Three leading medical groups published revised criteria for advanced imaging in pediatric patients June 27, to keep pace with advancements.
Pediatric use of advanced ultrasounds, computed tomography (CTs), and magnetic resonance imaging (MRIs) were evaluated and jointly assessed by the American Academy of Pediatrics, American College of Emergency Physicians, and American College of Radiology.
"Notwithstanding these advances, it is important for physicians, physician assistants, and nurse practitioners to understand the risks and limitations associated with advanced imaging in children and to limit imaging studies that are considered low value, when possible," the groups wrote in the introduction, published in The American Academy of Pediatrics.
The new guidance recommends that emergency departments:
- Ensure proper computer tomography protocols and parameters are used.
- Use ultrasound for first-line imaging for patients with appendicitis or nephrolithiasis.
- Implement and enforce policies for pediatric image consultations that include both a pediatric radiologist and a general radiologist to reduce transfers that require only imaging review.
The document also includes strategies for condition-specific recommendations, shared decision-making, and clinical support mechanisms.
“One of the easiest ways to optimize advanced imaging in a community emergency department is to defer imaging in children who are going to be transferred to a pediatric referral center regardless of the imaging result, if the result will not alter management prior to or during transfer," Jennifer Marin, MD, lead author of the policy statement and member of the AAP Committee on Pediatric Emergency Medicine, said in the June 27 press release. "Often, there are delays in accessing outside studies, and many studies need to be repeated if not optimally performed or the images were not transferred successfully."