THE DIGITAL REVOLUTION IN PEDIATRIC RADIOLOGY: FROM ULTRASOUND TO AI-DRIVEN DIAGNOSTICS – A NARRATIVE REVIEW

Authors

DOI:

https://doi.org/10.31435/ijitss.1(49).2026.5020

Keywords:

Ultrasound Elastography, Contrast-Enhanced Ultrasound, Hybrid Imaging Techniques, Artificial Intelligence, Radiomics

Abstract

Background: The rapid development in AI and imaging technologies has enabled pediatric radiology to become digital. The objective of modern diagnostic methods is to achieve balance between radiation safety and accuracy in diagnosis by adapting imaging techniques to the anatomical, physiological, and ethical requirements of pediatric patients.

Aim: The aim of this study is to summarize recent advancements in artificial intelligence applications across pediatric imaging modalities and to evaluate their impact on diagnostic accuracy, workflow efficiency, and patient safety.

Methods: Recent peer-reviewed studies in pediatric radiology and artificial intelligence were analyzed to conduct a narrative review. The primary focus included advancements in ultrasound, MRI, CT, and hybrid imaging systems, as well as AI-driven diagnostic applications, workflow optimization, and ethical considerations.

Results: Ultrasound remains the preferred choice, and quantitative tools like contrast-enhanced ultrasonography and elastography render it more valuable. Diffusion imaging, spectroscopy, and faster acquisition methods have made magnetic resonance imaging more accessible and less probable to require sedation. Thanks to advances in CT and PET/CT, often enhanced by iterative and AI-driven reconstruction, radiation exposure has declined considerably. Hybrid PET/MRI provides both molecular and structural details while minimizing radiation exposure significantly. Artificial intelligence is now an integral part of almost all subspecialties in pediatrics.

Conclusions: Integrating AI, radiomics, and hybrid modalities is altering theranostic processes in medicine and shows how crucial it is to monitor ethics, equitable access, and professional learning possibilities. To ensure worldwide equity, it's necessary to establish clear validation processes, collaborate across fields, and launch international initiatives.

References

Ahmad, R., Hu, H. H., & Krishnamurthy, R. (2018). Reducing sedation for pediatric body MRI using accelerated and abbreviated imaging protocols. Pediatric Radiology, 48(1), 37–49. https://doi.org/10.1007/s00247-017-3987-6

Ajmal, S. (2021). Contrast-enhanced ultrasonography: Review and applications. Cureus, 13(9), e18243. https://doi.org/10.7759/cureus.18243

Alkhulaifat, D., Rafful, P., Khalkhali, V., Welsh, M., & Sotardi, S. T. (2023). Implications of pediatric artificial intelligence challenges for artificial intelligence education and curriculum development. Journal of the American College of Radiology, 20(8), 724–729. https://doi.org/10.1016/j.jacr.2023.04.013

Bayramoglu, Z., Kandemirli, S. G., Akyol Sarı, Z. N., Kardelen, A. D., Poyrazoglu, S., Bas, F., … Adaletli, I. (2020). Superb microvascular imaging in the evaluation of pediatric Graves disease and Hashimoto thyroiditis. Journal of Ultrasound in Medicine, 39(5), 901–909. https://doi.org/10.1002/jum.15171

Brady, A. P., & Neri, E. (2020). Artificial intelligence in radiology—Ethical considerations. Diagnostics, 10(4). https://doi.org/10.3390/diagnostics10040231

Brady, S. L., Trout, A. T., Somasundaram, E., Anton, C. G., Li, Y., & Dillman, J. R. (2021). Improving image quality and reducing radiation dose for pediatric CT by using deep learning reconstruction. Radiology, 298(1), 180–188. https://doi.org/10.1148/radiol.2020202317

Brzewski, M. (2017). Current standards in abdominal cavity ultrasound examination in children. Journal of Ultrasonography, 17(68), 41–42. https://doi.org/10.15557/JoU.2017.0006

