Tomà’s path into medicine began in Genoa, where he earned his medical degree from the University of Genoa in 1976. Even at that early stage, he demonstrated an unusually clear sense of direction. Rather than choosing between the two disciplines that fascinated him most, he completed dual training in both radiology and paediatrics, a combination that would become the foundation of his entire professional identity. Understanding children as patients, not merely as small adults, and understanding imaging as a tool to serve their specific clinical needs, allowed him to approach diagnostic problems with a perspective that many colleagues spent careers trying to emulate.

In 1980, he joined the Department of Imaging at the G. Gaslini Institute in Genoa, one of Italy’s most prestigious paediatric hospitals. There he advanced steadily from registrar to senior roles, eventually serving as Director of the Ultrasound Division from 1992 to 1994. Ultrasound was, during those years, transforming paediatric imaging: it offered a radiation-free window into the bodies of infants and children, and Tomà became one of its most articulate champions. His leadership of the division coincided with the rapid maturation of paediatric sonographic techniques, and he was widely regarded as a clinician who insisted that technological capability must always be matched by clinical judgement.

His exceptional leadership capabilities led to his appointment as Director of Radiology at the G. Gaslini Institute, a position he held from 1995 to 2009. His responsibilities expanded further when he took on the role of Director of the Department of Imaging between 2005 and 2009, overseeing a broad portfolio of diagnostic services at one of Europe’s leading children’s hospitals. In 2010, Tomà relocated to Rome to assume the directorship of the Imaging Department at the Bambino Gesù Children’s Hospital, the Vatican-affiliated paediatric institution that ranks among Italy’s foremost centres for children’s medicine. The move cemented a legacy that spanned the country’s two great paediatric institutions, and under his guidance the Rome department continued to develop as a national reference point for advanced paediatric diagnostics.

Alongside his institutional responsibilities, Tomà was a deeply committed educator. In 1990 he was appointed Professor of Paediatric Radiology at Genoa University’s Postgraduate Schools, and for more than three decades, across both Genoa and Rome, he mentored, inspired, and led generations of talented young Italian paediatric radiologists. Former trainees describe an environment in which rigor was expected but never at the expense of encouragement, and in which the intellectual excitement of the field was communicated with characteristic warmth. Many of the radiologists now leading paediatric imaging services throughout Italy trace their professional formation directly to his teaching, a measure of mentorship that few in any subspecialty can claim.

As a researcher, Tomà was prolific and influential. He published more than 300 papers in peer-reviewed journals, alongside numerous book chapters and textbooks that became standard references for trainees and practitioners alike. His major scientific contributions advanced three areas in particular: radiation protection in children, early screening protocols for neonatal hip dysplasia, and advanced paediatric chest imaging. Each of these fields carries enormous practical weight. Radiation protection addresses one of the central ethical tensions in paediatric medicine, since children’s developing tissues are more sensitive to ionizing radiation and their longer lifespans amplify cumulative exposure risks. Tomà’s work helped embed the principle of keeping paediatric doses as low as reasonably achievable into everyday clinical practice.

His contributions to neonatal hip dysplasia screening were similarly consequential. Developmental dysplasia of the hip affects a meaningful proportion of newborns, and ultrasound-based screening protocols, refined and validated by researchers across Europe, have allowed clinicians to identify and treat the condition early, often avoiding the need for invasive interventions later in childhood. Tomà’s work in this area helped establish the evidence base and the practical screening frameworks that many European services adopted. In paediatric chest imaging, meanwhile, his research pushed the field toward techniques that maximized diagnostic yield while minimizing the burden on young patients, an approach that anticipated the modern emphasis on patient-centred imaging.

Tomà’s expertise made him a cornerstone of radiological societies in Italy and far beyond its borders. At home, he served as President of the Italian Society of Paediatric Radiology from 1996 to 2000 and acted as a long-term delegate for the Italian Society of Medical and Interventional Radiology, known as SIRM, representing Italian paediatric imaging on the international stage. In Europe, his influence was even more visible. He served as Vice-President of the European Society of Paediatric Radiology from 1999 to 2002 and then as President from 2002 to 2003, guiding the society through a period of growing collaboration among national paediatric imaging communities. He later served as a Trustee and elder statesman, a role known within the ESPR Board as that of a Wise Man, offering counsel drawn from decades of institutional experience.

