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Society for Pediatric Radiology – Poster Archive
Final ID: Paper #: 037
Pediatric Diagnostic Reference Ranges for Dual-energy Dual-source Contrast-enhanced Chest CT
Purpose or Case Report: To develop diagnostic reference ranges (DRRs) for pediatric contrast-enhanced dual-energy CT (DECT) examinations as a function of patient size and radiation output of the CT scanner with comparison to conventional single energy CT (SECT).
Methods & Materials: This is an institutional review board-approved, retrospective study which included pediatric patients (age 8.0 ± 6.6 years, range newborn to 21 years) undergoing contrast-enhanced chest CT with either SECT or DECT on a dual-source CT system (Somatom Flash, Siemens), from September 2014 until September 2018. Volume CT dose index (CTDIvol) and patient effective diameter were extracted using dose tracking software (Radimetrics): SECT (N=264) and DECT (N=291). All exams used automatic exposure control and iterative reconstruction. SECT used automated kilovoltage selection (range 80 to 120 kV), and DECT used 80/140Sn kV. Patient data were grouped into one of five effective diameter ranges to allow development of DDRs as a function of patient size. The median, 25th and 75th quartile of the two CT dose indexes were determined for the corresponding effective diameters. Quantitative image metrics assessed included contrast, noise and contrast-to-noise ratio. Subjective image quality (scale 1, excellent, to 4, non-diagnostic) of 10 DECT and SECT scans from each circumference group was assessed Statistical unpaired comparisons were made between groups.
Results: For the five effective diameters (< 15cm, 15-19cm, 20-24cm, 25-30 cm and > 30cm), the median CTDIvol [25th-75th quartile] for DECT were 1.2 [0.9-1.3], 1.7 [1.4-2.0], 3.0 [2.4-3.6], 5.0 [4.3-6.0], 7.7 [6.0-12.8] mGy; and for SECT 1.0 [0.7-1.4], 1.2 [1.0-1.7], 3.5[2.4-5.0], 6.3[4.9-7.3], 9.4[8.1-12.1] mGy; respectively. The CTDIvol values were statistically similar between SECT and DECT across all groups, except in the 20-24cm group where the CTDIvol for DECT was lower (P < 0.01). Quantitative and qualitative image quality was similar for both groups.
Conclusions: Dual energy CT can be used clinically in pediatric chest CT with radiation exposures and image quality similar to those of SECT. The DRRs (median, 25th and 75th quartiles) reported in this study as a function of patient size and radiation output can serve as reference standards to help manage pediatric patient radiation doses and image quality in DECT
Methods & Materials: This is an institutional review board-approved, retrospective study which included pediatric patients (age 8.0 ± 6.6 years, range newborn to 21 years) undergoing contrast-enhanced chest CT with either SECT or DECT on a dual-source CT system (Somatom Flash, Siemens), from September 2014 until September 2018. Volume CT dose index (CTDIvol) and patient effective diameter were extracted using dose tracking software (Radimetrics): SECT (N=264) and DECT (N=291). All exams used automatic exposure control and iterative reconstruction. SECT used automated kilovoltage selection (range 80 to 120 kV), and DECT used 80/140Sn kV. Patient data were grouped into one of five effective diameter ranges to allow development of DDRs as a function of patient size. The median, 25th and 75th quartile of the two CT dose indexes were determined for the corresponding effective diameters. Quantitative image metrics assessed included contrast, noise and contrast-to-noise ratio. Subjective image quality (scale 1, excellent, to 4, non-diagnostic) of 10 DECT and SECT scans from each circumference group was assessed Statistical unpaired comparisons were made between groups.
Results: For the five effective diameters (< 15cm, 15-19cm, 20-24cm, 25-30 cm and > 30cm), the median CTDIvol [25th-75th quartile] for DECT were 1.2 [0.9-1.3], 1.7 [1.4-2.0], 3.0 [2.4-3.6], 5.0 [4.3-6.0], 7.7 [6.0-12.8] mGy; and for SECT 1.0 [0.7-1.4], 1.2 [1.0-1.7], 3.5[2.4-5.0], 6.3[4.9-7.3], 9.4[8.1-12.1] mGy; respectively. The CTDIvol values were statistically similar between SECT and DECT across all groups, except in the 20-24cm group where the CTDIvol for DECT was lower (P < 0.01). Quantitative and qualitative image quality was similar for both groups.
Conclusions: Dual energy CT can be used clinically in pediatric chest CT with radiation exposures and image quality similar to those of SECT. The DRRs (median, 25th and 75th quartiles) reported in this study as a function of patient size and radiation output can serve as reference standards to help manage pediatric patient radiation doses and image quality in DECT
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Due to circumstances surrounding the coronavirus pandemic, this final ePoster exhibit was not submitted.
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