Calixto, C., & Gee, M. S. (2025). Practical strategies to improve MRI operations and workflow in pediatric radiology. Pediatric Radiology, 55(1), 12–23. https://doi.org/10.1007/s00247-024-06114-0

Chandra, T., Podberesky, D. J., Romberg, E. K., Tang, E. R., Iyer, R. S., & Epelman, M. (2020). Optimization of pediatric body CT angiography: What radiologists need to know. American Journal of Roentgenology, 215(3), 726–735. https://doi.org/10.2214/AJR.19.22273

Chen, M., Qiu, M., Liu, Y., Zhou, W., Xie, X., & Zhou, L. (2023). Utility of the pediatric liver contrast-enhanced ultrasound criteria in differentiating malignant and benign multifocal lesions. Pediatric Radiology, 53(10), 2004–2012. https://doi.org/10.1007/s00247-023-05694-7

Daldrup-Link, H. (2017). How PET/MR can add value for children with cancer. Current Radiology Reports, 5(3). https://doi.org/10.1007/s40134-017-0207-y

Daldrup-Link, H. (2019). Artificial intelligence applications for pediatric oncology imaging. Pediatric Radiology, 49(11), 1384–1390. https://doi.org/10.1007/s00247-019-04360-1

Davendralingam, N., Sebire, N. J., Arthurs, O. J., & Shelmerdine, S. C. (2021). Artificial intelligence in paediatric radiology: Future opportunities. British Journal of Radiology, 94(1117), 20200975. https://doi.org/10.1259/bjr.20200975

Davis, L. M., Martinez-Correa, S., Freeman, C. W., Adams, C., Sultan, L. R., Le, D. Q., … Hwang, M. (2025). Ultrasound innovations in abdominal radiology: Techniques and clinical applications in pediatric imaging. Abdominal Radiology, 50(4), 1744–1762. https://doi.org/10.1007/s00261-024-04616-x

Desai, S. B., Pareek, A., & Lungren, M. P. (2022). Current and emerging artificial intelligence applications for pediatric interventional radiology. Pediatric Radiology, 52(11), 2173–2177. https://doi.org/10.1007/s00247-021-05013-y

Di Renzo, D., Gentile, C., Persico, A., Lauriti, G., Chiarelli, F., & Lisi, G. (2025). Contrast-enhanced ultrasonography (CEUS) in the management of pediatric renal injuries: Where are we now? Journal of Ultrasound, 28(2), 429–436. https://doi.org/10.1007/s40477-025-01011-0

Dias, A. H., Andersen, K. F., Fosbøl, M., Gormsen, L. C., Andersen, F. L., & Munk, O. L. (2025). Long axial field-of-view PET/CT: New opportunities for pediatric imaging. Seminars in Nuclear Medicine, 55(1), 76–85. https://doi.org/10.1053/j.semnuclmed.2024.10.007

Don, S., Macdougall, R., Strauss, K., Moore, Q. T., Goske, M. J., Cohen, M., … Whiting, B. R. (2013). Image gently campaign back to basics initiative: Ten steps to help manage radiation dose in pediatric digital radiography. American Journal of Roentgenology, 200(5), W431–W436. https://doi.org/10.2214/AJR.12.9895

Ferraioli, G., Barr, R. G., & Dillman, J. R. (2021). Elastography for pediatric chronic liver disease: A review and expert opinion. Journal of Ultrasound in Medicine, 40(5), 909–928. https://doi.org/10.1002/jum.15482

Gallée, L., Kniesel, H., Ropinski, T., & Götz, M. (2023). Artificial intelligence in radiology—Beyond the black box. RöFo, 195(9), 797–803. https://doi.org/10.1055/a-2076-6736

Gatidis, S., la Fougère, C., & Schaefer, J. F. (2016). Pediatric oncologic imaging: A key application of combined PET/MRI. RöFo, 188(4), 359–364. https://doi.org/10.1055/s-0041-109513

