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Hepatic enhancement analysis in children using smart prep monitoring for 2 : 1 pitch helical scanning
A Vade1, M C Olson, C P Vittore
1Department of Radiology, Loyola University Medical Center, 2160 S. First Avenue, Maywood, IL 60153, USA.
Insights
Pediatric CT scans using Smart Prep protocols show that children weighing 30 lbs or more achieve optimal liver enhancement. Younger children (<30 lbs) may require adjusted contrast doses for adequate hepatic enhancement.
Area of Science:
- Radiology
- Pediatric Imaging
Background:
- Contrast-enhanced computed tomography (CT) is crucial for pediatric abdominal imaging.
- Optimizing contrast delivery protocols, such as Smart Prep, is essential for diagnostic quality in children.
Purpose of the Study:
- To evaluate the effectiveness of Smart Prep protocols for hepatic enhancement in pediatric patients across different weight groups.
- To assess the impact of weight-based protocols on contrast enhancement during helical CT imaging in children.
Main Methods:
- 55 children (20–180 lbs) underwent contrast-enhanced abdominal helical CT using Smart Prep.
- Protocols were stratified by nine weight groups; 21 studies were excluded due to protocol non-adherence.
- Scan delay, aortic and hepatic time-to-peak, and liver enhancement were analyzed.
Main Results:
- Adequate contrast enhancement was achieved in 46 patients.
- No significant difference in time-to-peak enhancement between aorta and liver across weight groups.
- Children < 30 lbs showed lower mean hepatic enhancement (<50 HU) compared to those ≥ 30 lbs (>50 HU).
Conclusions:
- Smart Prep protocols were successfully implemented in two-thirds of pediatric CT studies, yielding good enhancement.
- Optimal liver enhancement (>50 HU) was consistently observed in children weighing 30 lbs or more.
- Lower enhancement in younger children (<30 lbs) suggests potential need for contrast dose adjustments.
Purpose:
To analyze hepatic enhancement by using Smart Prep protocols appropriate for children of different weight groups and 2:1 pitch helical CT imaging as the investigative tools.
Patients And Methods:
A group of 55 children ranging in weight between 20 and 180 lbs underwent 67 contrast-enhanced abdominal helical CT examinations using Smart Prep (GE Medical Systems, Milwaukee, Wisc.). Of these studies, 21 (31 %) were excluded because of failure to follow the prescribed Smart Prep protocols. Smart Prep protocols were established for nine different weight groups. Scan delay, aorta and liver time to peak, and liver enhancement over baseline were recorded.
Results:
Optimal abdominal CT studies with adequate contrast enhancement of hepatic and portal veins were obtained in 46 patients. There was no significant difference in the time between peak aortic and the liver enhancement among different weight groups (mean time 12.0 +/- 7.1 s for all children). However, the mean hepatic enhancement over baseline in children weighing < 30 lbs was below 50 Hounsfield units (HU) compared to the rest of the children who had mean hepatic enhancement of > 50 HU.
Conclusion:
Two-thirds of the Smart Prep protocols were successfully implemented, and all of these resulted in good contrast enhancement of hepatic and portal veins. Optimal mean liver enhancement (> 50 HU) was seen in children >/= 30 lbs. Children < 30 lbs had mean liver enhancement of 33 HU +/- 7.2 above the baseline likely caused by contrast dose.
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