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Image Gently Mission Statement Update 

The mission of the Image Gently Alliance is, through advocacy, to improve safe and effective imaging care of children worldwide.

Campaign Overview

The Image Gently Campaign and the Image Gently Alliance rely on the generous donations of resources from the founding organizations (Society for Pediatric Radiology, American College of Radiology,  American Society for Radiologic Technologists, and the American Association of Physicists in Medicine), all Alliance Organizations, supporters, and Cincinnati Children's Hospital Medical Center. The leadership gratefully acknowledges the time, talent and expertise from representatives of GE Healthcare, Philips Healthcare, Toshiba America, and Siemens Medical Systems, who are committed to improving healthcare for children through activities related to this campaign.

The Alliance is grateful for the unrestricted educational grant from GE Healthcare made in 2007.  The campaign does not accept corporate financial donations at this time.

Great News! 

The SPR has arranged for Image Gently donations to be made through their secure website system.  Support the Image Gently Campaign here!

2017 Butterfly Award Winner


2017 Butterfly Award
Dr. S. Ted Treves and Dr. Fred Fahey accepted the 2017 Butterfly Award on behalf of the Image Gently Nuclear Medicine Working Group at the 2017 Image Gently Alliance Meeting in Chicago, Illinois on November 27, 2017.

Children's Book on CT

A children’s book entitled, Learning about X-rays with Lula and Ethan is based on one young child, Ethan, getting a head CT after having a minor playground injury. Read more here....




May 10: The Japanese College of Radiology (JCR) joins the Image Gently Alliance

Image Gently announces the addition of the Japanese College of Radiology (JCR) to the Alliance roster! Founded in 1973, JCR has 5,616 members.


May 3: Management Decisions for Adolescent Idiopathic Scoliosis Significantly Affect Patient Radiation Exposure

Steven M. Presciutti, MD; Teja Karukanda, BS; and Mark Lee, MD


Background context

Adolescent idiopathic scoliosis (AIS) patients treated before the 1990s have a 1% to 2% increased lifetime risk of developing breast and thyroid cancer as a result of ionizing radiation from plain radiographs. Although present plain radiographic techniques have been able to reduce some of the radiation exposure, modern treatment algorithms for scoliosis often include computed tomography (CT) and intraoperative fluoroscopy. The exact magnitude of exposure to ionizing radiation in adolescents during modern scoliosis treatment is therefore unclear.


To determine the difference in radiation exposures in patients undergoing various forms of treatment for AIS.

Study design

Retrospective cohort.

Patient sample

Patients aged 9 to 18 years with a diagnosis of AIS, followed and/or treated with nonoperative or operative management for a minimum of 2 years.

Outcome measures

Number of radiographs and total radiation exposure calculated.


The charts and radiographs of patients managed for AIS at a single institution between September 2007 and January 2012 were reviewed. Patients were divided into three groups: operative group, braced group, and observation group. Patient demographics, Cobb angles, and curve types were recorded. The number of radiographs per year that each patient received and the total radiation dose were recorded. The plain radiographic radiation exposure was then combined with the direct exposure recording from ancillary tests, such as fluoroscopy and CT, and a radiation exposure rate was calculated (mrad/y). A single-factor analysis of variance (α=0.01) with a Tukey honest significant difference post hoc analysis was used to test significance between groups.


Two hundred sixty-seven patients were evaluated: 86 operative, 80 brace, and 101 observation. All groups had similar demographics and curve type distribution. The mean initial

April 24: What is Radiation - Am I Exposed to Background Radiation Each Day Even if I Do Not Have an X-Ray Examination?

Background radiation

  1. Background radiation refers to the ionising radiation from high energy particles or rays that we are unavoidably exposed to in our daily lives, which gives each of us a small but continuous dose of ionising radiation.
  2. Part of background radiation is due to the electromagnetic radiation spectrum, and this includes ‘ionising’ components such as X-radiation (X-rays) and gamma rays, and ‘non-ionising’ components such as visible light and radio waves.
  3. X-rays, gamma rays and some other high energy particles are called ‘ionising radiation’ because they can deposit enough energy into a body tissue to change its molecules or proteins by ejecting an electron from an atom.
  4. The sources of ionising radiation in our environment are cosmic rays from the universe, naturally occurring radioactive substances in the food and water we eat and drink, the air we breathe, in the ground, in building materials, and so on.
  5. We are all weakly radioactive due to the presence of radioactive elements in our bodies (such as potassium 40 and carbon 14), and this contributes to our background radiation exposure.
  6. Background radiation is most commonly given in units of millisievert (mSv), which both measures and combines the radiation dose and the consequent risk delivered by an exposure.
  7. The amount of background radiation varies widely in different parts of the world due to the radioactivity of the soil, latitude, height above sea level and lifestyle (predominantly indoors or outdoors). In Australia, the background radiation is estimated to be 2 mSv, which is approximately equivalent to 100 single chest X-rays per year. A few parts of the world have background radiation 10 or more times greater than that generally found in Australia, but there are no studies that have shown an increased risk of cancer in populations living in areas with a higher background radiation level.


