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

Objectives To evaluate the use of video goggles for patient distraction during whole body PET/CT, and to evaluate the severity of CT and PET artifacts caused by the video goggles.

Methods Video goggles with minimal amounts of internal radio-opaque material were identified and used in this study. 30 PET/CT studies, during which patients age 4 to 13 years watched videos of the patients' choice using video goggle, were reviewed. 15 patient studies were performed on each of 2 PET/CT scanners. Fused PET/CT scans were reviewed for head movement between PET and CT acquisition. CT and PET scans of the head were reviewed for streak or other artifacts caused by the video goggles. CT exposure settings were recorded for each scan for the anatomic level at which the goggles were worn during the scan.

Results Of 30 scans, only 1 scan had evidence of significant patient motion of the head that precluded co-registration of PET and CT. 2/30 scans showed minor co-registration problems due to motion and 27/30 demonstrated very good to excellent co-registration. Using a 2006 PET/CT scanner, 2/15 localization CT scans of head demonstrated no streak artifact in brain tissue, 6/15 had mild streak artifact and 6/15 had moderate streak artifact in brain. Mild streak artifact in bone was noted in 2/15 studies. For the 2013 PET/CT scanner, 7/15 studies had mild streak artifact and 8/15 had no streak artifact in brain tissue, while there was no streak artifact in bone in all 15 studies preformed on that scanner. There were no artifacts on FDG PET brain images attributable to the goggles in any of 30 studies (15 on each scanner). Average CT exposure parameters at the level of orbits were calculated to be 59% lower for the 2013 scanner compared to the 2006 scanner.

Conclusions Video goggles may be used 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.