Pediatric Radiology最新文献

{"title":"Utilizing a chest CT interstitial lung disease scoring system for commonly encountered pediatric rheumatologic diseases with associated interstitial lung disease with clinical correlation.","authors":"HaiThuy N Nguyen, Terry Robinson, Beverley Newman, Natalie A Mahieu, Paul G Thacker, Paul Iskander, Evan Zucker, Tzielan C Lee, Rajdeep Pooni, Joyce Hsu, Lu Tian, Michal Cidon, Rex A Moats","doi":"10.1007/s00247-026-06685-0","DOIUrl":"10.1007/s00247-026-06685-0","url":null,"abstract":"<p><strong>Background: </strong>Chest CT is useful for early detection and monitoring of rheumatologic-related interstitial lung disease (ILD) in children. However, interpretation is inconsistent and lacks standardization.</p><p><strong>Objective: </strong>This study employs prior disease-specific CT scoring systems to systematically assess most rheumatologic diseases with ILD in pediatric patients and correlate scores with clinical findings.</p><p><strong>Materials and methods: </strong>This retrospective study included patients (ages 0-21 years) with rheumatologic-related ILD and chest CT. Two pediatric radiologists determined CT quality and separated patients into disease and disease control groups. Three different blinded pediatric radiologists scored CT scans using this Pediatric Rheumatologic Interstitial Lung Disease (PRILD) scoring system, comprising of parenchymal, nodule/mass/cavitary/cyst, and pleural/pericardial components (total score, 125). Clinical data were extracted from medical records. Non-parametric tests were used for group comparisons, intraclass correlation coefficient (ICC) for interobserver agreement, and Spearman's correlation for CT and pulmonary function relationships.</p><p><strong>Results: </strong>Median age was 13.8 years and 84% were female. The disease group had statistically significant higher median total PRILD scores than the disease control group (7.3 vs. 1.7, P<0.001) and a higher percent active rheumatologic disease (93% vs 78%, P=0.039). There were no statistically significant differences between the two groups regarding age, sex, rheumatologic disease type, disease duration, or pulmonary symptoms. Interrater agreement was poor; ICC was 0.41. When both groups were combined, there were weak negative correlations with pulmonary function tests.</p><p><strong>Conclusion: </strong>PRILD scoring system aids in systematic evaluation of thoracic involvement in rheumatologic-related ILD. However, further refinement and education are needed to improve interrater agreement, and given the rare nature of these diseases, a multicenter collaboration is necessary for validation of this CT scoring system.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"2446-2458"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148252713","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":"Commentary: Ferumoxytol in pediatric cardiovascular imaging.","authors":"Cynthia K Rigsby, Andrada R Popescu, Nazia Husain","doi":"10.1007/s00247-026-06725-9","DOIUrl":"10.1007/s00247-026-06725-9","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"2443-2445"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148448618","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":"Subarachnoid space in infancy and early childhood: a systematic review of measurements.","authors":"Jennifer Xu, Sofia Valencia Osorio, M Katherine Henry, Susan Sotardi, Joanne N Wood, Jakob Seidlitz, Aaron Alexander-Bloch, Jamie Catalano, Barbara H Chaiyachati","doi":"10.1007/s00247-026-06640-z","DOIUrl":"10.1007/s00247-026-06640-z","url":null,"abstract":"<p><strong>Background: </strong>Benign enlargement of the subarachnoid space (BESS) is a condition characterized by widened subarachnoid spaces, typically associated with macrocephaly or increasing head circumference during infancy or early childhood. Often described as idiopathic and self-limiting, BESS has also been associated with developmental delays and spontaneous subdural collections. Yet, complete interrogation of these associations is limited by lack of normative subarachnoid space characterization and standardized diagnostic criteria.</p><p><strong>Objective: </strong>This project aimed to review and synthesize literature on imaging criteria and subarachnoid space measurements for BESS in infants and young children.</p><p><strong>Materials and methods: </strong>A systematic PubMed search was conducted using BESS-related terminology, informed by preliminary findings from a manual snowball review. We limited results to reports that provided subarachnoid space measurements from computed tomography (CT), magnetic resonance imaging (MRI), or ultrasound (US) neuroimaging and investigated subjects with or without BESS and/or macrocephaly from birth to 5 years old. Reports with concomitant neurological conditions affecting brain size were excluded.