CION Ameerpet
Pediatric Cancer — Diagnosis & Tests
Scans for childhood cancer — CT, MRI, PET & radiation safety
Medically reviewed by Dr. Kirti Ranjan Mohanty, Radiation Oncologist, CION Cancer Clinics · Last reviewed June 2026
When a doctor suspects cancer in a child, one of the first questions is: which scan is needed, and is it safe? This page explains what each type of scan does, how doctors choose between them, and what parents need to know about imaging child cancer and radiation safety for children. Understanding the process can make a frightening time feel a little less uncertain.
- Ultrasound first — no radiation, painless, same-day in most cases
- MRI for soft tissue — brain, spine, and muscle tumours without radiation
- CT used carefully — modern paediatric dose protocols minimise exposure
- 45-minute consultations — we explain every scan, every step, before it happens
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Imaging Child Cancer
The four scans used when childhood cancer is investigated
No single scan tells the whole story. Doctors use different types depending on where in the body a problem is suspected, how urgent the situation is, and how old your child is. Here is what each one does.
No radiation
Ultrasound
Uses sound waves to create images of internal organs. Completely painless and requires no preparation beyond a full bladder for abdominal scans.
Used for: First-look at a lump or swollen abdomen. Checking kidneys, liver, spleen, and lymph nodes. Monitoring a known tumour during treatment.
What to expect: A gel is applied to the skin and a small probe is pressed gently over the area. Children of all ages usually manage this without sedation. Results are often available within an hour.
No radiation
MRI (Magnetic Resonance Imaging)
Uses magnetic fields and radio waves to create highly detailed images of soft tissue — the brain, spinal cord, muscles, and internal organs. No radiation at all.
Used for: Brain tumours, spinal cord tumours, soft-tissue sarcomas, and cases where exact tumour boundaries matter for surgery planning.
What to expect: The scan takes 30–60 minutes. Your child must lie very still inside a tunnel-shaped machine. Children under 5–6 years often need mild sedation. The machine makes a loud knocking noise — the team will prepare your child in advance.
Low-dose protocol
CT Scan (Computed Tomography)
Uses X-rays to create cross-sectional images. Fast (2–5 minutes), widely available, and excellent for the chest and bony structures. Modern paediatric CT uses low-dose protocols.
Used for: Lung metastasis assessment, chest tumours, bone involvement, abdominal tumours where an MRI is not available or not practical in an emergency.
What to expect: Your child lies on a table that slides into a ring-shaped machine. Most children over 5 do not need sedation. A contrast dye may be injected through a small IV to make blood vessels and tumours clearer. The team will explain this beforehand.
After diagnosis
PET-CT Scan
Combines a metabolic map (PET — Positron Emission Tomography) with a structural image (CT). PET detects areas of high cellular activity, which cancer cells show. Used for staging, not first investigation.
Used for: Lymphoma staging, bone tumour spread assessment, checking whether cancer has reached distant lymph nodes or organs before treatment begins.
What to expect: A small dose of radioactive tracer is injected and your child waits 45–60 minutes before the scan. The scan itself takes 20–30 minutes. Most children over 6 manage without sedation. The radioactivity clears the body within a few hours.
A note on MIBG and bone scans: For specific cancers such as neuroblastoma, doctors may use a specialised nuclear medicine scan called an MIBG scan rather than PET-CT. For cancers that may involve the bone, a bone scan (skeletal scintigraphy) may be ordered. Your child's oncologist will explain if either of these is needed.
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MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
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How it works
How doctors choose and sequence scans for child cancer
Imaging child cancer is a process, not a single scan. Each step builds on the last. Here is what the pathway typically looks like from the first concern to a confirmed diagnosis.
Clinical assessment — doctor examines your child
Before any scan is ordered, your child's doctor takes a detailed history and performs a physical examination. Where is the lump? How long has it been there? Is your child losing weight, running fevers, or tiring more than usual? This assessment shapes which scan is most useful. An experienced oncologist will not order every scan at once — they choose the test most likely to give the clearest answer first.
Ultrasound — the usual first step
For most lumps and abdominal symptoms, an ultrasound is ordered first. It is quick, uses no radiation, and is available in most centres. It tells the doctor whether a mass is solid or fluid-filled, how big it is, and whether nearby lymph nodes are affected. If the ultrasound is reassuringly normal (for example, a lump turns out to be a benign lymph node or a simple cyst), further imaging may not be needed. If it shows something that needs more detail, the next step is planned.
MRI or CT — detailed anatomical imaging
When more detail is needed, the choice between MRI and CT depends on the location and type of concern. Brain and spinal tumours almost always go to MRI first — it gives far better soft-tissue detail and carries no radiation. Chest tumours and suspected lung involvement often go to CT first because it is faster and better at showing lung detail. Bone tumours may need both — MRI for the local extent, CT for lung staging. The team discusses this choice and explains it to you before the scan is booked.
