AOfPR February 2016

Soon after Wilhelm Conrad Röntgen discovered x-rays on November 8, 1895, he sent details of his discovery to physicists throughout the world and it was warmly received. Others replicated his discovery and many of the earliest radiographic examinations were of infants and children. Earlier indications for x-ray were trauma, foreign body search, skeletal maturation and variations, but these indications have rapidly expanded to include inherited disorders, inflammatory processes and tumors. With the introduction of advanced imaging modalities and technique, medical imaging has become a vital component of healthcare delivery particularly in children.
It is without a doubt that pediatric radiology is one of the oldest subspecialty in radiology. It deals with diagnosis and sometimes treatment of illnesses in infants, children and young adults utilizing various medical imaging techniques. This field also includes advanced imaging of fetal abnormalities. “Children are not small adults”, for diseases and its manifestations in children are generally different with that of adults. Some cancers are only found in children, such as Wilms’ tumor and neuroblastoma, and there are other conditions seen only in newborn or premature infants. A child’s body mechanics and response to injury or stress is also different from an adult, and children have an immature immune system making them a lot more prone to infections. In addition to acquired illnesses, a unique group of congenital malformations are also common in pediatric population. Not only is there a difference in the disease process, the approach to therapy and care of an ailing child is also different from that of an adult.
Having gone thru specialized training, a pediatric radiologist is equipped with the general knowledge of childhood diseases as it relates to imaging. Pediatric radiology practitioners not only deal with their patients, but they also have to deal with the parents as well as the pediatricians and primary care providers. As an expert, the pediatric radiologist is not only responsible for interpreting the imaging findings, but also makes sure that the appropriate study is performed safely and for the right indication. Ultimately, the pediatric radiologist communicates with the pediatrician or any referring consultant about the disease, the choice of imaging study, treatment and even follow up.
There are now global initiatives to improve and standardize medical imaging in children, which include the Image Gently campaign of the American College of Radiology (ACR) and Society for Pediatric Radiology (SPR), as well as the EuroSafe Imaging campaign of the European Society of Radiology (ESR). There are also regional societies all over the world that promote education on imaging diagnosis but also highlight the best imaging practices for the benefit of children. The newly formed World Federation of Pediatric Imaging (WFPI) helps in bridging these various international organizations including those that belong to lower resource settings. There is much more to learn and accomplish and the pediatric imaging community is determined to do just that.

The Asian and Oceanic Society for Pediatric Radiology (AOSPR) was formed in June 2000 under the leadership of the founding president Prof. Mutsuhisa Fujioka. The main objective is to improve healthcare standards in the imaging of children in the Asia-Oceanic region through cooperative research, teaching and education. One of the organization’s activities is the yearly AOSPR congress that is held in various historical, scenic, and exotic cities of Asia and Oceania. These meetings are a venue for solid continuing education with exchange of ideas, at the same time fostering camaraderie and stronger bond among its now 322 members from Asia, Oceanea, and beyond. The AOSPR website is an ongoing dynamic project which serves as an avenue to educate and communicate, but the introduction of Asian and Oceanic forum for Pediatric Radiology (AOfPR) in 2015 is an important milestone that further enhances this objective.

Although the practice of pediatric radiology is standardized and deemed a necessity in the western world and progressive countries of Asia, such is not the case in developing Asian countries. In the Philippines, the practice of radiology is unique because other than breast imaging and interventional radiology, the subspecialty societies and fellowship training available are modality-based (ultrasound, CT, and MRI). This being the norm, it poses inherent limitation to the practice and advancement of organ system-based radiology and specialized fields of interest, including pediatric radiology. Despite the small number and the absence of national acceptance brought about by the local practice standards, pediatric radiology practitioners in the Philippines continue to thrive with the aim to raise the level of healthcare delivery through imaging in the country. Philippine pediatric radiologists maintain a respectable stature in the international scientific community as contributors to current knowledge through their lectures, publications and researches, raising awareness about the subspecialty.

In a field of medicine that is constantly changing, it is very important to keep abreast with the current literature in order to be of better service to both patients and referring clinicians. The introduction of AOfPR is helpful in this endeavor. Since its initial release last year, the forum has gained support and following due to its education-focused format tackling pertinent, current, and must know topics in various subspecialties of pediatric radiology. Its open access, online format makes it even more appealing because it is readily available to everyone for free.
I would like to thank the AOSPR leadership, the AOfPR Editorial Board and the Webmasters for this honor and opportunity to serve the radiology community as a Guest Editor. I would also like to thank all of the authors in this issue for their hard work and outstanding contributions. My gratitude goes to the brother and sister team of Niko Bryan C. Sumaya and Dr. Amerrel C. Sumaya for the cover design showcasing various images and sights in the Philippines. I would also like to acknowledge and thank my colleagues, fellows, and residents at St. Luke’s Medical Center, Philippines for their unwavering trust and support. Not to forget, I would like to thank my family for their unconditional love, support, and understanding.
It is with great pride that I present to you the current issue of AOfPR. I am certain that these articles will be very helpful in your radiology practice and I hope you enjoy reading them.