  1. Visible light and X-rays both travel in straight lines, and cast a shadow when they interact with a solid object.
  2. X-rays have more energy than visible light, and can go much deeper into and through objects. An
  3. X-ray beam is absorbed differently by different parts of the body, and these differences make shadows that are used to create an image or picture.
  4. A dense structure, such as bone, [Read more…]

April 18, 2018: Minor head injury not reason enough for CT scan in children

New study helps emergency physicians avoid CT scans that carry cancer risk for young patients

(SACRAMENTO, Calif.) —

A nationwide study of more than 40,000 children evaluated in hospital emergency departments for head trauma found that if children had only loss of consciousness, and no other signs or symptoms related to the head trauma, they are very unlikely to have sustained serious brain injuries. Children who have only isolated loss of consciousness after head trauma do not routinely require computed tomography (CT) scans of the head, reported researchers from UC Davis Health System and Boston Children’s Hospital.

[Read more...]

the Butterfly Effect - April 2018 - Image Gently's Newsletter!

3/27/2018: Enhancing Image Quality in the Era of Radiation Dose Reduction: Postprocessing Techniques for Body CT

Authors:  Pamela T. Johnson, MD and Elliot K. Fishman, MD


The pillars of excellence in body CT are guided by traditional goals of quality (protocol optimization and interpretative accuracy) and safety (radiation modulation and avoiding contrast-induced nephropathy). As medicine transitions to high-value practice, excellence has evolved into providing the most diagnostically accurate information possible from each CT examination while protecting patients from unnecessary scans, radiation, and costs. Body CT is a leading source of patient radiation exposure in medical imaging [1, 2], and the Image Wisely Campaign encourages all radiology professionals to safeguard patients by pledging to optimize radiation use 3. In body CT, radiation dose is tempered by limiting the number of phases performed during each CT and modulating tube current and peak kilovoltage [4, 5]. The ACR recently released their second slate of [Read more...]

3/15/2018: Effect of staff training on radiation dose in pediatric CT

With ongoing technological developments in radiation protection, CT has become integral to pediatric radiology, and has established itself as an important part of the diagnostic algorithm [1–6]. Nevertheless, the awareness of the possible effects of ionizing radiation in the young and growing bodies of children requires that radiation dose and scan protocols be adapted to size, age, and clinical needs [6–9], according to the ALARA (as low as reasonably achievable) principles. In addition, [Read more...]

3/8/2018: A doctor talks about: Radiation risk from medical imaging

There’s been a lot in the media lately about radiation exposure from medical imaging, and many of my patients are asking about it. They want to know if radiation from mammograms, bone density tests, computed tomography (CT) scans, and so forth will increase their risk of developing cancer. For most women, there’s very little risk from routine x-ray imaging such as mammography or dental x-rays. But many experts are concerned about an explosion in the use of higher radiation–dose tests, such as CT and nuclear imaging.  [Read more...]

3/1/2018: 5 – 7 Mar 2018 in Vienna: Technical Meeting on Experiences with the Implementation of the Bonn Call for Action

In 2012, in Bonn, Germany, the International Atomic Energy Agency (IAEA) organized the International Conference on Radiation Protection in Medicine — Setting the Scene for the Next Decade. This conference, which was co-sponsored by the World Health Organization (WHO), resulted in [Read more...]

2/5/2018: Invitation to the next webinar in radiation protection in dentistry held by IAEA – tomorrow, Feb. 6th!

Participate in our free webinars on the radiation protection topics in medical uses of ionizing radiation, and take the opportunity to learn from the world’s leading radiation protection experts. [Read More...]

