The Department of Radiology at Boston Children's Hospital is one of the largest and most respected pediatric radiology programs in the world and has continued to be a leader in innovation.
Faculty members in the Radiology Department Research Center participate in clinical research activities, and many do laboratory research as well. Current areas of focus include:
- Advanced Image Analysis Laboratory
- Computed Tomography (CT) Innovations
- Diagnostic Radiology Innovations
- Interventional Radiology Innovations
- Magnetic Resonance Imaging (MRI) Innovations
- Neuroradiology Innovations
- Nuclear Medicine and Molecular Imaging Innovations
- Ultrasound Innovations
Computed Tomography (CT or CAT Scan)
Our NeuroLogica CereTom portable CT scanner allows the medical team to assess the neurological condition of critically ill patients who are too clinically unstable to move. The portable unit performs head CT scans of babies and children right in their hospital beds, giving doctors and nurses instant information about acute, potentially life-threatening events such as strokes, hemorrhages or hydrocephalus.
The portable scanner is also sometimes used in the operating rooms during neurosurgery.
Diagnostic Radiology Innovations
Our facilities in Boston and our satellite locations include state-of-the-art X-ray and fluoroscopy units. See ‘Technology’ for more information.
Child Life Specialist
Our Child Life specialist is available to support your family before and during fluoroscopy exams to make your child's visit as safe, pleasant and comfortable as possible. She is an expert on child development and is specially trained in supporting children and families in a hospital environment. The support of the child life specialist has resulted in little need for sedation and a high level of satisfaction from parents.
We recently surveyed 200 parents whose children underwent VCUGs at the hospital this year and found that 92 percent of the parents came away from the experience satisfied. Angela Franceschi, one of two child life specialists in the Department of Radiology, presented the results at the American Academy of Pediatrics meeting this year.
Our unique approach to pediatric radiology means that a radiologist with subspecialty expertise in the disease or organ system under investigation will interpret your child's study. Specialty areas include:
- Cardiac Imaging
- Fetal and Neonatal Imaging
- Gastrointestinal/Abdominal Imaging
- Genitourinary Imaging
- Head and Neck Imaging
- Musculoskeletal Imaging
- Oncologic Imaging
- Pulmonary Imaging
- Vascular Malformations/Intervention
Innovations in Interventional Radiology
Angiography in children
Angiography in children is different than in adults, because children have smaller and more delicate blood vessels. Our interventional radiologists and neuroradiologists are highly trained in using the specialized techniques and small catheters necessary for performing this procedure in children.
We are one of the few centers in the world that specialize in minimally invasive, image-guided treatments for aneurysms and disorders of the brain, head, neck and spine in babies and children. Learn more.
New ways of treating and diagnosing vascular malformations
Vascular malformations are tangled and misrouted arteries and veins, which cause pain, swelling, and disfigurement. Because Children's operates a world-famousVascular Anomalies Center, we have extensive experience in using interventional techniques to evaluate and treat abnormal blood vessels without the need for surgery.
We also specialize in:
- Pediatric tumor diagnosis and therapy
- Radiofrequency ablation, a technique in which an electrode is delivered through a needle to "burn" bone lesions and tumors.
Functional MRI (fMRI)
MR technology allows physicians to see the anatomic structure of the body's organs and tissues. Functional MR (fMR) enables physicians to see how the body functions. An fMRI is performed on a conventional MRI unit that consists of a very large magnet and uses a safe, non-invasive magnetic field and radiofrequency waves to take pictures of the brain while it is working. The technique measures changes in blood flow all over the brain. In this way, the fMRI scan allows us to see what areas of the brain are activated during a specific activity. For example, by having people perform simple tasks during the scan (such as moving digits or limbs) we can see which part of the brain controls those tasks.
At Boston Children's Hospital, fMR scans are used to provide additional information used for treatment planning for neurological disorders such as epilepsy, brain tumors, brain injury, mental retardation, autism, and learning disabilities. Read here about the fMR simulator that prepares kids for research studies. The hospital's Dream magazine also looks at fMR.
Image Fusion and Post-Processing
The Advanced Image Analysis Laboratory in the Radiology Department at Boston Children's Hospital allows radiologists, nuclear medicine physicians, and referring clinicians to maximize information gained from computed tomography (CT), magnetic resonance imaging (MRI), and nuclear medicine exams. The three-dimensional models, fused images, and other advanced post-processing methods improve patient care by aiding diagnosis, treatment planning and surgical intervention. The images can also be used for patient-friendly explanations and answering research questions.
‘Try-Without Sedation’ and ‘Feed and Wrap’ programs
We routinely offer cooperative children ages 4-6 years the chance to try undergoing their MRIs without sedation after a pilot program showed that most of them can do so successfully with proper preparation and distraction. Movement will cause the MRI images to be blurry, so we use a variety of techniques to help children lie still, such as listening to music or watching videos during the exam with special goggles and headphones. Motion-reduction sequences are also used to improve the quality of the images. Our Child Life Specialist helps to prepare children and families before and during the MRI to make the visit as safe, pleasant and comfortable as possible.
Additionally, we perform "feed and wrap" imaging of sleeping, unsedated newborns, ages 0 to 3 months. Our custom made 32-channel head coils for newborns and six month olds improve signal to noise and our ability to accelerate image acquisition.
