Radiation dose analysis of computed tomography coronary angiography in Children with Kawasaki disease

Table 1 Comparison of effective radiation dose on dual source computed tomography coronary angiography platforms in patients with Kawasaki disease

Ref.	Country	Number of cases	Platform	ECG triggering	Age	Radiation dose	Remarks
Duan et al[27], 2012	China	19	DSCT	Prospective	Range: 3 mo-5 yr	ED (mean ± SD): 0.36 ± 0.06 mSv
Kim and Goo[28], 2013	Korea	51	DSCT: (1) 64-Slice: n = 49; and (2) 128-Slice: n = 2	Retrospective in most of the patients	Mean (range): 13.2 (1-24) yr	ED (mean ± SD): (1) 64-Slice: 2.6 ± 2.7 mSv; and (2) 128-Slice: 2.1 ± 0.6 mSv	ED was only 0.6 ± 0.5 mSV in 5 children < 2 yr of age, who underwent prospective ECG-triggering
Ghoshhajra et al[29], 2014	United States	52	DSCT: (1) 64-Slice: n = 16; and (2) 128-Slice: n = 36	Prospective	Range: 0-18 yr	Median (IQR) ED: (1) 64-Slice: 2.9 (0.9-4.1) mSV; and (2) 128-Slice: 1.0 (0.6-2.0) mSV	ED significantly reduced compared to 16 and 64-Slice Scanner platforms
Kantarcı et al[30], 2019	Turkey	17	128-Slice DSCT	Details NA	Mean (range): 3 yr (2 mo-11.3 yr)	ED range: 1.2-4.3 mGy depending on the patient’s body weight
van Stijn et al[26], 2020	Netherlands	70	DSCT: (1) 2 × 192-Slice: n = 56; and (2) Other CT scanners (64/128/320-Slice): n = 14	Prospective	Median (range): 15.1 (0.5-59.5) yr	Median (range) ED: (1) 2 × 192-Slice: 1.5 (0.3-9.4) mSv; and (2) Other CT scanner: 3.8 (1.7-20.0) mSv	This is the only study on 3rd generation DSCT platform
Borhanuddin et al[31], 2022	Malaysia	52	64-slice DSCT	Retrospective	Median (range): 5 (1-18) yr	Median (range) ED: 0.81 (0.4-5.8)
Present study, Chandigarh	India	85	128-Slice DSCT	Prospective	Median (range): 5 yr (2 mo-11 yr)	Median (IQR) ED: 0.83 (0.68-1.01)	Largest study on 128-Slice platform which provides data that CTCA can be performed in sub-millisievert doses

CTCA: Computed tomography coronary angiography; DSCT: Dual source computed tomography; ED: Effective radiation dose; IQR: Interquartile range.

Table 2 Conversion factors for chest in different age groups at 80 kV according to recent International Commission on Radiological Protection recommendations (20)

S.No.	Age group	Tube voltage (kV)	Conversion factor
1	< 1 yr	80	0.0823
2	> 1 - < 5 yr	80	0.0525
3	> 5 - < 10 yr	80	0.0344
4	≥ 10 yr	80	0.0248

Table 3 Effective computed tomography radiation exposure according to age in adaptive prospective electrocardiography-triggered sequence computed tomography coronary angiography on 128-dual source computed tomography platform

S.No.	Age group	Mean DLP (mGy.cm)	Mean effective radiation dose (mSv)
1	0-1 yr (n = 10)	9.19 ± 2.21	0.63 ± 0.16
2	1-5 yr (n = 29)	18.82 ± 8.48	0.85 ± 0.41
3	5-10 yr (n = 38)	31.79 ± 14.14	1.04 ± 0.37
4	> 10 yr (n = 8)	55.67 ± 19.39	1.38 ± 0.48

DLP: Dose length product; mSV: Millisievert.