Pediatric Radiology最新文献

{"title":"T2-weighted MRI radiomics for the prediction of pediatric and young adult rhabdomyosarcoma alveolar subtype and distant metastasis: a pilot study.","authors":"Adarsh Ghosh, Hailong Li, Alexander Towbin, Brian Turpin, Andrew Trout","doi":"10.1007/s00247-025-06205-6","DOIUrl":"https://doi.org/10.1007/s00247-025-06205-6","url":null,"abstract":"<p><strong>Introduction: </strong>Rhabdomyosarcomas are the most common soft tissue sarcoma in children. While treatment outcomes have improved, risk-based therapy classification relies on staging and tumor subtypes for therapeutic planning.</p><p><strong>Objective: </strong>This study investigated the utility of T2-weighted MR radiomics features and machine learning models in identifying the presence of distant metastasis and alveolar histological subtypes at baseline imaging in children diagnosed with rhabdomyosarcoma.</p><p><strong>Materials and methods: </strong>This retrospective cross-sectional study utilized MRIs from 86 patients, 49 (median age (IQR) 59 months (37-161), alveolar subtype=15, distant metastasis=9) of whom had been imaged at outside imaging centers (training set); and 37 (median age 52 months (24-164), alveolar subtype=14, distant metastasis=8) of whom were imaged at our institution (holdout validation set). Radiomic features were extracted from T2-weighted images. We selected features that demonstrated intra-scan repeatability and used maximum relevance and minimum redundancy supervised feature selection to identify the 50 most important features. Lasso logistic regression and support vector machine (SVM) classifiers were trained to predict binary outcomes. The median of all predictions for a given patient was used as patient-level predictions. DeLong's test compared the area under the receiver operating characteristic curves (AUC). Cut-offs obtained by maximizing the Youden index were evaluated on an external validation set, and accuracy metrics were reported.</p><p><strong>Results: </strong>On the validation set, the Lasso and SVM classifiers obtained patient level AUCs of 0.76 (95% CI 0.59-0.94) and 0.73 (0.54-0.92), respectively, in predicting alveolar subtype, with the Lasso regressor obtaining 71.4% (41.9-91.6) sensitivity and 60.9% (38.5-80.3) specificity. When predicting the presence of distant metastasis, the Lasso and SVM classifier had AUCs of 0.81 (0.67-0.95) and 0.77 (0.58-0.97), respectively. There were no differences between model performance (P>0.05). A total of 12 and 18 features had nonzero coefficients in the Lasso regressors for predicting alveolar subtype and tumor metastasis, respectively.</p><p><strong>Conclusion: </strong>MRI radiomics from baseline T2-weighted MRI demonstrated potential in predicting alveolar subtype and distant metastatic disease at presentation. Larger studies are needed to explore multinomial multiclass models for better prognostication of pediatric rhabdomyosarcomas.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing T2* imaging for adolescent and young adult patients at 7 T.","authors":"Sergio Valencia, Fedel Machado-Rivas, Arman Avesta, Emil J Barkovich, Samuel C D Cartmell, Simon K Warfield, Camilo Jaimes, Onur Afacan","doi":"10.1007/s00247-025-06213-6","DOIUrl":"10.1007/s00247-025-06213-6","url":null,"abstract":"<p><strong>Background: </strong>T2*-weighted imaging at 7 T offers detailed visualization of brain structures, but image quality and artifacts depend on echo time (TE) adjustments. Optimizing TE is crucial for tissue contrast and artifact minimization.</p><p><strong>Objective: </strong>To evaluate the impact of TE on tissue contrast and image quality in T2*-weighted sequences at 7 T in adolescents and young adults.</p><p><strong>Materials and methods: </strong>Ten adolescent and young adult patients underwent 7-T MRI with multi-echo T2*-weighted sequences. Six TEs (8.1 ms to 36 ms) were acquired. Signal contrast ratios (CR) for seven brain regions-caudate nuclei, corpus callosum genu, frontal cortex, cortical veins, globi pallidi, medullary veins, and left optic radiation-were analyzed. Two blinded neuroradiologists assessed image quality and artifact severity using a 4-point Likert scale (IQS). Statistical trends were analyzed using the Jonckheere-Terpstra test. A P-value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>The study cohort consisted of 4 male and 6 females; the median age of the patients was 16 years (range 15-23 years). CR increased significantly with higher TEs for most regions except the caudate, where CR decreased (P < 0.05). Longer TEs led to greater artifact severity in the brainstem, temporal, occipital, and frontal lobes (P < 0.02), but not in parietal lobes (P > 0.05). Kappa agreement for IQS was 0.76.