Shah Amisha,  Rees Mitchell,  Kar Erica,  Bolton Kimberly,  Panigrahy Ashok,  Lee Vince

Final Pr. ID: Poster #: SCI-029

To evaluate the effect of different levels of adaptive statistical iterative reconstruction (ASIR) in pediatric lower extremity CT scan to compare the radiation dose, objective imaging parameters and subjective diagnostic image quality ratings. Read More

Authors:  Shah Amisha , Rees Mitchell , Kar Erica , Bolton Kimberly , Panigrahy Ashok , Lee Vince

Keywords:  ASIR, Radiation dose, CT scan, pediatric, extremity

Green Jesse,  Butler Nikki,  Riegert Kimberly,  Simoneaux Stephen

Final Pr. ID: Poster #: SCI-001 (T)

To compare the radiation doses that result from different digital radiography imaging methods on neonatal patients in Giraffe Beds using phantom imaging and radiation measurement devices. The lowest dose options will be considered to design an imaging process. Read More

Authors:  Green Jesse , Butler Nikki , Riegert Kimberly , Simoneaux Stephen

Keywords:  isolette, dose reduction, SID

Finkle Joshua,  Marshall Emily,  Reiser Ingrid,  Zhang Yue,  Lu Zheng Feng,  Jones Anji,  Feinstein Kate

Final Pr. ID: Poster #: SCI-005

Global mAs reduction is accepted as being superior to bismuth breast shields in reducing breast organ dose for children undergoing CT of the chest. However, in imaging of chest, abdomen, and pelvis (CAP), globally reducing mAs degrades image quality in the abdomen and pelvis. This study compares bismuth shields to global mAs reduction including a region-specific boost feature to maintain abdominal image quality. Read More

Authors:  Finkle Joshua , Marshall Emily , Reiser Ingrid , Zhang Yue , Lu Zheng Feng , Jones Anji , Feinstein Kate

Keywords:  Bismuth breast shields, CT dose

Verma Nupur,  Patel Pratik,  Rajderkar Dhanashree

Final Pr. ID: Poster #: EDU-108

Accidents remain a top cause of morbidity and mortality in pediatric patient. Assessment for blunt trauma to the abdomen is difficult in the trauma patient and findings of bowel injury can be subtly or confounded by visceral injuries. The most specific finding of free air in blunt hollow visceral organ is often minimally present, or entirely unseen. The pediatric radiologist must be familiarity with the more often seen and less specific secondary signs on CT, including free fluid, bowel wall thickening, and mesenteric contusion injury. We present, by case example, bowel injuries in the traumatic pediatric patient and their management and outcomes, while addressing common pearls and pitfalls. As many of these patients do well with non-operative treatment the radiologist must also be familiar with findings that would allow such option, to appropriately advice referring providers and manage potential re-image of the pediatric patient. Read More

Authors:  Verma Nupur , Patel Pratik , Rajderkar Dhanashree

Keywords:  Trauma, Pediatrics, Dose Reduction in CT, Abdominal Injury

Barczuk Marzena,  Roik Danuta,  Ostapska Zofia,  Biejat Agnieszka,  Brzewski Michal

Final Pr. ID: Poster #: EDU-007

Computed tomography with its excellent spatial and temporal resolution remains valuable diagnostic modality in pediatrics. On the other hand there has been increasing attention placed on the radiation risks associated with CT imaging, especially in children.
In recent years many advances in CT hardware and software, for example automatic exposure control tools and iterative reconstruction techniques allowed for the reduction of applied radiation dose while maintaining image quality.

The aim of our educational exhibit is:

- to present optimal protocols for chest CT in the youngest age group of children, scanned according to body weight protocols (0-10kg; 10-30kg) with assesement of image quality and dose indices (CTDIvol and DLP; SSDE)
- to present pictorial review of the pediatric chest pathologies in low dose chest CT Read More

Authors:  Barczuk Marzena , Roik Danuta , Ostapska Zofia , Biejat Agnieszka , Brzewski Michal

Keywords:  Pediatrics, Dose, CT

Brandt Ryan

Final Pr. ID: Poster #: SCI-056

1. To compare the effective dose of dual energy CT with plain films in the pediatric population.
2. To compare effective dose using Turbo Flash scanning technique with that of standard scanning technique on single energy CT. Read More