1/30/2018: Informed Imaging Improves Safety for Children

Informed Imaging Improves Safety for Children

Children with complex diseases, such as congenital and acquired heart disease, frequently have complicated medical needs, sometimes requiring multiple surgeries and experiencing long hospitalizations. As a result, they are often exposed to many procedures involving ionizing radiation. Although the procedures are important for making an accurate diagnosis and planning the most effective course of treatment, ionizing radiation itself is potentially harmful and can lead to an increased risk of cancer over a patient’s... [Read more]

1/10/2018: Radiation dose management for pediatric cardiac computed tomography: a report from the Image Gently ‘Have-A-Heart’ campaign


Children with congenital or acquired heart disease can be exposed to relatively high lifetime cumulative doses of ionizing radiation from necessary medical imaging procedures including radiography, fluoroscopic procedures including diagnostic and interventional cardiac catheterizations, electrophysiology examinations, cardiac computed tomography (CT) studies, and nuclear cardiology examinations. Despite the clinical necessity of these imaging studies, the related ionizing radiation exposure could pose an increased lifetime attributable cancer risk. The Image Gently “Have-A-Heart” campaign is promoting the appropriate use of medical imaging studies in children with congenital or acquired heart disease while minimizing radiation exposure. The focus of this manuscript is to provide a comprehensive review of radiation dose management and CT performance in children with congenital or acquired heart disease.  [Read more...]

1/3/2018: Development of a tool to aid the radiologic technologist using augmented reality and computer vision


This technical innovation describes the development of a novel device to aid technologists in reducing exposure variation and repeat imaging in computed and digital radiography. The device consists of... [Read more]

12/28/2017 CT scan is a diagnostic medical test that produces multiple images of the inside of the body

Children’s (Pediatric) CT (Computed Tomography)
Pediatric computed tomography (CT) is a fast, painless exam that uses special x-ray equipment to create detailed images of your child’s internal organs, bones, soft tissues and blood vessels. It may be used to help diagnose abdominal pain or evaluate for injury after trauma.

Tell your doctor about... [Read more]

12/14/2017 First Focused Ultrasound Pediatric Brain Tumor Study Begins

Researchers at Nicklaus Children’s Hospital in Miami, Florida have performed the first procedure in a pediatric and young adult brain tumor study. The trial aims to demonstrate feasibility and safety of using focused ultrasound to ablate a variety of benign tumors located in the central part of the brain in ten patients, ages 8 to […]  Read more

12/12/2017 To sedate or not to sedate… General anesthetic considerations in pediatric imaging

In December of 2016, the US Food and Drug Administration (FDA) released a safety warning concerning the risk of repeated use of general anesthetics and sedation drugs in young children and pregnant women1.  From a review of the literature, including both animal and human studies, the FDA found consensus data to suggest that early, repeated exposure may […] Read more

12/8/2017 Global X-Ray Safety Glasses Market 2017 Production Chain, Growth Rate, Application, Trend and Analysis

The Market and Research study, titled Worldwide X-Ray Safety Glasses Market 2017, presents critical information and factual data about the X-Ray Safety Glasses market globally, providing an overall statistical study of the X-Ray Safety Glasses market on the basis of market drivers, X-Ray Safety Glasses Market limitations, and its future prospects. The prevalent global X-Ray […] Read more

12/6/2017 This X-Ray Shows Why Parents Should Cut Up Even Grapes For Their Kids

A child dies from choking on food every five days in the US. The third most likely foodstuff children are in peril of choking on is, perhaps surprisingly, whole grapes. This shocking X-ray was recently shared by the Finlee and Me parenting blog along with some simple advice to help stop that from happening. The X-ray shows […] Read more

12/5/17 Dec Children with Nontraumatic Back Pain and No Red Flags May Not Need Imaging Children with Nontraumatic...

Imaging is likely not indicated among children who present with nontraumatic back pain without evidence of clinical red flags, according to an article published in the Journal of the American College of Radiology.  The Expert Panel on Pediatric Imaging draws up evidence-based guidelines and makes recommendations regarding the appropriateness of imaging and treatment procedures for […] Read more

12/3/14 Pediatric Information for X-ray Imaging Device Premarket Notifications

On November 28, 2017, the FDA published a final guidance document entitled “Pediatric Information for X-ray Imaging Device Premarket Notifications,” encouraging manufacturers to consider child safety when designing X-ray imaging devices. In the guidance, which applies to new devices and modifications requiring the submission of a new 510(k), the FDA recommends manufacturers design these devices […] Read more

12/1/17 All radiation safety global alliances/campaigns gathered together at RSNA 2017

At RSNA all global alliances/campaigns gathered together for first time ever to present updates on recent activities and successes. Pictured (with organizations represented) from left to right are: Boudjema Mansouri, MD Arab Safe Michael Kawooya MD, PhD, AFROSAFE (English and French) Donald Frush MD, Image Gently Alliance Kanako Kumamaru,MD, PhD Japan Safe Radiology Guy Frija […]  Read more

11/30/17 The use of noninvasive diagnostic imaging has declined over the past decade and a half, with only CT...

