Pediatric Radiology最新文献

{"title":"Discordance between knee and hand-wrist bone age in adolescents: implications for skeletal maturity assessment and its association with thyroid-stimulating hormone levels.","authors":"Yuxin Sun, Zhibo Zhou, Xueqing Zheng, Hanze Du, Fengdan Wang, Shi Chen, Hui Pan","doi":"10.1007/s00247-025-06363-7","DOIUrl":"https://doi.org/10.1007/s00247-025-06363-7","url":null,"abstract":"<p><strong>Background: </strong>Hand-wrist radiographs may not fully reflect skeletal bone age (BA) during mid-to-late puberty. Knee magnetic resonance imaging (MRI), a non-radiative imaging technique, may provide detailed evaluation of the lower limbs.</p><p><strong>Objective: </strong>To validate the San Diego MRI-based knee BA atlas in a Chinese adolescent cohort presenting with growth deceleration, evaluate the concordance between knee and hand-wrist BA, and explore factors influencing potential discrepancies.</p><p><strong>Materials and methods: </strong>This study involved 227 adolescents. Hand-wrist BA was assessed using the Greulich and Pyle atlas with hand-wrist radiographs, and knee BA using the San Diego atlas with knee MRI. Correlations between knee BA, hand-wrist BA, and chronological age (CA) were analyzed. Discrepancies between the two sites were further evaluated for associated clinical factors.</p><p><strong>Results: </strong>Knee BA correlated better with CA (r_s = 0.816, P < 0.001) than with hand-wrist BA (r_s = 0.763, P < 0.001). The mean difference between hand-wrist BA and CA was 1.08 ± 1.19 years, and between knee BA and CA was 0.71 ± 1.06 years (P < 0.001). 14.1% of adolescents showed more advanced knee maturity than hand-wrist bones. Thyroid-stimulating hormone (TSH) levels were positively associated with the difference between hand-wrist and knee BA (r_s = -0.198, P = 0.011). Subclinical hypothyroidism significantly increased the risk of knee overmaturity (OR = 6.022, P < 0.001).</p><p><strong>Conclusion: </strong>Knee MRI is a reliable imaging modality for assessing skeletal maturity in adolescents with growth retardation. A moderate correlation was observed between hand-wrist and knee BA. In adolescents with elevated TSH levels, knee MRI may be preferable to hand-wrist radiographs for predicting final height, evaluating growth potential, and guiding growth hormone therapy decisions.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964006","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":"White paper on the current state of imaging biomarkers in paediatric oncology.","authors":"Rutger A J Nievelstein, Lise Borgwardt, Emilio J Inarejos Clemente, Thekla Von Kalle, Martin Kyncl, Maarten H Lequin, Annemieke S Littooij, Erika Pace, Pier L Di Paolo, Rick R Van Rijn, Julian M M Rogasch, Jurgen Schäfer, Irmina Sefic Pasic, Anita Spezzacatene, Nelleke Tolboom, Simon M Wan, Pietro Zucchetta","doi":"10.1007/s00247-025-06372-6","DOIUrl":"https://doi.org/10.1007/s00247-025-06372-6","url":null,"abstract":"<p><p>In paediatric oncology, imaging biomarkers play an increasing role in diagnostic imaging and research. They can be used for prediction, detection, staging, and grading of diseases, as well as for assessment of response to treatment. Imaging biomarkers are complementary to tissue-based biomarkers, enabling a more personalised approach in oncology care. In this white paper by the European Society of Paediatric Radiology (ESPR) Oncology Taskforce and European Association of Nuclear Medicine (EANM) Paediatrics Committee, an overview is given of the current knowledge on the use of imaging biomarkers in general and per tumour group.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964067","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":"Liver stiffness measured by MR elastography in children and adults with Fontan circulation: defining expected values and clinical associations.","authors":"Julia Razavi, Andrew T Trout, Cara E Morin, Alexander R Opotowsky, Clayton Smith, Joseph J Palermo, Julie A Bonn, Jonathan R Dillman","doi":"10.1007/s00247-025-06366-4","DOIUrl":"https://doi.org/10.1007/s00247-025-06366-4","url":null,"abstract":"<p><strong>Background: </strong>MRI is increasingly used to assess Fontan-associated liver disease (FALD), but the expected range and variability of MR elastography (MRE) shear stiffness measurements as well as their clinical associations remain poorly understood.</p><p><strong>Objective: </strong>This study aimed to define the range of MR elastography (MRE) measured liver shear stiffness and its clinical associations in a large pediatric and adult cohort of patients post-Fontan.