</p><p><strong>Results: </strong>The final collection included twenty-four reports (US n=10, CT n=6, MRI n=6, multiple n=2), consisting of 2,731 infants and children aged 0-36 months. Most reports evaluated non-BESS/macrocephaly subjects (n=15), followed by BESS and/or macrocephalic subjects (n=3) or both (n=6). Subarachnoid space measurements which were not expressly designated or were without detailed descriptions were the most commonly reported subarachnoid space index measure (n=14), followed by craniocortical width (CCW, n=9). Upper CCW measurements for non-BESS/macrocephaly subjects in US reports ranged from 5 mm to 10.86 mm. In general, for each study that included both non-BESS/macrocephaly and BESS and/or macrocephaly subjects, measurements reported were greater among BESS and/or macrocephaly subjects. There was some evidence of overlapping measurements between the subjects, such as those of CCW measurements in US studies.</p><p><strong>Conclusion: </strong>Overall, substantial variability was observed in imaging methodology and measurement thresholds. This review underscores the need for standardized diagnostic criteria to improve the consistency and reliability of BESS diagnosis.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"2549-2563"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13430205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148176448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: \"A reliable measurement is not the same as a reliable diagnosis\" by Nawaz Tahir et al.","authors":"Jan Peter, Miklos Csato, Inga Paravicini, Martina Wehrli, Petra Schweinhardt, Anke Langenfeld","doi":"10.1007/s00247-026-06783-z","DOIUrl":"10.1007/s00247-026-06783-z","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"2584-2585"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative susceptibility mapping reveals abnormal iron reduction in deep gray matter of children with global developmental delay.","authors":"Tianyu Li, Xin Zhao, Liang Zhou, Lin Lu, Meiying Cheng, Honglei Shang, Xueyan Liu, Ning Wang, Desheng Xuan, Junjie Liao, Xiang Yue, Xiaoan Zhang","doi":"10.1007/s00247-026-06669-0","DOIUrl":"10.1007/s00247-026-06669-0","url":null,"abstract":"<p><strong>Background: </strong>Global developmental delay is a common pediatric condition that affects multiple developmental domains. Emerging evidence suggests that iron deposition in the deep gray matter nuclei may play a critical role in neurodevelopmental processes. However, brain iron deposition in children with global developmental delay remains insufficiently characterized.</p><p><strong>Objective: </strong>This study aimed to investigate abnormal brain iron deposition patterns on neuroimaging in children with global developmental delay, with the goal of facilitating early detection, timely diagnosis, and targeted intervention.</p><p><strong>Materials and methods: </strong>This study enrolled 71 children with global developmental delay and 31 typically developing controls. Quantitative susceptibility mapping (QSM) data were acquired using a 3.0-T magnetic resonance imaging scanner and post-processed on the MATLAB platform. Between-group comparisons of susceptibility values in the deep gray matter nuclei were performed, followed by correlation analyses between regional susceptibility values and Gesell Developmental Scale scores in the differentially affected brain regions. Receiver operating characteristic (ROC) curves were constructed to assess the diagnostic performance of quantitative susceptibility mapping. The Benjamini-Hochberg false discovery rate (FDR) method was applied, with significance set at corrected P<0.05.</p><p><strong>Results: </strong>Children in the global developmental delay group exhibited significantly lower magnetic susceptibility in the bilateral thalamus, substantia nigra, and dentate nucleus (all P<0.05). Susceptibility values of the bilateral dentate nucleus were positively correlated with gross motor and personal-social Gesell sub-scores (right dentate nucleus: r=0.41, P<0.001 and r=0.26, P=0.027; left dentate nucleus: r=0.36, P=0.002 and r=0.26, P=0.026). ROC analysis showed that the right dentate nucleus had the highest area under the curve (AUC=0.83).</p><p><strong>Conclusion: </strong>Children with global developmental delay demonstrate decreased magnetic susceptibility within the deep gray matter nuclei, which supports imaging-based inference of dysregulated brain iron metabolism, potentially reflecting underlying pathophysiological mechanisms of neurodevelopment.