Pediatric and Special Populations Oncology Imaging Guidelines

This Evicore pediatric oncology guideline defines condition- and syndrome‑specific covered imaging (preferred modalities and surveillance schedules—MRI favored for brain/spine/orbits, CT for chest/pulmonary mets, MIBG for neuroblastoma, limited PET indications) while excluding routine advanced imaging in asymptomatic patients, PET for infection/inflammation/post‑op healing or lesions <8 mm, and generally restricting PET/MRI. Key requirements: a recent clinical evaluation (≤60 days) and usually histologic confirmation (unless disease‑specific exceptions), documentation that imaging will affect management (including COG protocol details or genetic confirmation for predisposition syndromes, ANC for infection imaging), and adherence to timing/frequency rules (e.g., delay PET ≥12 weeks after radiation; specified response imaging intervals).

"Hepatoblastoma - Treatment Response (CT Chest every 2 cycles and MRI Abdomen every 2 cycles when incompletely resected)"