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Multi-institutional evaluation of the indications and radiation dose of functional cardiovascular computed tomography (CCT) imaging in congenital heart disease

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Abstract

Ventricular volumes and ejection fraction are often used in clinical decision making in patients with congenital heart disease (CHD). The referral diagnosis, radiation exposure and image quality of functional cardiac computed tomography (CT) in a relatively large cohort of patients of CHD has not been reported. This is a retrospective evaluation of functional CT studies performed in CHD patients from three institutions (1/2007–3/2013). Patient and scanner characteristics, radiation dose estimates and image quality were compared. Two hundred ninety-eight functional CT studies were evaluated. The most common referral diagnosis were tetralogy of Fallot (33 %), transposition complexes (24 %) single ventricle heart disease (15 %), and left sided obstruction (15 %). The reason for cardiac CT was presence of pacemaker (60 %), need for detailed coronary artery imaging (18 %), metallic artifact in CMR (12 %), evaluation of prosthetic valve function (4 %), and claustrophobia or BMI too large for the available MR scanner (6 %). 266 (89.3 %) scans allowed quantification of ventricular function, 25 (8.4 %) scans allowed qualitative assessment of function, and 7 (2.3 %) of the scans were non-diagnostic for functional analysis. Median DLP was 399 mGy cm (186, 614), and median effective dose was 5.5 mSv (2.6, 8.5). Radiation dose and image quality varied across institutions. Cardiac CT function imaging can be performed in patients with congenital heart disease when CMR is contraindicated or has poor image quality. Radiation dose and image quality varies across institutions.

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Authors and Affiliations

  1. Minneapolis Heart Institute and Foundation, Minneapolis, MN, USA

    B. Kelly Han, Ross F. Garberich & John R. Lesser

  2. c/o The Children’s Heart Clinic, Children’s Hospitals and Clinics of Minnesota, 2530 Chicago Ave South, Suite 500, Minneapolis, MN, 55404, USA

    B. Kelly Han

  3. Medical University of South Carolina, Charleston, SC, USA

    Anthony M. Hlavacek & Tam Dan N. Pham

  4. Indiana University, Bloomington, IN, USA

    W. Aaron Kay

  5. Siemens Medical Solutions, Malvern, PA, USA

    Katharine Grant

  6. Ohio State University, Columbus, OH, USA

    Subha V. Raman

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  1. B. Kelly Han
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Correspondence to B. Kelly Han.

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Conflict of interest

John R. Lesser, B. Kelly Han, and Anthony M. Hlavacek receive grant support from Siemens Medical, Katharine Grant is a Siemens employee.

Ethical approval

This was a retrospective data review, all studies were anonymized and an IRB waiver was obtained. All studies were clinically indicated and not performed for the purpose of research. This is in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Han, B.K., Hlavacek, A.M., Kay, W.A. et al. Multi-institutional evaluation of the indications and radiation dose of functional cardiovascular computed tomography (CCT) imaging in congenital heart disease. Int J Cardiovasc Imaging 32, 339–346 (2016). https://doi.org/10.1007/s10554-015-0775-y

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  • DOI: https://doi.org/10.1007/s10554-015-0775-y

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