The Image Gently campaign, conducted by the ACR’s Alliance for Radiation Safety in Pediatric Imaging, has developed a series of online teaching materials and checklists as part of its Pause & Pulse campaign to help providers use the lowest dose necessary to perform fluoroscopic procedures on children.
Intended to promote radiation protection when using fluoroscopy with pediatric patients, the Pause & Pulse campaign was created, in part, as follow-up to a public meeting on the topic held by the Food & Drug Administration.. "Fluoroscopy in children is a commonly performed study, and there is a significant opportunity to decrease radiation dose for children, while still performing a diagnostic exam,” stated Marilyn Goske, MD, who chairs the alliance. “These materials raise awareness and provide evidence-based educational materials to work toward this goal.”
Under the umbrella of the campaign, providers are urged, where appropriate when fluoroscopic procedures are indicated, to pause and child-size the technique (match kVp and mAs to size of child), use the lowest possible pulse rate, limit fluoroscopic time and use of magnification mode, carefully collimate the area of interest and utilize appropriate shielding. Practitioners are also strongly encouraged to employ pulsed digital fluoroscopic equipment with adjustable frame speeds and last image hold and capture capability, as well as to consider ultrasound or, when applicable, MRI in lieu of a fluoroscopic study.
Moreover, referring physicians are encouraged to ask any imaging provider to whom they refer their pediatric patients whether a given facility is accredited by the American College of Radiology (ACR), if the technologists are certified or licensed, and whether they have experience with children. Other questions such physicians are urged to pose to imaging providers encompass how frequently the facility performs the requested fluoroscopic study in children; and whether a board-certified radiologist with pediatric experience or a pediatric radiologist will be performing and interpreting the study.
“This extension of the Image Gently initiative gives providers real-world, practical guidance to help ensure that the radiation dose administered to children via these procedures is as low as possible given the particular circumstances of each case,” said Marta Hernanz-Schulman MD, chair, American College of Radiology Pediatric Guidelines and Standards Committee.
The Alliance For Radiation Safety in Pediatric Imaging was founded by the ACR, the Society for Pediatric Radiology (SPR), the American Society of Radiologic Technologists (ASRT), and the American Association of Physicists in Medicine (AAPM). It now encompasses more than 50 medical organizations serving more than 500,000 health care providers worldwide.