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Patient positioning during pediatric cardiothoracic computed tomography using a high-resilience pad system and
Satoshi Higuchi1,2, Tatsuya Nishii3, Atsushi Hirota4
1Department of Radiology, National Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Suita, Osaka, Japan. satoshi.higuchi.b4@tohoku.ac.jp.
Insights
Accurate patient positioning in pediatric CT scans is crucial. Using a high-resilience pad and pre-scan measurements significantly improved isocenter alignment and image quality in children with congenital heart disease.
Area of Science:
- Medical Imaging
- Pediatric Radiology
- Cardiothoracic Imaging
Background:
- Precise patient positioning at the isocenter of a CT gantry is vital for optimal image quality and radiation dose management.
- Accurate positioning presents a significant challenge in pediatric patients, particularly those with congenital heart disease.
Purpose of the Study:
- To evaluate the efficacy of a high-resilience pad and pre-scan chest thickness measurement for accurate patient positioning in pediatric cardiothoracic CT.
- To compare image quality and radiation dose between manual positioning and a calculated positioning method.
Main Methods:
- Sixty-seven pediatric patients (≤7 years) with congenital heart disease undergoing cardiothoracic CT were enrolled.
- Patients were positioned manually or using a calculated method based on pad and chest thickness to align isocenters.
- Isocenter distance and image quality metrics (SNR, SNRD) were assessed.
Main Results:
- The calculated positioning group showed significantly smaller isocenter distance compared to the manual group (4.1 mm vs. 12.3 mm).
- Higher signal-to-noise ratio (SNR) and dose-normalized SNR (SNRD) were observed in the descending aorta for the calculated group.
- The system facilitated more accurate positioning, leading to enhanced image quality in pediatric patients.
Conclusions:
- The combination of a high-resilience pad and pre-scan measurements enables accurate isocenter positioning in pediatric cardiothoracic CT.
- This method improves image quality and potentially optimizes radiation dose for pediatric patients.
- The findings support the adoption of this technique for routine pediatric CT imaging.
Abstract:
Patient positioning at the isocenter of the CT gantry is important for optimizing image quality and radiation dose, but accurate positioning is challenging in pediatric patients. We evaluated whether the high-resilience pad and pre-scan measurement of chest thickness allow accurate positioning in pediatric patients with congenital heart disease. Sixty-seven patients aged 7 years or younger who underwent cardiothoracic CT were enrolled. The ideal table height, defined as the position at which the scanner's and patient's isocenters coincided, was determined by radiographers either manually (manual group) or based on the pad's and chest's thickness (calculated group). The distance between the two isocenters and image quality were evaluated. The calculated group demonstrated smaller isocenter distance and standard deviation (distance: 0.2 ± 5.8 mm vs. - 8.3 ± 11.6 mm, p < 0.01; absolute value: 4.1 [1.9-8.0] mm vs. 12.3 [5.1-16.3] mm, p < 0.01), and higher signal-to-noise ratio (SNR) and dose-normalized SNR (SNRD) in the descending aorta than the manual group (SNR: 39.8 [31.0-53.7] vs. 31.9 [28.9-36.6], p = 0.048, SNRD: 39.8 [31.0-53.7] vs. 31.9 [28.9-36.6], p = 0.04). The system allowed for more accurate positioning in pediatric cardiothoracic CT, yielding higher image quality.
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