Reduced-dose C-arm computed tomography applications at a pediatric institution

Background Reduced-dose C-arm computed tomography (CT) uses flat-panel detectors to acquire real-time 3-D images in the interventional radiology suite to assist with anatomical localization and procedure planning. Objective To describe dose-reduction techniques for C-arm CT at a pediatric institutio...

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Veröffentlicht in:Pediatric radiology Jg. 47; H. 13; S. 1817 - 1824
Hauptverfasser: Acord, Michael, Shellikeri, Sphoorti, Vatsky, Seth, Srinivasan, Abhay, Krishnamurthy, Ganesh, Keller, Marc S., Cahill, Anne Marie
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2017
Springer Nature B.V
Schlagworte:
Adolescent
Arm
Child
Child, Preschool
Computation
Computed tomography
Copper
Female
Fluoroscopy
Humans
Image acquisition
Image quality
Imaging
Imaging, Three-Dimensional
Localization
Male
Medicine
Medicine & Public Health
Neuroradiology
Nuclear Medicine
Oncology
Original Article
Ostomy
Pediatrics
Radiation Dosage
Radiation effects
Radiation Exposure
Radiation Protection - methods
Radiography, Interventional - methods
Radiology
Reduction
Retrospective Studies
Tomography, X-Ray Computed - methods
Ultrasound
Children
C-arm computed tomography
Computed tomography
Flat-panel computed tomography
Interventional radiology
Dose reduction
ISSN:0301-0449, 1432-1998, 1432-1998
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Zusammenfassung:Background Reduced-dose C-arm computed tomography (CT) uses flat-panel detectors to acquire real-time 3-D images in the interventional radiology suite to assist with anatomical localization and procedure planning. Objective To describe dose-reduction techniques for C-arm CT at a pediatric institution and to provide guidance for implementation. Materials and methods We conducted a 5-year retrospective study on procedures using an institution-specific reduced-dose protocol: 5 or 8 s Dyna Rotation, 248/396 projection images/acquisition and 0.1–0.17 μGy/projection dose at the detector with 0.3/0.6/0.9-mm copper (Cu) filtration. We categorized cases by procedure type and average patient age and calculated C-arm CT and total dose area product (DAP). Results Two hundred twenty-two C-arm CT-guided procedures were performed with a dose-reduction protocol. The most common procedures were temporomandibular and sacroiliac joint injections (48.6%) and sclerotherapy (34.2%). C-arm CT was utilized in cases of difficult percutaneous access in less common applications such as cecostomy and gastrostomy placement, foreign body retrieval and thoracentesis. C-arm CT accounted for between 9.9% and 80.7% of the total procedural DAP. Conclusion Dose-reducing techniques can preserve image quality for intervention while reducing radiation exposure to the child. This technology has multiple applications within pediatric interventional radiology and can be considered as an adjunctive imaging tool in a variety of procedures, particularly when percutaneous access is challenging despite routine fluoroscopic or ultrasound guidance.
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ISSN:0301-0449
1432-1998
1432-1998
DOI:10.1007/s00247-017-3964-0