Gokli, A., Dillman, J. R., Humphries, P. D., Ključevšek, D., Mentzel, H. J., Rubesova, E., … Anupindi, S. A. (2021). Contrast-enhanced ultrasound of the pediatric bowel. Pediatric Radiology, 51(12), 2214–2228. https://doi.org/10.1007/s00247-020-04868-x

Gottumukkala, R. V., Kalra, M. K., Tabari, A., Otrakji, A., & Gee, M. S. (2019). Advanced CT techniques for decreasing radiation dose, reducing sedation requirements, and optimizing image quality in children. Radiographics, 39(3), 709–726. https://doi.org/10.1148/rg.2019180082

Greffier, J., Macri, F., Larbi, A., Fernandez, A., Khasanova, E., Pereira, F., … Beregi, J. P. (2015). Dose reduction with iterative reconstruction: Optimization of CT protocols in clinical practice. Diagnostic and Interventional Imaging, 96(5), 477–486. https://doi.org/10.1016/j.diii.2015.02.007

Harrington, S. G., Jaimes, C., Weagle, K. M., Greer, M. C., & Gee, M. S. (2022). Strategies to perform magnetic resonance imaging in infants and young children without sedation. Pediatric Radiology, 52(2), 374–381. https://doi.org/10.1007/s00247-021-05062-3

Hayatghaibi, S. E., Kandil, A. I., Zhang, B., Alves, V. V., Ayyala, R. S., Dillman, J. R., & Trout, A. T. (2023). Trends in anesthesia/sedation for computed tomography and magnetic resonance imaging encounters in pediatric emergency departments, 2012–2022. JAMA Pediatrics, 177(10), 1105–1107. https://doi.org/10.1001/jamapediatrics.2023.2832

He, K., Boukind, A., Sanka, A. S., Ribaudo, J. G., Chryssofos, S., Skolnick, G. B., … Patel, K. B. (2025). Systematic review and meta-analysis of radiation dose reduction studies in pediatric head CT. American Journal of Neuroradiology, 46(9), 1875–1883. https://doi.org/10.3174/ajnr.A8730

Horst, K. K., Zhou, Z., Hull, N. C., Thacker, P. G., Kassmeyer, B. A., Johnson, M. P., … Yu, L. (2025). Radiation dose reduction in pediatric computed tomography (CT) using deep convolutional neural network denoising. Clinical Radiology, 80, 106705. https://doi.org/10.1016/j.crad.2024.09.011

Huang, J., Shlobin, N. A., Lam, S. K., & DeCuypere, M. (2022). Artificial intelligence applications in pediatric brain tumor imaging: A systematic review. World Neurosurgery, 157, 99–105. https://doi.org/10.1016/j.wneu.2021.10.068

Hultenmo, M., Pernbro, J., Ahlin, J., Bonnier, M., & Båth, M. (2025). Evaluation of an artificial intelligence noise reduction tool for conventional X-ray imaging—A visual grading study of pediatric chest examinations at different radiation dose levels using anthropomorphic phantoms. Pediatric Radiology, 55(7), 1475–1486. https://doi.org/10.1007/s00247-025-06251-0

Inarejos Clemente, E. J., Navarro, O. M., Navallas, M., Ladera, E., Torner, F., Sunol, M., … Barber, I. (2022). Multiparametric MRI evaluation of bone sarcomas in children. Insights into Imaging, 13(1), 33. https://doi.org/10.1186/s13244-022-01177-9

Iwayama, H., Hayata, N., Takagi, M., Fukatsu, R., Kawahara, K., Somiya, H., … Okumura, A. (2025). Parental presence improves pediatric MRI success without sedation: A prospective randomized study. Frontiers in Pediatrics, 13, 1559935. https://doi.org/10.3389/fped.2025.1559935

