Advanced Imaging to Assess Airway Dynamics.

Endoscopy remains the gold standard for assessing dynamic airway abnormalities in pediatric patients, but its invasiveness and variable interoperator agreement have driven interest in imaging-based alternatives. Four-dimensional computed tomography (CT) now enables objective quantification of tracheal collapse during free breathing, while photon-counting CT achieves effective doses approaching chest radiography, fundamentally altering the risk-benefit calculus for serial monitoring. MRI approaches-from real-time cine for obstructive sleep apnea localization to retrospectively gated techniques achieving submillimeter resolution without sedation-provide radiation-free dynamic assessment. This article reviews these modalities alongside ultrasound and optical coherence tomography, with guidance for modality selection based on clinical indication.