Published online Sep 9, 2023. doi: 10.5409/wjcp.v12.i4.230
Peer-review started: May 17, 2023
First decision: July 4, 2023
Revised: July 12, 2023
Accepted: August 9, 2023
Article in press: August 9, 2023
Published online: September 9, 2023
There is evolving role of computed tomography coronary angiography (CTCA) in non-invasive evaluation of coronary artery abnormalities in children with Kawasaki disease (KD). Despite this, there is lack of data on radiation dose in this group of children undergoing CTCA.
To audit the radiation dose of CTCA in children with KD.
Study (December 2013-February 2018) was performed on dual source CT scanner using adaptive prospective electrocardiography-triggering. The dose length product (DLP in milligray-centimeters-mGy.cm) was recorded. Effective radiation dose (millisieverts-mSv) was calculated by applying appropriate age adjusted conversion factors as per recommendations of International Commission on Radiological Protection. Radiation dose was compared across the groups (0-1, 1-5, 5-10, and > 10 years).
Eighty-five children (71 boys, 14 girls) with KD underwent CTCA. The median age was 5 years (range, 2 mo-11 years). Median DLP and effective dose was 21 mGy.cm, interquartile ranges (IQR) = 15 (13, 28) and 0.83 mSv, IQR = 0.33 (0.68, 1.01) respectively. Mean DLP increased significantly across the age groups. Mean effective dose in infants (0.63 mSv) was significantly lower than the other age groups (1-5 years 0.85 mSv, 5-10 years 1.04 mSv, and > 10 years 1.38 mSv) (P < 0.05). There was no significant difference in the effective dose between the other groups of children. All the CTCA studies were of diagnostic quality. No child required a repeat examination.
CTCA is feasible with submillisievert radiation dose in most children with KD. Thus, CTCA has the potential to be an important adjunctive imaging modality in children with KD.
Core Tip: Dual source computed tomography (CT) scanners by virtue of high temporal resolution, faster gantry rotation, electrocardiography triggered tube current modulation, large area coverage, body adaptive automatic selection of tube current modulation and iterative reconstruction algorithm have largely addressed the issue of high radiation exposure when subjecting children with Kawasaki disease (KD) to CT coronary angiography. It is now possible to evaluate these patients using submilliseivert radiation exposure. This is a significant advance in management of KD.