Comparison of the different imaging modalities used to image pediatric oncology patients: A COG diagnostic imaging committee/SPR oncology committee white paper

Abstract

Diagnostic imaging is essential in the diagnosis and management, including surveillance, of known or suspected cancer in children. The independent and combined roles of the various modalities, consisting of radiography, fluoroscopy, ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), and nuclear medicine (NM), are both prescribed through protocols but also function in caring for complications that may occur during or subsequent to treatment such as infection, bleeding, or organ compromise. Use of a specific imaging modality may be based on situational circumstances such as a brain CT or MR for a new onset seizure, chest CT for respiratory signs or symptoms, or US for gross hematuria. However, in many situations, there are competing choices that do not easily lend themselves to a formulaic approach as options; these situations depend on the contributions of a variety of factors based on a combination of the clinical scenario and the strengths and limitations of the imaging modalities. Therefore, an improved understanding of the potential influence of the imaging decision pathways in pediatric cancer care can come from comparison among the individual diagnostic imaging modalities. The purpose of the following material to is to provide such a comparison. To do this, pediatric imaging content experts for the individual modalities of radiography and fluoroscopy, US, CT, MRI, and NM will discuss the individual modality strengths and limitations.

Review of Development and Recent Advances in Biomedical X-ray Fluorescence Imaging

“…Collimated detectors containing thick sensors of either Si (Li) or Ge point at right angles to both the primary and the scattered beam, with a goal to reduce the number of background counts. Optimization strategies in [ 8 ] mainly consist of increasing the measurement time and using an X-ray tube, which mainly produces characteristic radiation of a high fluence rate to further decrease the detection limit.…”

“…CT scans are now typically used to diagnose many diseases, such as various types of cancers, heart diseases such as myocardial disease and analyses of the liver or pancreas of patients [ 7 ]. Since the 1970s and 1980s, the speed of image acquisition has substantially improved, and modern CT scanners are capable of imaging patients in a matter of seconds or less [ 8 ]. A major drawback of CT is that large masses within the gastrointestinal tract may not be visible during scans, and more sophisticated methods such as dual-energy CT are required to differentiate materials with the same attenuation at a certain energy for better lesion depiction [ 7 , 9 ].…”