</p><p><strong>Conclusion: </strong>TE significantly affects contrast and artifacts in 7-T T2*-weighted imaging. TEs between 20 and 30 ms offer the best balance between tissue contrast and artifact severity, optimizing image quality for clinical and research applications.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative evaluation of magnetic resonance imaging features in aneurysmal bone cysts after percutaneous cryoablation.","authors":"Usama Anwar, Horacio M Padua, Gulraiz Chaudry, Ahmad I Alomari, Mohammad Amarneh, Kyung Rae Kim, Raja Shaikh","doi":"10.1007/s00247-025-06199-1","DOIUrl":"https://doi.org/10.1007/s00247-025-06199-1","url":null,"abstract":"<p><strong>Background: </strong>Aneurysmal bone cysts (ABCs) are benign vascular lesions commonly affecting the pediatric population.</p><p><strong>Objective: </strong>To assess magnetic resonance imaging (MRI) features of ABCs after percutaneous cryoablation.</p><p><strong>Materials and methods: </strong>A retrospective review of the hospital's electronic medical record database was conducted to identify patients who underwent percutaneous image-guided cryoablation for aneurysmal bone cysts between March 2014 and April 2024. Patients were excluded if they lacked pre- or post-treatment MRI, underwent surgical curettage and bone grafting between cryoablation treatments, or received adjunctive therapies such as sclerotherapy or bone grafting. Demographic data and pre- and post-cryoablation MRI characteristics of the lesions were collected and analyzed.</p><p><strong>Results: </strong>We retrospectively analyzed 20 patients (mean age = 14.6 years). The average ABC volume decreased from 83 cm³ pre-treatment to 32.7 cm³ post-treatment. In the final post-treatment MRI, there was a 50% decrease in the cystic component in 90% (n = 18) of patients, improved cortical integrity in 75% (n = 9), resolution of peri-lesional edema and mass effect in all (n = 20), and development of organized fibrosis in 50% (n = 10) of the patients. The average time was 8.3 months for a 50% reduction in cystic component, 7.3 months for improvement in cortical integrity, 6.4 months for improvement in mass effect, 15 months for complete resolution of peri-lesional enhancement, and 16.1 months for the development of organized fibrosis.</p><p><strong>Conclusion: </strong>These findings suggest MRI is a valuable tool for monitoring ABC response to cryotherapy, guiding future treatment protocols.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of the pathologic morphology on magnetic resonance imaging with Tönnis and International Hip Dysplasia Institute classification in developmental dysplasia of the hip.","authors":"Lian Duan, Weizheng Zhou, Lianyong Li","doi":"10.1007/s00247-025-06207-4","DOIUrl":"https://doi.org/10.1007/s00247-025-06207-4","url":null,"abstract":"<p><strong>Background: </strong>The Tönnis classification is widely used to quantify the severity of developmental dysplasia of the hip (DDH) based on the epiphyseal ossification center, while the International Hip Dysplasia Institute (IHDI) has proposed an alternative system. However, the pathological morphology associated with these classifications remains inadequately defined.</p><p><strong>Objective: </strong>This study aimed to elucidate the correlation between the Tönnis classification and the IHDI classification with the pathological morphology of cartilage and soft tissues in DDH.</p><p><strong>Materials and methods: </strong>A retrospective analysis was performed on preoperative imaging data from 170 DDH children (210 hips). The degree of dislocation was classified according to the Tönnis and IHDI classifications. Magnetic resonance imaging (MRI) was utilized to observe limbus morphology, the relationship between the femoral head and acetabulum, and the coverage of the cartilaginous femoral head.</p><p><strong>Results: </strong>In the Tönnis classification, all limbus in grade I were everted, whereas inverted or mixed grades comprised 95.1% in grade II and were 100% in grades III and IV. The IHDI classification showed similar trends. For the Tönnis classification, grade I exhibited joint formation in acetabular structures, while joint formation was noted in only 27.5% of grade II, 3.2% of grade III, and 6.3% of grade IV. In the IHDI classification, joint formation was complete in grades I and II, observed in 27.3% of acetabular structures in grade III and 3.6% in grade IV.