{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T06:28:09Z","timestamp":1787120889211,"version":"build-2736575974"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017686","name":"Fujian Provincial Health Technology Project","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100017686","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the feasibility of ultra\u2013low tube voltage (70\u2005kV) cardiac CT angiography (CTA) with weight-adapted iodine delivery in neonates and to compare image quality, coronary visibility, radiation exposure, and iodine delivery with those of a conventional 80-kV protocol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study included 125 neonates with congenital heart disease who underwent prospectively ECG-triggered cardiac CTA using a 256-row CT scanner. Patients were divided into an 80-kV group reconstructed with 50% adaptive statistical iterative reconstruction-V (ASIR-V) (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200961) and a 70-kV group reconstructed with 70% ASIR-V (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200964). Both protocols used standardized weight-adapted iodine delivery (450\u2005mg I\/kg). Subjective and objective image quality, coronary artery visibility, radiation dose, and iodine delivery were compared between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall interobserver agreement for subjective image quality assessment was excellent (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u2009=\u20090.815). Subjective image quality scores were comparable between the two groups across most coronary segments, with no significant differences in overall image quality (3.98\u2009\u00b1\u20091.04 vs. 3.95\u2009\u00b1\u20091.05,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.545). Objective image quality parameters, including CT attenuation, image noise, signal-to-noise ratio, and contrast-to-noise ratio, also showed no significant differences between groups (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05). Coronary artery visibility remained high in both groups, with overall visibility rates exceeding 89%. Importantly, distal coronary segments remained diagnostically assessable in approximately 75% of cases under the 70-kV protocol. Compared with the 80-kV protocol, the 70-kV protocol achieved a 24% reduction in effective radiation dose (0.32\u2009\u00b1\u20090.05 vs. 0.42\u2009\u00b1\u20090.06\u2005mSv,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) without increasing iodine delivery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Ultra-low tube voltage (70\u2005kV) cardiac CT with weight-adjusted iodine delivery is feasible for neonatal imaging and can substantially reduce radiation exposure while preserving coronary artery image quality and visibility. This approach may help achieve a more balanced trade-off among image quality, radiation dose, and contrast administration in neonatal cardiac CT examinations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1882665","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T05:48:55Z","timestamp":1787118535000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Ultra-low 70-kV cardiac CT angiography in neonates: a comparative dose-optimized approach with preserved image quality"],"prefix":"10.3389","volume":"13","author":[{"given":"Xiaofang","family":"He","sequence":"first","affiliation":[{"name":"Department of Radiology, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi","family":"Nie","sequence":"additional","affiliation":[{"name":"Department of Radiology, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Radiology, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Radiology, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenxiao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruqi","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumin","family":"Zhong","sequence":"additional","affiliation":[{"name":"Diagnostic Imaging Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"527","DOI":"10.5543\/tkda.2017.24162","article-title":"Prevalence and characteristics of coronary artery anomalies in children with congenital heart disease diagnosed with coronary angiography.","volume":"45","author":"Temel","year":"2017","journal-title":"Turk Kardiyol Dern Ars-Arch Turk Soc Cardiol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e1573403X321942","DOI":"10.2174\/011573403X321942241023112517","article-title":"Comprehensive review of coronary artery anatomy relevant to cardiac surgery","volume":"21","author":"Kesieme","year":"2025","journal-title":"Curr Cardiol Rev"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2373","DOI":"10.1111\/jocs.15572","article-title":"Anomalies of coronary arteries in tetralogy of Fallot: evaluation on multidetector CT angiography using dual-source scanner","volume":"36","author":"Pandey","year":"2021","journal-title":"J Card Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"838","DOI":"10.1017\/S1047951123003438","article-title":"Efficacy and safety of coronary computed tomography angiography in diagnosing coronary lesions in children","volume":"34","author":"Gould","year":"2024","journal-title":"Cardiol Young"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1269","DOI":"10.1056\/NEJMoa2502098","article-title":"Medical imaging and pediatric and adolescent hematologic cancer risk","volume":"393","author":"Smith-Bindman","year":"2025","journal-title":"N Engl J Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1016\/j.jcct.2025.09.008","article-title":"Optimizing contrast administration in pediatric cardiovascular CT: safety and technique","volume":"19","author":"Ganigara","year":"2025","journal-title":"J Cardiovasc Comput Tomogr"},{"key":"B7","doi-asserted-by":"publisher","first-page":"567","DOI":"10.33963\/KP.a2022.0088","article-title":"Image quality and radiation doses of volumetric 320-row computed tomography angiography with prospective electrocardiogram-gating in the assessment of coronary arteries in neonates and infants","volume":"80","author":"Roik","year":"2022","journal-title":"Kardiol Pol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"2213","DOI":"10.1007\/s00330-024-11059-x","article-title":"Deep learning reconstruction algorithm and high-concentration contrast medium: feasibility of a double-low protocol in coronary computed tomography angiography","volume":"35","author":"Caruso","year":"2025","journal-title":"Eur Radio"},{"key":"B9","doi-asserted-by":"publisher","first-page":"3051","DOI":"10.21037\/qims-20-1158","article-title":"Improving