High-Pitch CT Offers Diagnostic Accuracy for Children

Accurate diagnosis in children with congenital heart failure at lower doses of radiation

MONDAY, June 6 (HealthDay News) -- Use of high-pitch, dual-source computed tomography (CT) in pediatric patients with congenital heart disease offers diagnostic accuracy at lower radiation doses, according to a study published in the May 15 issue of The American Journal of Cardiology.

B. Kelly Han, M.D., from the Children's Heart Clinic of Minnesota in Minneapolis, and colleagues used a clinical pediatric population to compare radiation exposure, anesthesia use, and diagnostic accuracy between standard-pitch, single-source CT, and high-pitch, dual-source CT for image quality and risk. Children aged younger than 2 years with complex congenital heart disease underwent consecutive CT scans. A total of 61 scans, comprising 29 at standard pitch and 32 at high pitch, were reviewed. In a subset of patients who underwent surgical intervention, scans were validated procedurally (17 standard-pitch, 16 high-pitch).

The investigators found that body surface area, scan length, and indications were similar in the standard and high-pitch scans. The median dose-length product was 66 mGy cm for standard scans. For high-pitch scans, the median dose-length product was 7 mGy cm for all high-pitch scans, 28 mGy cm for variable high-pitch scans, and 5 mGy cm for the highest fixed-pitch scans. High-pitch scans had higher image noise and lower contrast-to-noise ratios, but diagnostic confidence was similar to standard scans. Diagnostic accuracy determined by procedural validation was 100 percent in the two groups. All standard scans were performed under general anesthesia and high-pitch scans under sedation with free breathing.

"High-pitch, dual-source computed tomography provides excellent diagnostic accuracy and markedly reduces radiation dose, although image quality is mildly reduced," the authors write.

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