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Wake Radiology is committed to low-dose.
Children & Radiology
Wake Radiology is the first and only to provide dedicated outpatient pediatric imaging services in Wake County and remains the largest pediatric radiology group in the area. Our radiologists and technologists bring the special care, patience and adaptation as well as skillful hands needed to image our smallest patients.
The need for pediatric radiologists
Pediatric radiologists are specially trained to understand the unique needs of children, parents and pediatricians in the diagnostic process. They have detailed knowledge of illnesses and medical conditions of infants and children. All their equipment, procedures and staff are oriented to the special needs of children. Pediatric radiologists work as part of a diagnostic team along with your pediatrician or pediatric specialist to provide the best possible care for your child.
More specifically, pediatric radiologists are experts in selecting the best imaging techniques to diagnose disease, injury and even surgical complications in infants, children and adolescents. Examples of imaging techniques include ultrasound, X-ray and fluoroscopy, CT, MRI and nuclear medicine. Pediatric radiologists make sure that testing is performed properly and safely, and they also interpret the results of the test and make an appropriate diagnosis.
Pediatric radiologists have the following formal training:
- A degree from a medical school.
- One year or more of clinical medicine training and four years of training in diagnostic radiology.
- One or more additional years of training in the diagnosis of infants and children using imaging equipment.
- Pediatric radiologists usually are certified by the American Board of Radiology and have additional certification in their subspecialty.
At Wake Radiology, all our pediatric radiologists are 100% devoted to imaging children. They are exceptionally trained, having attained a certificate of added qualification (CAQ) in pediatric radiology in addition to being board certified by the American Board of Radiologists (ABR) and fellowship trained in pediatric radiology. Having also worked at busy tertiary hospitals, Wake Radiology physicians have the level of clinical experience that can only be gained at high-volume centers. They have also published and presented at numerous national meetings due to their involvement in important pediatric radiology research.
Their unique background gives Wake Radiology pediatric radiologists greater experience with normal variants and developmental anatomy. This allows them to more confidently and correctly identify normal findings (e.g., spasm of the pyloric muscle versus pyloric stenosis), which prevents unnecessary follow-up imaging or intervention. Our physicians also have expertise in pathology unique to children, such as developmental dysplasia of the hip, Legg-Calve-Perthes disease and pediatric musculoskeletal tumors, which can also lead to more accurate diagnosis and classification. They also understand the benefits of each modality that is unique to children, including the obvious and not-so-obvious benefits of ultrasound for those under 18.
The importance of collaboration
Wake Radiology’s breadth and depth of imaging expertise enables the level of internal collaboration needed to deliver the most accurate interpretation in even the most challenging or time-sensitive situations. Since our pediatric radiologists are part of a much larger group of subspecialists, they can take a team approach for complex neurologic, orthopedic or interventional/vascular issues. For example, if a teenager has had a concussion, our neuroradiologists will also interpret the CT or MRI images to help Wake Radiology develop the most accurate and conclusive interpretation/report. In other cases, our pediatric radiologists will consult with our body experts on MRE procedures performed for possible Crohn’s disease.
The role of hands-on ultrasound
In many things pediatric, ultrasound often makes the best first choice in imaging modalities because it is radiation free. This imaging technology uses high frequency sound waves to view internal organs and produce diagnostic images of the human body. Ultrasound’s weaknesses as a modality for adults are its strengths for children. It has the advantage of not producing any radiation, and the fact that it’s insensitive to motion makes it the perfect modality for pediatric imaging, especially for young children or infants who can’t stay still for CT scans or even X-rays (AKA plain films). Ultrasound can penetrate only a certain number of centimeters through soft tissue, which is fine for kids but can be limiting in adults.
At our pediatric imaging center we go above the standard of care, ensuring that a highly trained pediatric radiologist is always in the room, performing the ultrasound (versus interpreting it after a technologist has conducted the test). By taking this hands-on approach, our pediatric radiologist can tailor the exam for the specific patient and ask the child to tell us when we are directly over the site of the pain. Our physicians can also feel palpable abnormalities to make sure they have used the ultrasound to image the exact/precise area of concern that the pediatrician identified during their physical exam.
