Quality & Safety Committee

Resources for Parents

CT Scans

CT (also called CAT scan) is a technology which uses ionizing radiation to take pictures of the human body. CT scans can provide important information to your doctor about what is going on inside your child's body. However, there are risks associated with CT scans which are important to understand.

To learn more.....

MRI

Magnetic resonance imaging (MRI) is a noninvasive examination which uses magnetic fields to acquire detailed pictures within the body.  MRI does not use radiation. MRI can be utilized in many different types of evaluations in children including the brain, spine, knees, shoulders, abdomen (such as the liver, kidneys, and bowel) and heart.  MRI is also often employed in pregnant patients for assessment of the developing fetus. 

RadiologyInfo.org is a comprehensive patient and family centered website that provides reliable information about MRI in the pediatric patient.  This website is jointly sponsored by the American College of Radiology and Radiologic Society of North America; both are major medical imaging professional organizations dedicated to patient care, education, and research.   While much of the RadiologyInfo.org information is applicable to both children and adults, special pediatric specific content is designated by a teddy bear symbol.

Nuclear Medicine

Introduction: 

Welcome to the section of pediatric nuclear medicine studies on the Society of Pediatric for Radiology Quality and Safety Committee website.  The purpose of this document is to provide parents/guardians some general information regarding nuclear medicine exams either for diagnostic or therapeutic purpose. It is NOT in any way to substitute for a further detailed discussion between parents/guardians with both the referring physician and with the treating radiologist/nuclear medicine physician. Some of the references provided below for further consultation are from peer-reviewed papers and guidelines. We will follow a question-and-answer format that we as radiologists often engage in with parents/guardians. We aim to provide the readers with a broad overview of Nuclear Medicine and its usefulness.


To learn more ......

Radiation Issues

We all are exposed to small amounts of radiation daily from soil, rocks, building materials, air, water, and cosmic radiation. This is called naturally occurring background radiation. The radiation used in X-rays and CT scans has been compared to background radiation we are exposed to daily. This comparison may be helpful in understanding relative radiation doses to the patient.

 

Radiation source                                  Days Background Radiation

 

Background.............................................................1 day

Chest X-ray (single).................................................1 day

Head CT.................................................................up to 8 months

Abdominal CT..........................................................up to 20 months

For more information visit the website of the Alliance for Radiation Safety in Pediatric Imaging:
www.imagegently.org. 

Sedation

Sedation is vital for many imaging exams in children. The goals of sedation include: 

  1. Keep the child safe.
  2. Minimize pain or discomfort.
  3. Minimize anxiety.
  4. Reduce motion to ensure a successful exam.

Your child may be receiving sedation from member(s) of a sedation team. This team may consist of one or more doctors, nurses, technologists, child life specialists, and other medical personnel. The team will work together to create a sedation experience that is as safe and effective as possible for your child.

In general, healthy children 6-7 years and older can tolerate many radiology exams without sedation, including MRI. Many infants under 3-4 months old can avoid sedation for MRI exams by feeding and falling asleep just prior to the examination. Young children between these age groups most often require sedation. Some older children may also need sedation to reduce motion and anxiety. Interventional radiology (IR) exams often require sedation to keep children safe and still during procedures.

Your sedation provider will conduct a screening evaluation for your child before the exam. It is very important to let this provider know of any allergies along with illnesses, either recent or chronic, that your child may have. A caregiver should be present for this evaluation in order to provide consent for the sedation.

The sedation team will also inform you of fasting requirements for your child at least the day prior to the exam. One common fasting regimen is the following:           

Clear liquids                        2 hours

Breast milk                          4 hours

Infant formula                    6 hours

All other milk                      6 hours

Light meal                           6 hours

Finally, many healthcare facilities have resources available for children to avoid sedation. Some of these sedation alternatives may include MRI-compatible video goggles, DVD players, wall-mounted televisions, and headphones. Pacifiers, sugar solution (e.g. Sweet-Ease®), and swaddling may be used for infants. Child life or play specialists may also help calm anxious children with various toys and resources.

If at any point you have any questions or concerns about your child receiving sedation for his or her imaging study…. do not hesitate to ask your provider!

Ultrasound

Ultrasound is a safe, fast, portable and extremely useful imaging test that is frequently used on babies and children in Radiology departments.  Ultrasound involves no radiation and hardly ever requires a needle to be placed into a vein. 

