Role of low-dose cardiac CT scans in young children: a systematic review

PURPOSE: To perform a systematic review of the diagnostic accuracy of low-dose cardiac CT scans in young children. METHODS: A search of MEDLINE via the PubMed, Web of Science Core Collection, Cochrane Library, and ScienceDirect databases for English-language literature was performed to identify studies on low-dose cardiac CT for the diagnosis of congenital heart disease. The image quality, diagnostic value and effective radiation dose of low-dose cardiac CT scans were compared. RESULTS: Fourteen studies utilized a total sample size of 474 neonates, infants, and young children. Twelve studies reported diagnostic accuracies ranging between 95.60% and 100.00%. Among the individual studies, the sensitivity ranged between 91.00% and 96.70%, whereas the specificity ranged between 92.30% and 99.91%. The effective radiation dose between individual studies ranged between 0.07mSv and 1.81mSv. The subjective image quality was either rated on a 5-point or a 4-point scale. Among the studies that used the 5-point scale, the image quality ranged between 3.77 and 4.90, whereas among the studies that used the 4-point scale, the image quality ranged between 1.20 and 3.06. CONCLUSIONS: The findings of this study indicate that advanced CT scan protocols, such as high-pitched, dual-source, and ECG-triggered methods, can produce high-quality images and achieve very high diagnostic accuracy at extremely low radiation doses.