In recognition of his outstanding lifelong service, the European Society of Paediatric Radiology awarded him its prestigious Gold Medal in 2016, one of the highest honours the subspecialty can bestow. He was also a member of numerous editorial boards, including that of the journal Pediatric Radiology, where he served for many years and helped shape the scientific record of the field he loved. Colleagues across these organizations consistently described him as a figure whose opinion carried weight precisely because it was offered with such care and generosity, never as a reflex but always as a considered contribution to a shared enterprise.

Beyond his immense academic accolades, Professor Tomà was widely recognized for his wisdom, patience, and perspective. Colleagues frequently noted his gentle ability to differentiate between the truly important and the merely urgent, a philosophy that made him a calming and authoritative guide for young doctors and international boards alike. In a medical culture often driven by haste and metrics, he modelled a different kind of leadership, one grounded in listening, reflection, and long-term thinking. He leaves behind a legacy of scientific excellence and profound kindness. As a true polymath, his knowledge of the arts, literature, and history was profound, and those who worked with him recall an understated, brilliant mind that he shared with humour and sensitivity. He is survived by a global community of colleagues, students, and friends who will miss him deeply, and by a field that stands, in large part, on the foundations he helped to build.

Subject of Research: The life and scientific legacy of paediatric radiology pioneer Professor Paolo Tomà

Article Title: Professor Paolo Tomà

Article References: Rosendahl, K., & M. Owens, C. (2026). Professor Paolo Tomà. Pediatric Radiology, 56(10), 2092-2093. https://doi.org/10.1007/s00247-026-06723-x

Image Credits: AI Generated

DOI: 10.1007/s00247-026-06723-x

Keywords: Paolo Tomà, paediatric radiology, obituary, ultrasound, radiation protection, hip dysplasia screening, chest imaging, G. Gaslini Institute, Bambino Gesù Children's Hospital, European Society of Paediatric Radiology, medical mentorship, Italy

The survey, conducted jointly by the Society for Pediatric Radiology and the European Society of Paediatric Radiology, was distributed to members of both societies between August and September 2025. It asked radiologists whether their institutions had adopted ultrasound as the first imaging test for suspected midgut volvulus, how long they had been using it, who performed the examinations, what their protocols looked like, and what obstacles stood in the way of wider adoption. A total of 227 responses representing 179 hospitals across 38 countries were analyzed, with results stratified by geographic region to expose patterns that a single-country study would have missed.

The headline finding is a stark transatlantic divide. In Europe, 78.2 percent of responding hospitals reported using ultrasound as their first-line test for suspected volvulus. In other regions of the world, adoption stood at 61.1 percent. North America lagged dramatically behind, with only 28.9 percent of hospitals making sound waves the initial diagnostic probe. That means a newborn with the same life-threatening presentation may be sent first to an ultrasound suite in Munich or London but to a fluoroscopy suite in many US and Canadian centers, purely as a function of geography and institutional tradition rather than any difference in the underlying disease.

The reasons behind the gap are as revealing as the numbers themselves. When the researchers asked what barriers impeded adoption, European respondents most frequently pointed to acceptance among radiologists themselves, a professional culture question about whether ultrasound can reliably replace the long-entrenched upper gastrointestinal series. In North America, by contrast, the dominant barrier was sonographer training and competence. The distinction matters because it points to different solutions: persuading physicians to change their diagnostic habits is a different organizational challenge from building the technologist workforce capable of performing technically demanding pediatric bowel ultrasound at any hour of the day or night.

The technical demands of the examination help explain that workforce problem. Ultrasound for malrotation and volvulus hinges on mapping the vascular anatomy of the midgut, primarily by identifying the relative positions of the superior mesenteric vein and artery and by tracing the bowel loops to determine whether the duodenum courses in its expected retroperitoneal pattern. In volvulus, the sonographer may see the classic whirlpool sign, with the mesentery and vessels spiraling around a central axis, or a distended, fluid-filled proximal duodenum that tapers abruptly. Obtaining these views reliably in a squirming, crying infant, often in the middle of the night, requires hands-on training that cannot be transmitted through a written protocol alone.

Perhaps the most sobering discovery in the survey is what is missing even where ultrasound has been adopted. Across all regions, most institutions reported having no formal clinical pathway governing when and how first-line ultrasound should be used, no standardized reporting template to ensure that radiologists communicate their findings consistently, and no routine administration of oral or nasogastric fluid to distend the stomach and duodenum during the examination. Each of these omissions carries consequences. Without a clinical pathway, triage decisions fall to individual clinicians under pressure; without standardized reports, surgeons may receive ambiguous guidance on whether the bowel is at risk; without fluid instillation, some examinations may be nondiagnostic and default back to fluoroscopy anyway.

