideline documents pertaining to indications for intervention. In the context of this background information, recommendations for CCT scan acquisition and a standardized approach for reporting prior to surgical or transcatheter pulmonary valve replacement are proposed and presented. It is the first Imaging for Intervention collaboration for CHD patients and encompasses imaging and reporting recommendations prior to both surgical and percutaneous pulmonary valve replacement.

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“…The typical scan range spans from the lung apices to the diaphragms, but adjustments can be made based on the area of interest, particularly for coronary assessment. Customised protocols are essential for neonates and young children with pre-or postoperative TOF due to their small size, rapid heart rate, and tendency to move during the procedure [60,[62][63][64].…”

Section: Protocolsmentioning

confidence: 99%

Multimodality Imaging Assessment of Tetralogy of Fallot: From Diagnosis to Long-Term Follow-Up

Moscatelli,

Pergola,

Motta

et al. 2023

Children

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Tetralogy of Fallot (TOF) is the most common complex congenital heart disease with long-term survivors, demanding serial monitoring of the possible complications that can be encountered from the diagnosis to long-term follow-up. Cardiovascular imaging is key in the diagnosis and serial assessment of TOF patients, guiding patients’ management and providing prognostic information. Thorough knowledge of the pathophysiology and expected sequalae in TOF, as well as the advantages and limitations of different non-invasive imaging modalities that can be used for diagnosis and follow-up, is the key to ensuring optimal management of patients with TOF. The aim of this manuscript is to provide a comprehensive overview of the role of each modality and common protocols used in clinical practice in the assessment of TOF patients.

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Multi-institution assessment of the use and risk of cardiovascular computed tomography in pediatric patients with congenital heart disease

Cited by 18 publications

References 26 publications

Use of advanced cardiac imaging in congenital heart disease: growth, indications and innovations

Use of advanced cardiac imaging in congenital heart disease: growth, indications and innovations

Technical Recommendations for Computed Tomography Guidance of Intervention in the Right Ventricular Outflow Tract: Native RVOT, Conduits, and Bioprosthetic Valves

Multimodality Imaging Assessment of Tetralogy of Fallot: From Diagnosis to Long-Term Follow-Up

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