Original Articles

Cardiac computed tomography and conventional angiography in the diagnosis of congenital cardiac disease in children: recent trends and radiation doses

Guy G. Gherardi^a1 c1, Gareth R. Iball^a2, Michael J. Darby^a3 and John D.R. Thomson^a4

^a1 School of Medicine, Leeds Institute of Medical Education, University of Leeds, Leeds, United Kingdom

^a2 Department of Medical Physics, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom

^a3 Department of Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom

^a4 Department of Paediatric Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom

Abstract

Background The use of imaging that employs ionising radiation is increasing in the setting of paediatric cardiology. Children's high radiosensitivity and the lack of contemporary radiation data warrant a review of the radiation doses from the latest “state-of-the-art” angiography and computed tomography systems.

Objectives In children aged less than 16 years with congenital cardiac disease, we aimed to report: recent trends in the use of diagnostic angiography and cardiac dual-source computed tomography; the characteristics, lesions, and imaging histories of patients undergoing these procedures; and the average radiation doses imparted by each modality.

Study design Retrospective review of consecutive cases undergoing cardiac computed tomography or diagnostic angiography in a teaching hospital between January, 2008 and December, 2009. Radiation doses were converted to effective doses (millisievert) using published conversion factors.

Results Angiography was performed 3.7 times more often than computed tomography. Computed tomography examinations increased by 92.5%, whereas angiography decreased by 26.4% in 2009 compared with 2008. Patients undergoing computed tomography were younger and weighed less than those undergoing angiography, but lesions were similar between the 2 groups. Multiple lifetime angiography was more prevalent than multiple lifetime computed tomography (p < 0.001). The median procedural dose – range – from angiography and computed tomography was 5 (0.2–27.8) and 1.7 (0.5–9.5) millisieverts, respectively (p < 0.001).

Conclusion Despite not being completely analogous investigations, computed tomography should be considered prior to angiography and not withheld on radiation dose concerns, given that it imparts lower and more consistent doses than conventional angiography.

(Received January 06 2011)

(Accepted March 14 2011)

(Online publication May 10 2011)

Keywords

• Paediatric cardiology;
• imaging;
• dual-source computed tomography

Correspondence:

^c1 Correspondence to: G.G. Gherardi, School of Medicine, University of Leeds, 7.09 Worsley Building, Leeds LS2 9JT, United Kingdom. Tel: 07763907615; Fax: 01133434375; E-mail: guygherardi@gmail.com