DSCT and pediatrics

The following question has been sent by Bellalize Steenkamp, radiographer, Unitas Hospital, South Africa:

Is there a place for DSCT in paediatric diagnoses?

Hatem Alkadhi, M.D., University Hopsital Zurich, Switzerland:

Dear Ms Steenkamp
Thank you for your question regarding the use of DSCT in pediatric patients.
The answer is: Yes.
First, you may perform any DSCT examination in this population as you are used to do with other CT scanners, i.e., you can adjust the kV and mAs to the respective body constitution and age of the pediatric patient.
Second, you may be even able to scan the heart in these patients who usually have a high heart rate (often above 100bpm). The big advantage of the DSCT technology is the ability to scan even at these high heart rates. For example, you may scan a pediatric patient with congenital heart disease with the question of co-existing coronary anomaly (which often is associated with CHD and usually cannot be diagnosed by MRI or echocardiography). The additional advantage of DSCT in these patients is that the radiation dose decreases with higher heart rates (due to the increasing pitch). Thus, besides the lowering of the tube voltage and tube current setting in these patients, the dose of a cardiac CT examination can be further decreased to a level that is as low as reasonably achievable.
Of course, I do not advocate the extensive use of CT in the pediatric population. But when the indication is given and no other imaging modality than CT can provide the necessary information, DSCT is very well feasible in these patients and has the advantage – with regard to cardiac imaging – to allow for scanning even at very high heart rates and at the same time with a low radiation dose.
Best regards,
Hatem Alkadhi

See a corresponding question on DSCT and pediatrics