Evidence-Based Imaging in Pediatrics: Clinical Decision Support for Optimized Imaging in Pediatric Care

This book provides evidence-based guidance for pediatric imaging to radiologists, pediatricians, and all subspecialists caring for children, as well as policy advocates. While the majority of pediatric radiology books concentrate on diagnosis, this book highlights how imaging should be used in optimal care, allowing comparisons between different modalities and addressing follow up, complications and the issue of timing of imaging.

The primary objective of this book is to provide a summary of appropriate imaging use in terms of modality and timing based on the best available evidence. The book therefore acts as a resource for optimized clinical care of children and effective decision-making. A secondary objective is to collate the evidence-based practices that constitute quality care for children in the setting of value-based imaging. Radiologists are often in the position of helping clinicians decide when and how to image children with suspected diseases or confirmed diagnoses. However, traditional residency training has done little to fulfill the need for this up-to-date evidence knowledge. Moreover, in spite of furthering subspecialization of the field, the great majority of children’s imaging (and care) occur outside of children’s hospitals, where clinicians and radiologist might need this type of general guidance for establishing best-practices.

The book is divided in two parts, non-diagnostic considerations such as evidence-based imaging, safety, value, and the practice of radiology in low resource settings and a second larger clinical component divided in prenatal, oncology, neurological, musculoskeletal, cardiothoracic, and abdominal imaging. This new edition incorporates changes in practice and guidelines in the decade since the first edition was written with many new chapters in emerging topics including prenatal, oncology and neurological imaging. This is an ideal guide for radiologists, pediatricians, policy advocates, and all healthcare professionals caring for children.

Hansel Otero is an associate professor of Radiology at the Perelman School of Medicine at the University of Pennsylvania. He is an attending physician within the body division of the radiology department at Children’s Hospital of Philadelphia and serves as the vice-chair for clinical research, John Westgate Hope Endowed Chair for faculty development.
Dr. Otero was born in Caracas, Venezuela, where he completed medical school at the Luis Razetti School of Medicine at Universidad Central de Venezuela. After working as a general practitioner in San Jose de Barlovento, Miranda, Venezuela, he joined Doctors without Borders/Médecins Sans Frontières (MSF) and completed assignments in Liberia, Sudan, Angola, Pakistan, and Yemen. Dr. Otero completed 2 years of Management and Hospital Administration research fellowship at Brigham and Women’s Hospital, an affiliated hospital of Harvard Medical School in Boston, MA. Then, he pursued a career in radiology, completing his diagnostic radiology residency at Tufts Medical Center in Boston, MA, and pediatric radiology fellowship at Children’s Hospital of Philadelphia.
Dr. Otero maintains a busy dedicated pediatric imaging clinical practice with special interest in body MRI techniques as well as cardiac, lymphatic, and genitourinary imaging. He participates in teaching and mentorship of medical students, residents, fellows, and junior faculty with a special emphasis in their academic productivity and scholarly publishing. He has also continued his international outreach in pediatric radiology with service and education programs in Haiti, Ghana, Ethiopia, Botswana, El Salvador, and others He also serves as the director of outreach for the World Federation of Pediatric Imaging and a global health scholar of the Center for Global Health, Perelman School of Medicine at the University of Pennsylvania.
Dr. Otero is core faculty at Clinical Futures (formerly Center for Pediatric Clinical Effectiveness) and a senior fellow of the Leonard Davis Institute of Health Economics at the University of Pennsylvania. He is a peer reviewer for over 10 journals and abstract reviewer for multiple scientific meetings including the SPR and RSNA annual meetings. He has guest edited special issues for Pediatric Radiology and the Journal of the American College of Radiology (JACR). Dr. Otero currently serves as the chairperson of the Section on Radiology of the American Academy of Pediatrics and an associate editor of the Journal of the American College of Radiology.

Summer L. Kaplan is an associate professor of Clinical Radiology at the Perelman School of Medicine at the University of Pennsylvania. She is an attending physician within the body division of the radiology department at Children’s Hospital of Philadelphia (CHOP), where she serves as associate chair for Quality in the Department of Radiology. She is also medical director for Point-of-Care Ultrasound for CHOP, working closely with clinical teams using ultrasound.
Dr. Kaplan attended medical school at the University of Pennsylvania Perelman School of Medicine, completing MD and MS Neuroscience degrees. After a pediatrics internship at St. Christopher’s Hospital for Children in Philadelphia, Dr. Kaplan completed radiology residency at Temple University Hospital and pediatric radiology fellowship at CHOP. Following fellowship, she began her career in pediatric radiology at CHOP, focusing on pediatric emergency imaging, radiation dose, and quality improvement.
Dr. Kaplan’s research focuses on utilization of imaging in emergency department and critical care settings. She has studied techniques to reduce radiation risks for children undergoing radiographic and fluoroscopic exams, including the use of shielding and contrast in these patients. Her work has also centered on use of imaging resources in acute care settings and building consensus with clinical care providers. Dr. Kaplan is a member of the Clinical Pathways Committee and contributed to clinical decision support guidelines for imaging use in pediatrics. She has participated in both pediatric and emergency radiology panels for the American College of Radiology’s Appropriateness Criteria. Through improvement and resource utilization work with the Pan-American Health Organization, Dr. Kaplan has studied application of quality improvement and appropriateness criteria in low- and low-middle income settings. As a senior fellow of the Leonard Davis Institute of Health Economics at the University of Pennsylvania, she has focused on how imaging costs affect patients and families.