Tests & Procedures

An audiogram is used to test how well your child hears. Some medications used to treat cancer can affect hearing. If your child needs these medications, their hearing will be tested before and during treatment. 

• Let's Talk About Hearing and Testing

Blood draws are done to measure the number of blood cells, the amount of certain elements, or the level of a drug in your child's body.

If your child has a central venous catheter, the nurse will draw the blood from the central venous catheter, put it into a collection tube, and then send it to the laboratory to have the ordered tests run. If your child does not have a central line, then a phlebotomist will draw the blood for the tests from a vein in your child's arm. 

Inside some of our bones is a spongy material called bone marrow. Bone marrow makes red blood cells, white blood cells, and platelets. They are all part of the blood that flows in our bodies.

A bone marrow aspirate is a test to see if the bone marrow is making blood cells correctly. A biopsy is a test in which your doctor takes a little bit of bone marrow tissue and looks at it under a microscope. Looking at the bone marrow can help your doctor diagnose different diseases including some cancers. He can also determine how far a disease has progressed and evaluate how effective certain treatments have been. Some children prefer to be sedated during this procedure.

• Let's Talk About Bone Marrow Aspirate and Biopsy

CT is short for computed tomography. The CT scan is a procedure that uses x-rays, a scanner, and a computer to make detailed images of a specific area of the body. The CT scanner is a large camera shaped like a circle around your child's body. The camera holds still and the bed your child lies on moves slightly when the pictures are being taken.

Your child needs to remain very still for the scan. The machine makes some noise that your child will hear. The procedure takes about 15 to 30 minutes.

Some CT scans are done with contrast media; substances that help highlight certain body parts. This contrast media is given through your child's IV catheter, or by mouth. Some children need to receive sedation medicine so they can relax and keep still for the scan. CT scans are painless. The CT technician will let you know if you can stay in the room with your child during the procedure.

An echocardiogram, sometimes called an "echo" for short, is a painless way of taking a picture of the heart. The echo uses high-pitched sound waves (higher than we can hear) to see structures in the body. This is the same technology used in ultrasounds. Sound waves are sent out through a handheld probe that the technician places against your child's skin. The waves reflect off solid structures, such as the heart, and they are read by a very sensitive machine.

An echocardiogram uses no radioactivity, and you can stay with your child for the entire procedure. Because children need to stay still for 20 minutes to one hour, sometimes sedation medicine is given. However, the test is completely painless.

An electrocardiogram is a test that measures how well the heart is working. It is also known as an ECG or an EKG. Because some medications used to treat cancer can affect heart muscles, your child may need this test before receiving these medications and may need follow up testing as well. The test is not painful and there are no side effects.

• Let's Talk About Electrocardiogram (ECG/EKG)

An electroencephalogram is a recording of the electrical activity in your child's brain. Electrodes are attached to your child's head using small sticky pads so this electrical activity can be measured and recorded. The procedure is painless and causes no side effects, but may be scary. Your child's doctor will tell you if your child should be awake or sleeping (sedated).

• Let's Talk About EEG (Electroencephalogram)

A lumbar puncture or spinal tap is a procedure used to collect a sample of cerebrospinal fluid (CSF). Cerebrospinal fluid is a clear liquid that surrounds the brain and spinal cord. The fluid is checked for cancer cells, viruses, bacteria, or blood in your child's central nervous system.

A lumbar puncture is performed by inserting a needle into the spinal cord into an area called the subarachnoid space and collecting a small amount of fluid. While the needle is in place, the doctor may also put in some medicine. Some children prefer to be sedated during this procedure.

• Let's Talk About Lumbar Puncture (Spinal Tap)

An MRI is a painless procedure used to take a picture of your child's body. It uses a powerful magnet and radio waves to make detailed images of soft tissues, muscles, nerves, and bones. Because MRI uses a strong magnet, metal objects interfere with the scan, so your child cannot wear a watch, earrings, or other metal objects during the exam. If you enter the MRI room, you must remove metal objects as well.

Some MRIs are done with contrast media, which highlights certain body parts. This contrast media is given through your child's IV catheter or by mouth.

The machine makes some loud noise that your child will hear. Your child may be given earplugs or can choose to listen to music to muffle the noise of the machine. Some children need to receive sedation medicine so they can relax and keep still for the scan. An MRI typically takes about 30 to 60 minutes. During this time there are moments between the pictures when your child can move slightly to relieve an itch or cramp.

Nuclear medicine scans are safe, reliable ways to get information and pictures of the body. Nuclear scans can be performed on bone, liver, lung, heart, or the complete body.

Before the procedure, your child is given a very small amount of radioactive material (called a tracer) that travels to a specific part of the body. The tracer is usually given through your child's IV catheter. Depending on the scan, the pictures may be taken minutes, hours, or days after the tracer is given. When the pictures are taken, no extra radiation is used. The tracer shows up on the film. The material is quickly excreted by your child through her urine or stool (bowel movement). It is completely gone within a day or two.

Positron emission tomography scans are a new, safe way to get information and pictures of the body. The scan is done in a room that is similar to a CT or MRI room. Before the procedure, your child is given a very small amount of radioactive material (called a tracer) that travels to a specific part of the body. The tracer is usually given through your child's IV catheter. The machine then takes pictures of the area of the body to be scanned. These pictures show metabolic and chemical activity of the tumor and the surrounding area.

A PET scan could show spread of the tumor cells to a lymph node even though the lymph node is not enlarged yet. The scan is painless but it can take from 30 to 90 minutes. Some children need to receive sedation medicine so they can relax and keep still.

A pulmonary function test is a measure of how much air your child can hold in their lungs. The test is simple and painless, the child blows into a tube as forcefully as they can and then sucks air back into their lungs as fully as they can. This is done about three times and usually lasts about five minutes. This test helps find out if your child has a condition that affects breathing, such as asthma. It is also used to check for side effects some medicines will have on the lungs.

There are a number of medicines that can be used to increase comfort, relax your child, or help your child sleep during uncomfortable procedures. For simple procedures, local anesthetics (medicines applied to the skin) may be used. Other procedures may require that your child is less active or asleep (sedated). Sedation is the use of medicine to help a child with tests or procedures.

Sedation is used to decrease your child's activity or make him/her sleepy. Sedation medicines may be given through your child's catheter or by mouth. The type of sedation is based on how still your child must be for a procedure and how long the procedure will last. If your child likes one type of medicine over another, please talk with the care team before a procedure is done to determine whether that medicine is available for use.

• Let's Talk About Sedation for Tests and Procedures

An ultrasound is a painless procedure that uses high-frequency sound waves (higher than we can hear) to make images of soft tissues and motion within the body. An ultrasound uses no x-rays.

The ultrasound technician rubs a warm gel on the surface of the skin over the area to be studied, then gently passes a handheld probe over the skin that has gel on it. The probe sends the sound waves into the body and receives them as they bounce back. The sound waves are interpreted by a computer, and an image is generated on a computer screen.

X-rays are used to take pictures of the body. An x-ray machine delivers invisible rays through the body and onto film. When x-rays pass through the body, they are absorbed differently by each body tissue. Bone absorbs the most of the rays and the air in the lungs and the intestines causes the least amount of rays to be absorbed. The procedure is painless, but your child will have to stay still in the position that is needed for the best picture.

Regular x-rays produce good pictures of bones and the lungs (chest x-ray), but in order to see body parts such as the kidneys and blood vessels, contrast media is used. This contrast media is given through your child's IV catheter or by mouth.