Pediatric and Special Populations Oncology Imaging Guidelines

Covers diagnosis- and disease-specific pediatric oncology imaging with modality preferences (MRI for CNS/musculoskeletal, 123I‑MIBG for neuroblastoma, CT for lymphomas/most solid tumors) and tightly restricts PET/CT and PET/MRI to specific situations (equivocal conventional imaging, biopsy guidance, residual mass ≥8 mm when results will change immediate treatment, salvage decisions), while excluding routine/asymptomatic surveillance, lesions <8 mm, post‑operative/healing, inflammatory/infectious indications (except specified urgent immunocompromised situations), and most non‑standard PET tracers. Key requirements for approval include a recent clinical evaluation (within 60 days) and usually histologic confirmation/staging, documentation that the imaging will change management (and that PET/CT is unavailable for PET/MRI), plus disease‑ or syndrome‑specific documentation (e.g., genetic confirmation for predisposition syndromes, neuroblastoma risk group, ANC for infectious imaging) and adherence to timing restrictions (e.g., delay PET/CT ≥12 weeks after radiation).