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Cardiac computed tomography angiography with and without bolus tracking methods in infants with congenital heart

Takayuki Yoshiura1,2, Takanori Masuda3, Masahiro Tahara4

  • 1Graduate School of Health Sciences, Kumamoto University, 4-24-1 Kuhonji, Kumamoto, 862-0976, Japan.

Radiation Protection Dosimetry
|December 13, 2023
PubMed

Insights

Cardiac CT angiography without bolus tracking significantly reduces radiation dose in infants with congenital heart disease. This method maintains excellent vascular enhancement and image quality, offering a safer diagnostic option.

Area of Science:

  • Medical Imaging
  • Pediatric Cardiology
  • Radiology

Background:

  • Congenital heart disease (CHD) necessitates advanced imaging like cardiac computed tomography angiography (CCTA).
  • Bolus tracking (BT) is often used in CCTA to optimize contrast timing.
  • Assessing radiation dose and image quality in pediatric CCTA is crucial.

Purpose of the Study:

  • To compare radiation dose, vascular enhancement, and image quality of CCTA with and without BT in infants with CHD.
  • To determine if BT is essential for achieving diagnostic quality in pediatric CCTA.

Main Methods:

  • Retrospective analysis of CCTA scans in infants with CHD, with and without BT.
  • Measurement of radiation dose parameters: CTDIvol, DLP, and effective dose.
  • Assessment of image quality: aortic/pulmonary artery CT numbers, image noise, and CNR.

Main Results:

  • CCTA without BT showed significantly lower median CTDIvol (0.44 mGy vs 2.20 mGy), DLP (6.20 mGy·cm vs 8.10 mGy·cm), and effective dose (0.51 mSv vs 0.66 mSv) compared to CCTA with BT (p < 0.001).
  • No significant differences were observed in vascular CT enhancement, image noise, or contrast-to-noise ratio (CNR) between the two groups.
  • Diagnostic image quality was maintained without BT.

Conclusions:

  • CCTA without BT effectively reduces radiation exposure in infants with CHD.
  • Eliminating BT in CCTA for this population is feasible without compromising diagnostic image quality or vascular enhancement.
  • This approach offers a safer imaging strategy for pediatric CHD patients.

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