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Pediatric Cardiac-Gated CT Angiography: Assessment of Radiation Dose

¹ Department of Radiology, Division of Pediatric Radiology, 1905 McGovern-Davison Children's Health Center, Box 3803, Department of Radiology, Duke University Medical Center, Durham, NC 27710.
² Division of Radiation Safety, Duke University Medical Center, Durham, NC.
³ Department of Radiology, Stanford University Medical Center, Palo Alto, CA.

OBJECTIVE. The purpose of our study was to determine a dose range for cardiac-gated CT angiography (CTA) in children.

MATERIALS AND METHODS. ECG-gated cardiac CTA simulating scanning of the heart was performed on an anthropomorphic phantom of a 5-year-old child on a 16-MDCT scanner using variable parameters (small field of view; 16 x 0.625 mm configuration; 0.5-second gantry cycle time; 0.275 pitch; 120 kVp at 110, 220, and 330 mA; and 80 kVp at 385 mA). Metal oxide semiconductor field effect transistor (MOSFET) technology measured 20 organ doses. Effective dose calculated using the dose–length product (DLP) was compared with effective dose determined from measured absorbed organ doses.

RESULTS. Highest organ doses included breast (3.5–12.6 cGy), lung (3.3–12.1 cGy), and bone marrow (1.7–7.6 cGy). The 80 kVp/385 mA examination produced lower radiation doses to all organs than the 120 kVp/220 mA examination. MOSFET effective doses (± SD) were as follows: 110 mA: 7.4 mSv (± 0.6 mSv), 220 mA: 17.2 mSv (± 0.3 mSv), 330 mA: 25.7 mSv (± 0.3 mSv), 80 kVp/385 mA: 10.6 mSv (± 0.2 mSv). DLP effective doses for diagnostic runs were as follows: 110 mA: 8.7 mSv, 220 mA: 19 mSv, 330 mA: 28 mSv, 80 kVp/385 mA: 12 mSv. DLP effective doses exceeded MOSFET effective doses by 9.7–17.2%.

CONCLUSION. Radiation doses for a 5-year-old during cardiac-gated CTA vary greatly depending on parameters. Organ doses can be high; the effective dose may reach 28.4 mSv. Further work, including determination of size-appropriate mA and image quality, is important before routine use of this technique in children.

Keywords: CT angiography • dosimetry • pediatric radiology • radiation dose

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