Pediatric breast lesions are uncommon and can be a source of alarm to both pediatric patients and their caretakers. Lesions may be incidentally detected on imaging or may be associated with clinical symptoms prompting presentation. Prior to reviewing pathology, it is important for the radiologist to first have a clear understanding of the natural course of breast development in pediatric patients. We provide a multi-modal imaging review of breast bud development from the neonatal period through puberty. Next, we present a breadth of multimodal imaging cases of both benign and malignant lesions within the pediatric breast, including accessory breast tissue, gynecomastia, masses of the breast, masses of the chest wall mimicking breast masses, infection, trauma, and more. Lastly, this exhibit highlights key imaging characteristics that may prompt concern or need for further workup, offers optimization and best practices for imaging, and reviews appropriate management and referral recommendations for common entities. Read More

Meeting name: SPR 2025 Annual Meeting , 2025

Authors: Dhami Alysha, Seekins Jayne

Keywords: Breast, Ultrasound and MRI, Multimodality

The aim of this strategy is to standardize the performance of our modified barium swallow studies (MBSS) with a focus on communication between team members and the reduction of fluoroscopic radiation dose exposure to the radiosensitive head and neck region. The radiation dose reduction strategy is composed of the following steps: The radiology technologist will initiate the patient encounter, begin room setup, and notify the radiologist of patient arrival. The radiologist will review prior examinations, if available, and discuss the current indication and goal of the examination with the Speech/Occupational Therapist and Radiology Technologist. The pulsed acquisition rate is standardized at 15 frames/second, and the optimal field of view will be discussed and adjusted dynamically, if necessary. The team will utilize standardized consistencies based on the International Dysphagia Diet Standardization Initiative (IDDSI). Once the in-room team has a clear objective the performing radiologist will proceed with the fluoroscopic examination. The radiologist will announce to the in-room team when fluoroscopic time points are met at 1 minute, 2 minutes, and a "hard-stop" at 3 minutes of fluoroscopic exposure. In order for an examination to continue beyond the 3 minute time point a mandatory discussion regarding clinical necessity will occur between the supervising radiologist and the in-room team members. The average fluoroscopic time required for the acquisition of a MBSS at our institution was calculated and reviewed before (2.07 minutes) and after (1.35 minutes) the implementation of this fluoroscopic radiation dose reduction strategy. The result is a 36 percent reduction in time of fluoroscopic exposure. The implementation of a radiation dose reduction strategy to our MBSS protocol has resulted in decreased fluoroscopic times, and therefore, a decrease in fluoroscopic radiation dose. An emphasis on verbal communication between team members ensures an understanding of the goal of the examination and awareness of proper management of radiation dose to patients and workers. This modified approach to the MBSS better aligns with the principle of “as low as reasonably achievable” (ALARA). Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Contreras Jesus, Seekins Jayne

Keywords: ALARA, FLUOROSCOPY

Ultrasound (US) of the kidneys is one of the most frequently performed imaging examination in the pediatric population. Conventionally, curvilinear probes (6-10MHz) are used for initial assessment. Liner high-resolution probes (HRP) (>15MHz) have been reported to improve the visualization of renal pyramid pathology. At our institution, we have implemented the use of HRP (15 or 18MHz) in addition to the lower-resolution probes (LRP) to the renal US protocol. This is a study to investigate whether the routine utilization of HRP can increase the detection and confidence in the diagnosis of nephrocalcinosis. Read More

Meeting name: SPR 2025 Annual Meeting , 2025

Authors: Lee Alexander, Kennedy Ii William, Seekins Jayne, Rubesova Erika

Keywords: Renal, Ultrasound, Calcifications