Challenges with the PRETEXT staging system: a SIOPEL Radiology Group position paper.

IF 2.5 3区医学 Q2 PEDIATRICS

Pediatric Radiology Pub Date : 2026-10-05 DOI:10.1007/s00247-026-06786-w

Siri Margrete Hugo Lohne, Hanna Hebelka, Jip Frederik Prince, Anneloes Elisabeth Bohte, Annemieke Simone Littooij, Charlotte de Lange, Annamaria Deganello, Silvia Costa Dias, Greg Chambers, Seema Toso, Céline Habre, Erika Pace, Stéphanie Franchi-Abella, Helen Woodley, Simon P McGuirk

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引用次数: 0

Abstract

Background: The PRETreatment EXTent of disease (PRETEXT) staging system is widely used in malignant pediatric liver tumors; however, significant challenges associated with this system remain.

Objective: To describe challenges and limitations of the current PRETEXT system and propose potential strategies to mitigate them, from the European (SIOPEL) perspective.

Methods: Expert insights from the SIOPEL Radiology Group, derived from both clinical and research experience, have been integrated into a position paper.

Results: Key limitations include acquisition and inter-observer variability, definitional ambiguity for PRETEXT group and annotation factors, lack of structured reporting, gaps in surgical integration, and POST-Treatment EXTent of disease (POSTTEXT)-related pitfalls. Proposed strategies to address PRETEXT challenges include broader implementation of standardized imaging protocols and structured reporting, multidisciplinary integration, central review, definition refinement, and emerging technologies.

Conclusion: Addressing these challenges may improve diagnostic accuracy, risk stratification, and clinical decision-making in pediatric patients with malignant liver tumors.

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托普分期系统的挑战：SIOPEL放射学小组的立场文件。

背景：疾病前处理程度分期系统在小儿恶性肝肿瘤中被广泛应用；然而，与该系统相关的重大挑战仍然存在。目的：从欧洲（SIOPEL）的角度描述当前托普制度的挑战和局限性，并提出缓解这些挑战和局限性的潜在策略。方法：来自SIOPEL放射学组的专家见解，来源于临床和研究经验，已整合到立场文件中。结果：主要限制包括获取和观察者之间的差异，托普组和注释因素的定义模糊，缺乏结构化报告，手术整合的差距，以及治疗后疾病程度（POSTTEXT）相关的陷阱。提出的应对托词挑战的策略包括更广泛地实施标准化成像协议和结构化报告、多学科集成、中央审查、定义细化和新兴技术。结论：解决这些挑战可以提高儿童恶性肝肿瘤患者的诊断准确性、风险分层和临床决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Radiology 医学-核医学

CiteScore

4.40

自引率

17.40%

发文量

300

审稿时长

3-6 weeks

期刊介绍： Official Journal of the European Society of Pediatric Radiology, the Society for Pediatric Radiology and the Asian and Oceanic Society for Pediatric Radiology Pediatric Radiology informs its readers of new findings and progress in all areas of pediatric imaging and in related fields. This is achieved by a blend of original papers, complemented by reviews that set out the present state of knowledge in a particular area of the specialty or summarize specific topics in which discussion has led to clear conclusions. Advances in technology, methodology, apparatus and auxiliary equipment are presented, and modifications of standard techniques are described. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.