the image quality of pediatric chest CT angiography with low radiation dose and contrast volume using deep learning image reconstruction","volume":"11","author":"Sun","year":"2021","journal-title":"Quant Imaging Med Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"4162","DOI":"10.21037\/qims-20-1159","article-title":"Performance evaluation of using shorter contrast injection and 70 kVp with deep learning image reconstruction for reduced contrast medium dose and radiation dose in coronary CT angiography for children: a pilot study","volume":"11","author":"Sun","year":"2021","journal-title":"Quant Imaging Med Surg"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1024","DOI":"10.1007\/s11547-020-01280-1","article-title":"The sub-millisievert era in CTCA: the technical basis of the new radiation dose approach","volume":"125","author":"Schicchi","year":"2020","journal-title":"Radiol med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"946","DOI":"10.1007\/s11604-021-01133-5","article-title":"Application of prospective ECG-gated multiphase scanning for coronary CT in children with different heart rates","volume":"39","author":"Tang","year":"2021","journal-title":"Jpn J Radiol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"937","DOI":"10.1007\/s10554-018-01526-0","article-title":"Image quality and radiation dose of two prospective ECG-triggered protocols using 128-slice dual-source CT angiography in infants with congenital heart disease","volume":"35","author":"Chen","year":"2019","journal-title":"Int J Cardiovasc Imaging"},{"key":"B14","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1093\/rpd\/ncad295","article-title":"Cardiac computed tomography angiography with and without bolus tracking methods in infants with congenital heart disease","volume":"200","author":"Yoshiura","year":"2024","journal-title":"Radiat Prot Dosim"},{"key":"B15","doi-asserted-by":"publisher","first-page":"2912","DOI":"10.1007\/s00330-021-08424-5","article-title":"High-strength deep learning image reconstruction in coronary CT angiography at 70-kVp tube voltage significantly improves image quality and reduces both radiation and contrast doses","volume":"32","author":"Li","year":"2022","journal-title":"Eur Radio"},{"key":"B16","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1093\/rpd\/ncp271","article-title":"Alpha particles at energies of 10 MeV to 1 TeV: conversion coefficients for fluence-to-absorbed dose, effective dose, and gray equivalent, calculated using Monte Carlo radiation transport code MCNPX 2.7.a","volume":"138","author":"Copeland","year":"2010","journal-title":"Radiat Prot Dosim"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1485","DOI":"10.1007\/s10554-018-1363-8","article-title":"Patient-related factors influencing detectability of coronary arteries in 320-row CT angiography in infants with complex congenital heart disease","volume":"34","author":"Yamasaki","year":"2018","journal-title":"Int J Cardiovasc Imaging"},{"key":"B18","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1016\/j.jcct.2024.03.001","article-title":"Gated cardiac CT in infants: what can we expect from deep learning image reconstruction algorithm?","volume":"18","author":"Gulizia","year":"2024","journal-title":"J Cardiovasc Comput Tomogr"},{"key":"B19","doi-asserted-by":"publisher","first-page":"4494","DOI":"10.1007\/s00330-023-10493-7","article-title":"How subjective CT image quality assessment becomes surprisingly reliable: pairwise comparisons instead of Likert scale","volume":"34","author":"Hoeijmakers","year":"2024","journal-title":"Eur Radio"},{"key":"B20","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/j.ejmp.2020.12.002","article-title":"Selection of optimal cardiac phases for ECG-triggered coronary CT angiography in pediatrics","volume":"81","author":"Le Roy","year":"2021","journal-title":"Phys Med"},{"key":"B21","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1186\/s12880-025-01608-1","article-title":"Achieving low radiation dose and contrast agents dose in coronary CT angiography at 60-kVp ultra-low tube voltage","volume":"25","author":"He","year":"2025","journal-title":"BMC Med Imaging"},{"key":"B22","doi-asserted-by":"publisher","first-page":"3891","DOI":"10.21037\/qims-22-1141","article-title":"Image quality of coronary CT angiography at ultra low tube voltage reconstructed with a deep-learning image reconstruction algorithm in patients of different weight","volume":"13","author":"Zhu","year":"2023","journal-title":"Quant Imaging Med Surg"},{"key":"B23","doi-asserted-by":"publisher","first-page":"517","DOI":"10.3233\/XST-210856","article-title":"Imaging pediatric acute head trauma using 100-kVp low dose CT with adaptive statistical iterative reconstruction (ASIR-V) in single rotation on a 16 cm wide-detector CT","volume":"29","author":"Zhu","year":"2021","journal-title":"J Xray Sci Technol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"7804015","DOI":"10.1155\/2022\/7804015","article-title":"Ladder-like low iodine delivery rate injection protocols based on BMI at 70 KV by automated tube voltage selection in coronary CTA","volume":"2022","author":"Ge","year":"2022","journal-title":"Contrast Media Mol Imaging"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1659","DOI":"10.1007\/s00247-023-05638-1","article-title":"Dose length product to effective dose coefficients in children","volume":"53","author":"Chu","year":"2023","journal-title":"Pediatr Radiol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"e0300090","DOI":"10.1371\/journal.pone.0300090","article-title":"Assessment of deep learning image reconstruction (DLIR) on image quality in pediatric cardiac CT datasets type of manuscript: original research","volume":"19","author":"Cho","year":"2024","journal-title":"PLoS One"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/RCT.0000000000001401","article-title":"Iterative reconstruction: state-of-the-art and future perspectives","volume":"47","author":"Guido","year":"2023","journal-title":"J Comput Assist Tomogr"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1882665\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T05:48:56Z","timestamp":1787118536000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1882665\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,19]]},"references-count":27,"alternative-id":["10.3389\/fcvm.2026.1882665"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2026.1882665","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,19]]},"article-number":"1882665"}}