Pediatric Oncology Imaging Guidelines

This policy covers pediatric oncology imaging, including general guidelines, screening for cancer predisposition syndromes, and disease‑specific imaging for a wide range of pediatric malignancies (e.g., leukemias, CNS tumors, lymphomas, neuroblastoma, renal, soft tissue, bone, germ cell, liver, retinoblastoma). Major limitations: applies to pediatric patients (guideline assignment by age at initial diagnosis with AYA 15–39 overlap), atypical presentations or indications not specifically addressed require physician review/authorization, advanced imaging generally requires a recent (≤60 days) history/physical and labs except for scheduled off‑therapy surveillance, routine imaging of asymptomatic patients without localizing signs or abnormal radiography/ultrasound is not indicated, research/COG‑only imaging is excluded, and radiation exposure should be minimized.

"Pediatric CNS tumors (PEDONC-4)"