Advertisement

Pediatric Radiology

, Volume 36, Issue 1, pp 50–53 | Cite as

Dose reduction for CT in children with cystic fibrosis: is it feasible to reduce the number of images per scan?

  • Pim A. de Jong
  • Yasutaka Nakano
  • Maarten H. Lequin
  • Harm A. W. M. Tiddens
Original Article

Abstract

Background

Reducing the dose for each CT scan is important for children with cystic fibrosis (CF).

Objective

To determine whether the number of CT images and therefore the dose per CT scan could be reduced without any significant loss of information in children with CF.

Materials and methods

A cohort of children with CF was followed with biennial surveillance CT scans, obtained in inspiration after a voluntary breath-hold as 1-mm thick images at 10-mm intervals from lung apex to base. A random set of 20 baseline CT scans and 10 follow-up CT scans were blinded. Sets of every image (10-mm intervals), every second image (20-mm intervals), every third image (30-mm intervals) and a selection of three and five images were scored randomly using a published CT scoring system by one experienced observer.

Results

The 20 subjects were 10 years of age with a range of 3.7–17.6 years at baseline. Fewer CT images resulted in a significantly lower (less abnormal) CT score and the number of patients positive for abnormalities decreased subsequently. At intervals greater than 20 mm no significant change in CT score over 2 years could be detected, while the CT scores at 10-mm (P=0.02) and 20-mm (P=0.02) intervals worsened significantly.

Conclusions

A reduction in the number of inspiratory CT images by increasing the interval between images to greater than 10 mm is not a valid option for radiation dose reduction in children with CF.

