Pediatric Radiology最新文献

{"title":"From patient to author: the journey of \"Case 2\" and the story of a legacy.","authors":"Alessandro Tamburrini","doi":"10.1007/s00247-025-06181-x","DOIUrl":"https://doi.org/10.1007/s00247-025-06181-x","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080656","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":"3D ultrasound volume quantification for pediatric urinary tract dilation: a semi-automated segmentation software inter-rater analysis.","authors":"Tatiana Morales-Tisnés, Laith R Sultan, Laurence Rouet, James Jago, Trudy A Morgan, Wondwossen Lerebo, Mohamed M Elsingergy, Arun Srinivasan, Anush Sridharan, Hansel J Otero, Kassa Darge, Susan J Back","doi":"10.1007/s00247-024-06132-y","DOIUrl":"10.1007/s00247-024-06132-y","url":null,"abstract":"<p><strong>Objective: </strong>We determined the reliability of a three-dimensional (3D) ultrasound (US) segmentation software for evaluating volumetric hydronephrosis index (HI) and renal parenchymal and pelvicalyceal volume in children with urinary tract dilation (UTD).</p><p><strong>Material and methods: </strong>From 1/2019 to 9/2023, children clinically scheduled for a renal imaging exam to assess UTD at a single center were prospectively enrolled. They underwent a dedicated two-dimensional (2D) and 3D US renal exam. A UTD score was assigned per kidney from the 2D images based on the 2014 consensus classification by an experienced pediatric radiologist. From the 3D dataset, the renal parenchyma and collecting system were independently segmented by three trained raters using a semi-automated software. From this segmentation, the kidney parenchymal and pelvicalyceal volume, dimensions, and volumetric HI values were analyzed using the intraclass correlation coefficient to grade inter-rater reliability.</p><p><strong>Results: </strong>Forty-eight studies from 47 patients were included (65% male; median age 24 months; IQR 61 months). From these, 46 right and 40 left kidneys were chosen based on image quality. Twenty-nine (33.7%) kidneys had no UTD, 10 (11.6%) had UTD P1, 23 (26.7%) had UTD P2, and 24 (27.9%) had UTD P3. Inter-rater reliability was almost perfect across all parameters, with estimates ranging from 0.85 to 0.95. In sub-analysis of kidneys with UTD P2 and UTD P3, volumetric HI had the lowest inter-rater agreement (0.75 and 0.66, respectively).</p><p><strong>Conclusions: </strong>Semi-automated 3D US segmentation for kidneys with UTD can reliably assess renal dimensions, parenchymal and collecting system volumes, and volumetric HI among raters.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"297-304"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847296","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 to talk to parents.","authors":"Antoine Martin-Champetier, Alexia Dabadie","doi":"10.1007/s00247-024-06146-6","DOIUrl":"10.1007/s00247-024-06146-6","url":null,"abstract":"<p><p>Effective communication with the child and his/her parents is of paramount importance in our daily work in paediatric radiology to establish a trusting relationship and enhance satisfaction for both patients and physicians. Although communication skills and empathy can be effectively taught, and efforts have been made in this area in medical schools, there is still much room for improvement, as communication skills tend to decline throughout medical training. Certain methods are valuable for conducting effective consultations with both the child and the parents, not only when breaking bad news. Paying attention to non-verbal cues can improve our understanding of the family's thoughts and enhance our ability to communicate through all channels. Rethinking the general environment of the department and consultation/ultrasound rooms may also promote effective communication. Having basic knowledge of intercultural communication and strategies for communicating with families with low literacy skills can also be beneficial. In paediatric interventional radiology, specific techniques can be used to better explain the procedure and the concept of risk and to address the family's anxiety.