Justification and Modality Choice
Prefer ultrasound and MRI over ionizing modalities when clinically appropriate and justify CT or radiography based on expected diagnostic benefit. Use pediatric specific appropriateness criteria and involve pediatric radiology consultation for complex cases. Screening and surveillance protocols should minimize cumulative exposure over a child s lifetime.
Protocol Tailoring
Adjust acquisition parameters by weight or cross sectional diameter and use automatic exposure control with pediatric presets. Reduce scan length and use lower kVp settings when feasible while maintaining diagnostic contrast. Implement iterative reconstruction and vendor pediatric packages to preserve image quality at lower dose.
Sedation and Motion Management
Use non pharmacologic techniques such as distraction and feed and wrap to reduce the need for sedation and repeat imaging. When sedation is necessary coordinate with anesthesia and use rapid sequences for MRI to shorten scan time. Proper preparation and child life support improve cooperation and reduce repeat exposures.
Family Communication and Follow Up
Provide caregivers with clear explanations of risks benefits and alternatives and document discussions in the record. Track cumulative imaging exposure for children with chronic conditions and coordinate imaging schedules to avoid unnecessary repeats. Engage families in shared decision making about surveillance imaging.