Cardiac CT Techniques in Neonates (and infants)

Similar documents
9/8/2009 < 1 1,2 3,4 5,6 7,8 9,10 11,12 13,14 15,16 17,18 > 18. Tetralogy of Fallot. Complex Congenital Heart Disease.

Low Dose Era in Cardiac CT

Computed tomography. Department of Radiology, University Medical School, Szeged

CT Myocardial Perfusion: Is there Added Value to Coronary CT?

Fellows on this rotation are expected to attend nuclear conferences and multimodality imaging conference.

Cardiac Computed Tomography

Protocols in Cardiac CT Dr. Bruce Precious Dalhousie University Friday, April 15, 2016

Aquilion ONE: Pediatric Imaging. Richard Mather, PhD. Senior Manager, CT Clinical Science Toshiba America Medical Systems, Inc.

(Non-EKG Gated) CTA Thoracic Aorta = CTA Chest

ROLE OF MULTISLICE COMPUTED TOMOGRAPHY IN CARDIAC IMAGING

, David Stultz, MD. Cardiac CT. David Stultz, MD Cardiology Fellow, PGY 6 March 28, 2006

Multisclice CT in combination with functional imaging for CAD. Temporal Resolution. Spatial Resolution. Temporal resolution = ½ of the rotation time

Improvement of Image Quality with ß-Blocker Premedication on ECG-Gated 16-MDCT Coronary Angiography

ECG Gated CT Aorta in Transcatheter Aortic Valve Implantation

Cardiac CT - Coronary Calcium Basics Workshop II (Basic)

Fundamentals, Techniques, Pitfalls, and Limitations of MDCT Interpretation and Measurement

CT Versus MR for the Runoff

Disclosure Information

Technology Assessment Institute: Summit on CT Dose Cardiac CT - Optimal Use of Evolving Scanner Technologies

CT angiography techniques. Boot camp

Scientific Exhibit. Authors: D. Takenaka, Y. Ohno, Y. Onishi, K. Matsumoto, T.

Correlation of Cardiac CTA to Conventional Cardiac Angiography in Diagnosing Coronary Artery Stenosis in a Community Based Center

Pushing the limits of cardiac CT. Steven Dymarkowski Radiology / Medical Imaging Research Centre

Isolated congenital coronary anomalies: Evaluation by multislice-ct or MRI

Liver 4 Phase CT Abdomen WO W - NC.A.V.D

Cardiac CT Lowering the Dose Dramatically

Ultrasound. Computed tomography. Case studies. Utility of IQon Spectral CT in. cardiac imaging

Non Contrast MRA. Mayil Krishnam. Director, Cardiovascular and Thoracic Imaging University of California, Irvine

CTA Pulmonary Embolism CTA Chest W (arterial)

Radiation Dose Reduction Strategies in Coronary CT Angiography

Managing Radiation Risk in Pediatric CT Imaging

Basic and Advanced Cardiac CTA for Technologists Course Top class knowledge for development

Cardiac Imaging Tests

Dual Energy CT of the Heart: Perfusion and Beyond

CT Renal 3 Phase + Pelvis CT Abdomen Pelvis WO W - NC.A.V, Pelvis during V

CT Pancreas 3 Phase CT Abdomen WO W - NC.A.V

Cardiac MRI in ACHD What We. ACHD Patients

2/20/2013. Why use imaging in CV prevention? Update on coronary CTA in 2013 Coronary CTA for 1 0 prevention: pros and cons Are we there yet?

Customizing Contrast Injection for Body MDCT: Algorithmic Approach

CTA Chest Pulmonary Embolism & Routine CT Abdomen + Pelvis W CTA Chest W (arterial) & CT Abdomen + Pelvis W (venous)

Simon Nepveu 1, Irina Boldeanu 1, Yves Provost 1, Jean Chalaoui 1, Louis-Mathieu Stevens 2,3, Nicolas Noiseux 2,3, Carl Chartrand-Lefebvre 1,3

Bottom up cardiac CT for CABG assessment to resolve breathing artefact

Feasibility of contrast agent volume reduction on 640-slice CT coronary angiography in patients with low heart rate

Additional Value of 3DRA in the Diagnostic Evaluation and Percutaneous Treatment of Children With Univentricular Hearts

Imaging Strategies for Endovascular Cardiovascular Procedures and Percutaneous Aortic Valves. Roy K Greenberg, MD

Horizon Scanning Technology Summary. Magnetic resonance angiography (MRA) imaging for the detection of coronary artery disease

Triple Rule-out using 320-row-detector volume MDCT: A comparison of the wide volume and helical modes

General Cardiovascular Magnetic Resonance Imaging

CT Perfusion. U. Joseph Schoepf, MD, FAHA, FSCBT MR, FSCCT Professor of Radiology, Medicine, and Pediatrics Director of Cardiovascular Imaging

