Pediatric illnesses

Using diagnostic imaging to detect illness in children requires extra safety measures and care. Radiation doses must be kept as low as possible and examinations have to be fully justified so that benefits exceed by far any possible risk.

A sick child and a sick adult must be approached differently. A child cannot be considered simply a miniature adult. Treating children with nuclear medicine techniques requires a tailored approach. Physicians and technologists need to display a wide range of capacities and capabilities to effectively handle sick children, especially when using radionuclides for diagnosis and therapy. The very nature of radionuclide use demands awareness of radiation safety issues and technical proficiency to ensure quality control.

The IAEA provides a number of expanded learning and training opportunities on paediatric nuclear medicine, including multidisciplinary clinical management; appropriate dosimetry; sedation and immobilization of patients during medical procedures; image magnification; radioactive waste management; and protecting family members from radiation. The principles conveyed in these courses are used to great advantage in the early detection or prompt diagnosis of diseases such as childhood cancer and congenital and developmental malformations that arise in infancy and childhood.

Diagnosing and treating disease in children

In most countries, nuclear medicine diagnostic and therapeutic applications have become mature technologies by now. Hospitals and medical centres equipped with nuclear medicine facilities routinely use radionuclide techniques, whether the patient is an adult or a child. The high volume of such cases has also often translated into a strong expertise and skill-set among physicians and technologists dealing with sick children.

Paediatric nuclear medicine practice refers to examinations done in babies, young children and teenagers (up to the age of 18). Diseases occurring in children present problems and peculiarities that may not be seen or could be overlooked in routine diagnostic imaging investigations designed for adults. There are higher incidences of developmental malformations and congenital anomalies discovered in childhood than later in life.

Paediatric nuclear medicine imaging is performed to help diagnose life-threatening childhood disorders that are infectious, non-infectious or congenital, or that develop during childhood, such as cancer. Nuclear medicine imaging techniques are used to evaluate children with cancer and other conditions that affect organ systems, such as the kidney; urinary bladder; bones; liver; gallbladder; gastrointestinal tract; heart; lungs; and thyroid.

Several nuclear medicine techniques are in use to diagnose and manage congenital and acquired urogenital diseases and childhood cancers: planar nuclear medicine imaging techniques; SPECT (single photon emission computed tomography) and SPECT/CT (computed tomography); positron emission tomography (PET)/CT; and nuclear medicine therapy technology.

Nuclear medicine scans are typically used to help diagnose urinary blockage in the kidney, backflow of urine from the bladder into the kidney, bone cancer, infections and trauma, gastrointestinal bleeding, jaundice in new-borns and older children, congenital hypothyroidism, and most importantly cancer and its metastasis in the body.

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