About

Susan J. Back, MD, FAAP, FAIUM, is an Associate Professor of Radiology at the Children's Hospital of Philadelphia. She holds a medical degree from the Lewis Katz School of Medicine at Temple University and completed her undergraduate studies in Biology at the University of Pennsylvania. Her professional focus includes pediatric radiology, with specific expertise in genitourinary imaging and pediatric contrast ultrasound. Dr. Back is the Director of the Center for Pediatric Contrast Ultrasound and the Director of the Section of Genitourinary Imaging within the Division of Body Imaging at Children's Hospital of Philadelphia. She is actively involved in research related to ultrasound techniques, contrast-enhanced voiding urosonography, and the imaging features of pediatric urinary tract conditions. Her contributions include developing curricula for ultrasound skills and advancing imaging protocols for pediatric patients.

Research topics

• Radiology
• Medicine
• Surgery
• Internal medicine
• Emergency medicine

Selected publications

• Establishing a dynamic magnetic resonance genitography protocol for presurgical evaluation of genitourinary malformations: a single-center experience

  Pediatric Radiology · 2026-05-16

  articleSenior author
  PublisherDOI

• Introducing the M-factor: A ratio to normalize measurements of pubic diastasis with growth

  Journal of Pediatric Urology · 2026-04-01

  articleSenior author
  PublisherDOI

• Utilization of Pediatric Contrast-Enhanced Ultrasound in the United States After FDA Approval: Insights From a Large Claims Database

  American Journal of Roentgenology · 2026-04-01

  article
  PublisherDOI

• Femoral Head Perfusion Varies Widely Following Surgical Reduction for Infantile Developmental Dysplasia of the Hip

  Journal of Bone and Joint Surgery · 2026-02-02

  article

  BACKGROUND: Surgical hip reduction is an accepted treatment option for infantile developmental dysplasia of the hip (DDH) but may be complicated by the development of osteonecrosis, recently re-termed proximal femoral growth disturbance (PFGD) . Since the etiology of PFGD is likely related to compromised vascular supply to the femoral head, the need exists for an intraoperative method of assessing changes in femoral head perfusion prior to irreversible injury. This study sought to utilize contrast-enhanced ultrasound (CEUS) to assess intraoperative changes in perfusion following surgical reduction for infantile DDH, with the ultimate goal of predicting and eventually preventing PFGD. METHODS: In this prospective study, CEUS was performed before and immediately after surgical reduction and spica casting in infants undergoing surgery for DDH between 4 and 18 months of age. Delta projections were used to quantitatively analyze changes in perfusion, and a statistical analysis was performed to assess the relationships between patient factors, including casting position, and changes in epiphyseal perfusion. RESULTS: The study population of 32 patients included 34 hips, comprising 30 hips of female patients (88.2%) and 4 hips of male patients (11.8%), with a mean age and standard deviation of 9.3 ± 3.3 months. A lower perfusion index following surgical reduction (p = 0.003) was seen in the majority (79.4%) of hips. In the remaining hips, a higher perfusion index was observed following reduction (p = 0.03). The greatest significant decreases in perfusion index were observed in the central region of the femoral head epiphysis (p = 0.002), followed by the peripheral region of the femoral head epiphysis (p = 0.03). Axial abduction was correlated with a post-reduction decrease in perfusion index (r = 0.35; p = 0.04). There was a moderately positive correlation between body mass index (BMI) and a post-reduction change in perfusion index (r = 0.45; p = 0.01). CONCLUSIONS: There was wide variation in post-reduction changes in femoral head perfusion after surgical hip reduction and spica casting for infantile DDH, with a gradient of change across the regions of the femoral head. In addition, BMI and in-cast hip position seemed to influence perfusion changes. With continued analysis of these relationships and longer follow-up from our ongoing prospective investigation, we aim to identify the risk factors for PFGD development. LEVEL OF EVIDENCE: Therapeutic Level II . See Instructions for Authors for a complete description of levels of evidence.