Wake Radiology Pediatric Imaging Center is specially designed, equipped and staffed to obtain high quality ultrasound examinations of pediatric patients of any size, age and medical condition, including tiny newborns, small infants, toddlers, young children and maturing adolescents.
Less complicated pediatric cases performed at our other Wake Radiology offices are reviewed remotely by a pediatric radiologist before the child leaves to ensure a complete study is done. Our unique approach exemplifies individualized care when compared to all other competitive outpatient or inpatient locations.
The role of low-dose CT
Computed tomography (CT) is a vital and accurate tool for rapid diagnostic evaluation of serious illness or injury in children. This extremely useful imaging modality can provide valuable and even life-saving medical information as well as help children avoid unnecessary surgery.
CT is particularly useful because it can show many different types of tissue with great clarity, and images can be obtained quickly. It can often obtain specific diagnostic information that is not provided by other imaging technologies such as ultrasound, nuclear medicine and magnetic resonance imaging. Despite the many benefits of CT, a disadvantage is the inevitable radiation exposure. This is why our group of fellowship-trained pediatric radiologists—all of whom trained under national leaders in the dose-reduction movement—is focused on minimizing our youngest patients’ radiation exposure while maintaining high-quality imaging. Learn more
The role of low-dose pulsed fluoroscopy
Fluoroscopic studies are widely used for pediatric patients, most commonly for urinary tract infections, vomiting and dysphagia. To minimize children’s exposure, Wake Radiology’s new Siemens advanced low-dose “pulsed” fluoroscopic system in its West Raleigh office is able to reduce the dose for fluoroscopic studies by up to 80% versus continuous fluoroscopic imaging. This is particularly good news for children, who often need such procedures as VCUG and upper GI examinations.
The role of MRI
In an increasing number of cases, MRI (magnetic resonance imaging) is the right choice for imaging a young patient, and the modality uses no ionizing radiation. MRI is particularly useful as an alternative to CT in following chronic conditions for which the frequency of imaging would otherwise quickly lead to a large cumulative radiation dose. Examples of this include inflammatory bowel disease, such as Crohn’s disease or some childhood cancers, in particular of the kidney or the liver. There are other indications for which MRI is a better initial test, including the workup of some pediatric cardiovascular abnormalities.
At Wake Radiology, age is not a restriction. MRI and MR angiography (MRA) are performed at our Raleigh MRI office for children ages 6 and up. MRI studies that require pediatric sedation are scheduled at the hospital in conjunction with the pediatric intensivists who administer and monitor the sedation.
MR Enterography (MRE) and adolescents
Crohn’s disease (AKA Crohn syndrome or regional enteritis) predominantly affects the small bowel (ileum, jejunum and duodenum), but can affect any segment of the GI tract. In Crohn’s disease, since symptoms typically begin in children around ages 8 to 10, these young patients stand to receive as many as 40 or 50 CT scans in their lifetimes. While ongoing imaging for Crohn’s was previously conducted with CT almost exclusively, MRI (which uses no radiation) can now replace CT as the imaging method for determining disease activity and response to medical therapy.
MR Enterography (MRE), a study specifically designed for Crohn’s disease patients, is available at our Cary and Raleigh MRI offices. This allows Crohn’s patients in the Triangle greater options and convenience for their required, lifelong imaging surveillance needs.
The role of nuclear medicine
Newborns and children less than one year old with a spectrum of diseases present differently from older children or adults. For these young children, nuclear medicine studies play an important role in evaluating a wide range of congenital conditions and can be helpful for evaluating acquired conditions such as infection, cancer and trauma.
Evaluation of these patients during the first year of life differs from that of other children and must accommodate a different range of clinical problems and special imaging requirements. Extra care and attention to the special needs of this population must be paid to acquire high-quality images that address the clinical question while delivering the lowest radiation dose possible. A full range of nuclear medicine studies that are typically obtained for patients in this age group includes oncologic studies and studies of the brain, thyroid, heart, lungs, liver, gastrointestinal tract, kidneys and genitourinary tract, spleen, lymphatic system and skeleton.