The use of noninvasive diagnostic imaging has declined over the past decade and a half, with only CT imaging showing slight growth, according to an article published in the journal Health Affairs. Researchers from Thomas Jefferson University Hospital in Philadelphia examined recent data to determine if previously reported levelling off of the use of imaging […] Read more

11/29/17 A global view of radiation safety initiatives at RSNA

A global view of radiation safety initiatives at RSNA November 29, 2017 by Lisa Chamoff , Contributing Reporter CHICAGO — Radiologists around the world are working hard to make sure that patients, particularly caregivers of pediatric patients, and providers understand the potential risks of low-level radiation exposure. At a session during the 2017 RSNA annual meeting, representatives […] Read more

11/28/17 University of Rochester Medical Center Opens Neuromedicine and Behavioral Health Center for Pediatric Patients

UR Medicine’s Neuromedicine and Behavioral Health Center celebrates its opening on March 29. The center brings together Developmental and Behavioral Pediatrics, Child Neurology, and Child Psychiatry to collaborate on care for pediatric patients, and is home to the new William and Mildred Levine Autism Clinic that provides specialized care for patients with autism spectrum disorder. [...] Read more

11/27/17 FDA: Pediatric Information for X-ray Imaging Guidance Document

Today, FDA published a final guidance document entitled “Pediatric Information for X-ray Imaging Device Premarket Notifications,” encouraging manufacturers to consider child safety when designing X-ray imaging devices. [...] Read more

11/23/17 A case of giant fetal intracranial capillary hemangioma cured with propranolol

Fetal brain tumors are rare. This report describes a giant posterior fossa capillary hemangioma treated with 3 mg/kg/day of propranolol for 6 months.  [...] Read more

11/22/17 When should your child first visit the dentist? It might be earlier than you think

Most American children don’t see their family dentist until they are well over 2 years old, far later than is recommended by both dental and medical professionals. [...] Read more

11/21/17 Contrast MRI for Perforated, Non-Perforated Pediatric Appendicitis

Contrast-enhanced MRI can differentiate between perforated and non-perforated appendicitis among children, and may help guide management decisions in the work-up of pediatric appendicitis, according to [...] Read more

11/16/17 Imaging in Child Abuse

Caffey’s landmark article of 1946 noted an association between healing long-bone fractures and chronic subdural hematomas in infancy, and it was the first to [...] Read more

11/14/2017: Brain MRI findings in pediatric patients post ECMO

Neurologic complications can occur with ECMO due to several factors. Prior studies identified neonates as having unique risk factors and neuro-imaging findings post-ECMO. The aim of this study is to describe brain MRI findings of pediatric patients treated with ECMO. We conducted a retrospective study of non-neonatal pediatric patients who underwent a comprehensive brain MRI [...] Read more

11/09/2017: Association between Testicular Microlithiasis and Testicular Neoplasia: Large Multicenter Study in a Pediatric Population

To retrospectively define the strength of association between testicular microlithiasis and testicular neoplasia in a large geographically diverse pediatric population.  [Read more...]

11/08/2017: What parents need to know before orders for X-Rays, Scans and Radiation for Kids

When a child is ill or injured, you want your child to get whatever medical tests are needed, as soon as possible. But when it comes to imaging tests — such as X-rays, PET scans, and CT scans — the key word is “needed.” Those tests use radiation that, if exposed to often enough, has [Read more...]

11/07/2017: Global Pediatric Brain Tumor Market Is Growing Continuously And Expected To Grow At A CAGR ...

Of 4.1% From 2017 To 2023.  [Read more...]

11/02/2017: Diffusion-Tensor Imaging of the Physes: A Possible Biomarker for Skeletal Growth—Experience with 151 Children

Purpose To determine the changes of diffusion-tensor imaging (DTI) and tractography in the distal femur and proximal tibia related to age, sex, and height. Materials and Methods Following institutional review board approval, with waiver of consent and with HIPAA compliance, the authors retrospectively analyzed DTI images of the knee in 151 children, 73 girls (median [Read more…]

10/20/2017: What Parents Should Know about the Safety of Dental Radiology

There are many different types of x-ray images (pictures) that can be taken of children in the dental office to assist in diagnosis. These include the panoramic and orthodontic (cephalometric) extraoral images, intraoral images such as bitewings and periapicals (little films that go inside the mouth) and cone beam computed tomography (CBCT). All of these [Read More...]

10/2/2017: Optimizing Medical Imaging for Children of All Sizes

A proposed framework balances quality and safety of computed tomography protocols across a range of body sizes in pediatric populations.  Read about it here.

New Guidance for Pediatric CT by AAPM Alliance for Quality Computed Tomography

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