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"2537-2548"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148176457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal lung interstitial tumor (FLIT): a case report and review of prenatal imaging features.","authors":"An T Hoang, Zeynep Ruhioglu, David Carpentieri, Luis F Goncalves","doi":"10.1007/s00247-026-06732-w","DOIUrl":"10.1007/s00247-026-06732-w","url":null,"abstract":"<p><p>Fetal lung interstitial tumor (FLIT) is a rare benign mesenchymal lung tumor that is often mistaken for more common congenital lung lesions such as congenital pulmonary airway malformation (CPAM). Prenatal detection is exceedingly uncommon. Here, we report a case of prenatally detected FLIT presenting in the third trimester with rapid interval growth, mediastinal shift, and fetal hydrops, raising concern for a malignancy, including pleuropulmonary blastoma. Prenatal ultrasonography and fetal magnetic resonance imaging (MRI) demonstrated a rapidly enlarging right lung mass first identified late in gestation with associated findings of pleural effusion, ascites, and diffuse skin edema consistent with hydrops. Progressive mass effect prompted expedited delivery. Postnatal imaging confirmed a large pulmonary lesion, and the neonate developed significant respiratory distress requiring lobectomy. Histopathologic evaluation revealed an immature mesenchymal proliferation diagnostic of FLIT. This case highlights the imaging overlap between FLIT, CPAM, and pleuropulmonary blastoma and underscores the importance of considering FLIT in the differential diagnosis of late-presenting fetal lung masses. Although imaging is essential for detection and prenatal planning, definitive diagnosis requires histopathologic confirmation, and complete surgical resection yields an excellent prognosis.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"2596-2603"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Zero-shot performance of a general-purpose vision-language model for pediatric appendicitis diagnosis.","authors":"Ceren Altintas Mese, Ismail Mese, Tugba Akinci D'Antonoli","doi":"10.1007/s00247-026-06687-y","DOIUrl":"10.1007/s00247-026-06687-y","url":null,"abstract":"<p><strong>Background: </strong>General-purpose vision-language models can analyze medical images without task-specific training, but their value for pediatric abdominal ultrasound is unknown.</p><p><strong>Objective: </strong>To investigate the zero-shot performance of a general-purpose vision-language model to diagnose pediatric appendicitis using multimodal inputs, including images, report text, and clinical information.</p><p><strong>Materials and methods: </strong>In this retrospective study, diagnostic capabilities of Llama 4 Maverick were evaluated on the Regensburg Pediatric Appendicitis Dataset. Five experiments were conducted using the following inputs as well as input combinations: images only, ultrasound report text only, images and ultrasound text, images and clinical data, entire multimodal input. Reference standard of appendicitis was defined based on histopathology in patients who underwent surgical resection and on clinical follow-up in patients managed conservatively. Performance was assessed at the patient level using accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and F1-score. Area under the receiver operating characteristic curve (AUROC) was evaluated secondarily as a measure of discrimination.</p><p><strong>Results: </strong>Of 782 patients, 294 met inclusion criteria; based on data availability, four experiments are conducted using 293 patients and in the fifth experiment, 284. Images-only experiment showed very low specificity (13.5%) and had the poorest discrimination (AUROC, 0.567). Ultrasound report text improved classification performance, with specificity increasing to 63.5% while maintaining high sensitivity; discrimination was also strong (AUROC, 0.883). Adding images to ultrasound text or combining all available inputs did not yield further meaningful improvement. Differences between images-only experiment and text-containing experiments were statistically significant (P≤0.002).</p><p><strong>Conclusion: </strong>Zero-shot visual interpretation of pediatric abdominal ultrasound by a general-purpose vision-language model is inadequate for safe appendicitis diagnosis. Performance is driven primarily by a structured sonographic imaging report, supporting a role for such models as text-based decision support tools rather than autonomous ultrasound image interpreters.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"2478-2487"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199723","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":"Deep learning reconstruction improves appendix visualization on pediatric magnetic resonance imaging (MRI): a single-center experience.","authors":"Sebastian Gallo-Bernal, Valeria Pena-Trujillo, Navaira Shoaib, Fedel Machado-Rivas, Teresa Victoria, Rimaz Khadir, Eugene Milshteyn, Arnaud Guidon, John Conklin, Michael S Gee","doi":"10.1007/s00247-026-06686-z","DOIUrl":"10.1007/s00247-026-06686-z","url":null,"abstract":"<p><strong>Background: </strong>Thin-slice MRI may improve appendix visualization in children with suspected appendicitis, but reducing slice thickness decreases signal-to-noise ratio (SNR) and can degrade image quality. Deep learning reconstruction (DLR) enables denoising of thin-slice images and may mitigate these limitations.