Some ultrasound studies require preparation such as having nothing to eat until the study is done or by coming to the appointment with a full bladder (if your child is potty trained). Most studies require no preparation, so you should not be concerned if you have not received any instructions.
Ultrasound studies are performed by highly trained ultrasound technicians who are used to dealing with children and are knowledgeable about keeping them comfortable.  Most children do not need to undress but they may be asked to pull up their top or roll up their sleeve depending on the area being examined.  The technician will put some warm gel on your child’s skin and place a probe over the area being examined.  They may push slightly, but this should not be uncomfortable in any way.
Once the technician has finished taking the pictures, a pediatric radiologist may come into the room to check them. The pediatric radiologist would be more than happy to speak to you and your child after the study to explain the findings and answer any questions you may have.

X-ray and Fluoro

X-rays are a form of invisible electromagnetic radiation (energy) that can penetrate human tissues. Doctors use x-rays to see inside your child’s body by creating a picture (radiograph). Depending on how dense the tissue is, more or less of the x-rays energy will be absorbed. This difference creates the contrast seen on a radiograph. Bones for example are dense structures and will always be shown as white areas, while soft tissues are depicted as a gray tones.
To learn more...

Contrast Considerations CT and MRI

What is contrast?
Contrast for CT and MRI examinations is a liquid that can be injected in a vein, taken by mouth or placed in the rectum. It is sometimes called as contrast material, contrast agent or contrast media.

What does contrast material do?
Often contrast is necessary to improve the CT or MRI pictures, allowing your radiologist to distinguish normal from abnormal.

How should I prepare my child for the imaging test with contrast material?

Because contrast materials carry a slight risk of causing an adverse reaction, you should tell your doctor about the child’s:
• Prior history of allergy to contrast materials
• Other allergies to medications, food, preservatives including herbal supplements and animals.
• Recent illnesses, surgeries, or other medical conditions
• History of asthma and hay fever
• History of heart disease, diabetes, kidney disease, thyroid problems or sickle cell anemia

You will be given specific instructions on how to prepare your child for the exam.

What does the child experience before and after receiving intravenous contrast material?
The needle in the vein may cause some pain when it is placed, but a numbing cream is applied on the skin before to help with the discomfort. Your child may experience a warm sensation and a metallic taste in the mouth that lasts for a few minutes. Once the test is done and the needle is removed, there may be some bruising.

Where does the contrast material go after the test is over?

The contrast may be absorbed by the body from the blood, excreted in urine or may be expelled with stool.

Are contrast materials safe?

Contrast materials are extremely safe; and most of the reactions are mild, like nausea, vomiting, skin rash, flushing or mild wheezing. In rare situations, throat swelling, severe shortness of breath or seizures can occur, which may require placing a tube in the throat to give oxygen to breath. If your child has had such a reaction to contrast material in the past, please alert your healthcare provider both before and at the time of the imaging study.

For more information on Contrast Material please check this website:  http://www.radiologyinfo.org/en/info.cfm?pg=safety-contrast

AAP - Patient Safety Website

 

Resources for Professionals

American College of Radiology page on safety and quality

National Quality Forum

ACGME

 

Joint Commission

Radiation Safety

MRI Safety

http://www.mrisafety.com  (resources to keep patients safe in the MRI environment, including a list of implantable devices, implants and other objects and their relative safety in an MRI scanner at different field strengths)

 
The Image Gently Campaign's goal is to raise awareness of the opportunities to lower radiation dose in the imaging of children. Visit the website at www.imagegently.org and become a fan of our Facebook page for timely updates.



Video courtesy of Radiologyinfo.org

Quality & Safety Committee

Roster

Ramesh S. Iyer, MD
Einat Blumfield, MD
Mary K Drake, MD
Thomas Robin Goodman, MBBH
Kristopher N. Lewis, MD
Laura T. Meyer, MD
Michael M. Moore MD
Thang Ngo, MD
Christina L. Sammet, PhD
Arta-Luana Stanescu, MD
David W. Swenson, MD
Thomas Slovis, MD, Advisory

Pediatric Radiologists

Where to find a Pediatric Radiologist?

Pediatric Radiology Departments

This map shows sites where SPR members (voluntarily) report they practice in the US and Canada. If you do not find a location near you marked on the map, a good place to consider is a local children's hospital. NACHRI - the National Association of Children's Hospitals and Related Institutions hosts a search function on its website.    SPR members: If you would like your place noted on the map, contact the office to request.  This link is to the Wikipedia listing for Children's Hospitals in the US. This link is to the Wikipedia listing for Children's Hospitals in Canada

View SPR Find a Pediatric Radiologist in a larger map

Why Choose a Pediatric Radiologist?