</p><p><strong>Materials and methods: </strong>This retrospective cross-sectional study included children and adults who underwent baseline clinical liver MRE between February 2013 and June 2024. Mean liver stiffness (kPa) and liver volume (mL) were obtained from clinical reports, while spleen length was measured on coronal T2-weighted images. Clinical data, Fontan conduit size, Fontan pathway pressure, fenestration status, and presence of protein-losing enteropathy were collected within 6 months of imaging. Associations between liver stiffness and clinical variables were assessed using Pearson correlation and multiple linear regression. Clinical characteristics were compared between patients in the lowest (≤ 20th) and highest (≥ 80th) percentiles of liver stiffness.</p><p><strong>Results: </strong>Our study sample included 206 Fontan patients (mean age 19.7 years; 114 male). Mean liver stiffness was 4.4 ± 1.0 kPa (range 2.1-7.4 kPa). Liver stiffness was associated with aspartate aminotransferase (AST) (r=0.23, P=0.003), total bilirubin (r=0.31, P<0.0001), and male sex (4.6 vs. 4.1 kPa; P=0.0002), but not with liver volume (r=0.06, P=0.39) or spleen length (r=0.08, P=0.25). In a regression model excluding Fontan conduit size and Fontan pressure (n=143), male sex (P = 0.02), total bilirubin (P=0.003), and AST (P = 0.048) were independent predictors of liver stiffness (R²=0.16). In a smaller cohort with available conduit size and pressure data (n=32), predictors of liver stiffness were AST (P=0.002), ALT (P=0.03), Fontan pressure (P=0.0004), and male sex (P = 0.03) (R² = 0.59). Patients with ≥ 80th percentile liver stiffness were more likely to be male (P=0.004), had a lower BMI (23.2 vs. 26.3 kg/m², P=0.04), and had a higher total bilirubin (1.4 vs. 0.8 mg/dL, P=0.01) compared to those with ≤ 20th percentile liver stiffness.</p><p><strong>Conclusion: </strong>MRE liver stiffness is elevated and highly variable in individuals with Fontan circulation, with higher measurements associated with male sex, liver-related laboratory changes, and Fontan pathway pressure.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963980","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":"18F-Fluorodeoxyglucose positron emission tomography/computed tomography in pediatric renal tumors: reply to Sun et al.","authors":"Annemieke Simone Littooij, Justine Naomi van der Beek, Ana Coma, Henrique Lederman, Carlo Morosi, Daniela Pinto, Rodrigo Tostes, Kristina Vult von Steyern, Tom A Watson, Hervé J Brisse","doi":"10.1007/s00247-025-06352-w","DOIUrl":"https://doi.org/10.1007/s00247-025-06352-w","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963940","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":"Comparative analysis of an automated bone age tool with manual assessment in a multiethnic Southeast Asian paediatric cohort in Singapore.","authors":"Daniel Chan, Chai-Hoon Nowel Tan, Poh Voon Cheah, Nicole Kim Luan Lee, Luke Han Wei Toh, Phua Hwee Tang, Mahadev Arjandas, Rashida Farhad Vasanwala","doi":"10.1007/s00247-025-06374-4","DOIUrl":"https://doi.org/10.1007/s00247-025-06374-4","url":null,"abstract":"<p><strong>Background: </strong>Bone age assessment is essential for evaluating growth and pubertal disorders, but manual methods such as the Greulich-Pyle atlas are subject to inter-observer variability. Automated tools like BoneXpert may improve accuracy and consistency.</p><p><strong>Objective: </strong>To validate the accuracy and reliability of BoneXpert, an automated bone age assessment tool, compared to traditional manual methods performed by paediatric endocrinologists and radiologists in a multiethnic paediatric cohort in Singapore.</p><p><strong>Materials and methods: </strong>This retrospective cohort study was conducted at KK Women's and Children's Hospital and included paediatric patients aged 0 years to 17 years who presented to the endocrine clinic between February 2012 and September 2021. Bone age was assessed independently using the Greulich and Pyle (GP) method by radiologists and paediatric endocrinologists and compared with BoneXpert's automated assessments.</p><p><strong>Results: </strong>The study included 200 paediatric patients with a mean age of 9.4 years (± 3.5 years). BoneXpert demonstrated excellent agreement with endocrinologists, with intraclass correlation coefficients (ICC) of 0.983 (95% CI: 0.977-0.987) and 0.974 (95% CI: 0.967-0.980) for Endocrinologists 1 and 2, respectively. The root mean square error (RMSE) between BoneXpert and the endocrinologists was 0.652 years and 0.852 years, indicating high accuracy. However, the RMSE between BoneXpert and radiologists was higher at 1.178 years, reflecting greater variability. Bland-Altman plots showed good agreement between BoneXpert and manual assessments.