Authors:  Brandt Ryan

Keywords:  Pediatric, Dual Energy, Effective Dose

Royall Ivey,  Grekoski Vincent,  Hough Matthew,  Sensakovic William

Final Pr. ID: Poster #: SCI-005

To compare methods of estimating the fetal radiation dose delivered during computed tomography (CT) scanning. Further, to assess sources of variability in estimation methods. Read More

Authors:  Royall Ivey , Grekoski Vincent , Hough Matthew , Sensakovic William

Keywords:  Fetal, Radiation dose

Siegel Marilyn,  Ramirez Giraldo Juan Carlos,  Cullinane Mike,  Bhalla Sanjeev

Final Pr. ID: Paper #: 136

Patients undergoing lung and stem cell transplants require serial CT examinations and hence dose reduction techniques are mandatory. The newest 3^rd generation dual-source CT scanner incorporates spectral beam shaping at 100 kilovoltage (kVp) using a dedicated tin filter (100 kVp Sn), which improves dose efficiency by removing low-energy photons that contribute little to noncontrast image quality. The purpose of this study was to compare radiation exposure in non-contrast-enhanced pediatric chest CT at 100 kVp Sn imaging and at conventional low kVp imaging in the same patient cohort. Read More

Authors:  Siegel Marilyn , Ramirez Giraldo Juan Carlos , Cullinane Mike , Bhalla Sanjeev

Keywords:  Dose Reduction, ALARA, Lung and Stem Cell Transplant

Semple Thomas,  Schofield Rebecca,  Petraco Da Cunha Ricardo,  Owens Catherine,  Nicol E,  King Lawrence,  Castellano I

Final Pr. ID: Poster #: EDU-009

To review the basics of CT dose calculation, in particular the nuances of dose calculation / estimation in cardiac CT and the many and varied methods of dose reduction in cardiac and cardiovascular CT. Read More

Authors:  Semple Thomas , Schofield Rebecca , Petraco Da Cunha Ricardo , Owens Catherine , Nicol E , King Lawrence , Castellano I

Keywords:  Dose Reduction, CT, Radiation, Physics, ALARA

Kim Jesi,  Nimkin Katherine,  Westra Sjirk,  Gee Michael,  Stockton Katherine,  Savage Cristy

Final Pr. ID: Poster #: SCI-002

Pectus excavatum (PEx) is a chest wall deformity that leads to sternal depression and can impair cardiopulmonary function. CT imaging is used for surgical planning but exposes children to a significant radiation dose. Ultra-low dose CT enables PEx assessment in children with radiation exposure comparable to plain radiographs. The purpose of this study is to evaluate image quality and detection of thoracic pathology on ultra-low dose CT in children with PEx. Read More

Authors:  Kim Jesi , Nimkin Katherine , Westra Sjirk , Gee Michael , Stockton Katherine , Savage Cristy

Keywords:  Pectus excavatum, ultra-low dose, pediatrics

Gelfand Michael,  Treves S.

Final Pr. ID: Poster #: EDU-140

The North American and European administered activity recommendations will be reviewed and compared in this educational exhibit. Read More

Authors:  Gelfand Michael , Treves S.

Keywords:  Nuclear medicine, dose reduction

Davis James,  Servaes Sabah,  Nevo Elad,  States Lisa

Final Pr. ID: Paper #: 139

We aim to evaluate qualitative and quantitative image quality of low-dose PET-MRI in young patients. Read More

Authors:  Davis James , Servaes Sabah , Nevo Elad , States Lisa

Keywords:  PET/MRI, dose reduction

Zhu Xiaowei,  Whitaker Jayme,  Shellikeri Sphoorti,  Cahill Anne Marie

Final Pr. ID: Poster #: EDU-046

It is important for radiologists to recognize and discuss with patients and families the potential risks and clinical manifestations of high Peak Skin Dose. In children undergoing complex Interventional procedures accurate Peak Skin Dose estimates are complicated and time consuming despite reference point doses being available. The availability of the Dose Structure Report (SR) on modern fluoroscopic equipment allows such estimates to be timely and consistent. The process of creating a Peak Skin Dose estimate using a validated radiation data management system (RDMS), capable of collecting detailed acquisition data and modeling will be discussed. Read More

Authors:  Zhu Xiaowei , Whitaker Jayme , Shellikeri Sphoorti , Cahill Anne Marie

Keywords:  Peak Skin Dose Estimation, Interventional fluoroscopic, Radiation Data Management System

