Computed Tomography Imaging in Patients with Congenital Heart Disease, Part 2: Technical Recommendations. An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT): Endorsed by the Society of Pediatric Radiology (SPR) and the North American Society of Cardiac Imaging (NASCI)

This is the second of two complementary documents commissioned by the SCCT to provide recommendations on the use and optimal performance of cardiac computed tomography (CT) in patients of all ages with congenital heart disease (CHD). The aim of the first document was to describe the current uses of cardiac CT in CHD, review the risks and limitations of current CT technology, provide lesion specific indications for appropriately selected patients, and outline a consensus opinion on the essential skills and knowledge needed to perform cardiac CT in patients with CHD.1 An extensive literature review is included in the part 1 document. The aim of this second document is to provide recommendations on patient preparation and technical scan acquisition for the most commonly referred CHD lesions, and to provide a brief description of radiation dose reduction techniques specific to CT in CHD.
The clinical use of cardiac CT in CHD is evolving rapidly and this document is based on the authors' experience, supported by literature when available. The population of adults with congenital heart disease is rapidly increasing as a result of improved outcomes of medical, surgical and catheter-based treatment strategies.2, 3, 4 As patients live longer, there is a greater need for coronary imaging in addition to anatomic imaging, increased use of electrophysiology devices that are MRI unsafe, and higher prevalence of metallic implants that adversely affect MRI image quality. For these patients, CT is increasingly the preferred imaging modality when echocardiography is insufficient to answer the clinical question. This consensus document assumes competence in cardiac CT imaging, and will focus on tailoring the exam for the most commonly referred CHD lesions.
The goal of this document is to provide guidance regarding:
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Individualized patient preparation.
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Acquisition protocols for the most commonly referred CHD lesions.
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Brief overview of radiation dose reduction techniques.