Nancy R. Fefferman MD, Abstract Co-Author: Nothing to Disclose

Carolyn Wassong MD, Presenter: Nothing to Disclose

Mitya Barreto, Abstract Co-Author: Employee, Siemens AG

Sarah Milla MD, Abstract Co-Author: Nothing to Disclose

Lynne Patricia Pinkney MD, Abstract Co-Author: Nothing to Disclose

Naomi Anne Strubel MD, Abstract Co-Author: Nothing to Disclose

Shailee V. Lala MD, Abstract Co-Author: Nothing to Disclose

James S. Babb PhD, Abstract Co-Author: Nothing to Disclose

The advent of multi-detector CT (MDCT) resulted in the decreased use of anesthesia among pediatric patients undergoing body CT. However, the need for anesthesia has not been completely eliminated. The purpose of this study is to assess the feasibility of performing pediatric chest CT scans without anesthesia using a high pitch acquisition (HPA) protocol for patients who normally would require anesthesia.

We retrospectively reviewed 10 pediatric chest CT scans acquired using a HPA protocol (collimation 128 x 0.6 mm for each tube, temporal resolution 75 ms, pitch 3.0) on a dual source scanner (Definition FLASH, Siemens Healthcare, Malvern, PA) without anesthesia and 10 pediatric chest CT scans using a standard pediatric protocol on MDCT scanners (Sensation 16 and Sensation 40, Siemens Healthcare, Malvern, PA) with anesthesia. The CT images were reviewed by 4 experienced pediatric radiologists for image quality using a 5 point scale, 1 being non-diagnostic and 5 being excellent, for both lung and mediastinal windows. Motion artifact was also assessed on a 3 point scale with 0 being no motion and 2 being extensive motion. The scores from each patient group were analyzed (Mann-Whitney test) to compare the HPA protocol on a dual source scanner without anesthesia and the standard pediatric protocol on MDCT scanners with anesthesia for image quality (lung and mediastinal windows) and motion artifact.

With the HPA, the time to scan a length of 20cm was 0.69 s compared to 4.5 s for the standard pediatric MDCT acquisition. HPA protocol dual source scans without anesthesia had significantly better image quality compared to standard pediatric protocol MDCT scans with anesthesia (mean score +/- standard deviation) on lung windows (HPA 4.3 +/- 0.6, standard 3.0 +/- 0.7, p < 0.01), mediastinal windows (HPA 4.3 +/- 0.6, standard 3.8 +/- 0.5, p = 0.01) and had significantly less motion artifact (HPA 0.2 +/- 0.4, standard 1.1 +/- 0.6, p < 0.01), for all readers.

Using the HPA protocol on a dual source scanner enables pediatric chest CT scans to be performed without anesthesia in patients normally requiring sedation with better image quality and less motion artifact.

Elimination of anesthesia for pediatric chest CT imaging has significant benefits for patient care and health care costs.

Fefferman, N, Wassong, C, Barreto, M, Milla, S, Pinkney, L, Strubel, N, Lala, S, Babb, J, Elimination of Anesthesia for Pediatric Chest Imaging Using a High Pitch CT Acquisition Protocol on a Dual Source Scanner.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9004973.html