The survey did identify one intervention that respondents believed could overcome these fragmentation problems: the publication of formal, evidence-based guidelines. This was the most commonly cited factor that would facilitate broader adoption, ahead of technological improvements or institutional policies. The finding echoes a broader literature on implementation science, which has repeatedly shown that the translation of best evidence into routine practice stalls without authoritative, consensus-based guidance to legitimize change and standardize technique. Radiology is no exception, and pediatric bowel ultrasound, with its steep learning curve and operator-dependent accuracy, may be an especially strong candidate for guideline-driven standardization.

The scientific groundwork for a guideline already exists. A 2022 expert panel narrative review in the American Journal of Roentgenology laid out the techniques and interpretive framework for ultrasound in malrotation and volvulus, and a 2021 systematic review and meta-analysis in Archives of Disease in Childhood synthesized diagnostic accuracy data across studies. Individual centers have published encouraging institutional experiences, including a UK tertiary hospital series in Clinical Radiology reporting on ultrasound as the first-line investigation for midgut malrotation, and work examining the significance of nondiasonic examinations when ultrasound cannot answer the clinical question. Economic analyses have even suggested that ultrasound-first pathways can reduce cost and examination time compared with fluoroscopy, removing one traditional objection to the switch.

The practical stakes of this transition are considerable. A child with suspected volvulus typically undergoes imaging in an urgent, often out-of-hours setting, and the choice of first test determines how quickly a surgeon can be mobilized. Ultrasound offers advantages that matter enormously in pediatrics: it involves no ionizing radiation in a population that is more radiosensitive than adults, it requires no contrast ingestion in a vomiting child, it can be performed at the bedside in unstable patients, and it can be repeated without cumulative dose concerns. Fluoroscopy, for its part, offers a dynamic view of contrast passing through the duodenum that some radiologists still consider indispensable for excluding malrotation, even when ultrasound has already addressed the immediate question of whether volvulus is present.

What this survey ultimately documents is the moment of transition itself, captured before the dust settles. The authors’ conclusion is measured: the use of ultrasound as first-line imaging for suspected midgut volvulus varies widely across regions, the barriers reflect local staffing and training models, and formal published guidelines are frequently identified as a potential facilitator of broader implementation. In other words, the science has largely outrun the systems built to deliver it. Whether a child with bilious vomiting gets a radiation-free ultrasound first or a fluoroscopic contrast study still depends heavily on which side of an ocean they happen to be born on, and closing that gap will require not just more evidence but the deliberate work of training sonographers, persuading radiologists, and writing the guidelines that turn individual expertise into dependable, worldwide practice.

Subject of Research: International adoption of ultrasound as first-line imaging for suspected midgut volvulus in children

Article Title: International practice patterns in the use of ultrasound as first-line imaging for suspected midgut volvulus in children: a joint society for pediatric radiology–European society of paediatric radiology survey

Article References: Tutman, J., Perucca, G., Chan, S., El-Ali, A., Kljucevsek, D., Limantoro, I., Riccabona, M., Petit, P., Nguyen, H. N., & Samet, J. (2026). International practice patterns in the use of ultrasound as first-line imaging for suspected midgut volvulus in children: a joint society for pediatric radiology–European society of paediatric radiology survey. Pediatric Radiology. https://doi.org/10.1007/s00247-026-06792-y

Image Credits: AI Generated

DOI: 10.1007/s00247-026-06792-y

Keywords: midgut volvulus, pediatric radiology, ultrasound, malrotation, upper gastrointestinal series, international survey, clinical guidelines, sonographer training, bilious vomiting, medical imaging, Society for Pediatric Radiology, European Society of Paediatric Radiology

The study led by D’Hondt, Shelmerdine, and Aertsen highlights the importance of MRI as a non-invasive diagnostic tool in the context of fetal and neonatal deaths. Traditionally, postmortem examinations have relied heavily on autopsies, which, while essential, can be invasive and discomforting for families. The recommendations presented not only aim to reduce the emotional and physical toll on bereaved families but also to improve diagnostic capabilities through state-of-the-art imaging techniques. This dual focus on compassion and medical advancement sets the tone for a new era in pediatric postmortem care.

Central to the recommendations is the emphasis on the technical aspects of conducting postmortem MRI scans. The authors recommend specific imaging protocols, including the utilization of high-resolution sequences that can provide detailed insight into congenital anomalies and other pathological changes. These imaging sequences allow for a powerful diagnostic examination, capturing critical information about the condition of the fetus or neonate that may not be visible through traditional methods. The incorporation of advanced imaging software further enhances the interpretative capabilities of healthcare professionals involved in these sensitive cases.

