Development of low-dose protocols for thin-section CT assessment of cystic fibrosis in pediatric patients
Owen J O'Connor1, Moya Vandeleur, Anne Marie McGarrigle
1Department of Radiology, University College Cork and Cork University Hospital, Wilton, Cork 1111, Ireland.
Insights
Low-dose thin-section computed tomographic (CT) protocols offer effective assessment of cystic fibrosis (CF) in children, with radiation doses comparable to chest radiography. These protocols provide excellent visualization of lung structures and are suitable for evaluating pediatric CF patients.
Area of Science:
- Radiology
- Pediatric Imaging
- Pulmonology
Background:
- Cystic Fibrosis (CF) requires accurate imaging for disease assessment.
- Standard CT protocols may involve higher radiation doses for pediatric patients.
- Developing low-dose imaging techniques is crucial for minimizing radiation exposure in children.
Purpose of the Study:
- To establish low-dose thin-section CT protocols for pediatric CF assessment.
- To evaluate the clinical utility of these protocols compared to chest radiography.
- To determine optimal parameters for low-dose pediatric CT imaging.
Main Methods:
- 14 pediatric patients with CF and 11 controls underwent low-dose thin-section CT (1 mm or 0.5 mm sections).
- Image quality, diagnostic acceptability, and disease severity were assessed by radiologists.
- Effective radiation doses were calculated and compared between protocols and with chest radiography.
Main Results:
- Low-dose CT protocols achieved mean effective doses of 0.19 mSv (protocol A) and 0.14 mSv (protocol B).
- Both protocols demonstrated excellent image quality for bronchovascular structures; protocol B was slightly inferior for mediastinal assessment.
- Patients with CF showed significantly higher lung disease scores (mean Bhalla score 9.2) compared to controls (1.1).
- Thin-section CT correlated excellently with chest radiography (r = 0.88-0.92).
Conclusions:
- Low-dose thin-section CT provides effective evaluation of pediatric CF patients at reduced radiation doses.
- These protocols are suitable for assessing lung parenchyma and bronchovascular changes, including bronchiectasis.
- The radiation effective doses approach those of chest radiography, making it a safer alternative for frequent monitoring.
Purpose:
To develop low-dose thin-section computed tomographic (CT) protocols for assessment of cystic fibrosis (CF) in pediatric patients and determine the clinical usefulness thereof compared with chest radiography.
Materials And Methods:
After institutional review board approval and informed consent from patients or guardians were obtained, 14 patients with CF and 11 patients without CF (16 male, nine female; mean age, 12.6 years ± 5.4 [standard deviation]; range, 3.5-25 years) who underwent imaging for clinical reasons underwent low-dose thin-section CT. Sections 1 mm thick (protocol A) were used in 10 patients, and sections 0.5 mm thick (protocol B) were used in 15 patients at six levels at 120 kVp and 30-50 mA. Image quality and diagnostic acceptability were scored qualitatively and quantitatively by two radiologists who also quantified disease severity at thin-section CT and chest radiography. Effective doses were calculated by using a CT dosimetry calculator.
Results:
Low-dose thin-section CT was performed with mean effective doses of 0.19 mSv ± 0.03 for protocol A and 0.14 mSv ± 0.04 for protocol B (P < .005). Diagnostic acceptability and depiction of bronchovascular structures at lung window settings were graded as almost excellent for both protocols, but protocol B was inferior to protocol A for mediastinal assessment (P < .02). Patients with CF had moderate lung disease with a mean Bhalla score of 9.2 ± 5.3 (range, 0-19), compared with that of patients without CF (1.1 ± 1.4; P < .001). There was excellent correlation between thin-section CT and chest radiography (r = 0.88-0.92; P < .001).
Conclusion:
Low-dose thin-section CT can be performed at lower effective doses than can standard CT, approaching those of chest radiography. Low-dose thin-section CT could be appropriate for evaluating bronchiectasis in pediatric patients, yielding appropriate information about lung parenchyma and bronchovascular structures.
More Related Videos
03:38Unilateral Lung Volume Analysis Using Micro-CT for Enhanced Assessment of Pulmonary Fibrosis in Preclinical Models
Published on: June 20, 2025
06:15Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Related Concept Videos
01:24Cystic Fibrosis: Management
Sinus disease and chronic sinusitis...
01:23Cystic Fibrosis: Pathogenesis
CF is primarily caused by a genetic mutation in a chromosome 7 gene coding for the cystic fibrosis transmembrane conductance regulator (CFTR) protein. The most common gene mutation leading to CF is the ΔF508 mutation, but...