Pediatric Radiology: 5 Things You Should Know
Most likely, your child will need to have some type of imaging done before they reach adulthood - whether your kid falls and breaks a bone, or the pediatrician wants to work up an illness. Medical imaging is a vital part of health care and has significantly evolved since the discovery of x-rays in 1895. Radiologists now have a variety of non-invasive techniques such as CT scan, PET scan, ultrasound, MRI, nuclear medicine, to see inside your child’s body to make a diagnosis.
Our radiologists see more than 15,000 patients a month – from fractures to more complex medial cases. We asked Dr. Doug Rivard, Chairman of the Department of Radiology, Dr. Manish Kotecha, Section Chief of Ultrasound and Dr. Laura Dinneen to share what parents need to know about radiology.
Radiologists are Medical Doctors
Dr. Rivard: Most people think radiologists are x-ray technologists – the health care professionals who perform the diagnostic imaging procedures, but we’re actually the physician piece of the medical imaging team.
Our role is to work with the referring primary care physician, medical or surgical specialist physician, or advanced practice provider to determine what test would be best for the child to make a diagnosis, supervise the test with the technologist and interpret the images to figure out what is going on.
Dr. Kotecha: Radiology allows us to see inside the body without cutting the child open. It’s a non-invasive way to diagnose disease and injury, across the spectrum, to get the answers the care team needs.
Every case is like a puzzle and many times a diagnosis or next steps are unknown until the imaging is done, whether it’s a simple chest x-ray or something more advanced like a brain MRI.
Collaboration is key. We’re trained to have broad base knowledge of all subspecialties throughout the hospital because of the insight we provide, whether it’s GI, neurology, neonatology or pulmonology.
Every day, we’re interacting with colleagues in different departments to make the best decision possible for our patients.
Kids Are Not Little Adults
Dr. Kotecha: Pediatric radiologists have additional medical training, because kids are so different than adults. All radiologists have a minimum five-year post-graduate training after completing medical school to learn how to image various body parts, but pediatric radiologists have a minimum of one extra year training in pediatric imaging. It’s an entirely different language and set of diagnoses.
Dr. Rivard: Pediatric radiologists are trained to recognize things unique to a child’s physiology and anatomy. For instance, a radiologist not completely familiar with a child’s body may mistake normal findings (such as a growth plate) as a tumor and the child might have to undergo unnecessary additional testing or possibly a painful biopsy.
Dr. Dinneen: The way a child fractures or injures a bone is different than an adult because their bones are growing. It's not just bones that are distinctive. Other organ systems and tissues are maturing too like the brain for example. The age of the patient and their stage of brain development will affect what diseases we look for. At Children’s Mercy we look at the earliest brains (in fetal life) all the way up to the most mature brains (young adult). Yes, anatomically children and adults are similar, but kids develop over time and you must know where the child is developmentally when approaching the patient. We consider all these things when studying images.
Children are also different behaviorally. We tailor each exam to the individual to make sure the child feels at ease, so we can get the study we need in the shortest amount of time possible. Everything we do is intentional with children, because without cooperation we’re not going to get the best image or diagnostic results.
Children Should Receive the Lowest Amount of Radiation Exposure Possible
Dr. Rivard: Everyone is exposed to radiation that naturally occurs in the environment every day - from radon in our homes to radiation from the sun. However, too much radiation is bad and medical imaging is the largest non-natural source of radiation exposure.
Children are more sensitive to radiation, so we take great caution to minimize exposure and determine benefit versus risk for every procedure we do. When possible, we use an ultrasound or MRI - imagining techniques that don’t produce radiation. If an x-ray or CT scan is required, we’ll make sure the child receives the lowest dose possible. Children’s Mercy has the most sophisticated imaging equipment and software available that we use up to 86% less radiation than other local imaging facilities. We also track the amount of radiation the child is exposed to over time.
Dr. Dinneen: Our scans are tailored to patient-size so we can acquire the quality of image we need with just the exact amount of radiation. Basically, the goal is to minimize exposure, but maximize results.
What makes our team unique is we have two physicists on staff constantly monitoring protocols. If I have a question about a scan or there’s an image quality or dose issue the physicists are readily available troubleshoot the problem immediately.
Pediatric Radiologists at Children’s Mercy Do More than Diagnose Images
Dr. Rivard: Beyond diagnosing, we also perform procedures. Some are basic, such as when we use a real-time x-ray machine to observe a child’s upper GI after taking a contrast, which improves the visibility of the anatomy. Others are more cutting-edge techniques using Interventional Radiology (IR), which is when medical imaging is used to guide minimally-invasive surgical procedures. IR allows us to use our knowledge and expertise as radiologists to do advanced interventions, whether it’s using an ultrasound to guide a needle for a liver biopsy or to place a catheter in a small vessel to deliver medication specifically to the tumor or lesion.
There are many benefits to IR. Conditions that once required surgery can now be treated non-surgically and performed as an outpatient procedure or during a short hospital stay.
Not only does IR allow us to be more precise in a patient’s treatment, it also reduces risk as well as pain and recovery time, which makes it less stressful and nerve-racking for both the patient and the family.
Pediatric Radiologists are Focused on Taking Care of Kids
Dr. Kotecha: Every facet of the patient's team, including radiology, cares about the child’s outcome.
Parents have choices about where to take their kids and there’s no other place in the region that is solely dedicated to pediatric imaging, diagnosis, therapy and pediatric care, from head-to-toe.
Dr. Dinneen: Children’s Mercy is an incredible resource to have in our own backyard. There’s no question that people who work with kids bring an added edge to optimizing the child’s health and wellness.
Dr. Rivard: One of the things I love about Children's Mercy is how we use our resources and skills in innovative ways to provide the best patient care. We have the entire package, from the latest technology and equipment, to the support of the medical and nursing staff, to do some incredible life-changing procedures for kids.
Learn more about Interventional Radiology at Children’s Mercy.