Pediatric and Special Populations Oncology Imaging Guidelines

This policy covers pediatric and special‑population oncology imaging — including advanced imaging for diagnosis, staging, treatment response, and surveillance across a wide range of childhood cancers (eg, leukemias, CNS tumors, lymphomas, neuroblastoma, renal/soft tissue/bone tumors, retinoblastoma, germ cell, liver/pancreas, thyroid, melanoma) as well as screening in cancer predisposition syndromes and long‑term survivors. Major limitations require a relevant clinical evaluation and, unless disease‑specific guidance allows otherwise, histologic confirmation and staging before imaging; routine or asymptomatic screening and frequent repeat studies are not supported, timing must follow diagnosis‑specific intervals (eg, ~6–12 weeks for response scans), and atypical or unlisted requests require physician review.

"Long Term Pediatric Cancer Survivors (PEDONC-19)"

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