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Effective Radiation Dose in Computed Tomographic Angiography of the Chest and Diagnostic Cardiac Catheterization in Pediatric Patients

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Abstract

Computed tomographic angiography (CTA) and cardiac catheterization are useful adjuncts to echocardiography for delineating cardiovascular anatomy in pediatric patients. These studies require ionizing radiation, and it is paramount to understand the amount of radiation pediatric patients receive when these tests are performed. Modern dosimetry methods facilitate the conversion of radiation doses of varying units into an effective radiation dose. To compare the effective radiation dose between nongated CTA of the chest and diagnostic cardiac catheterization in pediatric patients. This is a retrospective cohort study of patients of patients who underwent either nongated CTA of the chest or diagnostic cardiac catheterization between July 2009 and April 2010. Fifty patients were included in each group as consecutive samples at a single tertiary care center. An effective radiation dose (mSv) was formulated using conversion factors for each group. The median effective dose (ED) for the CTA group was 0.74 mSv compared with 10.8 mSv for the catheterization group (p < 0.0001). The median ED for children <1 year of age in the CTA group was 0.76 mSv compared with 13.4 mSv for the catheterization group (p < 0.0001). Nongated CTA of the chest exposes children to 15 times less radiation than diagnostic cardiac catheterization. Unless hemodynamic data are necessary, CTA of the chest should be considered in lieu of diagnostic cardiac catheterization in patients with known or presumed cardiac disease who need additional imaging beyond echocardiography

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Abbreviations

CTA:

Computed tomographic angiography

ED:

Effective dose

DLP:

Dose length product

CTDIvol:

Volume CT dose index

CFw :

Weighted conversion factors

mSv:

Millisievert

MRI:

Magnetic Resonance Imaging

KAP:

Kerma area product

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Conflict of interest

Dr. Schoepf receives research support from and is a consultant for Bayer-Schering, Bracco, General Electric, Medrad, and Siemens. Financial support provided to Dr. Watson by the National Institutes of Health: Ruth L. Kirschstein National Research Service Award (NRSA) T32 Grant. The authors do not have any other relationships with industry.

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Authors and Affiliations

  1. Department of Pediatrics (Cardiology), The Children’s Heart Program, Medical University of South Carolina, 165 Ashley Ave, MSC 915, Charleston, SC, 29425, USA

    Timotheus G. Watson & Anthony M. Hlavacek

  2. Department of Radiology and Radiological Science, Medical University of South Carolina, 169 Ashley Ave, PO Box 250322, Charleston, SC, 29425, USA

    Eugene Mah, U. Joseph Schoepf & Walter Huda

  3. Department of Pediatrics, Medical University of South Carolina, Mailstop 567, 135 Rutledge Ave, Charleston, SC, 29425, USA

    Lydia King

Authors
  1. Timotheus G. Watson
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  2. Eugene Mah
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  3. U. Joseph Schoepf
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  5. Walter Huda
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  6. Anthony M. Hlavacek
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Correspondence to Timotheus G. Watson.

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Watson, T.G., Mah, E., Joseph Schoepf, U. et al. Effective Radiation Dose in Computed Tomographic Angiography of the Chest and Diagnostic Cardiac Catheterization in Pediatric Patients. Pediatr Cardiol 34, 518–524 (2013). https://doi.org/10.1007/s00246-012-0486-2

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  • DOI: https://doi.org/10.1007/s00246-012-0486-2

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