One of the standout features of the proposed protocol is its multidisciplinary approach. It calls for the involvement of pediatric radiologists, neonatologists, and pathologists, who can collaboratively review the imaging results and provide a comprehensive understanding of the circumstances surrounding the death. This teamwork is essential because it brings together different areas of expertise, ensuring that no critical information is overlooked in the evaluation. Such a holistic perspective is vital in understanding the complex interplay of factors that can lead to fetal or neonatal death.

Moreover, the new protocol outlines the importance of obtaining informed consent from families prior to conducting postmortem MRI scans. Given the sensitive nature of this subject, it is crucial that families understand the purpose and potential outcomes of the scans. This transparency fosters trust and ensures that families feel involved in the decision-making process regarding the handling of their loved ones. Communication plays a key role in alleviating the distress families experience during such tragic circumstances.

As technology continues to evolve, the landscape of pediatric imaging will undergo significant transformations. One of the most promising aspects of this new protocol is the incorporation of artificial intelligence (AI) in image analysis. AI can assist radiologists by identifying patterns and anomalies within the scans that may be challenging to detect through the human eye alone. This integration of AI not only enhances diagnostic accuracy but also streamlines the workflow, allowing radiologists to focus on more complex cases that require deeper analytical input.

The authors emphasize that training and education are fundamental in the successful implementation of this new protocol. Specialist training programs should be developed to ensure that pediatric radiologists are not only proficient in MRI technology but also in sensitive communication with grieving families. This dual focus on technical skill and empathetic engagement is critical in ensuring that transitioning to this new protocol enhances both the quality of care and the emotional support provided to families in their time of need.

Ethical considerations are also central to the discussion surrounding the implementation of postmortem imaging protocols. The authors stress the need for a delicate balance between advancing medical knowledge and respecting the dignity of the deceased. They advocate for stringent ethical guidelines to govern the use of postmortem imaging, ensuring that these practices serve to honor the memory of the individuals involved while contributing to the advancement of medical science.

Reassessing standard practices in postmortem care can lead to profound benefits, not only for the families that experience loss but also for medical professionals striving to find answers in difficult cases. The establishment of a standardized protocol as suggested in this recent study encourages communication and consistency in procedures across institutions. Given the diversity of practices currently in place, this uniform approach may help to bridge gaps in experiences for families affected by neonatal and fetal loss.

The transition to utilizing MRI in postmortem examinations reflects a broader trend within medicine towards non-invasive procedures. As engaging in more humane practices takes precedence, the medical community is challenged to reassess traditional methods that may not align with current ethical standards. By broadening the scope of diagnostic tools available, healthcare providers can better comprehend the various factors contributing to fetal and neonatal deaths.

Ultimately, the development of these recommendations signifies a commitment to improving the standard of care within the realm of pediatric postmortem evaluations. By prioritizing the needs of families while maintaining the integrity of medical inquiries, the authors hope to pave the way for future advancements in the field. They believe that this protocol will not only facilitate better clinical outcomes but also foster an atmosphere of compassion and understanding during what is often an incredibly painful time for families.

The groundbreaking work of D’Hondt and colleagues presents an opportunity for pediatric radiology to evolve and adapt to the changing needs of families grappling with loss. By advocating for advancements in imaging and promoting multidisciplinary collaboration, this study lays the foundation for improved practices that will undoubtedly resonate with both families and healthcare professionals alike. The hope is that through rigorous adherence to these recommendations, the intersection of medicine and compassion can lead to better circumstances for those navigating the challenges of neonatal and fetal loss.

Subject of Research: Postmortem Magnetic Resonance Imaging in Fetal and Neonatal Cases

Article Title: Fetal and neonatal postmortem magnetic resonance imaging clinical protocol: recommendations from the European society of paediatric radiology postmortem task force.

Article References: D’Hondt, A., Shelmerdine, S., Aertsen, M. et al. Fetal and neonatal postmortem magnetic resonance imaging clinical protocol: recommendations from the European society of paediatric radiology postmortem task force. Pediatr Radiol (2025). https://doi.org/10.1007/s00247-025-06337-9

Image Credits: AI Generated

DOI: https://doi.org/10.1007/s00247-025-06337-9

Keywords: Postmortem MRI, Fetal Imaging, Neonatal Care, Pediatric Radiology, Ethical Guidelines, Multidisciplinary Approach, Non-Invasive Procedures, Artificial Intelligence in Imaging.