PMID- 32286868 OWN - NLM STAT- MEDLINE DCOM- 20200702 LR - 20200702 IS - 1546-3141 (Electronic) IS - 0361-803X (Linking) VI - 214 IP - 6 DP - 2020 Jun TI - Reducing Radiation Dose and Contrast Medium Volume With Application of Dual-Energy CT in Children and Young Adults. PG - 1199-1205 LID - 10.2214/AJR.19.22231 [doi] AB - OBJECTIVE. The purpose of this study was to assess if dual-source dual-energy CT (DS-DECT) can be used with lower radiation doses and contrast material volumes than single-energy CT (SECT) in children and young adults. MATERIALS AND METHODS. This retrospective study included 85 consecutive children and young adults (age range, 1 month old to 19 years old; 81 male, 70 female) who underwent contrast-enhanced DS-DECT of the chest (n = 41) or the abdomen and pelvis (n = 44) on second- or third-generation dual-source CT scanners (Somatom Flash or Force, Siemens Healthineers) for clinically indicated reasons. We included 66 age-, sex-, body region-, and weight-matched patients who underwent SECT on the same scanner. Patients were scanned with either SECT (with automatic exposure control using both CARE kV [Siemens Healthineers] and CARE Dose 4D [Siemens Healthineers]) or DS-DECT (with CARE Dose 4D). Two pediatric radiologists assessed clinical indications, radiologic findings, image quality, and any study limitations (noise or artifacts). Patient demographics (age, sex, weight), scan parameters (tube voltage, tube current-time product, pitch, section thickness), CT dose descriptors (volume CT dose index, dose-length product, size-specific dose estimate [SSDE]), and contrast material volume were recorded. Descriptive statistics, paired t test, and Cohen kappa test were performed. RESULTS. Mean patient ages and weights +/- SD in DS-DECT (10 +/- 6 years old, 38 +/- 23 kg) and SECT (11 +/- 7 years old, 43 +/- 29 kg) groups were not significantly different (p > 0.05). Respective SSDEs for chest DS-DECT (4.0 +/- 2.1 mGy), chest SECT (6.1 +/- 4.4 mGy), abdomen-pelvis DS-DECT (5.0 +/- 5.0 mGy), and abdomen-pelvis SECT (8.3 +/- 4.0 mGy) were significantly different (p = 0.003-0.005). Contrast material volume for DS-DECT examinations was 19-22% lower compared with the weight- and body region-matched scans obtained with SECT. Image quality of DECT was acceptable in all patients. CONCLUSION. In children and young adults, chest and abdomen-pelvis DS-DECT enables substantial radiation dose and contrast volume reductions compared with weight- and region-matched SECT. FAU - Tabari, Azadeh AU - Tabari A AD - Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 75 Blossom Ct, Ste 248, Boston, MA 02114. FAU - Gee, Michael S AU - Gee MS AD - Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 75 Blossom Ct, Ste 248, Boston, MA 02114. FAU - Singh, Ramandeep AU - Singh R AD - Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 75 Blossom Ct, Ste 248, Boston, MA 02114. AD - MGH Webster Center for Quality and Safety, Massachusetts General Hospital and Harvard Medical School, Boston, MA. FAU - Lim, Ruth AU - Lim R AD - Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 75 Blossom Ct, Ste 248, Boston, MA 02114. FAU - Nimkin, Katherine AU - Nimkin K AD - Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 75 Blossom Ct, Ste 248, Boston, MA 02114. FAU - Primak, Andrew AU - Primak A AD - Siemens Healthcare USA Inc., Malvern, PA. FAU - Schmidt, Bernhard AU - Schmidt B AD - Siemens Healthineers, Forchheim, Germany. FAU - Kalra, Mannudeep K AU - Kalra MK AD - Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 75 Blossom Ct, Ste 248, Boston, MA 02114. AD - MGH Webster Center for Quality and Safety, Massachusetts General Hospital and Harvard Medical School, Boston, MA. LA - eng PT - Journal Article DEP - 20200414 PL - United States TA - AJR Am J Roentgenol JT - AJR. American journal of roentgenology JID - 7708173 RN - 0 (Contrast Media) SB - IM MH - Adolescent MH - Child MH - Child, Preschool MH - Contrast Media/*administration & dosage MH - Female MH - Humans MH - Infant MH - Infant, Newborn MH - Male MH - *Radiation Dosage MH - Radiation Protection/*methods MH - *Radiography, Dual-Energy Scanned Projection MH - Retrospective Studies MH - *Tomography, X-Ray Computed MH - Young Adult OTO - NOTNLM OT - IV contrast medium OT - abdomen OT - chest OT - children OT - dual-energy CT OT - pelvis OT - radiation dose EDAT- 2020/04/15 06:00 MHDA- 2020/07/03 06:00 CRDT- 2020/04/15 06:00 PHST- 2020/04/15 06:00 [pubmed] PHST- 2020/07/03 06:00 [medline] PHST- 2020/04/15 06:00 [entrez] AID - 10.2214/AJR.19.22231 [doi] PST - ppublish SO - AJR Am J Roentgenol. 2020 Jun;214(6):1199-1205. doi: 10.2214/AJR.19.22231. Epub 2020 Apr 14.