CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2015; 25(04): 359-364
DOI: 10.4103/0971-3026.169466
Pediatric Radiology

Problems and preferences in pediatric imaging

Brij Bhushan Thukral
Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
› Author Affiliations
Financial support and sponsorship Nil.


Radiological imaging is extremely valuable as a diagnostic tool in the pediatric population, but it comes with a number of distinct challenges as compared to the imaging of adults. This is because of the following: It requires dedicated imaging protocols to acquire the images, there is need for sedation or general anesthesia for longer procedures such as MRI, specific training is required for the healthcare personnel involved, thorough knowledge and expertise should be applied for evaluating the images, and most importantly, it requires consideration for radiation exposure if ionizing radiation is being used. One of the challenges for clinical care personnel is to gain the child's trust and co-operation before and throughout the duration of an examination, which can prove to be difficult in children who may be ill and have pain. This is important to acquire quality images and prevent repeat examinations. Even with a quality examination, the accurate interpretation of images requires a thorough knowledge of the intricate and dynamic face of anatomy and specific pathological presentations in children. The increased radiation sensitivity of growing organs and children's longer expected life spans make them more susceptible to the harmful effects of radiation. Imaging pediatric patients in a dedicated pediatric imaging department with dedicated pediatric CT technologists may result in greater compliance with pediatric protocols and significantly reduced patient dose. In order to prevent the harmful effects of ionizing radiation, As Low As Reasonably Achievable (ALARA) principle should be strictly followed. This article seeks to draw attention to various challenges of pediatric imaging and the ways to overcome them.

Publication History

Article published online:
30 July 2021

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  • References

  • 1 Frush DP, Donnely LF, Rosen NS. Computed tomography and radiation risks: What pediatric health care providers should know. Pediatrics 2003;112:951-7.
  • 2 Goske MJ, Applegate KE, Boylan J, Butler PF, Callahan MJ, Coley BD, et al. The 'Image Gently' campaign: Increasing CT radiation dose awareness through a national education and awareness program. Pediatr Radiol 2008;38:265-9.
  • 3 Erondu OF. Challenges and peculiarities of paediatric imaging. Medical Imaging in Clinical Practice. 2013.
  • 4 NHS- National Imaging Board. Delivering quality Imaging services for Children. Available from: [Last accessed on 2010 Mar 30].
  • 5 Hall EJ. Lessons we have learned from our children: Cancer risks from diagnostic radiology. Pediatr Radiol 2002;32:700-6.
  • 6 BEIR (Committee on the Biological Effects of Ionising Radiation). Health Effects of Exposure of Low Levels of Ionizing Radiation. Washington DC: National Academy Press; 1990.
  • 7 International Commission on Radiological Protection. 1990 recommendations of the International Commission on Radiological Protection. Oxford, England: Pergamon ICRP publication 60; 1991.
  • 8 Brenner DJ, Elliston CD, Hall EJ, Berdon WE. Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR Am J Roentgenol 2001;176:289-96.
  • 9 Pearce MS, Salotti JA, Little MP, McHugh K, Lee C, Kim KP, et al. Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: A retrospective cohort study. Lancet 2012;380:499-505.
  • 10 Mathews JD, Forsythe AV, Brady Z, Butler MW, Goergen SK, Byrnes GB, et al. Cancer risk in 680 000 people exposed to computed tomography scans in childhood or adolescence: Data linkage study of 11 million Australians. BMJ 2013;346:f2360.
  • 11 Ditchfield M. 3T MRI in paediatrics: Challenges and clinical applications. Eur J Radio 2008;68:309-19.
  • 12 Mitchell CL, Vasanawala SS. An approach to pediatric liver MRI. AJR Am J Roentgenol 2011;196:W519-26.
  • 13 Machata AM, Willschke H, Kabon B, Prayer D, Marhofer P. Effect of brain MRI on body core temperature in sedated infants and children. Br J Anaesth 2009;102:385-9.
  • 14 Raschle N, Zuk J, Ortiz-Mantilla S, Sliva DD, Franceschi A, Grant PE, et al. Pediatric neuroimaging in early childhood and infancy: Challenges and practical guidelines. Ann N Y Acad Sci 2012;1252:43-50.
  • 15 Frush DP, Donnelly LF, Chotas HG. Contemporary pediatric thoracic imaging. AJR Am J Roentgenol 2000;175:841-51.
  • 16 Riad R, Omar W, Kotb M, Hafez M, Sidhom I, Zamzam M, et al. Role of PET/CT in malignant pediatric lymphoma. Eur J Nucl Med Mol Imaging 2010;37:319-29.
  • 17 Darge K, Anupindi SA, Jaramillo D. MR imaging of the abdomen and pelvis in infants, children and adolescents. Radiology 2011;261:12-29.
  • 18 Michael R. Potential of MR-imaging in the paediatric abdomen. Eur J Radiol 2008;68:235-44.