</p><p><strong>Conclusion: </strong>BoneXpert provides a reliable and efficient alternative to manual bone age assessments and aligns closely with endocrinologists' evaluations. This tool could significantly reduce inter-rater variability and enhance clinical efficiency, particularly in diverse ethnic populations.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963998","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":"Pediatric interventional radiology in Ethiopia: current status, challenges, and roadmap to establishment.","authors":"Bethlehem Tesfasilassie Kibrom, Tsegahun Manyazewal, Samuel Sisay Hailu","doi":"10.1007/s00247-025-06370-8","DOIUrl":"https://doi.org/10.1007/s00247-025-06370-8","url":null,"abstract":"<p><p>Pediatric interventional radiology (IR) utilizes image-guided, minimally invasive techniques to diagnose and treat diseases in children. While well-established in high-income countries, pediatric IR remains underdeveloped in many low- and middle-income countries, including Ethiopia. This review outlines the current state of pediatric IR in Ethiopia, highlights key barriers to its implementation, and proposes a practical, context-specific roadmap for building a sustainable practice. Overcoming these challenges could enable the country to deliver effective, personalized care to its pediatric population and contribute meaningfully to the advancement of this rapidly evolving field. Moreover, expanding pediatric IR is essential to ensure equitable access to critical medical innovations.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964042","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":"Female-to-female aggression in the workplace.","authors":"Ami Gokli, Mohammad Jalloul, Ethan Larsen, Summer L Kaplan, Teresa Victoria","doi":"10.1007/s00247-025-06345-9","DOIUrl":"https://doi.org/10.1007/s00247-025-06345-9","url":null,"abstract":"<p><strong>Background: </strong>Female-to-female aggression in the workplace describes behavior by a woman with higher power status that is intended to degrade, ridicule, or undermine the work of a woman with a lesser power status, and may impede the career goals of junior female radiologists. Senior women may or may not be aware of their role in perpetuating this behavior.</p><p><strong>Objective: </strong>To characterize the prevalence, impact, and perceptions of female-to-female workplace aggression among pediatric radiologists in order to raise awareness and inform strategies for prevention and intervention.</p><p><strong>Methods and materials: </strong>An adapted version of a validated survey was developed and distributed electronically in October 2022 to all Society for Pediatric Radiology (SPR) members. The 17-question survey included both multiple choice and free-text fields. Members were given 2 weeks to respond to the survey with two reminders electronically delivered prior to survey closing. Three questions addressed demographics, 11 questions addressed personal experience with this aggression, and three questions addressed potential causes and handling of this aggression. Descriptive statistics were used to summarize responses. Non-parametric statistics were used to compare group responses.</p><p><strong>Results: </strong>Survey response rate was 12% (199/1694) with 73% (144/199) female, 27% (54/199) male, and 0.5% (1/199) nonbinary. Respondents ranged from in-training to>21 years in practice and 25 years to>66 years of age + . Of all respondents, 47% (n=93) have personally been the recipient of female-to-female aggression, and 68% (n=35) have witnessed it. Thirty-six percent (n=71) of respondents admit to exerting this behavior on other women. Most respondents agree that this is a phenomenon limited to a few people rather than being widespread or caused by many; however, 39% (n=76) rank this aggression as a middle or top cause of stress/tension related to their jobs, and 46% (n=88) noted that it had changed or affected their career path. Seventy-six respondents included descriptions of their experiences and 109 had suggestions for solving problems related to female-to-female aggression.