Keywords

Lungs Cystic fibrosis CT Children 

References

  1. 1.
    Maffessanti M, Candusso M, Brizzi F, et al (1996) Cystic fibrosis in children: HRCT findings and distribution of disease. J Thorac Imaging 11:27–38PubMedCrossRefGoogle Scholar
  2. 2.
    Long FR, Williams RS, Castile RG (2004) Structural airway abnormalities in infants and young children with cystic fibrosis. J Pediatr 144:154–161CrossRefPubMedGoogle Scholar
  3. 3.
    de Jong PA, Nakano Y, Lequin MH, et al (2004) Progressive damage on high resolution computed tomography despite stable lung function in cystic fibrosis. Eur Respir J 23:93–97CrossRefPubMedGoogle Scholar
  4. 4.
    de Jong PA, Ottink MD, Robben SG, et al (2004) Pulmonary disease assessment in cystic fibrosis: comparison of CT scoring systems and value of bronchial and arterial dimension measurements. Radiology 231:434–439PubMedCrossRefGoogle Scholar
  5. 5.
    Brody AS, Klein JS, Molina PL, et al (2004) High-resolution computed tomography in young patients with cystic fibrosis: distribution of abnormalities and correlation with pulmonary function tests. J Pediatr 145:32–38CrossRefPubMedGoogle Scholar
  6. 6.
    de Jong PA, Nakano Y, Hop WC, et al (2005) Changes in airway dimensions on computed tomography scans of children with cystic fibrosis. Am J Respir Crit Care Med 172:218–224CrossRefPubMedGoogle Scholar
  7. 7.
    Hansell DM, Strickland B (1989) High-resolution computed tomography in pulmonary cystic fibrosis. Br J Radiol 62:1–5PubMedCrossRefGoogle Scholar
  8. 8.
    Lynch DA, Brasch RC, Hardy KA, et al (1990) Pediatric pulmonary disease: assessment with high-resolution ultrafast CT. Radiology 176:243–248PubMedGoogle Scholar
  9. 9.
    Santis G, Hodson ME, Strickland B (1991) High resolution computed tomography in adult cystic fibrosis patients with mild lung disease. Clin Radiol 44:20–22CrossRefPubMedGoogle Scholar
  10. 10.
    Brenner D, Elliston C, Hall E, et al (2001) Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR 176:289–296PubMedGoogle Scholar
  11. 11.
    Brenner DJ (2002) Estimating cancer risks from pediatric CT: going from the qualitative to the quantitative. Pediatr Radiol 32:228–233; discussion 242–224PubMedCrossRefGoogle Scholar
  12. 12.
    Mayo JR, Aldrich J, Muller NL (2003) Radiation exposure at chest CT: a statement of the Fleischner Society. Radiology 228:15–21PubMedCrossRefGoogle Scholar
  13. 13.
    Fogarty A, Hubbard R, Britton J (2000) International comparison of median age at death from cystic fibrosis. Chest 117:1656–1660CrossRefPubMedGoogle Scholar
  14. 14.
    Gibson RL, Burns JL, Ramsey BW (2003) Pathophysiology and management of pulmonary infections in cystic fibrosis. Am J Respir Crit Care Med 168:918–951CrossRefPubMedGoogle Scholar
  15. 15.
    Rosenfeld M, Davis R, FitzSimmons SC, et al (1997) Gender gap in cystic fibrosis mortality. Am J Epidemiol 145:794–803PubMedGoogle Scholar
  16. 16.
    Pierce DA, Shimizu Y, Preston DL, et al (1996) Studies of the mortality of atomic bomb survivors. Report 12, Part I. Cancer: 1950–1990. Radiat Res 146:1–27PubMedCrossRefGoogle Scholar
  17. 17.
    Preston DL, Shimizu Y, Pierce DA, et al (2003) Studies of mortality of atomic bomb survivors. Report 13: Solid cancer and noncancer disease mortality: 1950–1997. Radiat Res 160:381–407PubMedCrossRefGoogle Scholar
  18. 18.
    Linton OW, Mettler FA Jr (2003) National conference on dose reduction in CT, with an emphasis on pediatric patients. AJR 181:321–329PubMedGoogle Scholar
  19. 19.
    Haaga JR, Miraldi F, MacIntyre W, et al (1981) The effect of mAs variation upon computed tomography image quality as evaluated by in vivo and in vitro studies. Radiology 138:449–454PubMedGoogle Scholar
  20. 20.
    Frush DP (2002) Strategies of dose reduction. Pediatr Radiol 32:293–297CrossRefPubMedGoogle Scholar
  21. 21.
    Donnelly LF, Emery KH, Brody AS, et al (2001) Minimizing radiation dose for pediatric body applications of single-detector helical CT: strategies at a large children's hospital. AJR 176:303–306PubMedGoogle Scholar
  22. 22.
    Ambrosino MM, Genieser NB, Roche KJ, et al (1994) Feasibility of high-resolution, low-dose chest CT in evaluating the pediatric chest. Pediatr Radiol 24:6–10CrossRefPubMedGoogle Scholar
  23. 23.
    Brody AS, Molina PL, Klein JS, et al (1999) High-resolution computed tomography of the chest in children with cystic fibrosis: support for use as an outcome surrogate. Pediatr Radiol 29:731–735CrossRefPubMedGoogle Scholar
  24. 24.
    Dorlochter L, Nes H, Fluge G, et al (2003) High resolution CT in cystic fibrosis—the contribution of expiratory scans. Eur J Radiol 47:193–198CrossRefPubMedGoogle Scholar
  25. 25.
    Bonnel AS, Song SM, Kesavarju K, et al (2004) Quantitative air-trapping analysis in children with mild cystic fibrosis lung disease. Pediatr Pulmonol 38:396–405CrossRefPubMedGoogle Scholar
  26. 26.
    Goris ML, Zhu HJ, Blankenberg F, et al (2003) An automated approach to quantitative air trapping measurements in mild cystic fibrosis. Chest 123:1655–1663CrossRefPubMedGoogle Scholar
  27. 27.
    Robinson TE, Leung AN, Northway WH, et al (2003) Composite spirometric-computed tomography outcome measure in early cystic fibrosis lung disease. Am J Respir Crit Care Med 168:588–593CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Pim A. de Jong
    • 1
  • Yasutaka Nakano
    • 2
  • Maarten H. Lequin
    • 3
  • Harm A. W. M. Tiddens
    • 1
  1. 1.Department of Paediatric Pulmonology and Allergology, Erasmus MCSophia Children's HospitalRotterdamThe Netherlands
  2. 2.Department of Respiratory MedicineShiga University of Medical ScienceOtsuJapan
  3. 3.Department of Paediatric Radiology, Erasmus MCSophia Children's HospitalRotterdamThe Netherlands

Personalised recommendations