Impact of upgrading from a 25-cm to a 30-cm z-axis field of view digital PET/CT in a pediatric hospital.

Background: Increased positron emission tomography (PET) scanner z-axis coverage provides an opportunity in pediatrics to reduce dose, anesthesia, or repeat scans due to motion.

Objective: Recently, our digital PET scanner was upgraded from a 25-cm to a 30-cm z-axis coverage. We compare the two systems through National Electrical Manufacturing Association (NEMA) testing and evaluation of paired images from patients scanned on both systems.

An adult and pediatric size-based contrast administration reduction phantom study for single and dual-energy CT through preservation of contrast-to-noise ratio.

Background: Global shortages of iodinated contrast media (ICM) during COVID-19 pandemic forced the imaging community to use ICM more strategically in CT exams.

Purpose: The purpose of this work is to provide a quantitative framework for preserving iodine CNR while reducing ICM dosage by either lowering kV in single-energy CT (SECT) or using lower energy virtual monochromatic images (VMI) from dual-energy CT (DECT) in a phantom study.

Materials And Methods: In SECT study, phantoms with effective diameters of 9.

Implementation of AI image reconstruction in CT-how is it validated and what dose reductions can be achieved.

CT reconstruction has undergone a substantial change over the last decade with the introduction of iterative reconstruction (IR) and now with deep learning reconstruction (DLR). In this review, DLR will be compared to IR and filtered back-projection (FBP) reconstructions. Comparisons will be made using image quality metrics such as noise power spectrum, contrast-dependent task-based transfer function, and non-prewhitening filter detectability index ().

Computed tomography-based measurements of normative liver and spleen volumes in children.

Background: Quantification of organ size has utility in clinical care and research for diagnostics, prognostics and surgical planning. Volumetry is regarded as the best measure of organ size and change in size over time. Scarce reference values exist for liver and spleen volumes in healthy children.

Reducing Pediatric Intraoral Radiography Radiation Dose Using Reduced-Power Dental X-Ray Units: A Randomized Trial.

To assess the diagnostic confidence of intraoral radiographic image quality while reducing the pediatric patient's radiation exposure using a longer position indicating device (PID), additional X-ray beam filtration and rectangular collimation while using modern, lower-power intraoral dental X-ray units.
A randomized prospective study scored bitewing intraoral dental images based on relevant clinical features. Observer studies with pediatric dentists and dental residents were conducted to verify whether diagnostic confidence remained unchanged after dose reduction modifications.

Application of reference air kerma alert levels for pediatric fluoroscopic examinations.

The purpose of this study was to provide an empirical model to develop reference air kerma (RAK) alert levels as a function of patient thickness or age for pediatric fluoroscopy for any institution to use in a Quality Assurance program. RAK and patient thickness were collected for 10&663 general fluoroscopic examinations and 1500 fluoroscopically guided interventions (FGIs). RAK and patient age were collected for 6137 fluoroscopic examinations with mobile-C-arms (MC).

Defining Normal Ranges of Skeletal Muscle Area and Skeletal Muscle Index in Children on CT Using an Automated Deep Learning Pipeline: Implications for Sarcopenia Diagnosis.

Skeletal muscle area (SMA), representing skeletal muscle cross-sectional area at the L3 vertebral level, and skeletal muscle index (SMI), representing height-normalized SMA, can serve as markers of sarcopenia. Normal SMA and SMI values have been reported primarily in adults. The purpose of this study was to use an automated deep learning (DL) pipeline for muscle segmentation on abdominal CT to define normative age- and sex-based values for pediatric muscle cross-sectional area as a guide for diagnosis of sarcopenia in children.

Detection of urinary tract calculi on CT images reconstructed with deep learning algorithms.

Background: Deep learning Computed Tomography (CT) reconstruction (DLR) algorithms promise to improve image quality but the impact on clinical diagnostic performance remains to be demonstrated. We aimed to compare DLR to standard iterative reconstruction for detection of urolithiasis by unenhanced CT in children and young adults.

Methods: This was an IRB approved retrospective study involving post-hoc reconstruction of clinically acquired unenhanced abdomen/pelvis CT scans.

Comparison of 0.3-mSv CT to Standard-Dose CT for Detection of Lung Nodules in Children and Young Adults With Cancer.

. CT is the imaging modality of choice to identify lung metastasis. .

Automatic Detection of Inadequate Pediatric Lateral Neck Radiographs of the Airway and Soft Tissues using Deep Learning.

Purpose: To develop and validate a deep learning (DL) algorithm to identify poor-quality lateral airway radiographs.

Materials And Methods: A total of 1200 lateral airway radiographs obtained in emergency department patients between January 1, 2000, and July 1, 2019, were retrospectively queried from the picture archiving and communication system. Two radiologists classified each radiograph as adequate or inadequate.

Current and emerging artificial intelligence applications for pediatric abdominal imaging.

Artificial intelligence (AI) uses computers to mimic cognitive functions of the human brain, allowing inferences to be made from generally large datasets. Traditional machine learning (e.g.

Improving Image Quality and Reducing Radiation Dose for Pediatric CT by Using Deep Learning Reconstruction.

Background CT deep learning reconstruction (DLR) algorithms have been developed to remove image noise. How the DLR affects image quality and radiation dose reduction has yet to be fully investigated. Purpose To investigate a DLR algorithm's dose reduction and image quality improvement for pediatric CT.

Effect of Propranolol on 18F-Fluorodeoxyglucose Uptake in Brown Adipose Tissue in Children and Young Adults with Neoplastic Diseases.