Noncoronary Cardiac MDCT

SPECIFIC PRINCIPLES FOR DOSE REDUCTION IN HEAD CT IMAGING. Rajiv Gupta, MD, PhD Neuroradiology, Massachusetts General Hospital Harvard Medical School

Basic and Advanced Cardiac CTA for Technologists Course Top class knowledge for development

Low-dose prospective ECG-triggering dual-source CT angiography in infants and children with complex congenital heart disease: first experience

Coronary Artery Anomalies from Birth to Adulthood; the Role of CT Coronary Angiography in Sudden Cardiac Death Screening

Lung Perfusion Analysis New Pathways in Lung Imaging. Case Study Brochure PLA 309 Hospital

Aims and objectives. Page 2 of 13

Coronary Artery Imaging. Suvipaporn Siripornpitak, MD Inter-hospital Conference : Rajavithi Hospital

Cardiac CT Course Part A First step towards level 2 SCCT registration

Multimodality Imaging of Septal Defects

Cardiovascular Imaging

Index. radiologic.theclinics.com. Note: Page numbers of article titles are in boldface type.

Radiology Rounds A Newsletter for Referring Physicians Massachusetts General Hospital Department of Radiology

After the Chest X-Ray:

Alessandro Albonico Philips

Cardiac CT Course Part A First step towards level 2 SCCT registration

Dr Winnie Sze-Wun Chan. Cardiac Team Deputy Team Head Department of Radiology and Imaging Queen Elizabeth Hospital Hong Kong

Handzettel 1. CT Contrast Media. Agenda. Contrast Media Definition. Agenda. Why we need contrast media? Agenda

A new method for radiation dose reduction at cardiac CT with multi-phase data-averaging and non-rigid image registration: preliminary clinical trial

Combined Anatomical and Functional Imaging with Revolution * CT

Clinical Image Gallery Next Generation Volume 1

Patient preparation and coronary CTA techniques. Gregory Kicska, M.D. Ph.D. University of Washington, Thoracic Imaging

Computed Tomography of the Coronary Arteries

Cardiac CTA without and with IV Contrast

New Technologies for Cardiac CT. Geoffrey D. Rubin, MD, MBA, FACR, FNASCI Duke University

Radiation Dose Reduction and Coronary Assessability of Prospective Electrocardiogram-Gated Computed Tomography Coronary Angiography

Update on Acute Aortic Syndrome

Improving Diagnostic Accuracy of MDCT Coronary Angiography in Patients with Mild Heart Rhythm Irregularities Using ECG Editing

Medical Physics and Informatics Original Research

Case Report Computed Tomography Angiography Successfully Used to Diagnose Postoperative Systemic-Pulmonary Artery Shunt Narrowing

Volumetric Perfusion CT Using Prototype 256 Detector Row CT Scanner: Preliminary Study with Healthy Porcine Model V

NIH Public Access Author Manuscript Acad Radiol. Author manuscript; available in PMC 2009 September 16.

Pulmonary Embolism. Thoracic radiologist Helena Lauri

CARDIAC MRI. Cardiovascular Disease. Cardiovascular Disease. Cardiovascular Disease. Overview

Recent developments in cardiac CT

Original Article Application of flash dual-source CT at low radiation dose and low contrast medium dose in triple-rule-out (tro) examination

PREGNANCY AND CONGENITAL HEART DISEASE

With the ongoing evolution of ever faster and more. Coronary CTA. Image Acquisition and Interpretation SYMPOSIA

b. To facilitate the management decision of a patient with an equivocal stress test.

Interpreting CT Angiography: Three-Dimensional Reconstruction Techniques

CT: Common Protocols. Michael Steigner, M.D. Director, Vascular CT/MR Assistant Professor of Radiology

B-Flow, Power Doppler and Color Doppler Ultrasound in the Assessment of Carotid Stenosis: Comparison with 64-MD-CT Angiography

Aortic Valve Stenosis and TAVR: Putting it all together.

PULMONARY EMBOLISM ANGIOCT (CTA) ASSESSMENT OF VASCULAR OCCLUSION EXTENT AND LOCALIZATION OF EMBOLI 1. BACKGROUND

Imaging congestive heart failure: role of coronary computed tomography angiography (CCTA)

EXPERIMENTAL AND THERAPEUTIC MEDICINE 9: , 2015

...a view. Aquilion ONE... of the future. Introducing our. The European Scanning Centre Newsletter. Special Edition

Cardiac CT Course Part A First step towards level 2 SCCT registration

Cardiac CT Course Part A First step towards level 2 SCCT registration

Liver Perfusion Analysis New Frontiers in Dynamic Volume Imaging. Case Study Brochure Chang Gung Memorial Hospital.

