Pediatric Radiology最新文献

{"title":"Scanner-based real-time three-dimensional brain + body slice-to-volume reconstruction for T2-weighted 0.55-T low-field fetal magnetic resonance imaging.","authors":"Alena Uus, Sara Neves Silva, Jordina Aviles Verdera, Kelly Payette, Megan Hall, Kathleen Colford, Aysha Luis, Helena Sousa, Zihan Ning, Thomas Roberts, Sarah McElroy, Maria Deprez, Joseph Hajnal, Mary Rutherford, Lisa Story, Jana Hutter","doi":"10.1007/s00247-025-06165-x","DOIUrl":"10.1007/s00247-025-06165-x","url":null,"abstract":"<p><strong>Background: </strong>Motion correction methods based on slice-to-volume registration (SVR) for fetal magnetic resonance imaging (MRI) allow reconstruction of three-dimensional (3-D) isotropic images of the fetal brain and body. However, all existing SVR methods are confined to research settings, which limits clinical integration. Furthermore, there have been no reported SVR solutions for low-field 0.55-T MRI.</p><p><strong>Objective: </strong>Integration of automated SVR motion correction methods directly into fetal MRI scanning process via the Gadgetron framework to enable automated T2-weighted (T2W) 3-D fetal brain and body reconstruction in the low-field 0.55-T MRI scanner within the duration of the scan.</p><p><strong>Materials and methods: </strong>A deep learning fully automated pipeline was developed for T2W 3-D rigid and deformable (D/SVR) reconstruction of the fetal brain and body of 0.55-T T2W datasets. Next, it was integrated into 0.55-T low-field MRI scanner environment via a Gadgetron workflow that enables launching of the reconstruction process directly during scanning in real-time.</p><p><strong>Results: </strong>During prospective testing on 12 cases (22-40 weeks gestational age), the fetal brain and body reconstructions were available on average 6:42 ± 3:13 min after the acquisition of the final stack and could be assessed and archived on the scanner console during the ongoing fetal MRI scan. The output image data quality was rated as good to acceptable for interpretation. The retrospective testing of the pipeline on 83 0.55-T datasets demonstrated stable reconstruction quality for low-field MRI.</p><p><strong>Conclusion: </strong>The proposed pipeline allows scanner-based prospective T2W 3-D motion correction for low-field 0.55-T fetal MRI via direct online integration into the scanner environment.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"556-569"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033945","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":"Time-driven cost analysis of pediatric liver biopsy completed in pediatric sedation clinic and operating room.","authors":"Kylie K Ruprecht, Katryn N Furuya, Jonathan O Swanson, Eric J Monroe","doi":"10.1007/s00247-024-06142-w","DOIUrl":"10.1007/s00247-024-06142-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pediatric ultrasound (US)-guided percutaneous liver biopsy is a commonly performed procedure in children, and may be performed in a variety of clinical settings. However, there is little research on the relative costs associated with different sedation methods and locations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study uses time-driven activity-based costing (TDABC) to identify relevant costs associated with different biopsy sedation techniques and locations to help inform providers and patients as well as guide value-conscious care. This study analyzes the direct costs associated with pediatric liver biopsy performed in an OR versus a dedicated pediatric sedation clinic.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A single-center retrospective review including data from consecutive procedures all completed by one board-certified interventional radiology physician between June 2021 and April 2024 was performed. Exclusion criteria included procedures with lack of timestamps (N = 3), and multiple procedures being completed causing a deviation from the standard pathway process (N = 19). Direct costs were calculated using cost capacity rates (CCR) and TDABC methodology. Propensity score matching between procedures performed in a sedation clinic versus an operating room (OR) was performed adjusting for age, gender, American Society of Anesthesiologists (ASA) status, and inpatient status, and subsequent matches were analyzed via paired t-test in SPSS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 111 procedures performed in the OR (N = 71) or sedation clinic (N = 40) were found and considered for analysis (N = 55 male, N = 56 female; mean age = 9.13, SD = 6.69 years). A technical success rate of 100% and a complication frequency of 5% (N = 3, mean = 13.67, SD = 2.05, all grade 1) were observed. Complication frequency was not statistically significant between the sedation clinic (N = 1) and OR (N = 2) groups (P = 0.28). After propensity matching, N = 58 matched procedures (OR, N = 29; sedation clinic, N = 29) were included. Pre-procedure times in the sedation clinic were shorter in duration (62.11 ± 42.25) than in the OR (111.96 ± 62.11, P &lt; 0.001). Total procedure times were also shorter in duration in the sedation clinic (14.07 ± 4.99) than in the OR (21.76 ± 18.22, P = 0.03). In addition, procedures completed in the OR utilized additional anesthesia staff for an average of 72 min, contributing to overall cost. The average total included costs for matched liver biopsy procedures were $1,089.51 ± 384.34 in the sedation clinic and $2,801.36 ± 1,201.52 in the OR (P &lt; 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Liver biopsies completed in the sedation clinic were associated with significantly lower direct costs and were not associated with higher complication rates. These findings provide evidence for promoting pediatric sedation clinics as a safe and cost-effective location to perform liver biopsies in appropriate patients.","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"570-577"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979288","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":"Abdominopelvic