Yang Ronald,  Hayes Kari,  Milla Sarah,  Zhou Wei

Final Pr. ID: Poster #: SCI-005

Fluoroscopy is a valuable diagnostic tool, but it also exposes patients to radiation. Our study assesses variation in pediatric fluoroscopy radiation dose performance by hospital site and radiologist experience. Read More

Authors:  Yang Ronald , Hayes Kari , Milla Sarah , Zhou Wei

Keywords:  Fluoroscopy, Radiation Dose, Alara

Horst Kelly,  Zhongxing Zhou,  Hull Nathan,  Thacker Paul,  Thorne Jamison,  Fletcher Joel,  Mccollough Cynthia

Final Pr. ID: Poster #: SCI-001

We sought to evaluate the quality and interpretability of non-contrast chest CT images in pediatric patients for the diagnosis of airway disease at two low-dose levels with and without denoising using a deep convolutional neural network (CNN), with one of the dose levels approaching that in a standard chest radiograph. Read More

Authors:  Horst Kelly , Zhongxing Zhou , Hull Nathan , Thacker Paul , Thorne Jamison , Fletcher Joel , Mccollough Cynthia

Keywords:  reduced-dose chest CT, CNN denoising, iterative reconstruction

Colleran Gabrielle,  Callahan Michael,  Chow Jeanne

Final Pr. ID: Poster #: EDU-041

Pediatric urolithiasis is an important and increasingly prevalent cause of pediatric morbidity and hospital admission.

Ultrasound is the recommended primary imaging modality for suspected urolithiasis in children and this view is endorsed by all of the largest pediatric and urological societies.

There is however widespread use of CT as a first line study for abdominal pain in many institutions involved in pediatric care, many of whom are free standing hospitals delivering predominantly adult care.

The purpose of this educational review is to outline the state-of-the-art imaging modalities and methods for diagnosing urolithiasis in children and to suggest an imaging algorithm for best practice. Read More

Authors:  Colleran Gabrielle , Callahan Michael , Chow Jeanne

Keywords:  Urolithiasis, Ultrasound, Computed Tomography, ALARA, Dose optimized

Cheung Kenneth,  Lau Damian,  Lam Wendy

Final Pr. ID: Poster #: SCI-006

Our hospital is a local tertiary referral centre for paediatric spinal deformities. Patients were traditionally imaged with digital radiography and secondary digital stitching of images. Repeated imaging is routinely required for monitoring of disease progression.
EOS biplanar X-ray imaging unit is a novel system utilizing slot-scanning technology to acquire high-quality full-length images of patients in an upright weight-bearing position. The EOS system is now commonly used in Western countries. However, studies describing utilization in Asian population has not been published, according to our understanding. This study aims to describe our local experience, in particular lower radiation dose requirements when compared with default settings. Read More

Authors:  Cheung Kenneth , Lau Damian , Lam Wendy

Keywords:  EOS, Scoliosis, Dose Reduction, Comparison

Acord Michael,  Shellikeri Sphoorti,  Vatsky Seth,  Nazario Maricarmen,  Srinivasan Abhay,  Krishnamurthy Ganesh,  Keller Marc,  Cahill Anne Marie

Final Pr. ID: Poster #: EDU-074

Low dose C-arm Computed Tomography (CT), is a technology that uses flat panel detectors to acquire real-time 3D images during an interventional radiology (IR) procedure to assist with anatomic localization and procedural mapping. This study describes our low dose protocol and applications of its use at a pediatric institution. Read More

Authors:  Acord Michael , Shellikeri Sphoorti , Vatsky Seth , Nazario Maricarmen , Srinivasan Abhay , Krishnamurthy Ganesh , Keller Marc , Cahill Anne Marie

Keywords:  dose reduction, 3D fluoroscopy, guidance

Flowers Colleen,  Kaplan Summer,  Zhu Xiaowei

Final Pr. ID: Poster #: EDU-014 (T)

The objective for a low dose imaging protocol was to eliminate patient risks and to reduce radiation doses. Tube placements are confirmed via imaging thereby avoiding utilization of malpositioned tubes. Reduced technical parameters lessen the absorbed skin dose. A limited field of view which includes distal espohagus and airway allows accurate assessment of feeding tube position. The new region of interest eliminates unnecessary exposure to hypersensitive organs including, thyroid and reproductive structures. This coned down view requires a lower image quality thereby allowing a lower dose approach. Read More