Jaimes, C., Robson, C. D., Machado-Rivas, F., Yang, E., Mahan, K., Bixby, S. D., & Robertson, R. L. (2021). Success of nonsedated neuroradiologic MRI in children 1–7 years old. American Journal of Roentgenology, 216(5), 1370–1377. https://doi.org/10.2214/AJR.20.23654

Kibrom, B. T., Manyazewal, T., Demma, B. D., Feleke, T. H., Kabtimer, A. S., Ayele, N. D., … Hailu, S. S. (2024). Emerging technologies in pediatric radiology: Current developments and future prospects. Pediatric Radiology, 54(9), 1428–1436. https://doi.org/10.1007/s00247-024-05997-3

Kozyak, B. W., Yuerek, M., & Conlon, T. W. (2023). Contemporary use of ultrasonography in acute care pediatrics. Indian Journal of Pediatrics, 90(5), 459–469. https://doi.org/10.1007/s12098-023-04475-2

Laborie, L. B., Naidoo, J., Pace, E., Ciet, P., Eade, C., Wagner, M. W., … Shelmerdine, S. C. (2023). European Society of Paediatric Radiology Artificial Intelligence taskforce: A new taskforce for the digital age. Pediatric Radiology, 53(4), 576–580. https://doi.org/10.1007/s00247-022-05426-3

Lee, M. S., Sweetnam-Holmes, D., Soffer, G. P., & Harel-Sterling, M. (2024). Updates on the clinical integration of point-of-care ultrasound in pediatric emergency medicine. Current Opinion in Pediatrics, 36(3), 256–265. https://doi.org/10.1097/MOP.0000000000001340

Lin-Martore, M., & Kornblith, A. E. (2021). Diagnostic applications of point-of-care ultrasound in pediatric emergency medicine. Emergency Medicine Clinics of North America, 39(3), 509–527. https://doi.org/10.1016/j.emc.2021.04.005

Lundervold, A. S., & Lundervold, A. (2019). An overview of deep learning in medical imaging focusing on MRI. Zeitschrift für Medizinische Physik, 29(2), 102–127. https://doi.org/10.1016/j.zemedi.2018.11.002

Mastro, K. A., Flynn, L., Preuster, C., Summers-Gibson, L., & Stein, M. H. (2019). The effects of anesthesia on the pediatric developing brain: Strategies to reduce anesthesia use in pediatric MRI and nursing’s role in driving patient safety. Journal of PeriAnesthesia Nursing, 34(5), 900–910. https://doi.org/10.1016/j.jopan.2019.02.007

Medyńska-Przęczek, A., Stochel-Gaudyn, A., & Wędrychowicz, A. (2024). Liver fibrosis assessment in pediatric population—Can ultrasound elastography be an alternative method to liver biopsy? A systematic review. Advances in Medical Sciences, 69(1), 8–20. https://doi.org/10.1016/j.advms.2023.12.001

Mentzel, H. J., Glutig, K., Gräger, S., Krüger, P. C., & Waginger, M. (2022). Ultrasound elastography in children—Nice to have for scientific studies or arrived in clinical routine? Molecular and Cellular Pediatrics, 9(1), 11. https://doi.org/10.1186/s40348-022-00143-1

Meshaka, R., Pinto Dos Santos, D., Arthurs, O. J., Sebire, N. J., & Shelmerdine, S. C. (2022). Artificial intelligence reporting guidelines: What the pediatric radiologist needs to know. Pediatric Radiology, 52(11), 2101–2110. https://doi.org/10.1007/s00247-021-05129-1

Metin, İ., & Özdemir, Ö. (2025). Artificial intelligence in medicine: Current applications in cardiology, oncology, and radiology. World Journal of Methodology, 15(4), 106854. https://doi.org/10.5662/wjm.v15.i4.106854