</p><p><strong>Objective: </strong>To evaluate whether 2-mm T2-weighted magnetic resonance imaging (MRI) with DLR improves appendix visualization and diagnostic performance compared with conventional 4-mm MRI in pediatric appendicitis.</p><p><strong>Materials and methods: </strong>In this prospective, Institutional Review Board-approved, single-center study (January 2022-June 2025), 82 pediatric patients (mean age 9.6 years; age range 5-20 years) undergoing MRI for suspected appendicitis were included. MRI protocols contained both standard 4-mm and thin-slice 2-mm single-shot T2-weighted images; DLR was applied to 2-mm images (2-mm+DLR). Three blinded radiologists independently assessed paired series for appendix visualization, confidence, appendicitis diagnosis, ancillary findings, and overall image quality. Objective SNR was measured in psoas muscle, bladder, and fat. Diagnostic performance was calculated against surgical or clinical reference standards using paired statistical tests.</p><p><strong>Results: </strong>In the first 16 exploratory cases, quantitative analysis showed that the signal-to-noise ratio of 2-mm+DLR images was comparable to that of standard 4-mm images. Across the full cohort, pooled analysis showed improved appendix visualization with 2-mm+DLR compared with standard 4-mm MRI (88.2% [217/246] vs 83.3% [205/246], P=0.006). Overall diagnostic image quality was also higher with 2-mm+DLR (median 5 vs 4, P<0.001), while confidence in appendix visualization and appendicitis diagnosis was similar between techniques (both medians 4, P>0.1). Exploratory pooled diagnostic performance numerically favored 2-mm+DLR, with higher sensitivity (89% [78/87] vs 81% [71/87]) and accuracy (89% [218/246] vs 86% [210/246]), although paired comparisons did not reach statistical significance (Table 4).</p><p><strong>Conclusion: </strong>DLR-enhanced 2-mm MRI improves appendix visualization and overall diagnostic image quality in pediatric appendicitis without reducing reader confidence or specificity. Thin-slice DLR MRI supports improved depiction of the appendix and alternative abdominal pathology in children.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"2468-2477"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148176385","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":"Diffuse sclerosing papillary thyroid carcinoma in a child.","authors":"A Yigitcan Tacyıldız, H Nursun Ozcan","doi":"10.1007/s00247-026-06691-2","DOIUrl":"10.1007/s00247-026-06691-2","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"2612"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148252639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Widely available, general-purpose generative AI applications for radiology education: determining the teaching quality of synthetic pediatric neuroradiology images.","authors":"Thomas P Reith, Donna M D'Alessandro, Krishnakumari A Modi, Mohammed Sabawi, Catherina S Zadeh, Mikhael G Sebaaly, Lillian M Lai, Takashi Shawn P Sato, Simon C Kao, Yutaka Sato, Michael P D'Alessandro","doi":"10.1007/s00247-026-06708-w","DOIUrl":"10.1007/s00247-026-06708-w","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) is increasingly incorporated into medical education. Widely available, general-purpose generative AI applications are increasingly capable of producing high-fidelity synthetic medical images, which may have potential educational uses.</p><p><strong>Objective: </strong>To assess the ability of widely available, general-purpose generative AI applications to produce synthetic pediatric neuroradiology images of teaching quality.</p><p><strong>Materials and methods: </strong>Ten significant diagnostic errors in pediatric neuroradiologic emergencies were identified and divided into 22 individual clinical scenarios. Two widely available, general-purpose generative AI applications, GPT-5 (OpenAI, San Francisco, CA) and Gemini 3 Pro with the Nano Banana Pro image-generation engine (Google, Mountain View, CA), were prompted to generate five separate images for each scenario, yielding a total of 220 images. Eight fellowship-trained pediatric radiologists independently assessed each image for teaching quality. Ratings were recorded and analyzed. Differences between applications were evaluated using Fisher's exact test.</p><p><strong>Results: </strong>Overall, 8.6% of generated images (19/220) were deemed suitable for teaching by more than half of the pediatric radiologists. GPT-5 produced a higher proportion of acceptable images meeting this >50% criterion compared to Gemini 3 Pro (12.7% [14/110] vs. 4.5% [5/110]; P=0.031).</p><p><strong>Conclusion: </strong>At present, widely available, general-purpose generative AI applications should not be used to produce synthetic radiological images for educational purposes. Inaccuracies and inconsistencies limit reliability and may actively impair learning.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"2564-2572"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}