Transcription:

Cardiac CT Techniques in Neonates (and infants) Siddharth P. Jadhav, MD Director, Body CT and MRI Edward B. Singleton Department of Pediatric Radiology Texas Children s Hospital

Disclosures None

Objectives To describe technical aspects of cardiac CT for optimal image quality at low radiation dose Review practical tips to avoid pitfalls

Background Echocardiography CT Angiography MRI

Background CT Angiography High spatial resolution Accessible No sedation! No breath hold!

Trends in Cardiovascular CT Monthly Imaging Trends at Texas Children's Hospital CT MRI Total Studies 91 88 72 50 56 52 55 48 36 40 6 20 48 124 106 112 114 68 72 58 56 56 60 54 56 149 138 84 66 65 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

Potential/Perceived Detractors of CTA Radiation Post-processing Need support team for a successful program

CTA Protocol Considerations Individualization Patient Indication

CTA Protocol Considerations ECG Gating Sedation Contrast Helical vs. Volumetric kv, ma Breath Hold IV Access

CTA Protocol: ECG Gating Prospective 40%

CTA Protocol: ECG Gating Prospective 75%

ECG Gating: Target mode 40 % 75 % Target mode prospective gating without padding Conventional prospective gating with padding

CTA Protocol: ECG Gating Retrospective - some coronary imaging

CTA Protocol: IV Access Peripheral IV Gauge Location Lower extremity Right>Left upper Power (pressure) injector Saline test bolus 24G 22G 20G

CTA Protocol: Contrast Non-ionic, Iodinated Saline flush Volume of contrast Weight-based Typically 1.5-2.5 ml/kg Rate

CTA Protocol: Coverage 320 Detector allows 16cm Z-axis coverage 0.35-0.50 Seconds / gantry rotation 10cm

CTA Protocol: Sedation Dependent on: Scan time Indication Anesthesia availability http://www.texaschildrensblog.org

CTA Protocol: Bolus Timing Automated Bolus Tracking Manual Visual

CTA Protocol: Radiation Dose Parameters ALARA, Image Gently kv, ma Indication based New generation scanners Iterative reconstruction Jadhav S, et al. CT Angiography of neonates and infants: comparison of radiation dose and image quality of target mode prospectively ECG-gated 320-MDCT and ungated helical 64-MDCT. AJR 2015 Feb; 204(2):W184-191.

CTA Protocol: Radiation Dose Parameters ALARA, Image Gently kv, ma Indication based New generation scanners Iterative reconstruction Jadhav S, et al. CT Angiography of neonates and infants: comparison of radiation dose and image quality of target mode prospectively ECG-gated 320-MDCT and ungated helical 64-MDCT. AJR 2015 Feb; 204(2):W184-191.

CTA Protocol: Radiation Dose Parameters ALARA, Image Gently kv, ma Indication based New generation scanners Iterative reconstruction Airways Vascular Ring General Anatomy Coronary Anatomy Jadhav S, et al. CT Angiography of neonates and infants: comparison of radiation dose and image quality of target mode prospectively ECG-gated 320-MDCT and ungated helical 64-MDCT. AJR 2015 Feb; 204(2):W184-191.

CTA Protocol: Radiation Dose Parameters ALARA, Image Gently kv, ma Indication based New generation scanners Iterative reconstruction Jadhav S, et al. CT Angiography of neonates and infants: comparison of radiation dose and image quality of target mode prospectively ECG-gated 320-MDCT and ungated helical 64-MDCT. AJR 2015 Feb; 204(2):W184-191.

CTA Protocol: Radiation Dose Parameters ALARA, Image Gently kv, ma Indication based New generation scanners Iterative reconstruction Images courtesy of Dr. Prakash Masand Jadhav S, et al. CT Angiography of neonates and infants: comparison of radiation dose and image quality of target mode prospectively ECG-gated 320-MDCT and ungated helical 64-MDCT. AJR 2015 Feb; 204(2):W184-191.

CT Denoising with AIDR

CTA Indications: Anatomy Pulmonary arteries Vascular ring/sling Pulmonary veins Aorta Stent / conduit / shunt / LVAD Systemic veins Coronary arteries 3D printing

CTA Indications: Function Dynamic: Airway Pulmonary vein stenosis

CTA Indications: Function Dynamic: Airway Pulmonary veins

CTA Indications: Other Contraindication to MRI Pacemaker Renal failure

Take home points Cardiac CTA in pediatric CHD: Volume is increasing Provides surgical roadmap Newer generation scanners allow dose reduction Individualized approach Support team is critical

Acknowledgements Dr. Prakash Masand Dr. Pamela Ketwaroo Texas Children s Department of Radiology

Thank you! spjadhav@texaschildrens.org

2024 © healthdocbox.com Privacy Policy | Terms of Service | Feedback