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"242-251"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932107","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 accurate is high-resolution computed tomography of the chest in differentiating between pulmonary invasive fungal infections and other pulmonary infections in children with cancer?","authors":"Janine Nijhuis, Geertje P Verduin, Tom F W Wolfs, Tineke T Stolk, Daniela Cianci, Laura G Y Rotte, Caroline A Lindemans, Louis J Bont, Rutger A J Nievelstein","doi":"10.1007/s00247-024-06112-2","DOIUrl":"10.1007/s00247-024-06112-2","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary invasive fungal infections pose a serious risk for immunocompromised patients. Although diagnostic imaging plays an important role in the early detection of pulmonary invasive fungal infections, radiological differentiation between invasive fungal infection and other pulmonary infections is challenging.</p><p><strong>Objective: </strong>The aim of this study was to assess the accuracy of chest high-resolution computed tomography (HRCT) in the differentiation between pulmonary invasive fungal infections and other pulmonary infections in paediatric cancer patients.</p><p><strong>Materials and methods: </strong>In this retrospective study, baseline HRCTs of patients with probable or proven invasive fungal infections and other pulmonary infections were blindly assessed by two radiologists, followed by a consensus reading. The scoring form included imaging characteristics and radiological invasive fungal infection probability assessment. Inter-rater reliability was determined with Cohen's kappa.</p><p><strong>Results: </strong>Chest HRCTs (n = 77) of paediatric cancer patients with pulmonary invasive fungal infections (n = 45) and with other pulmonary infections (n = 32) were evaluated. In the consensus reading, nodules with halo sign and wedge-shaped consolidations were observed significantly more in pulmonary invasive fungal infections than in other pulmonary infections (86.7% vs. 34.4% and 28.9% vs. 9.4%), and ground-glass opacities were observed less frequently (61.4% vs. 87.5%). The kappa values for the individual imaging characteristics ranged from 0.121 to 0.408. Sensitivity of the HRCT to diagnose a pulmonary invasive fungal infection ranged from 0.78 to 0.80, and specificity from 0.66 to 0.88.</p><p><strong>Conclusion: </strong>The accuracy of chest HRCTs in differentiating between invasive fungal infections and other pulmonary infections is poor. There are two main reasons for this: no individual imaging characteristic was found to be able to fully distinguish between invasive fungal infections and other pulmonary infections, and the agreement between radiologists was only moderate.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"268-279"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142838634","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":"Intra- and interobserver agreement in evaluation of image-defined risk factors on computed tomography in pediatric neuroblastoma.","authors":"Yaw Amoako-Tuffour, Ian MacDonald, Tahani Ahmad, Irit Maianski, Ziad Farhat, Afshin Ansari, Mareen Sarah Kraus, Craig Erker, Rodrigo Romao, Rahim Moineddin, Teresa Fortuna, Kathleen O'Brien, Daddy Mata-Mbemba","doi":"10.1007/s00247-024-06138-6","DOIUrl":"10.1007/s00247-024-06138-6","url":null,"abstract":"<p><strong>Background: </strong>Image-defined risk factors (IDRFs) were introduced to provide a consensus approach for pre-treatment risk stratification on computed tomography (CT) and magnetic resonance imaging (MRI) in patients with neuroblastoma.</p><p><strong>Objective: </strong>To assess the intra- and inter-reader agreement of radiologists in identifying IDRFs on CT.</p><p><strong>Materials and methods: </strong>Approval for this retrospective study was granted by our institutional research ethics board with a waiver of consent. CT studies of pediatric patients with neuroblastoma were assessed by seven radiologists in two rounds. Each CT was accompanied by a standard form to indicate presence or absence of IDRFs for each patient. At least a 4-week period between rounds, randomization, and relabeling of the CT studies was required to minimize recall bias. Finally, three of the seven radiologists conducted a subsequent consensus reading to determine true positive IDRFs in the cohort. Fleiss' kappa statistic was used to evaluate readers' agreements and Pearson's correlation assessed the correlation between years of experiences of radiologists and their performance in accurately (intra-reader agreement) detecting IDRFs.