Purpose: To evaluate the effectiveness of propranolol at mitigating FDG uptake in brown adipose tissue (BAT) of pediatric patients with known or suspected malignancies.

Methods: PET/CT scans of 3 cohorts of patients treated from 2005 to 2017 were scored for the presence of FDG uptake by BAT at 7 sites: right or left neck/supraclavicular area, right or left axilla, mediastinum, posterior thorax, and abdomen/pelvis. Uptake was scored as follows: 0, none; 1, mild uptake < liver; 2, moderate uptake = liver; and 3, intense uptake > liver.

DeepLiverNet: a deep transfer learning model for classifying liver stiffness using clinical and T2-weighted magnetic resonance imaging data in children and young adults.

Background: Although MR elastography allows for quantitative evaluation of liver stiffness to assess chronic liver diseases, it has associated drawbacks related to additional scanning time, patient discomfort, and added costs.

Objective: To develop a machine learning model that can categorically classify the severity of liver stiffness using both anatomical T2-weighted MRI and clinical data for children and young adults with known or suspected pediatric chronic liver diseases.

Materials And Methods: We included 273 subjects with known or suspected chronic liver disease.

Achievable dose reductions with gonadal shielding for children and adults during abdominal/pelvic radiographic examinations: A Monte Carlo simulation.

Purpose: Recently, medical professionals have reconsidered the practice of routine gonadal shielding for radiographic examinations. The objective of this study was to evaluate the gonadal dose reduction achievable with gonadal shields in the primary beam during abdominal/pelvic radiographic examinations under ideal and non-ideal shielding placement.

Methods: CT scans of CIRS anthropomorphic phantoms were used to perform voxelized Monte Carlo simulations of the photon transport during abdominal/pelvic radiographic examinations with standard filtration and 0.

Analysis of quantitative [I-123] mIBG SPECT/CT in a phantom and in patients with neuroblastoma.

Purpose: To determine the accuracy of quantitative SPECT, intersystem and interpatient standardized uptake value (SUV) calculation consistency for a manufacturer-independent quantitative SPECT/CT reconstruction algorithm, and the range of SUVs of normal and neoplastic tissue.

Methods: A NEMA body phantom with 6 spheres (ranging 10-37 mm) was filled with a known activity-to-volume ratio and used to determine the contrast recovery coefficient (CRC) for each visible sphere, and the measured SUV accuracy of those spheres and background water solution. One hundred eleven 123I-metaiodobenzylguanidine ([I-123] mIBG) SPECT/CT examinations from 43 patients were reconstructed using SUV SPECT® (HERMES Medical Solutions Inc.

Machine Learning Prediction of Liver Stiffness Using Clinical and T2-Weighted MRI Radiomic Data.

The purpose of this study is to develop a machine learning model to categorically classify MR elastography (MRE)-derived liver stiffness using clinical and nonelastographic MRI radiomic features in pediatric and young adult patients with known or suspected liver disease. Clinical data (27 demographic, anthropomorphic, medical history, and laboratory features), MRI presence of liver fat and chemical shift-encoded fat fraction, and MRE mean liver stiffness measurements were retrieved from electronic medical records. MRI radiomic data (105 features) were extracted from T2-weighted fast spin-echo images.

Development and validation of an open source Monte Carlo dosimetry model for wide-beam CT scanners using Fluka.

Purpose: Development and validation of an open source Fluka-based Monte Carlo source model for diagnostic patient dose calculations.

Methods: A framework to simulate a computed tomography (CT) scanner using Fluka Monte Carlo particle transport code was developed. The General Electric (GE) Revolution scanner with the large body filter and 120 kV tube potential was characterized using measurements.

Radiation Dose for Pediatric CT: Comparison of Pediatric versus Adult Imaging Facilities.

Background The American College of Radiology Dose Index Registry for CT enables evaluation of radiation dose as a function of patient characteristics and examination type. The hypothesis of this study was that academic pediatric CT facilities have optimized CT protocols that may result in a lower and less variable radiation dose in children. Materials and Methods A retrospective study of doses (mean patient age, 12 years; age range, 0-21 years) was performed by using data from the National Radiology Data Registry (year range, 2016-2017) (n = 239 622).

Tissue segmentation of computed tomography images using a Random Forest algorithm: a feasibility study.

There is a need for robust, fully automated whole body organ segmentation for diagnostic CT. This study investigates and optimizes a Random Forest algorithm for automated organ segmentation; explores the limitations of a Random Forest algorithm applied to the CT environment; and demonstrates segmentation accuracy in a feasibility study of pediatric and adult patients. To the best of our knowledge, this is the first study to investigate a trainable Weka segmentation (TWS) implementation using Random Forest machine-learning as a means to develop a fully automated tissue segmentation tool developed specifically for pediatric and adult examinations in a diagnostic CT environment.

A Comprehensive Risk Assessment Method for Pediatric Patients Undergoing Research Examinations Using Ionizing Radiation: How We Answered the Institutional Review Board.

Objective: The objectives of this study are to establish a comprehensive method for radiation dose estimates for the most common imaging examinations performed for research, for internal use of institutional review board (IRB) and radiation safety committees; to provide investigators with relative examination doses so that they may better assess the potential radiation effects and risks for research subjects; and to provide simplified language that investigators can use in consent documents.

Materials And Methods: Nineteen common radiation-based examinations used in clinical research at our institution were identified. For each modality (CT, digital radiography, dual-energy x-ray absorptiometry, PET/CT, and nuclear medicine), a comprehensive patient-specific dosimetry method was established.