In a retrospective study, image quality was evaluated in 137 pediatric thoracic CT angiographies (CTA) obtained using either automated power injection with bolus tracking (119 patients) or manual contrast injection (18 patients). The injection protocols were analyzed and image quality was assessed both objectively and subjectively. Image quality was found to be significantly better with the bolus-tracking method (Likert scale 3-4), with strong inter-reader agreement (τ = 0.802, p < 0.001). The mean effective radiation dose did not differ significantly between the two groups (p=0.76). Power injector-based bolus tracking improves image quality in pediatric CTA using low contrast doses and with only a minimal increase in radiation exposure. This makes it particularly suitable for imaging in congenital heart disease.
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