</p><p><strong>Conclusion: </strong>Both classifications significantly correlate with pathological morphology in DDH, with the IHDI outperforming the Tönnis classification in distinguishing these morphologies as dislocation severity increases.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contrast-enhanced ultrasound of Crohn's disease in children and young adults: quantitative metric correlations and MRI disease severity associations.","authors":"Jonathan R Dillman, Adam F Prasanphanich, Katherine N Epstein, Alexander J Towbin, Andrew T Trout","doi":"10.1007/s00247-025-06203-8","DOIUrl":"https://doi.org/10.1007/s00247-025-06203-8","url":null,"abstract":"<p><strong>Background: </strong>There is a paucity of data comparing contrast-enhanced ultrasound (CEUS) to MR enterography in children and young adults with Crohn's disease.</p><p><strong>Objective: </strong>To measure correlations across CEUS quantitative metrics in children and young adults with Crohn's disease, and to evaluate if these metrics are associated with MRI features of disease activity.</p><p><strong>Materials and methods: </strong>Patients <21 years old with Crohn's disease affecting the terminal ileum who underwent clinically-indicated MR enterography were recruited between 2021 and 2024. Research CEUS of the terminal ileum was performed using sulfur hexafluoride lipid-type A microspheres, and images were analyzed using VueBox (Bracco Group). MRI exams were independently reviewed by three radiologists to document features of disease activity. Pearson's correlation (r) was used to measure associations across nine CEUS quantitative metrics and between CEUS metrics and mean or consensus MRI features.</p><p><strong>Results: </strong>Twenty-five participants, 13 (52%) male, with a mean age of 16.5 years (range, 13-20 years) were included. The mean terminal ileal maximum bowel wall thickness at MRI was 7.5 mm±1.8 mm. The mean sMaRIA score was 3.4±0.8, consistent with severely active disease. CEUS quantitative measurements were highly variable across participants. The mean rise time was 7.0±2.7 s, while the mean peak enhancement was 3,282±3,754 a.u. Twelve of 36 (36%) CEUS quantitative metric bivariate comparisons were highly collinear with r>0.8 (P<0.0001). There were significant positive correlations between CEUS rise time and MRI maximum bowel wall thickness (r=0.40; P=0.046), visual analog scale assessment of overall inflammation (r=0.43; P=0.032), and postcontrast enhancement ratio (r=0.47; P=0.018); there were no other significant correlations between CEUS metrics and MRI measures of inflammation.</p><p><strong>Conclusion: </strong>CEUS quantitative measurements are highly variable across patients with Crohn's disease, with multiple metrics being highly correlated with one another. CEUS rise time correlates with MRI features of disease activity.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid MRI for acute pediatric MSK infections: survey of current utilization and procedural practices.","authors":"M Alejandra Bedoya, Jade Iwasaka-Neder, Nancy A Chauvin, Jonathan D Samet, Arthur B Meyers, Patricia T Acharya, Cara E Morin, Michael Aquino, J Christopher Davis, Anna Thomas","doi":"10.1007/s00247-025-06206-5","DOIUrl":"https://doi.org/10.1007/s00247-025-06206-5","url":null,"abstract":"<p><strong>Background: </strong>Some institutions have implemented rapid MRI protocols for acute musculoskeletal (MSK) infections as an attempt to improve early diagnosis.</p><p><strong>Objective: </strong>To assess current utilization of pediatric rapid MSK MRI protocols (abbreviated protocol, no IV (intravenous) contrast, and no sedation) using a survey.</p><p><strong>Materials and methods: </strong>A 10-question survey was sent to members of the Society for Pediatric Radiology (SPR) and the Society of Skeletal Radiology, which differed depending on whether a rapid protocol was used or not. The survey was conducted by the SPR MSK and MRI committees.