Authors:  Flowers Colleen , Kaplan Summer , Zhu Xiaowei

Keywords:  Low Dose Protocol, Feeding tube confirmation

Luhar Aarti,  Vu Dan,  Holmes Nathan,  Renella Pierangelo

Final Pr. ID: Poster #: SCI-069

Computed Tomography Angiography (CTA) is a valuable non-invasive tool for assessment of congenital heart disease in neonates. Though it requires less radiation, contrast and sedation than catheter angiography, which is the current standard of care, traditional CTA can still necessitate significant radiation dose, sedation, breath-holding and/or low heart-rates to achieve diagnostic studies. In this frequently imaged neonatal patient population, it is imperative to minimize cumulative radiation to limit the lifetime risk of cancer. At our institution, we have successfully used a new fast-acquisition FLASH CTA protocol to achieve high quality imaging of neonates with complex congenital heart disease with minimal radiation dose and without sedation. Read More

Authors:  Luhar Aarti , Vu Dan , Holmes Nathan , Renella Pierangelo

Keywords:  Computed Tomography Angiography, Congenital Heart Disease, Radiation Dose Reduction

Park Ji Eun,  Choi Young Hun,  Cheon Jung-eun,  Kim Woo Sun,  Kim In-one,  Cho Hyun Suk

Final Pr. ID: Poster #: SCI-013

The use of pediatric abdominal CT has been increasing rapidly. However increased radiation exposure is a public health concern for children because of children are more sensitive to radiation than adults. The purpose of this study is to estimate which patient-related factors affect radiation dose, to pediatric patients undergoing abdominal CT Read More

Authors:  Park Ji Eun , Choi Young Hun , Cheon Jung-eun , Kim Woo Sun , Kim In-one , Cho Hyun Suk

Keywords:  Radiation dose, Abdominal CT

Siegel Marilyn,  Ramirez Giraldo Juan Carlos

Final Pr. ID: Paper #: 037

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). Read More

Authors:  Siegel Marilyn , Ramirez Giraldo Juan Carlos

Keywords:  Dual-Energy CT, Chest CT, Dose Reduction

Aljallad Mohammed,  Dunoski Brian

Final Pr. ID: Poster #: SCI-001

Balancing PEEP settings in mechanically ventilated premature infants to maximize air exchange while minimizing barotrauma is typically evaluated using bronchography. A 4D dynamic airway computerized tomography protocol (4D CT) was developed as a less invasive method to evaluate large and small airways collapse at variable PEEP settings. Our purpose was to evaluate the radiation dose from 4D CT and to demonstrate the number of cycles impact on the radiation dose. Read More

Authors:  Aljallad Mohammed , Dunoski Brian

Keywords:  Dynamic Airways, Effective Dose, Skin Dose

Miyazaki Osamu,  Sawai Hideaki,  Yamada Takahiro,  Murotsuki Jun,  Horiuchi Tetsuya,  Nishimura Gen

Final Pr. ID: Poster #: SCI-014

Fetal CT has almost the same utility as a postnatal skeletal survey. Despite this benefit, the associated radiation exposure is disadvantageous and radiation dose reduction is mandatory. It is however impossible to measure the actual radiation dose to the fetus directly. Several previous reports have described the CT dose index (CTDI) volume and dose length product (DLP) as representing an imagined fetal dose. The actual fetal radiation dose needs to be confirmed using a phantom that practically corresponds to a pregnant woman. Read More

Authors:  Miyazaki Osamu , Sawai Hideaki , Yamada Takahiro , Murotsuki Jun , Horiuchi Tetsuya , Nishimura Gen

Keywords:  skeletal dysplasia, fetal CT, radiation dose

O'connor Seán,  Graeber Brendon

Final Pr. ID: Poster #: EDU-036

Limiting radiation exposure while obtaining diagnostic-quality imaging is an essential goal of diagnostic radiology. This is particularly true for computed tomography (CT) scanning in children, who are more susceptible than adults to stochastic effects of radiation exposure. High-pitch technique with iterative reconstruction using modern dual-source CT scanners can reduce CT dose. This method uses some combination of peak kilovoltage (kVp) reduction and tube current modulation while also leveraging dual-source geometry to increase the pitch at which the images are acquired. Our institution recently transitioned to this method of performing CT scans. As part of a quality assurance study, we reviewed the dose exposure to our patients pre- and post-implementation. Read More

