Pediatric and Special Populations Oncology Imaging Guidelines

The guidelines specify appropriate pediatric oncology imaging modalities, timing and frequency—preferring MRI for CNS, 123I‑MIBG for neuroblastoma, CT for neck/thorax/abdomen/pelvis, and generally restricting PET/PET‑MRI and routine PET surveillance (excluding PET for small lesions <8 mm, CNS mets, inflammation/infection, post‑therapy monitoring, or when conventional imaging is definitive). Approvals require recent clinical evaluation (≤60 days), histologic confirmation of malignancy unless otherwise noted, documentation that the imaging will change management (specific justification for PET/PET‑MRI or MRI instead of CT to avoid radiation), and other condition‑specific documentation (e.g., INRG risk group for neuroblastoma, genetic confirmation for screening, ANC <500 for urgent infection imaging, echocardiography/MUGA justification).

"PET avidity in a residual mass at the end of planned therapy is not an indication for PET imaging during surveillance."