tumors of infancy: a pictorial essay.","authors":"Abubakr O Bajaber, Mody A Almarshad, Ahmed I Aldraihem, Aljoharah A Aljabr","doi":"10.1007/s00247-024-06147-5","DOIUrl":"10.1007/s00247-024-06147-5","url":null,"abstract":"<p><p>Abdominal and pelvic masses in infants present significant challenges for healthcare professionals and can be distressing for parents due to the wide spectrum of both benign and malignant conditions in this age group. This article concentrates on illustrating different types of abdominal and pelvic tumors, both benign and malignant, that occur in infants. It highlights the specific imaging characteristics of these tumors and covers non-neoplastic conditions that may appear similar on imaging. The aim is to aid radiologists in accurately diagnosing these conditions and distinguishing them from other differentials. By combining imaging results with clinical information, healthcare providers can timely identify and manage potentially concerning conditions, ultimately enhancing outcomes and the overall quality of life for affected infants and their families.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"437-458"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965684","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":"Radiation dose proportions of localizer radiograph and bolus tracking in low-dose pediatric cardiothoracic computed tomography.","authors":"Hyun Woo Goo, Seon Young Goo","doi":"10.1007/s00247-025-06163-z","DOIUrl":"10.1007/s00247-025-06163-z","url":null,"abstract":"<p><strong>Background: </strong>Optimization of localizer radiograph and bolus tracking doses is necessary, as their dose proportion may increase with a decreasing diagnostic scan dose in pediatric cardiothoracic computed tomography (CT).</p><p><strong>Objective: </strong>To evaluate the radiation dose proportions of the localizer radiograph and bolus tracking in low-dose pediatric cardiothoracic CT.</p><p><strong>Materials and methods: </strong>For low-dose pediatric cardiothoracic CT, a posteroanterior localizer radiograph was acquired with 80 kV, and 35 mA or 20 mA in 852 infants (age<1 year). Propensity score matching was employed in comparing the 35 mA and 20 mA groups on dose proportion, over z-axis proportion, visibility of anatomic landmarks, and image noise. The over z-axis coverage proportion was correlated with the dose proportion of the localizer radiograph in both groups. Additionally, bolus tracking was performed in 1,015 children (≤2 years). The effects of the number of monitoring scan, dose-length product of the diagnostic scan, age, and water-equivalent area of the scanned patient body on the radiation dose proportion of bolus tracking were evaluated.</p><p><strong>Results: </strong>The dose proportion of the localizer radiograph was significantly lower in the 20 mA group (2.5%, n = 94) than in the 35 mA group (6.5%, n = 94) (P < 0.001). While image noise was higher in the 20 mA group (2.1 Hounsfield units versus 1.0 Hounsfield units of the 35 mA-group, P < 0.001), all the anatomic landmarks remained visible in all cases. The over z-axis coverage proportion demonstrated high correlations with the dose proportion for both groups (R = 0.736, P < 0.001 for the 35 mA group and R = 0.660, P < 0.001 for the 20 mA group). The bolus tracking dose-length product proportion demonstrated the strongest positive correlation with the number of monitoring scans (R = 0.93, P < 0.001), while age, diagnostic scan dose-length product, and water-equivalent area showed weak negative correlations (R-values = -0.46~-0.50, P-values < 0.001).</p><p><strong>Conclusions: </strong>In low-dose pediatric cardiothoracic CT, the dose proportion of the localizer radiograph can be substantially reduced with a low tube current setting while maintaining image quality. Additionally, minimization of the over z-axis coverage proportion merits attention. The number of monitoring scans is the most significant factor for increasing the radiation dose proportion of bolus tracking, especially in young ages.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"466-478"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067060","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":"Mini-symposium \"Daily routine challenges for young paediatric radiologists\".","authors":"Julian H W Jürgens, Rutger A J Nievelstein","doi":"10.1007/s00247-025-06176-8","DOIUrl":"10.1007/s00247-025-06176-8","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"384-385"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067087","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":"Tips for success, managing the paediatric patient in radiology.","authors":"Clare M Simcock, Bella Said, Owen J Arthurs, Ian C Simcock, Catherine M Owens","doi":"10.1007/s00247-024-06029-w","DOIUrl":"10.1007/s00247-024-06029-w","url":null,"abstract":"<p><p>Paediatric radiology is a fascinating and diverse field of medicine with many opportunities to gain expertise in a range of imaging modalities and body areas. Working with children makes imaging both rewarding and challenging, due to the wide range of patient ages encountered and the inherent variation in developmental needs. This requires a patient-focussed approach to manage their anxiety and ensure cooperation of the patient and their carers. Several approaches to dealing with children have been developed including recognising individual needs, empathising with the child and carers, and involving the use of play and a range of age-relevant preparation materials. All of these make the radiology imaging environment and encounter a more effective and collaborative process. The purpose of this manuscript is to present a practical guide to overcoming these challenges, by making the child the focus of their radiological examination.