PET-CT or specialised nuclear scan — staging after diagnosis
If the imaging and biopsy confirm a cancer diagnosis, a PET-CT or another specialised nuclear medicine scan (such as MIBG for neuroblastoma) is often ordered to stage the disease — meaning, to find out whether cancer has spread beyond the original site. This information directly shapes the treatment plan. Staging scans are done once, before treatment begins, and the radiation exposure from a staging PET-CT is accepted because the clinical benefit of accurate staging is high. Your child's team will explain why a specific scan is being used for staging.
Follow-up imaging — monitoring during and after treatment
Scans continue during and after treatment to check how well the cancer is responding and to detect any recurrence early. The team chooses follow-up scans carefully — using the modality that gives the information needed with the lowest cumulative exposure. MRI and ultrasound are used for follow-up wherever they can replace CT. The schedule of follow-up scans is planned as part of the treatment protocol and is reviewed at each tumour board meeting. You will always be told why a follow-up scan is being ordered and what the team is looking for.
Tumor board for every patient at CION. Before any scan result leads to a treatment decision, it is reviewed by a multidisciplinary team — medical oncologist, surgical oncologist, radiation oncologist, radiologist — together. No single doctor makes a decision alone. This is standard at CION for every patient, including children. Learn more about our paediatric cancer care →
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Common questions
Questions parents ask about scans for child cancer
Which scan is most commonly used first when childhood cancer is suspected?
An ultrasound is almost always the first imaging step. It uses sound waves — no radiation — and gives the doctor a clear look at the organs in the abdomen and pelvis, including the kidneys, liver, spleen, and lymph nodes. It is painless and can be done the same day in most centres. If the ultrasound finds something suspicious, or if the concern is in the chest, brain, or bone, the doctor will order an MRI or CT scan to get more detail. The choice depends on where in the body the problem is suspected and how urgently more information is needed.
Is a CT scan safe for a child? I am worried about radiation.
This is one of the most common concerns parents have, and it is a reasonable one. Children are more sensitive to ionising radiation than adults, which is why paediatric oncology teams are careful about how often CT scans are used and how they are done. Modern CT scanners use dose-reduction protocols for children — the dose is significantly lower than older machines delivered. When a CT scan is medically necessary (for example, to assess a chest tumour or plan surgery), the benefit of getting accurate information far outweighs the small radiation risk. Doctors are also increasingly using MRI, which uses no radiation, wherever it gives equivalent information. Your child's oncology team will use the scan that gives the most useful information with the least exposure.
What is the difference between an MRI and a CT scan for a child with cancer?
Both produce detailed internal images, but they work differently. A CT scan uses X-rays and takes minutes — it is fast and widely available. An MRI uses magnetic fields and radio waves (no radiation) and takes 30–60 minutes. MRI gives much better detail of soft tissues — the brain, spinal cord, muscles, and internal organs — which is why it is preferred for brain tumours, spinal cord tumours, and many types of soft-tissue tumours. CT scan is preferred when speed matters, for chest assessment, or when MRI is not available. Young children often need mild sedation for an MRI because they must lie very still for a longer time. Your doctor will explain which is better for your child's situation.
When does the doctor recommend a PET-CT scan for a child?
A PET-CT scan is not the first step in investigating a suspected tumour in a child — it is usually ordered after a diagnosis has been made, to find out how far the cancer has spread (staging). It is commonly used for lymphoma, some bone tumours, and other cancers where spread to distant lymph nodes or organs needs to be checked before treatment begins. It combines a metabolic scan (PET, which uses a small amount of radioactive sugar to highlight active cancer cells) with a structural scan (CT). PET-CT exposes children to radiation, so it is used only when the clinical benefit is clear. For some cancers, MIBG scanning (a specialised nuclear medicine scan) is preferred over PET-CT — your oncology team will advise.
Will my child need to be sedated or put to sleep for the scan?
It depends on the child's age and the type of scan. An ultrasound does not require sedation — children of all ages can usually have one while awake. A CT scan takes only a few minutes, and most children over 5 can manage without sedation if the radiology team explains what is happening. MRI is longer (30–60 minutes) and requires the child to lie very still — babies, toddlers, and young children (typically under 5–6 years) often need sedation or general anaesthesia to get a clear image. The anaesthesia team at a paediatric oncology centre is experienced with this; sedation used for an MRI is short-acting and very well tolerated. The team will tell you in advance whether sedation is planned so you can prepare your child.
My child has had several scans already. How many is too many?
There is no single "maximum number" that applies universally — each scan is ordered because the treating team needs specific information at that point in the journey. Paediatric oncologists and radiologists follow ALARA (As Low As Reasonably Achievable) principles: they discuss each scan request and use the lowest dose, least-frequent imaging approach that still gives the clinical answer needed. Routine monitoring scans during and after treatment are carefully spaced. If you have concerns about cumulative radiation, raise them directly with your child's oncologist — it is a completely valid question and the team should be able to explain why each scan was ordered. MRI and ultrasound are used wherever they can replace CT to reduce exposure.