</p><p><strong>Results: </strong>A total of 134 surveys (representing 99 institutions) were completed. Twenty-two percent (22/99) of institutions used a rapid protocol. Pediatric institutions were more likely to perform it when compared to adult institutions (P-value<0.01, 37% (14/38) vs. 13% (8/61)). Comparing institutions that use rapid protocol with institutions that do not, the availability of on-call MRI technologists did not differ (P-value=0.33), and pediatric radiologists were more likely to interpret these studies (73% (16/22) vs. 36% (28/77), P-value=0.02). Reported rapid MRI completion times took less than 15 min in 64% (14/22) of the institutions. Seventy-three percent (16/22) of institutions performing rapid protocols have radiologists check images to evaluate the need for additional sequences or contrast. Sixty-eight percent (25/37) reported being very satisfied with rapid protocols. Seventy-seven of 99 institutions do not use a rapid protocol due to a lack of a consensus protocol and concerns about missing findings. Of these institutions, 62% (48/77) administer IV contrast routinely.</p><p><strong>Conclusion: </strong>There is limited and variable utilization of rapid MRI protocols for acute pediatric MSK infection. Lack of accepted consensus protocol is the most common reason for non-implementation, highlighting the need for consensus-driven rapid protocols.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rasmussen encephalitis: brain MRI and ¹⁸F-FDG PET findings.","authors":"Valentina Ferrer Valencia, Stephan D Voss, Neha Kwatra","doi":"10.1007/s00247-025-06210-9","DOIUrl":"https://doi.org/10.1007/s00247-025-06210-9","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MR imaging of pediatric meniscal retears: pearls and pitfalls - a pictorial review.","authors":"Oladipupo Fagbongbe, Rida Salman, Indranil Kushare, Pritish Bawa, Jason Zarahi Amaral, J Herman Kan","doi":"10.1007/s00247-025-06211-8","DOIUrl":"https://doi.org/10.1007/s00247-025-06211-8","url":null,"abstract":"<p><p>Differentiating expected pediatric knee MRI post-operative changes and meniscal retear after primary repair or debridement may be challenging. This pictorial essay reviews treatment strategies for meniscal tears with or without underlying discoid morphology. MRI pearls and pitfalls to identify meniscal retears and differentiate them from normal post-treatment findings will be shown, geared toward pediatric musculoskeletal radiologists.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed tomography for major aortopulmonary collateral arteries: a roadmap to unifocalized pulmonary arterial flow.","authors":"Hyun Woo Goo","doi":"10.1007/s00247-025-06202-9","DOIUrl":"https://doi.org/10.1007/s00247-025-06202-9","url":null,"abstract":"<p><p>In conjunction with catheter angiography, high-resolution, isotropic, three-dimensional computed tomography mapping of major aortopulmonary collateral arteries is useful for delineating complex thoracic arterial anatomy and has been increasingly utilized in patients with pulmonary atresia and ventricular septal defect. The presence, confluence, and size of the central (mediastinal native) pulmonary artery; the presence and course of a patent ductus arteriosus; the number of collateral arteries; the number of lung segments supplied by each collateral artery; significant distal pulmonary artery stenoses; and isolated or dual blood supply in each lung segment can be evaluated using computed tomography mapping. The detailed mapping can substantially reduce procedural time for catheter angiography, which delivers a higher radiation dose than computed tomography does, and is useful for surgical planning. Furthermore, the effect of surgical treatments including unifocalization and rehabilitation can be monitored with computed tomography mapping. In addition to pulmonary atresia with ventricular septal defect, a major aortopulmonary collateral artery may be observed in other cardiac defects associated with pulmonary atresia, scimitar syndrome, and systemic arterial supply to normal lung. Lastly, the review briefly discusses promising future applications of computed tomography mapping focusing on quantification of arterial and lung volumes.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Comparing magnetic resonance enterography and endoscopy findings to the motility of magnetic resonance imaging in pediatric Crohn's disease.","authors":"Brianna McSorley, Matthew Plunk, Sai Alekha Challa, Amy Y Pan, Joshua Noe","doi":"10.1007/s00247-025-06204-7","DOIUrl":"https://doi.org/10.1007/s00247-025-06204-7","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}