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"411-419"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081225","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":"Hermes.","authors":"","doi":"10.1007/s00247-025-06175-9","DOIUrl":"10.1007/s00247-025-06175-9","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"585-586"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047365","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":"Let's talk about radiation dose and radiation protection in children.","authors":"Claudio Granata, Carmelo Sofia, Mariantonietta Francavilla, Marek Kardos, Joanna Kasznia-Brown, Rutger Aj Nievelstein, Bogdan Stefan Olteanu, Catherine Owens, Sergio Salerno, Erich Sorantin, Ilze Apine","doi":"10.1007/s00247-024-06009-0","DOIUrl":"10.1007/s00247-024-06009-0","url":null,"abstract":"<p><p>Children are more sensitive to ionizing radiation than adults. Even though the risk is very low, exposure from radiological examinations can possibly cause them long-term side effects. Recent large epidemiological studies involving children and young adults have added evidence suggesting that even small doses of radiation, such as those from computed tomography scans, might slightly increase the risk of developing cancer later in life. Therefore, even though radiologic studies are essential for an accurate diagnosis and management of various conditions, it is crucial to minimize radiation exposure. This article addresses radiation protection for children in the medical use of ionizing radiation and it is set in the context of the European legislative framework regarding radiation protection. It advocates for a holistic approach to paediatric radiological tests. This approach includes the key principles of radiation protection, such as the justification of imaging procedures supported by referral guidelines, as well as the optimization of techniques (according to the ALARA principle) and effective communication with parents about the benefits and the risks of radiologic procedures. Protecting children from unnecessary radiation is not only a technical challenge, but also a moral obligation and a legal requirement.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"386-396"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879164","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":"Let us talk about mistakes.","authors":"Erich Sorantin, Michael Georg Grasser, Ariane Hemmelmayr, Sarah Heinze","doi":"10.1007/s00247-024-06034-z","DOIUrl":"10.1007/s00247-024-06034-z","url":null,"abstract":"<p><p>Unfortunately, errors and mistakes are part of life. Errors and mistakes can harm patients and incur unplanned costs. Errors may arise from various sources, which may be classified as systematic, latent, or active. Intrinsic and extrinsic factors also contribute to incorrect decisions. In addition to cognitive biases, our personality, socialization, personal chronobiology, and way of thinking (heuristic versus analytical) are influencing factors. Factors such as overload from private situations, long commuting times, and the complex environment of information technology must also be considered. The objective of this paper is to define and classify errors and mistakes in radiology, to discuss the influencing factors, and to present strategies for prevention. Hierarchical responsibilities and team \"well-being\" are also discussed.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"420-428"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110584","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":"Comparison of the natural course of clinical and radiologic features in 13 patients with TRPV4-related skeletal dysplasias.","authors":"Nilay Güneş, Dilek Uludağ Alkaya, Sebuh Kurugoğlu, Nuri Özyalvaç, Ayşegül Bursalı, Nursel H Elçioğlu, Beyhan Tüysüz","doi":"10.1007/s00247-024-06145-7","DOIUrl":"10.1007/s00247-024-06145-7","url":null,"abstract":"<p><strong>Background: </strong>Heterozygous TRPV4 mutations cause a group of skeletal dysplasias characterized by short stature, short trunk, and skeletal deformities.</p><p><strong>Objective: </strong>The aim of this study is to compare the natural history of clinical and radiologic features of patients with different TRPV4-related skeletal dysplasias.</p><p><strong>Materials and methods: </strong>Thirteen patients with a mutation in TRPV4 were included in the study, and 11 were followed for a median of 6.5 years. The clinical phenotype of five patients was compatible with spondylometaphyseal dysplasia Kozlowski type, three each with metatropic dysplasia and brachyolmia type 3, and one each with spondyloepiphyseal dysplasia Maroteaux type and congenital distal spinal muscular atrophy.</p><p><strong>Results: </strong>Short stature and bone pain when running, walking, and climbing stairs occurred in patients with spondylometaphyseal dysplasia Kozlowski type and metatropic dysplasia from the age of 5 years and worsened with increasing age. Kyphosis was more pronounced with increasing age in these two groups of patients, while severe scoliosis occurred in brachyolmia type 3. In the radiographs of patients with spondylometaphyseal dysplasia Kozlowski type and metatropic dysplasia, severe platyspondyly persisted into adulthood or puberty. The patients with spondylometaphyseal dysplasia Kozlowski type exhibited irregular proximal femora leading to destruction of the femoral head towards the end of puberty, whereas metatropic dysplasia showed marked irregularity and widening of the femoral neck. We also observed that metaphyseal dysplasia in long bones other than the proximal femur was so inconspicuous that it could be ignored in patients with spondylometaphyseal dysplasia Kozlowski type.</p><p><strong>Conclusion: </strong>Comparison of radiologic features that change with age in five different TRPV4-related skeletal dysplasias will be of great benefit in the management of this patient group.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"505-519"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009433","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}