Fluoroscopy in pediatric radiology: Review of current use and alternatives

Area of Science:

• Pediatric Radiology
• Medical Imaging Technology

Background:

• Fluoroscopy has been a cornerstone of pediatric radiology.
• Concerns regarding radiation exposure and staffing needs are driving a decline in its use.
• Exploration of alternative imaging modalities is increasing.

Purpose of the Study:

• To review trends in pediatric fluoroscopy utilization.
• To compare traditional fluoroscopy with alternative imaging techniques.
• To provide guidance on selecting appropriate imaging modalities for pediatric patients.

Main Methods:

• Analysis of data from the Pediatric Health Information System and institutional records.
• Review of national and institutional trends in fluoroscopic study utilization.
• Comparative analysis of fluoroscopy versus alternative modalities (endoscopy, ultrasound, CT).

Main Results:

• A decrease in annual fluoroscopic studies for pediatric inpatients was observed (56,371 in 2017-2020 to 46,973 in 2020-2023).
• Alternative modalities show promise for respiratory, gastrointestinal, and urinary system assessments.
• Alternative techniques offer advantages in accuracy, accessibility, cost, and radiation reduction.

Conclusions:

• While fluoroscopy retains value in specific pediatric cases, alternative imaging modalities are increasingly preferred.
• The choice of imaging should be individualized based on clinical context, patient factors, and resources.
• This review highlights the shift towards safer and more accessible imaging in pediatric radiology.