Improving the safety of medical imaging in children

Pediatric radiologists at OHSU Doernbecher Children’s Hospital consult with pediatricians, surgeons and other referring physicians to decide whether CT, radiograph (X-Ray), and/or fluoroscopy (angiogram) examinations are the best option for imaging a child in need of diagnostic radiology services.

These imaging exams:

  • Provide an intimate look at a child’s anatomy and sometimes their physiology.
  • Allow diagnosis of diseases and injuries, as well as normal anatomy.
  • Deliver ionizing radiation to the patient in order create these images.
  • Enable the radiologist to interpret the images and make diagnoses.

Sometimes magnetic resonance imaging (MRI) or ultrasound/sonography examinations — imaging exams that do not require exposure to ionizing radiation — are better choices and can be substituted for CT, radiographs or fluoroscopy.

Factors that help determine which radiological exam is the best choice for making a diagnosis include:

  • Urgency of the need to perform the exam.
  • A child’s comfort and ability to cooperate with the exam.
  • Possible need for sedation during the exam.
  • Ability to intervene and treat a condition during the exam.
  • Expected or known disease process being investigated; i.e., some anatomy, like the lungs and airway are best seen on CT rather than MRI.

The pediatric radiologists at OHSU Doernbecher use some of the newest, most innovative technology available when imaging children with CT, MRI and other imaging modalities.

Ironically, old image reconstruction techniques are now the newest thing possible for CT and are making a difference for our patients. We have ‘gone retro’ with how to reconstruct a CT image and have significantly decreased the amount of radiation given to our patients when they undergo a CT scan! In MRI ‘going retro’ is not ideal. At OHSU Doernbecher, we are taking giant steps forward in how MRI studies are performed using the most innovative scanners and image processing tools available anywhere in the world.

In every aspect and modality of imaging science, the pediatric radiologists are working with industry to advance technology to lower ionizing radiation dose and increase safety of medical imaging for children.

In future posts, I will discuss details of how pediatric radiologists at OHSU Doernbecher work to reduce ionizing radiation exposure to children, why parents and physicians should care about ionizing radiation and imaging, special techniques in imaging for children, advanced imaging techniques available only at OHSU Doernbecher, and other topics ranging from fetal MRI to research topics pertaining to imaging in children.


Dianna M. E. Bardo, M.D.
Associate Professor, Divisions of Diagnostic Radiology, Pediatrics and Cardiovascular Medicine
OHSU Doernbecher Children’s Hospital