  PublisherDOI

• Percutaneous Nephrolithotomy vs Ureteroscopy for Kidney Stones in Children

  JAMA Network Open · 2025-06-20 · 7 citations

  articleOpen access

  Importance: Based on expert opinion, clinical guidelines recommend percutaneous nephrolithotomy or shockwave lithotripsy for children and adolescents with kidney stones 20 mm or larger, without mention of ureteroscopy as an alternative. Objective: To compare clinical and patient-reported outcomes for percutaneous nephrolithotomy vs ureteroscopy in children and adolescents with kidney and/or ureteral stones. Design, Setting, and Participants: This prospective cohort study was performed at 31 medical centers in the US and Canada. Participants included patients aged 8 to 21 years undergoing surgery for kidney and/or ureteral stones between March 16, 2020, and July 31, 2023. Exposures: Percutaneous nephrolithotomy vs ureteroscopy. Main Outcomes and Measures: Stone clearance assessed by ultrasonography 6 (±2) weeks postoperatively. Secondary outcomes included patient-reported outcomes 1 week after surgery. Results: The study enrolled 1039 eligible patients (median age, 15.6 [IQR, 12.5-17.3] years; 629 female [60.5%]; 40 Black [3.8%]; 128 Hispanic [12.3%]; and 792 White [76.2%]). One hundred twenty-six urologists performed percutaneous nephrolithotomy for 98 kidneys and/or ureters and ureteroscopy for 1069, including 36 undergoing percutaneous nephrolithotomy and 43 undergoing ureteroscopy for stones larger than 15 mm. Stone clearance was 67.2% (95% CI, 46.0%-88.4%) for percutaneous nephrolithotomy and 73.4% (95% CI, 69.4%-77.4%) for ureteroscopy, a difference that was not statistically significant (risk difference, -6.2%; 95% CI, -27.7% to 15.4%). For stones larger than 15 mm, stone clearance was 94.0% (95% CI, 83.3%-100%) for percutaneous nephrolithotomy and 55.0% (95% CI, 32.9%-77.1%) for ureteroscopy, a statistically significant difference (risk difference, 39.0%; 95% CI, 14.4%-63.5%). Compared with ureteroscopy, percutaneous nephrolithotomy had significantly lower pain intensity (T score difference, -5.42; 95% CI, -10.38 to -0.46), pain interference (T score difference, -5.88; 95% CI, -11.02 to -0.75), anxiety (T score difference, -5.74; 95% CI, -9.26 to -2.22), psychological stress experiences (T score difference, -7.90; 95% CI, -13.13 to -2.67), sleep disturbance (T score difference, -5.57; 95% CI, -8.56 to -2.58), and urinary symptoms (symptom score difference, -6.37; 95% CI, -11.71 to -1.03) 1 week after surgery. Conclusions and Relevance: Compared with ureteroscopy, percutaneous nephrolithotomy had similar stone clearance and better lived experiences for children and adolescents and was associated with greater stone clearance of kidney stones larger than 15 mm. A future adequately powered prospective clinical trial is needed to reaffirm these results.

  PublisherOA PDFDOI

• Ureteroscopy vs Shockwave Lithotripsy to Remove Kidney Stones in Children and Adolescents

