Use of video goggles for patient distraction during PET/CT studies of school age children

Abstract

Objectives: For PET/CT imaging in children, (1) to evaluate the effectiveness of video goggles for patient distraction, and (2) to evaluate CT and PET artifacts caused by the video goggles. Methods: Video goggles with small amounts of internal radioopaque material were used in this study. During whole body PET/CT imaging, 30 unsedated patients age 4 to 13 years watched videos of their choice using video goggles. 15 patient studies were performed on a PET/CT scanner installed in 2006 and 15 were performed on a PET/CT scanner installed in 2013. Fused PET/CT scans were reviewed for evidence of head movement. The presence and severity of streak artifacts was reviewed on each CT and PET scan of the head. CT exposure settings were recorded for each scan at the anatomic level at which the goggles were worn during the scan. Results: Only one of 20 patient scans had evidence of significant patient head motion. Two of 30 scans had minor co-registration problems due to motion and 27 of 30 demonstrated very good to excellent co-registration. Using a 2006 PET/CT scanner, 2 of 14 evaluable localization CT scans of head demonstrated no streak artifacts in brain tissue, 6 of 14 had mild streak artifact and 6 of 14 had moderate streak artifact in brain. Mild streak artifact in bone was noted in 2 of 14 studies. For the 2013 scanner, seven of 15 studies had mild streak artifact and 8 of 15 had no streak artifact in brain tissue, while there was no streak artifact in bone in all 15 studies. There were no artifacts on FDG PET brain images attributable to the goggles in any of 30 studies. Average CT exposure parameters at the level of orbits were 59% lower on the 2013 scanner compared to the 2006 scanner. Conclusion: Video goggles may be used successfully as a patient distraction device for PET with localization CT, with no significant degradation of PET brain images and CT skull images. The amount of artifact on brain tissue images varies from none to moderate and depends on the CT equipment that is used.