Children in the 3 months to 4 years age group rarely undergo an MRI without sedation or anesthesia. A recent Catalyst funded grant is allowing us to focus on preparing children between the ages of 6 months and 1 year for a non-sedated MRI. Additionally, in collaboration with the Gaab Laboratory, we are developing distraction techniques to make improvements in this area for the 3 months to 4 years age group.
Motion Mitigation and Accelerated Image Acquisition
Movement during the MRI will cause the images to beblurry. Motion mitigation sequences track the head motion of a patient and readjust the image acquisition to account for a child’s movement during the scan. These are not yet commercially available, yet we use them routinely.
We also have custom made 32-channel head coils for newborns and six month olds to improve signal to noise and our ability to accelerate image acquisition.
MRI Imaging to Reduce Exposure to Radiation from CT Exams
In order to limit exposure to radiation, we are performing MRI studies for exams that were previously routinely imaged by CT. For example, IBD studies and ventricular size checks are now being performed using MRI, resulting in a decreased lifetime cumulative radiation dosage. Additionally, some airway (sleep apnea) exams are being obtained with MR instead of CT.
MR tractography uses data sets from diffusion weighted images to show white matter organization and orientation of white matter fibers in the brain. Tractography is helpful for preoperative planning and understanding seizure propagation in epilepsy and other brain disorders. In the future, it may also be able to play a role in evaluating how the brain as a whole is connected, and how such connectivity is altered in certain disease states.
Magnetoencephalography (MEG) monitors neural activity by recording magnetic fields in the brain. Current MEG devices are only available in adult sizes. In collaboration with the National Science Foundation, we are designing and building the first whole head MEG system for infants and children aged 0 to 3 years. This system will have the technical capabilities needed for monitoring neural activity in young patients.
Encephalographic MRI (eMRI) is a research technique that combines advanced magnetic resonance imaging (MRI) and electroencephalography (EEGs) in an attempt to more directly image the electrical changes in the brain than was previously possible. Early results demonstrate fast eMRI responses that correlate well with epilepsy spikes on the EEG. Work is now directed at trying to use eMRI to help with surgical planning for epilepsy patients. More generally, eMRI may prove to be a powerful tool for understanding the origin and spread of abnormal electrical activity in the brain in various epilepsy syndromes, both during wakefulness and sleep.
Computational Research Laboratory
Investigators in our Computational Research Laboratory use high performance computing technology to enhance radiological images and interpretation. This work helps pinpoint the origin of epileptic seizures and enhances navigation and visualization during image-guided brainsurgery.
Nuclear Medicine and Molecular Imaging
Nuclear medicine studies can be particularly useful when they are digitally combined with the anatomical images generated by computed tomography (CT) or magnetic resonance imaging (MRI). Boston Children's Hospital is one of the few pediatric nuclear medicine programs nationwide that is routinely capable of electronically fusing nuclear medicine studies with images obtained from CT or MRI. In many cases, this gives a more complete assessment of the problems being investigated. For example, a neurologist can see the exact location in the brain where a seizure originated or an oncologist can determine which parts of a tumor are growing the fastest. Nuclear medicine studies that can be combined with MRI or CT include bone scans, brain SPECTs, PET scans, and rest-stress myocardial perfusion scintigraphy.
More information on image fusion can be found on our Advanced Image Analysis Laboratory website.
Pediatric PET scanner
PET Scanner at the Nuclear Medicine and Molecular Imaging Department- Boston Children's Hospital
Positron emission tomography (PET) is a highly sensitive technology that generates three-dimensional images of biochemical changes too subtle to discover by other means. It is extremely useful in the early diagnosis, staging and assistance with treatment and follow-up of cancer, as well as the detection of neurological disorders and heart conditions. Boston Children's Hospital is the only facility in New England and one of the few in the country that has a PET scanner dedicated solely to children.
Advanced radiation treatment for neuroblastoma
Nuclear medicine physicians and scientists are an integral part of the Dana-Farber/Children's Cancer Care team's MIBG treatment for children with relapsed neuroblastoma (cancerous tumors that originate in the nerve tissues). The treatment, which uses a radioactive compound to kill tumor cells, is available in only a handful of major medical centers in North America and is the first therapy of its kind to be offered in New England.
We use the latest imaging equipment to perform the diagnostic evaluation that your child needs. Our state-of-the-art ultrasound units are designed specifically for the evaluation of fetal and pediatric patients, including 3D and 4D capabilities. We have a complete assortment of ultrasound transducers or probes, uniquely suited to image the great variety of patient sizes and shapes that we image on a daily basis. Color and waveform Doppler techniques are also performed regularly, on patients of all ages.
Learn more about the latest innovations in clinical practice and research in the Department of Radiology.
Watch on the web
Two neuroradiologists are part of the team for a surgical webcast: "Treating Moyamoya Disease."
Thriving highlights radiation safety
Read how our experts work to keep doses child-sized.
MRIs reveal bone changes in anorexics
MRIs show girls with anorexia have startling amounts of fat cells in their bone marrow but less than half of the healthy bone-forming cells as their peers, according to a study by radiologist Kirsten Ecklund, MD, and colleagues.