Action 1- The Paediatric Imaging WG cooperated with the ESR Imaging Referral Guidelines Working Group in establishing appropriateness criteria for diagnostic imaging.
These criteria were based on the review of the Appropriateness Criteria of the American College of Radiology (ACR) and the ACR Select content,
and adapted to make them applicable in Europe.
The results of this work have been recently implemented into the ESR iGuide.
In the ESR iGuide,
the appropriateness of imaging exams according to clinical indications,
gender,
and age is scored on a scale of 1 (least appropriate) to 9 (most appropriate),
with ratings grouped in three categories: 1-3 (usually not appropriate),
4-6 (may be appropriate),
7-9 (usually appropriate).
Besides Paediatric Imaging,
the ESR iGuide includes 9 different topic areas,
namely: breast imaging,
cardiac imaging,
gastrointestinal imaging,
musculoskeletal imaging,
neurologic imaging,
thoracic imaging,
urogenital imaging,
women's imaging.
Concerning Paediatric Imaging,
320 indications/scenarios were considered with a number of 2465 scored decision rules.
The ESR iGuide is presently available for free as a web-based,
stand alone decision support system for all ESR radiologist members (Fig.
1) [1].
Action 7- The Paediatric Imaging WG,
together with the European Society of Paediatric Radiology (ESPR),
participated in the PiDRL tender project (European Guidelines on Diagnostic Reference Levels for Paediatric Imaging).
This 27-month project was sponsored by the European Commission and awarded to a consortium headed by the ESR,
including ESPR,
the European Federation of Radiographer Societies (EFRS),
the European Federation of Organisations for Medical Physics (EFOMP),
and the Finnish Radiation and Nuclear Safety Authority (STUK).
This project also relied on an expert advisory panel made up of representatives from the World Health Organisation (WHO),
the International Atomic Energy Agency (IAEA),
the National Council on Radiation Protection and Measurement (NCRP),
the Cardiovascular and Interventional Radiological Society of Europe (CIRSE),
and the International Commission on Radiological Protection (ICRP).
The rationale of this project was that,
despite a large number of studies available from European countries,
European DRLs for paediatric patients were available only for some common radiological examinations.
Therefore,
there was a need to provide guidelines on the most appropriate methods for establishing,
implementing,
and using DRLs to improve the radiation protection of children.
The specific objectives of the project were: 1) to agree on a methodology for establishing DRLs for paediatric imaging including plain radiography,
fluoroscopy,
CT and interventional radiology procedures; 2) to update and extend the European DRLs to cover more procedures and a wider patient age/weight range based on current knowledge.
The results of this project have been published in issue 185 of the European Commission's Radiation Protection Series (Fig.
2) [2].
Action 8- Since 2015,
the Paediatric Imaging WG has regularly issued a series of Tips & Tricks for paediatric imaging,
concerning how to deal with common issues of radioprotection in children.
These Tips and Tricks are part of the ESR's e-learning platform "Education on Demand",
which is freely available on the EuroSafe website (Fig.
3) [3].
It is also possible to fill in questionnaires and earn e-CME points.