Photon-counting versus Dual-Source CT of Congenital Heart Defects in                     Neonates and Infants: Initial Experience

Dirrichs, Timm; Tietz, Eric; Rüffer, André; Hanten, J.; Nguyen, Thai Duy; Dethlefsen, Ebba; Kuhl, Christiane K.

doi:10.1148/radiol.223088

Cited by 15 publications

(7 citation statements)

References 20 publications

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“…For those below 1 year of age, median E eff was 0.30 mSv. Both values are lower than those in the only previous comparable PCCT study, where mean E eff was 0.50 mSv (± 0.23 mSv) at 90 kV, even though the children in that study (66 [10–161] days) were much younger than in the current study [ 8 ]. Further, Dirrichs et al [ 8 ] showed a mean DLP at 90 kV of 14.3 (± 6.6; range 3–42) mGy × cm for their very young children, compared with the current study’s mean DLP of 4 (range 3–8) mGy × cm.…”

Section: Discussioncontrasting

confidence: 86%

“…Also, agreement between observers was generally high. In regard to image quality, this is similar to a 90 kV PCCT study showing a 97% success rate; however, that study only showed moderate or poor interreader agreement [ 8 ].…”

Section: Discussionsupporting

confidence: 81%

“…Thus, image quality may be improved with a lower radiation dose. A study on small children that used PCCT at 90 kV for diagnosis of congenital heart defects achieved higher image quality than conventional CT but yet reported a similar effective dose (E eff ) [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Photon-counting computed tomography for paediatric congenital heart defects yields images of high diagnostic quality with low radiation doses at both 70 kV and 90 kV

Stålhammar,

Aurumskjöld,

Meyer

et al. 2024

Pediatr Radiol

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Background Photon-counting computed tomography (PCCT) is a new clinical method that may show better diagnostic quality at lower radiation doses than conventional CT. Objective To investigate the diagnostic quality and radiation dose of paediatric cardiovascular PCCT for diagnosis of congenital heart defects at 70 kV and 90 kV. Materials and methods This retrospective assessment included clinical non-gated paediatric PCCT examinations for assessment of congenital heart defects. Radiation doses were recorded, and overall and specific diagnostic quality (1–4) were scored by four paediatric radiologists. Agreement, differences, and trends were assessed by percent rater agreement, intraclass correlation, Mann–Whitney tests, and Jonckheere-Terpstra tests. Results Seventy children with congenital heart defects were examined at 70 kV (n = 35; age 2 days–16 years; 63% boys) or 90 kV (n = 35; age 2 days–17 years; 51% boys). All observers gave a median score of 4 (high diagnostic quality) for both 70 kV and 90 kV, with no difference in median values between tube voltages (all P > 0.06). Agreement for overall scores was 66–94% for 70 kV and 60–77% for 90 kV. Agreement for specific scores was 80–97% for 70 kV and 83–89% for 90 kV. Size-dependent dose estimate was 0.68 mGy (0.25–2.02 mGy) for 70 kV and 1.10 mGy (0.58–2.71 mGy; P < 0.001) for 90 kV. Effective dose was 0.30 mSv (0.15–0.82 mSv) for 70 kV and 0.39 mSv (0.22–1.51 mSv; P = 0.01) for 90 kV. Conclusion Paediatric cardiovascular PCCT yields images for congenital heart defects of high diagnostic quality with low radiation dose at both 70 kV and 90 kV.

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Section: Discussioncontrasting

confidence: 86%

Section: Discussionsupporting

confidence: 81%

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Photon-counting computed tomography for paediatric congenital heart defects yields images of high diagnostic quality with low radiation doses at both 70 kV and 90 kV

Stålhammar,

Aurumskjöld,

Meyer

et al. 2024

Pediatr Radiol

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“…There are currently some algorithms for flow modeling of the anatomic CT data (four-dimensional flow CT) that produce similar great vessels and intracardiac blood flow patterns similar to 4D flow MRI, the current reference standard, which probably will be incorporated into modern CT scanners in the near future. Moreover, photon counting CT could provide high image quality with a spatial resolution of less than 100 μm and, because of its intrinsic spectral information, reliable tissue characterization with a very low dose 84,85 …”

Section: Functional Evaluation and Myocardial Tissue Characterizationunclassified

Recommendations for cardiovascular magnetic resonance and computed tomography in congenital heart disease: a consensus paper from the CMR/CCT Working Group of the Italian Society of Pediatric Cardiology and the Italian College of Cardiac Radiology endorsed by the Italian Society of Medical and Interventional Radiology (Part II)

Festa,

Lovato,

Bianco

et al. 2024

Journal of Cardiovascular Medicine

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Cardiovascular magnetic resonance (CMR) and computed tomography (CCT) are advanced imaging modalities that recently revolutionized the conventional diagnostic approach to congenital heart diseases (CHD), supporting echocardiography and often replacing cardiac catheterization. This is the second of two complementary documents, endorsed by experts from the Working Group of the Italian Society of Pediatric Cardiology and the Italian College of Cardiac Radiology of the Italian Society of Medical and Interventional Radiology, aimed at giving updated indications on the appropriate use of CMR and CCT in different clinical CHD settings, in both pediatrics and adults. In this article, support is also given to radiologists, pediatricians, cardiologists, and cardiac surgeons for indications and appropriateness criteria for CMR and CCT in the most referred CHD, following the proposed new criteria presented and discussed in the first document. This second document also examines the impact of devices and prostheses for CMR and CCT in CHD and additionally presents some indications for CMR and CCT exams when sedation or narcosis is needed.

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“…Free-breathing scanning is one of the most notable advantages of dual-source CCT scans, along with a halved scan time, even in the presence of faster heart rates, without the need for beta-blocker administration. PC permits a spatial resolution of 0.2 mm (nominally 200 microns), and real-time ECG-gated acquisition will continue to revolutionize CCT imaging, providing higher spatial resolution images accompanied by good time resolution acquisition and even shorter scan time [ 52 , 62 ].…”

Section: Computed Tomographymentioning

confidence: 99%

Non-Invasive Imaging Assessment in Patients with Aortic Coarctation: A Contemporary Review

Leo,

Sabatino,

Avesani

et al. 2023

JCM

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Coarctation of the aorta (CoA) is a congenital abnormality characterized by a narrowing of the aortic lumen, which can lead to significant morbidity and mortality if left untreated. Even after repair and despite significant advances in therapeutic management, these patients have overall reduced long-term survival due to the consequences of chronic afterload increase. Cardiovascular imaging is key from the first diagnosis to serial follow-up. In recent years, novel imaging techniques have emerged, increasing accessibility to advanced imaging modalities and enabling early and non-invasive identification of complications after repair. The aim of this paper is to provide a comprehensive review of the role of different imaging techniques in the evaluation and management of patients with native or repaired CoA, highlighting their unique strengths and limitations.

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Photon-counting versus Dual-Source CT of Congenital Heart Defects in Neonates and Infants: Initial Experience

Cited by 15 publications

References 20 publications

Photon-counting computed tomography for paediatric congenital heart defects yields images of high diagnostic quality with low radiation doses at both 70 kV and 90 kV

Photon-counting computed tomography for paediatric congenital heart defects yields images of high diagnostic quality with low radiation doses at both 70 kV and 90 kV

Non-Invasive Imaging Assessment in Patients with Aortic Coarctation: A Contemporary Review

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