</p><p><strong>Conclusions: </strong>Female-to-female aggression was experienced by 60% of female radiologists during their medical career and may negatively impact the careers of junior female radiologists. Characterizing the extent of this experience in our field will raise awareness and may help prevent or mitigate it.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964028","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":"Utility of cardiac magnetic resonance imaging in the evaluation of cardiovascular involvement in pediatric Rosai-Dorfman disease.","authors":"Snigdha Bhatia, Sassan Hashemi, William McEachern, Timothy Slesnick, Chelsea Dennison, Hunter Wilson","doi":"10.1007/s00247-025-06389-x","DOIUrl":"https://doi.org/10.1007/s00247-025-06389-x","url":null,"abstract":"<p><p>Rosai-Dorfman disease is an infiltrative neoplastic process that can manifest with a variety of symptoms based on its location. Rarely, Rosai-Dorfman disease can present as an intracardiac mass or with compression of extracardiac vasculature. When cardiovascular involvement is considered, cardiac MRI can aid in tissue characterization, rule out alternative differential diagnoses, and assess physiological consequences of the mass. We describe the imaging and clinical course of a child with Rosai-Dorfman disease with cardiovascular involvement who exhibited successful response to targeted chemotherapy.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963971","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":"Reply to Littooij AS.","authors":"Hui Sun, Weiwei Cheng","doi":"10.1007/s00247-025-06365-5","DOIUrl":"https://doi.org/10.1007/s00247-025-06365-5","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963990","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":"How consistent is the interpretation of renal scarring in pediatric patients using technetium-99m dimercaptosuccinic acid scintigraphy.","authors":"Mansura Naznine, Muhammad E H Chowdhury, Abdus Salam, Abdusamea Shabani, Karuppiah Kumaresan, Nadezhda Komarova, Amitabh Arya, Takahiro Hosokawa, Khalsa Zahran Al-Nabhani, Tariq O Abbas","doi":"10.1007/s00247-025-06379-z","DOIUrl":"https://doi.org/10.1007/s00247-025-06379-z","url":null,"abstract":"<p><strong>Background: </strong>Technetium-99m dimercaptosuccinic acid (DMSA) scintigraphy plays a critical role in pediatric imaging for detecting renal cortical scarring, which is essential for diagnosing and managing kidney damage in children. However, variability in observer interpretation poses challenges, potentially impacting clinical decision-making and outcomes.</p><p><strong>Objective: </strong>This study aims to assess intra- and inter-observer agreement in interpreting DMSA scans for detecting renal cortical scarring in pediatric patients, focusing on the presence, location, and percentage of kidney involvement.</p><p><strong>Materials and methods: </strong>This prospective study analyzed 220 pediatric patients with suspected renal scarring. Four experienced radiologists independently reviewed DMSA scans on two separate occasions, 3-4 weeks apart, using standardized assessment criteria. Intra-observer agreement was measured using Cohen's kappa, while inter-observer agreement was assessed using pairwise Cohen's kappa for categorical evaluations and Kendall's tau-b for the percentage of kidney involvement.</p><p><strong>Results: </strong>Strong intra-observer agreement was observed across all four radiologists, with Cohen's kappa values for renal scarring stages ranging from 0.704 to 0.955. Observer-4 consistently showed the highest agreement across all metrics. Inter-observer agreement varied substantially depending on observer pairs. Pairs excluding Observer-2 demonstrated moderate to substantial agreement (kappa up to 0.8268 and Kendall's tau-b up to 0.7192), while pairs involving Observer-2 showed poor to slight agreement. Variability was particularly notable in assessing scarring severity and defect localization.</p><p><strong>Conclusion: </strong>While intra-observer consistency in interpreting DMSA scans is high, inter-observer variability remains a concern, especially in evaluating the severity and location of renal scarring. These findings underscore the need for standardized protocols and targeted training to enhance diagnostic accuracy. Moreover, the development of validated datasets could support the advancement of machine learning models for automated, precise detection of renal scarring, ultimately improving diagnostic reliability and patient outcomes.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963984","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}