Due to the anatomical and physiological differences between children and adults, taking pediatric patients for a CT scan requires individual consideration. The biggest hurdles in pediatric imaging are radiation dose, anesthesia, high heart rate, voluntary and involuntary movements to multiple image quality factors. The toughest hurdle to overcome in pediatric imaging is the requisite of attaining high definition image quality to get a proper diagnosis. High-end technology and adapting imaging parameters are important to meet the image quality requirements in such cases. In addition, it is essential to reduce dose as children are more sensitive to radiation.
New Technologies That Influence in Our Pediatric Imaging Practice
Ultra-High Pitch – turbo flash scanning
Ultra-High Pitch – turbo flash scanning has brought in a new era of CT imaging. Now in the blink of an eye we can perform a CT of the thorax and the abdomen at once. Further, Turbo FLASH dual-source CT helps us to reduce the radiation dose. Therefore, Ultra-High Pitch – turbo flash scanning is used specifically for pediatric and unresponsive adult CT cases. Turbo flash mode CT scan with low tube voltage helps us reduce contrast medium and patient dose significantly in pediatric imaging.
Sub-second scanning - Rotation Speed
High accuracy and speed in CT imaging is often necessary for pediatric and emergency patients. In CT imaging, high rotation speed guarantees reduction in radiation exposure. One key feature of Siemens Healthineers SOMATOM Force CT scanner is the rotation speed of the gantry, which translates into faster temporal resolution to reduce motion artifact and radiation dose. Today with the Siemens Healthineers SOMATOM Force CT scanner, we are able to perform CT scans with a rotational speed that is under 250 milliseconds. Systems with slower rotation speeds cannot capture the best images since there is a high chance of blurring caused due to motion. Further, lower rotations speeds will mean increased radiation dose.
An Environment for Children’s Care - Ambience and Patient Experience
In creating a safe and undaunting scanning experience for children – there is a need to create a relaxing environment with the most modern technology. Projected cartoons, light effects, sound and video films are helping us today in creating a calm and cooperative environment for children. This ambience in turn helps greatly in reducing the child’s anxiety.
Artificial Intelligence with Auto Planning, Auto Results, Auto KV and Auto mAs
AI embedded system are intelligent enough to suggest the ideal KV and mAs values according to your patient data from topogram. The system automatically guides you to the pediatric protocol if the HIS or RIS system maps the patient’s age. According to the patient data entry, the AI algorithm in the Siemens Healthineers SOMATOM Force CT scanner suggests the best possible automated KV and mAs settings for each individual patient. Further, AI guides the user in protocol selection, parameters, planning, dose limit and clinical results etc.
Iterative Reconstruction Algorithm
Conclusion
Adapting new CT technologies opens doors to a decisive factor in critical emergency situations and complex pediatric imaging. It helps us to perform CT studies without the need for breath-hold with high-quality diagnostic imaging. This is the case for trauma patients as well as for very young or elderly patients who are unable to hold their breath either at all or for longer periods of time. Here, fast scans eliminate the potential need for sedation or intubation, and thereby save additional costs. The Siemens Healthineers SOMATOM Force CT scanner can scan the entire thorax in sub seconds, and it can scan the thorax, abdomen, and pelvis together in 1 second in high-pitch mode. This leads to significantly reduced motion artifacts.
Pediatric imaging presents specific challenges that range from reducing X-ray doses to creating an anxiety-free environment during imaging procedures. Innovative concepts and new technologies can help address all these challenges.
References
1. Hameed TA, Teague SD, Vembar M. Low radiation dose ECG-gated chest CT angiography on a 256 slice multidetector CT scanner. Int J Cardiovasc Imaging. 2009;25:267–278.
2. Hein PA, Romano VC, Lembcke A. Initial experience with a chest pain protocol using 320 slice volume MDCT. Eur Radiol. 2009;19:1148–1155. [PubMed]
3. Gallagher MJ, Raff GL. Use of mutislice CT for the evaluation of emergency room patients with chest pain: the so-called triple rule-out. Catheter Cardiovasc interv. 2008;71:92–99. [PubMed]
4. Haidary A, Bis K, Vrachliotis T, Kosuri R, Balasubramaniam M. Enhancement performance of a 64-slice triple rule-out protocol vs 16-slice and 10-slice multidetector Ctangiography protocols for evaluation of aortic and pulmonary vasculature. J Comput Assist Tomogr. 2007;31:917–923. [PubMed]
5. European Study Group. European guidelines on quality criteria for computed tomography: EUR16262.
6. Lee CH, Goo JM, Ye HJ, Ye SJ, Park CM, Chun EJ, Im JG. Radiation dose modulation techniques in the multidetector CT era: from basics to practice. Radiographics. 2008;28:1451–1459. [PubMed]
7. Bischoff B, Meinel FG, Del Prete A, Reiser MF, Becker HC. High-pitch coronary CT angiography in dual-source CT during free breathing vs breath holding in patients with low heart rates. Eur J Radiol. 2013;82:2217–2221. [PubMed]
8. Beister M, Kolditz D, Kalender WA. Iterative reconstruction methods in X-ray CT. Phys Med 2012;28(2):94–108. 2. Gordic S, Morsbach F, Schmidt B, et al. Ultralow-dose chest computed tomography for pulmonary nodule detection: first performance evaluation of single energy scanning with spectral shaping. Invest Radiol 2014;49(7):465–473. 3. Goodenough DJ, Weaver KE. Factors related to low contrast resolution in CT scanners. Comput Radiol 1984;8(5):297–308.