Authors:  O'connor Seán , Graeber Brendon

Keywords:  Dose Reduction, dual-source, high-pitch

Seals Kevin,  Tesoriero Joseph,  Cagnon Christopher,  Boechat Ines,  Ghahremani Shahnaz,  Iskander Paul

Final Pr. ID: Poster #: EDU-097

We developed a free iOS application, RADiDOC, with the goal of simplifying the complex subject of medical radiation risk for pediatric patients and their parents. Utilization of medical imaging has risen over the past decade, making the topic of radiation safety an increasingly important issue that is increasingly featured in the popular media. Furthermore, given the unique risk profile of radiation exposure in the pediatric age group, there has been increased focus on the judicious use of ionizing radiation in the imaging of children. These efforts have resulted in the Image Gently campaign, which has offered an immense contribution to pediatric radiation safety issues.

In keeping with these efforts, we created the RADiDOC application to help pediatric patients and their parents understand key radiation safety information in a simple, intuitive way. To meet these ends, RADiDOC was created with three core functionality modes: (1) Consultation, (2) Radiation Log, and (3) Radiation 101. Consultation mode allows users to explore a multitude of imaging studies and image-guided procedures and learn about their associated radiation risk, including quantitative cancer risk estimated using the BIER VII dataset. To be more meaningful to patients, dose is described not only in terms of “effective dose” and its associated ACR category, but also in terms of intuitive measures such as the equivalent number of transatlantic flights and days of natural sun exposure. The Radiation Log mode allows patients or their parents to log additive radiation risk from all imaging received in their lifetime, creating a longitudinal radiation log of lifetime exposure. This may be of particular interest to pediatric oncology patients who receive long-term serial imaging. Finally, Radiation 101 offers a primer on the basics of radiation safety and radiation physics aimed at a broad audience of laypeople.

RADiDOC offers a free resource to facilitate the discussion of radiation risk between pediatric radiologists, clinicians, pediatric patients, and their parents. In this Technical Development presentation, we review key radiation safety concepts and elaborate on the core functionalities of this application and how it can be of use to pediatrics radiologists and their patients. Read More

Authors:  Seals Kevin , Tesoriero Joseph , Cagnon Christopher , Boechat Ines , Ghahremani Shahnaz , Iskander Paul

Keywords:  Radiation, Radiation Dose, Radiation Safety

Garcia Evelyn,  Mcelroy Kevin

Final Pr. ID: Poster #: SCI-037

Determine the most effective method of computed tomography (CT) dose reduction that maintains diagnostic imaging quality, relative to individual patient size characteristics, such as Body Mass Index (BMI) and maximal girth. Read More

Authors:  Garcia Evelyn , Mcelroy Kevin

Keywords:  Dose reduction, Iterative reconstruction, Computed tomography

Bauer Kimberly

Final Pr. ID: Poster #: EDU-01 (R)

Since children are more susceptible to the potential effects of ionizing radiation, every opportunity to lower pediatric radiation dose will be explored. Read More

Authors:  Bauer Kimberly

Keywords:  Dose Reduction, Pediatric Imaging

Zhou Wei,  Baldwin Heather,  Allen Jeron,  Butler Renee,  White Christina,  Milla Sarah,  Hayes Kari

Final Pr. ID: Poster #: SCI-013

To diagnose intestinal disease or guide an injection treatment, radiation from a fluoroscopy exam is often nontrivial. In addition to regulatory and accreditation requirements, it is clinically important to establish a mechanism to review and improve the use of fluoroscopy, particularly for pediatric patients who are more sensitive to radiation than adults. In this study, we aimed to implement a fluoroscopy dose monitor program, assess overall fluoroscopy performance, and evaluate radiologist performance, in a pediatric hospital system. Read More

Authors:  Zhou Wei , Baldwin Heather , Allen Jeron , Butler Renee , White Christina , Milla Sarah , Hayes Kari

Keywords:  Fluoroscopy, Radiation Dose, ALARA

Karl Barbara,  Le Judy,  Sammet Christina

Final Pr. ID: Poster #: EDU-003 (R)

To maximize the usage of our dose monitoring system, we will demonstrate different reports and dashboards that can be created to measure staff productivity, resource usage, protocol deviation and dose alerts. We are able to calculate cumulative dose to the patient on exams performed within our network. We will also discuss the electronic protocol book that is available in the dose monitoring program. Read More

Authors:  Karl Barbara , Le Judy , Sammet Christina

Keywords:  dose, productivity, dashboards