</p><p><strong>Results: </strong>A total of 31 children with a median age of 2.1 years (interquartile range (IQR) 1.1, 3.0; range 0-18; male=21 (67.7%)) were included and 251 total positive IDRFs were identified on their CT scans. The location of the primary tumor was in the neck in 1 patient (3.2%), within the chest in 2 patients (6.5%), within the abdomen in 27 patients (87.1%), and in the pelvis in 1 patient (3.2%). In determining IDRFs, the inter-reader agreement among radiologists was substantial: 0.65 (95% CI 0.60, 0.69) and the intra-reader agreement for each radiologist was substantial to near perfect, ranging from 0.67 (0.60, 0.70) to 0.86 (0.82, 0.90). The correlation between the number of years of experience of radiologists and their performances in accurately detecting IDRFs (their intra-reader agreements) was respectively low (r=45, P=0.30) for abdomino-pelvic IDRFs and high for organs' infiltration IDRFs (r=0.74, P=0.05).</p><p><strong>Conclusion: </strong>The determination of IDRFs on CT is reproducible with significant agreement among radiologists. The two IDRF items with the lowest overall inter-reader agreements were \"diaphragm infiltration\" and \"mesenteric infiltration.\"</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"305-311"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915481","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":"Cerebellar hemorrhage in neonates: pattern analysis by ultrasonography and magnetic resonance imaging.","authors":"Gayoung Choi, Young Hun Choi, Seul Bi Lee, Yeon Jin Cho, Seunghyun Lee, Jung-Eun Cheon, Seung Han Shin, Bo-Kyung Je","doi":"10.1007/s00247-024-06126-w","DOIUrl":"10.1007/s00247-024-06126-w","url":null,"abstract":"<p><strong>Background: </strong>Cerebellar hemorrhage in neonates is increasingly being identified but is still underdiagnosed. While magnetic resonance imaging (MRI) is the optimal imaging modality for cerebellar hemorrhage evaluation, ultrasonography (US) is commonly used for screening. Characterizing the patterns and distribution of cerebellar hemorrhage lesions can help facilitate its detection by aiding to focus on prevailing type of cerebellar hemorrhage.</p><p><strong>Objective: </strong>This study aimed to analyze the patterns of cerebellar hemorrhage in neonates, comparing US findings with MRI.</p><p><strong>Materials and methods: </strong>This was a retrospective study of 765 neonatal intensive care unit (NICU)-admitted neonates who underwent brain MRI due to various clinical and radiological requirements. Two pediatric radiologists reviewed brain MRI and US in consensus, and cerebellar hemorrhage patterns were classified based on MRI findings: type 1, punctate cerebellar hemorrhage without cerebellar volume loss; type 2, focal cerebellar hemorrhage with cerebellar volume loss; type 3, ovoid/crescent cerebellar hemorrhage in the periphery of the cerebellar hemisphere; type 4, isolated vermian cerebellar hemorrhage; type 5, cerebellar hemorrhage involving almost the entire cerebellar hemisphere. The distribution and US detection rates of cerebellar hemorrhage were compared according to the cerebellar hemorrhage type.</p><p><strong>Results: </strong>A total of 56 (33 male, 23 female) cases (7.32%) among 765 MRIs showed cerebellar hemorrhage (median gestational age, 27 + 1 weeks [IQR 5 + 2]; median birth weight, 955 g [IQR 882.5]). The most common pattern was type 1 (60.7%). Type 3 cerebellar hemorrhage was more commonly observed in the inferior and peripheral cerebellum compared to types 1 and 2 cerebellar hemorrhage (P=0.002). In retrospective review of images, type 3 was the most commonly missed type of cerebellar hemorrhage (initial US detection rate, 33.3%; retrospective US detection rate, 75%).</p><p><strong>Conclusion: </strong>This study underscores the importance of understanding cerebellar hemorrhage patterns and suggests that careful inspection of inferior and periphery of the cerebellum is important to avoid missed diagnosis of cerebellar hemorrhage.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"324-333"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927589","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":"Huge extrahepatic gallstone on percutaneous transhepatic biliary drainage tip-a pediatric case report.","authors":"Anna-Maria Odenthal, Carsten Meyer, Mark Born, Martin Heimbrodt, Julian Luetkens, Martha Dohna","doi":"10.1007/s00247-024-06156-4","DOIUrl":"10.1007/s00247-024-06156-4","url":null,"abstract":"<p><p>Biliary strictures, which are common in the first year after pediatric liver transplantation, are diagnosed and managed with percutaneous transhepatic cholangiography. In children undergoing percutaneous transhepatic cholangiography, early cholangitis is the most common complication while typical catheter-related complications are obstruction, dislodgement, kinking, or fracture. This case report discusses the unique presentation and management of a 5-year-old girl with an incidental percutaneous transhepatic biliary drainage-associated extrahepatic gallstone formation following treatment of biliary stricture after pediatric liver transplantation. It was effectively treated with percutaneous transhepatic lithotripsy. Although this is a rare but potentially harmful complication, in case of resistance at drainage removal, a drainage-tip stone should be excluded by ultrasound or fluoroscopy.