  JAMA Network Open · 2025-08-07 · 1 citations

  articleOpen access

  Importance: Most children and adolescents with kidney and ureteral stones are treated with ureteroscopy, despite the uncertainty and equal weight of guideline recommendations for ureteroscopy or shockwave lithotripsy. Objective: To compare stone clearance and patient-reported outcomes among children and adolescents after ureteroscopy or shockwave lithotripsy. Design, Setting, and Participants: This nonrandomized clinical trial enrolled patients between March 16, 2020, and July 31, 2023, at 31 medical centers in the US and Canada. Patients aged 8 to 21 years with kidney stones, ureteral stones, or both were included. Follow-up was completed on October 15, 2023. Interventions: Ureteroscopy or shockwave lithotripsy. Main Outcomes and Measures: The primary outcome was stone clearance assessed by standardized ultrasonography 6 (±2) weeks after surgery. Using inverse probability weighting and random intercepts for site, stone clearance was evaluated per kidney or ureter using logistic regression and estimated stone clearance rates were generated for each procedure. Results: This study included 1142 patients (690 females [60.4%]), with a median age of 15.6 years (IQR, 12.6-17.3 years). In terms of race and ethnicity, 41 patients (3.6%) were Black, 130 (11.4%) were Hispanic, and 884 (77.4%) were White. A total of 124 urologists treated 1069 and 197 kidneys or ureters with ureteroscopy and shockwave lithotripsy (n = 953 and n = 189 patients), respectively, with a median stone size of 6.0 mm (IQR, 4.0-9.0 mm). Ureteral stents were placed at time of index surgery for 841 procedures for 767 patients (80.4%) receiving ureteroscopy and for 6 procedures for 5 patients (2.6%) receiving shockwave lithotripsy. Stone clearance occurred in 474 patients who underwent ureteroscopy (71.2% [95% CI, 63.8%-78.5%]) and in 105 patients who underwent shockwave lithotripsy (67.5% [95% CI, 61.0%-74.1%]), a difference that was not statistically significant (risk difference, 3.6% [95% CI, -6.2% to 13.5%]). Compared with shockwave lithotripsy, ureteroscopy resulted in greater pain interference (T-score difference, 5.0 [95% CI, 2.3-7.8]) and urinary symptoms (symptom score difference, 3.9 [95% CI, 1.2-6.7]) 1 week after surgery. Patients who had ureteroscopy missed more school (risk difference, 21.3% [95% CI, 9.7%-32.8%]) and caregivers missed more work (risk difference, 23.0% [95% CI, 11.0%-35.0%]) in the week after surgery. Conclusions and Relevance: In this study of 1142 children and adolescents with kidney and ureteral stones, there was no clinically meaningful difference in stone clearance with ureteroscopy vs shockwave lithotripsy. Shockwave lithotripsy was associated with better patient-reported outcomes. These findings raise questions about the preference for ureteroscopy in practice. Trial Registration: ClinicalTrials.gov Identifier: NCT04285658.

  PublisherOA PDFDOI

• US-derived Pediatric Kidney Length and Volume Percentiles by Age: A Big Data Approach

  Radiology Artificial Intelligence · 2025-11-19 · 2 citations

  articleOpen access

  A large dataset of pediatric US measurements and natural language processing was used to calculate kidney length and volume percentiles, resulting in increased normative value precision and highlighting growth patterns.

  PublisherOA PDFDOI

• The PKIDS Study: Comparative Effectiveness of Surgical Interventions for Pediatric Patients With Kidney Stones

  2025-06-02

  report
  PublisherDOI

• Prenatal and Postnatal Imaging of the Bladder Epispadias-Exstrophy Complex

  2025-01-01

  book-chapterSenior author
  PublisherDOI

• Imaging of Pediatric Renal Cysts: An Update— <i>AJR</i> Expert Panel Narrative Review

  American Journal of Roentgenology · 2025-11-19

  articleSenior author

  Pediatric renal cysts can be isolated, hereditary, or related to acquired disease processes, and may be congenital or develop over time. Given the heterogeneity of pediatric renal cysts, their increasing detection, and the absence of unified pediatric-specific guidelines, additional practical imaging-based recommendations are needed. This AJR Expert Panel Narrative Review seeks to address such gaps by providing guidance for radiologists in evaluating renal cysts, focusing on imaging characteristics, diagnostic considerations, and management recommendations. The authors comprise a multidisciplinary panel of pediatric radiologists, a pediatric nephrologist, and a pediatric urologist. The article addresses incidental and syndromic cystic renal disease, differentiation between benign and malignant cystic lesions, and the role of clinical history in guiding radiologic assessment. The roles of ultrasound (including contrast-enhanced ultrasound), CT, and MRI are presented, along with application of the modified Bosniak renal cyst classification in pediatric cases. Consideration is given to surveillance strategies, subspecialist referral pathways, and integration of societal guidelines. By highlighting current controversies and knowledge gaps, the article aims to clarify where agreement currently exists and where further research and multidisciplinary consensus are needed to achieve standardized evidence-based care for children with renal cystic disease.

  PublisherDOI

Frequent coauthors

• Kassa Darge

  University of Pennsylvania

  115 shared

• Hansel J. Otero

  36 shared

• Dana A. Weiss

  33 shared

• Aikaterini Ntoulia

  Children's Hospital of Philadelphia

  30 shared

• Juan S. Calle‐Toro

  The University of Texas Health Science Center at San Antonio

  28 shared

• Sudha A. Anupindi

  Philadelphia University

  24 shared

• Carolina Maya

  23 shared

• Trudy A. Morgan

  Philips (United States)

  22 shared

Labs

• Susan J. Back LabPI