Volume 35, Number 4
August 2014
Letter From the Guest Editors
M
y co–guest editor, Dr Tara Catanzano, and I are delighted to have been asked to provide an update on pediatric imaging for this issue of Seminars in Ultrasound, CT and MRI. There have been tremendous advances in radiation protection in the last 15 years. The Image Gently Campaign and The Alliance for Radiation Safety in Pediatric Imaging have served as the fulcrum for the radiology community to improve awareness regarding opportunities to lower dose in the pediatric population. Keeping in mind the goal of The Alliance to change practice in the imaging community, we set out to cover selected topics directed at best practices, asking our authors to discuss opportunities for dose reduction while providing high-quality patient care. While attending RSNA 2013, I had the opportunity to see presentations by Drs Brent Little and Phuong-Anh Duong from Emory University discussing strategies for quality improvement in computed tomography (CT) imaging as part of an interactive session focused on reducing CT dose. They reported their experience using the ACR Dose Index registry as a cornerstone of their initiative to decrease and standardize CT radiation dose throughout a large, complex academic health care system. Impressed with the quality of their work (and wanting to learn more), I invited them to contribute to this issue, emphasizing the role of dose tracking. Much to my delight, they agreed and have provided a superb article that should become a mandatory reading for radiologists interested in or responsible for CT quality initiatives in their own departments. I have also asked my colleagues at Baystate Medical Center to contribute to the Seminars issue. Residents and faculty members collaborated to provide up-to-date review of magnetic resonance enterography to evaluate children with Crohn's disease. Imaging these patients plays an important role in the diagnosis and assessment for complications and response to treatment. Magnetic resonance enterography has assumed a leading role in abdominal imaging in this
http://dx.doi.org/10.1053/j.sult.2014.06.001 0887-2171/& 2014 Published by Elsevier Inc.
population, reducing the use of CT and fluoroscopy. A review of neonatal neurosonography discusses anatomy, pathophysiology, and imaging characteristics of intracranial hemorrhage and hypoxic ischemic injury; the most commonly encountered neurologic imaging problems in the neonatal intensive care setting. Two other teams from Baystate have also contributed pictorial essays. The first is a multimodality review of liver tumors seen in the pediatric population and discussion regarding techniques for diagnosis and staging. An imaging algorithm is also presented for the assessment of “lumps and bumps” encountered in children. The authors review clinical presentation, pathology, and imaging characteristics of several important entities and provide nice examples to drive home key concepts. Finally, we had the pleasure of recruiting help from a dear friend and former resident from our program, Dr Robert DeFlorio at Nemours Children's Clinic in Jacksonville, FL. Rob offered to collaborate with his colleagues from Nemours to contribute articles on several important topics addressing dose reduction. These include a state-of-the art review of imaging children with VP shunts, another at-risk group of children likely to require repeat imaging throughout their lives. Great opportunities for dose reduction are also addressed in imaging candidates for surgical correction of pectus excavatum and in those requiring interventional procedures. Finally, a multimodality pictorial essay is provided reviewing imaging of nontraumatic acute hip pain in children. I thank all of the authors for their hard work and commitment to this collaborative project. We are also indebted to Howard Raymond, Editor, and Dana Roth, Editorial Assistant, for their guidance and patience in putting together this issue. Stephen C. O'Connor, MD Tara M. Catanzano, MD Guest Editors
321
August 2014
Letter From the Guest Editors
M
y co–guest editor, Dr Tara Catanzano, and I are delighted to have been asked to provide an update on pediatric imaging for this issue of Seminars in Ultrasound, CT and MRI. There have been tremendous advances in radiation protection in the last 15 years. The Image Gently Campaign and The Alliance for Radiation Safety in Pediatric Imaging have served as the fulcrum for the radiology community to improve awareness regarding opportunities to lower dose in the pediatric population. Keeping in mind the goal of The Alliance to change practice in the imaging community, we set out to cover selected topics directed at best practices, asking our authors to discuss opportunities for dose reduction while providing high-quality patient care. While attending RSNA 2013, I had the opportunity to see presentations by Drs Brent Little and Phuong-Anh Duong from Emory University discussing strategies for quality improvement in computed tomography (CT) imaging as part of an interactive session focused on reducing CT dose. They reported their experience using the ACR Dose Index registry as a cornerstone of their initiative to decrease and standardize CT radiation dose throughout a large, complex academic health care system. Impressed with the quality of their work (and wanting to learn more), I invited them to contribute to this issue, emphasizing the role of dose tracking. Much to my delight, they agreed and have provided a superb article that should become a mandatory reading for radiologists interested in or responsible for CT quality initiatives in their own departments. I have also asked my colleagues at Baystate Medical Center to contribute to the Seminars issue. Residents and faculty members collaborated to provide up-to-date review of magnetic resonance enterography to evaluate children with Crohn's disease. Imaging these patients plays an important role in the diagnosis and assessment for complications and response to treatment. Magnetic resonance enterography has assumed a leading role in abdominal imaging in this
http://dx.doi.org/10.1053/j.sult.2014.06.001 0887-2171/& 2014 Published by Elsevier Inc.
population, reducing the use of CT and fluoroscopy. A review of neonatal neurosonography discusses anatomy, pathophysiology, and imaging characteristics of intracranial hemorrhage and hypoxic ischemic injury; the most commonly encountered neurologic imaging problems in the neonatal intensive care setting. Two other teams from Baystate have also contributed pictorial essays. The first is a multimodality review of liver tumors seen in the pediatric population and discussion regarding techniques for diagnosis and staging. An imaging algorithm is also presented for the assessment of “lumps and bumps” encountered in children. The authors review clinical presentation, pathology, and imaging characteristics of several important entities and provide nice examples to drive home key concepts. Finally, we had the pleasure of recruiting help from a dear friend and former resident from our program, Dr Robert DeFlorio at Nemours Children's Clinic in Jacksonville, FL. Rob offered to collaborate with his colleagues from Nemours to contribute articles on several important topics addressing dose reduction. These include a state-of-the art review of imaging children with VP shunts, another at-risk group of children likely to require repeat imaging throughout their lives. Great opportunities for dose reduction are also addressed in imaging candidates for surgical correction of pectus excavatum and in those requiring interventional procedures. Finally, a multimodality pictorial essay is provided reviewing imaging of nontraumatic acute hip pain in children. I thank all of the authors for their hard work and commitment to this collaborative project. We are also indebted to Howard Raymond, Editor, and Dana Roth, Editorial Assistant, for their guidance and patience in putting together this issue. Stephen C. O'Connor, MD Tara M. Catanzano, MD Guest Editors
321
