Neuroimaging Safety in Children

Abstract

Paediatric neuroimaging is distinct from adult imaging, warranting dedicated approaches that take into account the singularities of this population in the selection of the appropriate imaging techniques for each phase of the normal development. The impact of ionising radiation exposure or contrast media usage need to be taken into account when planning or performing paediatric imaging, with risk versus benefit needing a specific assessment in these age groups, especially considering x-ray exposure. Magnetic resonance is radiation safe and provides accurate anatomical detail of the brain and spinal cord, being the preferred imaging method in children, despite some reported adverse effects. To produce high quality images, radiologists must be aware that there are several challenges in children mainly due to their small size and immaturity. Non-cooperation is a challenge in this group that warrants creativity (with specific devices to use inside the scanners) and fast imaging methods, minimising the use of anaesthetics.

The scope of this article is to review the challenges of paediatric neuroimaging, focusing on the specificities of these patients, namely main indications for imaging, risks and concerns regarding the most commonly used neuroimaging techniques available, use of contrast media and the need of sedation or general anesthesia, and to provide recommendations that optimize safety in pediatric neuroimaging, proposing an algorithm approach based on risk/benefit assessment.