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August 3, 2020

Less Radiation but More Overall Advanced Imaging in Children—Good News or Bad News?

Author Affiliations
  • 1Division of Hospital Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California
  • 2Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California
JAMA Pediatr. 2020;174(9):e202222. doi:10.1001/jamapediatrics.2020.2222

During the past 2 decades, excessive diagnostic imaging has been a common target for high-value care efforts. Given concerns about ionizing radiation and the risk of subsequent cancers, numerous initiatives have aimed to reduce unnecessary computed tomography (CT), particularly in children. Advocacy campaigns, such as Image Gently, Image Wisely, and Choosing Wisely, have highlighted the downstream risks associated with radiation and have encouraged eliminating unnecessary studies while reducing the radiation dose of necessary ones. Evidence from previous work1 has facilitated protocols that enable more judicious imaging. In addition, for some conditions, alternative imaging modalities that do not impart radiation, such as ultrasonography and magnetic resonance imaging (MRI), have been proposed and used.2 The recent advent of so-called fast MRI, which frequently does not require sedation, has increased the allure of this imaging modality.3

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