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"347-351"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009437","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":"Response to Letter to Editor.","authors":"Venkatram Krishnan, Arabinda K Choudhary","doi":"10.1007/s00247-024-06161-7","DOIUrl":"10.1007/s00247-024-06161-7","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"369-370"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009439","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: Comparing magnetic resonance enterography and endoscopy findings to the motility of magnetic resonance imaging in pediatric Crohn's disease.","authors":"Sebastian Gallo-Bernal, Valeria Pena-Trujillo, Michael S Gee","doi":"10.1007/s00247-025-06171-z","DOIUrl":"https://doi.org/10.1007/s00247-025-06171-z","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075285","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":"RADHawk-an AI-based knowledge recommender to support precision education, improve reporting productivity, and reduce cognitive load.","authors":"Julian Lopez-Rippe, Manasa Reddy, Maria Camila Velez-Florez, Raisa Amiruddin, Wondwossen Lerebo, Ami Gokli, Michael Francavilla, Janet Reid","doi":"10.1007/s00247-024-06116-y","DOIUrl":"10.1007/s00247-024-06116-y","url":null,"abstract":"<p><strong>Background: </strong>Using artificial intelligence (AI) to augment knowledge is key to establishing precision education in modern radiology training. Our department has developed a novel AI-derived knowledge recommender, the first reported precision education program in radiology, RADHawk (RH), that augments the training of radiology residents and fellows by pushing personalized and relevant educational content in real-time and in context with the case being interpreted.</p><p><strong>Purpose: </strong>To assess the impact on trainees of an AI-based knowledge recommender compared to traditional knowledge sourcing for radiology reporting through reporting time, quality, cognitive load, and learning experiences.</p><p><strong>Materials and methods: </strong>A mixed methods prospective study allocated trainees to intervention and control groups, working with and without access to RH, respectively. Validated questionnaires and observed and graded simulated picture archiving and communication system (PACS)-based reporting at the start and end of a month's rotation assessed technology acceptance, case report quality, case report time and sourcing time, cognitive load, and attitudes toward modified learning strategies. Non-parametric regression analyses and Mann-Whitney tests were used to compare outcomes between groups, with significance set at P<0.05.</p><p><strong>Results: </strong>The intervention group (n=28) demonstrated a statistically significant reduction in the case report time by -162 s per case (95%CI -275.76 s to -52.40 s) (P-value = 0.002) and an increase of 14% (95%CI 8.1-19.8%) (P-value <0.001) in accuracy scores compared to the control group (n=29) at the end of the rotation. The intervention group also showed lower levels of mental demand (P=0.030) and experienced less effort (P=0.030) and frustration (P=0.030) while reporting. Additionally, >78% of the intervention group gave positive ratings on RH's effectiveness, increase in productivity, job usefulness, and ease of use. Eighty-nine percent of participants in the intervention group requested access to RH for their next rotation.</p><p><strong>Conclusion: </strong>This study demonstrates that RH, as the first reported AI-derived knowledge recommender for radiology education, significantly reduces reporting time and improves reporting accuracy while reducing overall workload and mental demand for radiology trainees. The high acceptance among trainees suggests its potential for supporting self-directed learning. Further testing of a larger external cohort will support more widespread implementation of RH for precision education.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"259-267"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792199","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}