Moore, M. M., Iyer, R. S., Sarwani, N. I., & Sze, R. W. (2022). Artificial intelligence development in pediatric body magnetic resonance imaging: Best ideas to adapt from adults. Pediatric Radiology, 52(2), 367–373. https://doi.org/10.1007/s00247-021-05072-1

Mărginean, C. O., Meliţ, L. E., Ghiga, D. V., & Săsăran, M. O. (2020). Reference values of normal liver stiffness in healthy children by two methods: 2D shear wave and transient elastography. Scientific Reports, 10(1), 7213. https://doi.org/10.1038/s41598-020-64320-w

Nagayama, Y., Oda, S., Nakaura, T., Tsuji, A., Urata, J., Furusawa, M., … Yamashita, Y. (2018). Radiation dose reduction at pediatric CT: Use of low tube voltage and iterative reconstruction. Radiographics, 38(5), 1421–1440. https://doi.org/10.1148/rg.2018180041

Ng, C. K. C. (2022). Artificial intelligence for radiation dose optimization in pediatric radiology: A systematic review. Children, 9(7). https://doi.org/10.3390/children9071044

Nikam, R. M., Yue, X., Kaur, G., Kandula, V., Khair, A., Kecskemethy, H. H., … Langhans, S. A. (2022). Advanced neuroimaging approaches to pediatric brain tumors. Cancers, 14(14). https://doi.org/10.3390/cancers14143401

Offiah, A. C. (2022). Current and emerging artificial intelligence applications for pediatric musculoskeletal radiology. Pediatric Radiology, 52(11), 2149–2158. https://doi.org/10.1007/s00247-021-05130-8

Ohana, O., Soffer, S., Zimlichman, E., & Klang, E. (2018). Overuse of CT and MRI in paediatric emergency departments. British Journal of Radiology, 91(1085), 20170434. https://doi.org/10.1259/bjr.20170434

Ohno, Y., Fujimoto, T., & Shibata, Y. (2017). A new era in diagnostic ultrasound, superb microvascular imaging: Preliminary results in pediatric hepato-gastrointestinal disorders. European Journal of Pediatric Surgery, 27(1), 20–25. https://doi.org/10.1055/s-0036-1593381

Pedersen, C., Aboian, M., McConathy, J. E., Daldrup-Link, H., & Franceschi, A. M. (2022). PET/MRI in pediatric neuroimaging: Primer for clinical practice. American Journal of Neuroradiology, 43(7), 938–943. https://doi.org/10.3174/ajnr.A7464

Pringle, C., Kilday, J. P., Kamaly-Asl, I., & Stivaros, S. M. (2022). The role of artificial intelligence in paediatric neuroradiology. Pediatric Radiology, 52(11), 2159–2172. https://doi.org/10.1007/s00247-022-05322-w

Ranschaert, E., Topff, L., & Pianykh, O. (2021). Optimization of radiology workflow with artificial intelligence. Radiologic Clinics of North America, 59(6), 955–966. https://doi.org/10.1016/j.rcl.2021.06.006

Regmi, P. R., Amatya, I., Paudel, S., & Kayastha, P. (2022). Modern paediatric radiology: Meeting the challenges in CT and MRI. JNMA: Journal of the Nepal Medical Association, 60(251), 661–663. https://doi.org/10.31729/jnma.7539

Salih, A. M., Menegaz, G., Pillay, T., & Boyle, E. M. (2024). Explainable artificial intelligence in paediatric: Challenges for the future. Health Science Reports, 7(12), e70271. https://doi.org/10.1002/hsr2.70271

Sammer, M. B. K., Akbari, Y. S., Barth, R. A., Blumer, S. L., Dillman, J. R., Farmakis, S. G., … Wald, C. (2023). Use of artificial intelligence in radiology: Impact on pediatric patients, a white paper from the ACR Pediatric AI Workgroup. Journal of the American College of Radiology, 20(8), 730–737. https://doi.org/10.1016/j.jacr.2023.06.003

