Pediatric Oncology Imaging Guidelines

This policy covers diagnostic and surveillance imaging for pediatric oncology patients — guidance on selection and timing of modalities (e.g., radiography, CT, MRI, PET) across a wide range of childhood malignancies including leukemias, CNS tumors, lymphomas, neuroblastoma, renal, liver, bone and soft-tissue tumors, retinoblastoma and other pediatric cancers. Major limitations require physician review for atypical or unaddressed presentations, a recent (≤60 days) history/physical and appropriate labs before advanced imaging (except guideline-supported off-therapy surveillance), restricted PET use after negative scans or resection, response imaging generally only after every 2 therapy cycles with ~6-week (solid tumor) or ~8–12-week (CNS) intervals, and routine imaging without localizing symptoms is not supported; the guideline set applies to patients <18 at initial diagnosis (with AYA routing rules and those ≥18 generally following adult oncology guidance).