ACR–SPR PRACTICE PARAMETER FOR THE PERFORMANCE OF CONTRAST ESOPHAGRAMS AND UPPER GASTROINTESTINAL EXAMINATIONS IN INFANTS AND CHILDREN

PREAMBLE

I. INTRODUCTION

II. INDICATIONS AND CONTRAINDICATIONS

III. QUALIFICATIONS OF PERSONNEL

IV. SPECIFICATIONS OF THE EXAMINATION

A. Patient Selection

IV. SPECIFICATIONS OF THE EXAMINATION

B. Examination Preliminaries

IV. SPECIFICATIONS OF THE EXAMINATION

C. Examination Technique

V. DOCUMENTATION

VI. EQUIPMENT SPECIFICATIONS

VII. RADIATION SAFETY IN IMAGING

VIII. QUALITY CONTROL AND IMPROVEMENT, SAFETY, INFECTION CONTROL, AND PATIENT EDUCATION

ACKNOWLEDGEMENTS

Writing Committee – members represent their societies in the initial and final revision of this practice parameter

ACR
Amodio, John B MD, Chair
Blumfield, Einat MD

SPR
Acharya, Patricia T MD
Sharma, Priya MD

Committee on Practice Parameters – Pediatric Imaging

(ACR Committee responsible for sponsoring the draft through the process)

Amodio, John B MD, Chair	Alizai, Hamza MD	Betz, Bradford W MD	Bhimaniya, Sudhir X MBBS, MD
Blumfield, Einat MD	Collard, Michael MD	Goldman-Yassen, Adam MD	Lai, Hollie A MD
Lala, Shailee V MD	Lasiecka, Zofia M MD, PhD	Laufer, Adina MD	Levin, Terry L MD
Li, Arleen MD	Maloney, John A MD	Noda, Sakura MD	Shah, Summit MD
Trout, Andrew T MD	Vatsky, Seth DO

Committee on Practice Parameters and Technical Standards

(ACR Committee responsible for sponsoring the draft through the process)

Caplin, Drew M MD, Chair

Bulas, Dorothy I MD, Chair, Commission on Pediatric Radiology

Larson, David B MBA, MD, Chair, Commission on Quality and Safety

Comments Reconciliation Committee

Kagetsu, Nolan MD - CSC, Chair	Wood, Monica MD - CSC, Co-Chair	Acharya, Patricia T MD	Amodio, John B MD
Blumfield, Einat MD	Bulas, Dorothy I MD	Caplin, Drew M MD	Crummy, Timothy MD, MHA - CSC
Larson, David B MBA, MD	Schoppe, Kurt MD - CSC	Sharma, Priya MD

REFERENCES

1. [27320840] Richer EJ, Sanchez R. Are esophagrams indicated in pediatric patients with spontaneous pneumomediastinum? J Pediatr Surg 2016;51:1778-81.
2. [-3120926] American College of Radiology. ACR-SPR Practice Parameter for Imaging Pregnant or Potentially Pregnant Patients with Ionizing Radiation. Available at: https://gravitas.acr.org/PPTS/GetDocumentView?docId=23+&releaseId=2.
3. [-3188535] American College of Radiology. ACR Committee on Drugs and Contrast Media. Manual on Contrast Media. Available at: https://www.acr.org/Clinical-Resources/Clinical-Tools-and-Reference/Contrast-Manual.
4. [-3197654] American College of Radiology. ACR-AAPM-SIIM Practice Parameter for Digital Radiography. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=135+&releaseId=2
5. [27853838] Creeden SG, Rao AG, Eklund MJ, Hill JG, Thacker PG. Pre-procedural scout radiographs are unnecessary for routine pediatric fluoroscopic examinations. Pediatr Radiol. 2017 Mar;47(3):290-293.
6. [5350681] Poznanski A. A simple device for administering barium to infants. Radiology. 1969 Nov;93(5):1106.
7. [1898811] Cohen MD, Towbin R, Baker S, et al. Comparison of iohexol with barium in gastrointestinal studies of infants and children. AJR Am J Roentgenol. 1991 Feb;156(2):345-50.
8. [3541032] Cohen MD. Choosing contrast media for the evaluation of the gastrointestinal tract of neonates and infants. [Review] [71 refs]. Radiology. 162(2):447-56, 1987 Feb.
9. [15737370] Fordham LA. Imaging of the esophagus in children. Radiol Clin North Am. 2005 Mar;43(2):283-302.
10. [-3197747] American College of Radiology. ACR-SPR Practice Parameter for the Performance of Modified Barium Swallow. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=14+&releaseId=2
11. [-3139111] American College of Radiology. ACR Practice Parameter for the Performance of Esophagrams and Upper Gastrointestinal Examinations in Adults. Available at: https://gravitas.acr.org/PPTS/GetDocumentView?docId=46+&releaseId=2
12. [16973777] Applegate KE, Anderson JM, Klatte EC. Intestinal malrotation in children: a problem-solving approach to the upper gastrointestinal series. [Review] [59 refs]. Radiographics. 26(5):1485-500, 2006 Sep-Oct.
13. [8911190] Hernandez RJ, Goodsitt MM. Reduction of radiation dose in pediatric patients using pulsed fluoroscopy. AJR Am J Roentgenol. 1996 Nov;167(5):1247-53.
14. [9933507] Koplewitz BZ, Daneman A. The lateral view: a useful adjunct in the diagnosis of malrotation. Pediatr Radiol. 1999 Feb;29(2):144-5.
15. [7596651] Berdon WE. The diagnosis of malrotation and volvulus in the older child and adult: a trap for radiologists. Pediatr Radiol. 1995;25(2):101-3.
16. [-3197868] Jamieson D, Stringer D. Small Bowel. In: Babyn PS, Stringer DA, ed. Pediatric Gastrointestinal Imaging and Intervention. 2nd ed. Hamilton, Ontario: Decker; 2000:311-32.
17. [3495124] Katz ME, Siegel MJ, Shackelford GD, McAlister WH. The position and mobility of the duodenum in children. AJR Am J Roentgenol. 1987 May;148(5):947-51.
18. [12136343] Simanovsky N, Buonomo C, Nurko S. The infant with chronic vomiting: the value of the upper GI series. Pediatr Radiol. 32(8):549-50; discussion 551, 2002 Aug.
19. [-3197621] American College of Radiology. ACR Practice Parameter for Communication of Diagnostic Imaging Findings. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=74+&releaseId=2
20. [-3197640] American College of Radiology. ACR-AAPM Technical Standard for Diagnostic Medical Physics Performance Monitoring of Radiographic Equipment. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=120+&releaseId=2
21. [-3197620] American College of Radiology. ACR–AAPM TECHNICAL STANDARD FOR DIAGNOSTIC MEDICAL PHYSICS PERFORMANCE MONITORING OF FLUOROSCOPIC EQUIPMENT. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=117+&releaseId=2