Study: Cardiac CTA poses pediatric challenges

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The utilization of adult cardiac computed tomography angiography (CTA) exam parameters for pediatric patients presents the danger of delivering a high-dose of radiation, according to a recent study conducted by researchers from Duke University Medical Center in Durham, N.C., and Stanford University Medical Center in Palo Alto, Calif., that was published in last month’s American Journal of Roentgenology.

Lead author Dr. Caroline Hollingsworth of Duke University Medical Center, said that technical advances in multidetector CTA have lead to increased utilization of this technology for evaluation of the coronary arteries in adults, but that the technology lacks systematic assessment in children.

For the study, an ECG-gated cardiac CTA simulating scanning of the heart was performed on a phantom of a 5-year-old child on a 16-slice CT scanner. The highest doses were of the breast (3.5-12.6 cGy), lung (3.3-12.1 cGy), and bone marrow (1.7-7.6 cGy).

Hollingsworth said that optimal techniques in children have yet to be developed and the results of this study show that gated CTA should be used cautiously in the pediatric population while further evaluation of newer techniques (modulation), applications and outcomes are evaluated.