Pediatric chest CT at 70 kVp: a feasibility study in 129 children

• Published in: Pediatric radiology Vol. 44; no. 11; pp. 1347 - 1357
• Main Authors: Niemann, Tilo, Henry, Simon, Duhamel, Alain, Faivre, Jean-Baptiste, Deschildre, Antoine, Colas, Lucie, Santangelo, Teresa, Remy, Jacques, Remy-Jardin, Martine
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.11.2014; Springer Nature B.V
• Subjects: Adolescent; Child; Child, Preschool; Feasibility Studies; Female; Humans; Imaging; Infant; Infant, Newborn; Male; Medicine; Medicine & Public Health; Neuroradiology; Nuclear Medicine; Oncology; Original Article; Pediatrics; Radiation Dosage; Radiation Protection - methods; Radiography, Thoracic - methods; Radiology; Reproducibility of Results; Sensitivity and Specificity; Signal-To-Noise Ratio; Tomography, X-Ray Computed - methods; Ultrasound; Chest; Radiation dose; Low-kilovoltage computed tomography; Computed tomography; Computed tomography arteriography; Child
• ISSN: 0301-0449; 1432-1998
• DOI: 10.1007/s00247-014-3027-8

Background Before introducing 70-kVp settings in the low-kilovoltage strategies for pediatric examinations, it was mandatory to demonstrate, at similar dose levels, an equivalence of image quality at 70 kVp and 80 kVp. Objective To assess image quality of chest CT examinations acquired at 70 kVp in comparison with standard scanning at 80 kVp. Materials and methods We prospectively evaluated 129 children with a 70-kVp scanning protocol (group 1). All scanning parameters were kept similar to those usually selected for pediatric standard 80-kVp protocols, except the milliamperage increased by a factor of 1.6 to maintain comparable radiation dose. Image quality of group 1 examinations was compared to that of a paired population scanned at 80 kVp (group 2). The noninferiority hypothesis was fixed at 10% of the mean level of image noise. Results There was no significant difference in the mean dose length product (DLP) and the volume computed tomography dose index (CTDI vol ) between the groups (DLP: 20.5 ± 5.8 mGy.cm [group 1] vs. 19.7 ± 7.6 mGy.cm [group 2]; P  = 0.06) (CTDI vol : 0.8 ± 0.1 mGy [group 1] vs. 0.8 ± 0.18 mGy [group 2]; P  = 0.94). The mean of differences in image noise between group 1 and group 2 examinations was −1.38 (−2.59; −0.18), verifying the noninferiority hypothesis. Subjective image quality did not significantly differ between group 1 and group 2 examinations ( P  = 0.18). Conclusion At equivalent radiation dose levels, 70-kVp protocols provide similar image quality to that achievable at 80 kVp.