Schalekamp, S., Klein, W. M., & van Leeuwen, K. G. (2022). Current and emerging artificial intelligence applications in chest imaging: A pediatric perspective. Pediatric Radiology, 52(11), 2120–2130. https://doi.org/10.1007/s00247-021-05146-0

Smith-Bindman, R., Alber, S. A., Kwan, M. L., Pequeno, P., Bolch, W. E., Bowles, E. J. A., … Miglioretti, D. L. (2025). Medical imaging and pediatric and adolescent hematologic cancer risk. New England Journal of Medicine, 393(13), 1269–1278. https://doi.org/10.1056/NEJMoa2502098

States, L. J., & Reid, J. R. (2020). Whole-body PET/MRI applications in pediatric oncology. American Journal of Roentgenology, 215(3), 713–725. https://doi.org/10.2214/AJR.19.22677

Taylor, A. M. (2022). The role of artificial intelligence in paediatric cardiovascular magnetic resonance imaging. Pediatric Radiology, 52(11), 2131–2138. https://doi.org/10.1007/s00247-021-05218-1

Trout, A. T., Anupindi, S. A., Gee, M. S., Khanna, G., Xanthakos, S. A., Serai, S. D., … Dillman, J. R. (2020). Normal liver stiffness measured with MR elastography in children. Radiology, 297(3), 663–669. https://doi.org/10.1148/radiol.2020201513

van Leeuwen, K. G., de Rooij, M., Schalekamp, S., van Ginneken, B., & Rutten, M. J. C. M. (2022). How does artificial intelligence in radiology improve efficiency and health outcomes? Pediatric Radiology, 52(11), 2087–2093. https://doi.org/10.1007/s00247-021-05114-8

Wang, G., Xie, X., Chen, H., Zhong, Z., Zhou, W., Jiang, H., & Zhou, L. (2021). Development of a pediatric liver CEUS criterion to classify benign and malignant liver lesions in pediatric patients: A pilot study. European Radiology, 31(9), 6747–6757. https://doi.org/10.1007/s00330-021-07784-2

Wiecek, S., Fabrowicz, P., Wos, H., Kordys-Darmolinska, B., Cebula, M., Gruszczynska, K., & Grzybowska-Chlebowczyk, U. (2022). Assessment of liver fibrosis with the use of elastography in paediatric patients with diagnosed cystic fibrosis. Disease Markers, 2022, 4798136. https://doi.org/10.1155/2022/4798136

Yan, L., Li, Q., Fu, K., Zhou, X., & Zhang, K. (2025). Progress in the application of artificial intelligence in ultrasound-assisted medical diagnosis. Bioengineering, 12(3). https://doi.org/10.3390/bioengineering12030288

Zhang, W., Yi, H., Cai, B., He, Y., Huang, S., & Zhang, Y. (2022). Feasibility of contrast-enhanced ultrasonography (CEUS) in evaluating renal microvascular perfusion in pediatric patients. BMC Medical Imaging, 22(1), 194. https://doi.org/10.1186/s12880-022-00925-z

Zhou, T., Qiao, B., Peng, B., Liu, Y., Gong, Z., Kang, M., … Sheng, M. (2024). Predicting histological grade in pediatric glioma using multiparametric radiomics and conventional MRI features. Scientific Reports, 14(1), 13683. https://doi.org/10.1038/s41598-024-63222-5

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2026-03-30

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Kącikowska, J., Szczepański, P. ., Sordyl , K., Bolek, O., Grzelak, O., Rogulski, K., Fengier, M., Kuśmierczyk, W., & Majkowska, M. (2026). THE DIGITAL REVOLUTION IN PEDIATRIC RADIOLOGY: FROM ULTRASOUND TO AI-DRIVEN DIAGNOSTICS – A NARRATIVE REVIEW. International Journal of Innovative Technologies in Social Science, 5(1(49). https://doi.org/10.31435/ijitss.1(49).2026.5020

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