Pediatric oncology surveillance imaging: two recommendations. Abandon CT scanning, and randomize to imaging or solely clinical follow-up.

Radiologic assessments in children with cancer provide information crucial to patient management at diagnosis and during follow-up. Many studies have now been published, however, questioning the usefulness of off-therapy surveillance imaging. There is growing concern regarding the hazards from diagnostic irradiation to young patients, most notably from CT scanning. In this paper we advocate abandoning repeated CT surveillance in young patients with a previously treated solid malignancy not arising in the central nervous system. In addition, randomized studies of imaging surveillance versus no imaging surveillance strategies are needed to determine whether earlier detection of recurrence results in improved survival.