Winter 2012

Advances in Pediatric Radiology Reduce Risk, Concerns

Dr. MacKenzie with Colleague

The imaging of children has always presented unique challenges. But, says John MacKenzie, M.D., chief of Pediatric Radiology at UCSF Benioff Children's Hospital, "A new generation of pediatric radiologists, imaging technology and techniques is enabling more child-focused imaging that increases our ability to detect and monitor disease."

Improved Diagnoses

For one thing, MacKenzie says, technology incorporated into the latest generation of magnetic resonance imaging (MRI) scanners allows for faster, noninvasive imaging of smaller, moving subjects — without anesthesia or radiation.

"There is less patient discomfort, even as we are more confident about the diagnosis of numerous conditions, such as bowel disease or problems with bones and joints, including children's cancer," MacKenzie says.

Yet, as with any clinical procedure, experience matters, as it enables more effective use of the technologies, better interpretation of results, and an improved experience for the child and family. "That is why we have assembled a team of pediatric radiologists, imagers and nurses with true expertise in imaging children," he says.

Reducing Radiation, IV Sticks

The technology and expertise also help address other significant concerns when children are the patients.

For example, as radiologists have learned how to better adapt the technologies to children — their ages, sizes and the increased likelihood that they will move during imaging — the radiologists have uncovered opportunities to reduce radiation exposure.

"We balance lowering exposure with maintaining excellent image quality for accurate diagnosis," he says. "In addition to using nonradiation techniques like MRI and ultrasound, we've designed our CT protocols so they are better tailored to the size of the child, with overall lower doses of ionizing radiation."

Similarly, improvements in pediatric imaging contribute to the growth of noninvasive, zero radiation procedures for specific surgeries. Intussusception reduction is one example.

"Rather than using fluoroscopy, as we’ve done in the past, we use ultrasound to see the obstruction and then push liquid through to unblock the intestine," MacKenzie says.

Pediatric MRI

And, as part of an institutional effort at UCSF Benioff Children's Hospital, the Pediatric Radiology team is helping to minimize the number of IV sticks children undergo by fostering system change — improved practices and provider education — that encourages the use of dual-purpose catheters where clinically appropriate. In other words, one IV stick is administered for medical care and imaging, rather than the patient having to be stuck twice.

"Often, kids are scared because they don’t know what to expect," says MacKenzie. "When we can minimize their discomfort, or when they realize we can look inside without actually touching them, and when their families know we are getting the best images possible, as safely as possible, that’s the ideal."

He is particularly excited when looking to the future at UCSF. When the new UCSF Benioff Children's Hospital opens at Mission Bay in early 2015, all these new ideas, leading-edge equipment and techniques will be available in one central location.

For more information, contact Dr. John MacKenzie at (415) 514-6330 or [email protected].

Hear an interview with MacKenzie on Medical Imaging and Radiation Risk in Children.

Winter 2012 Table of Contents

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Related Information

News Releases

$1 Million Grant Awarded to Develop Pediatric Medical Devices
The UCSF "D'Vice Squad," a group of innovators from across the Bay Area, has received a $1 million grant from the U.S. Food and Drug Administration (FDA) to expand its work to develop medical devices for children.

Steroids Linked to Impaired Brain Growth in Preemies
Premature infants exposed after birth to drugs known as glucocorticoids are at increased risk for having impaired growth of the cerebellum, according to findings from a new UCSF-led study.

New Children's Hospital Designed for Comfort, Technology
Patient rooms in the new UCSF Benioff Children's Hospital at Mission Bay are being designed to maximize comfort, efficiency and safety. The 180-bed facility will be part of a complex that includes 16 gardens.