Pediatric Radiology最新文献

{"title":"Image-guided ablation for pediatric malignant solid tumors: a review of modalities, evidence, and clinical applications.","authors":"Kumar Shashi, Jeremiah Sabado, Rush Chewning, Mohamed Shahin, Raja Shaikh","doi":"10.1007/s00247-026-06781-1","DOIUrl":"https://doi.org/10.1007/s00247-026-06781-1","url":null,"abstract":"<p><p>Image-guided percutaneous ablation has evolved into an increasingly utilized approach in selected pediatric oncologic indications. The evidence base remains thinner than clinical adoption would suggest. Most published series are small, retrospective, and limited to single institutional experiences. This review synthesizes evidence from 1995 through early 2025 on radiofrequency ablation (RFA), cryoablation, microwave ablation (MWA), irreversible electroporation (IRE), and electrochemotherapy across malignant solid tumors in patients aged 18 years or younger. Hepatoblastoma has shown the steepest rising incidence among ablation-relevant solid tumors with an annual percent change of +2.17%. Five-year survival for bone tumors and soft tissue sarcomas remains near 60%. For malignant solid tumors, the evidence remains limited to small retrospective series with heterogeneous populations and short follow-up, precluding conclusions about survival benefit. Surgical resection and systemic chemotherapy remain the primary treatment for all malignant solid tumors discussed; ablation is reserved for relapsed, refractory, or surgically limited scenarios. A coordinated multicenter registry with standardized survival endpoints remains the most urgent unmet need in the field.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930400","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":"Empowering leaders, empowering teams: fostering wellness through leadership.","authors":"Rama Ayyala","doi":"10.1007/s00247-026-06774-0","DOIUrl":"https://doi.org/10.1007/s00247-026-06774-0","url":null,"abstract":"<p><p>Pediatric radiology is deeply meaningful work, yet increasing workplace stress and burnout threaten workforce engagement, retention, and the delivery of high-quality patient care. Historically, many wellness initiatives have focused on individual-level interventions, such as resilience training and mindfulness, while inadequately addressing the organizational and operational factors that contribute to employee distress. Growing evidence suggests that burnout is driven less by deficiencies in individual resilience than by chronic workplace stressors, including excessive workload, inefficient workflows, staffing shortages, communication challenges, and organizational culture. As a result, leadership has emerged as a critical determinant of workforce well-being. In this commentary, a framework is proposed for wellness-centered leadership in pediatric radiology that reframes leadership itself as a primary wellness intervention. The framework is built upon three foundational pillars: caring about people by fostering psychological safety and trust; cultivating relationships through inclusive leadership, meaningful work, and community; and inspiring change by addressing operational barriers that create unnecessary workplace distress. Employee experience should be measured-including professional fulfillment, psychological safety, workplace inclusion, and retention risk-with the same rigor applied to traditional departmental metrics such as quality, access, productivity, and patient experience. Improving workforce well-being requires moving beyond performative wellness initiatives toward leadership strategies that intentionally shape organizational culture and the daily work environment. By creating psychologically safe, collaborative, and operationally effective workplaces, pediatric radiology leaders can promote professional fulfillment, strengthen workforce sustainability, and ultimately improve the care delivered to children and families.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930465","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/s00247-026-06779-9","DOIUrl":"https://doi.org/10.1007/s00247-026-06779-9","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930486","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 we do it: functional magnetic resonance urography in congenital anomalies of the kidney and urinary tract.","authors":"Lorenzo Anfigeno, Luca Basso, Giulia Gnocchi, Luca Barbieri, Edoardo Minetti, Beatrice Olivi, Enrico Verrina, Girolamo Mattioli, Maria Beatrice Damasio","doi":"10.1007/s00247-026-06745-5","DOIUrl":"https://doi.org/10.1007/s00247-026-06745-5","url":null,"abstract":"<p><p>Congenital anomalies of the kidney and urinary tract (CAKUT) are among the leading causes of chronic kidney disease in children. Early and accurate evaluation is essential to preserve nephron mass and guide appropriate management. Ultrasound represents the first-line imaging modality and acts as the gatekeeper for further diagnostic investigations, while vesicoureteral reflux should be evaluated with voiding cystourethrography or contrast-enhanced voiding urosonography. Functional magnetic resonance urography (functional MRU) is an advanced, non-ionizing \"one-stop-shop\" imaging technique that combines detailed anatomical assessment with quantitative functional evaluation. By using dynamic contrast-enhanced sequences and dedicated post-processing software, functional MRU enables comprehensive assessment of renal morphology, differential renal function, urinary drainage, excretory patterns, and urinary flow. Compared with renal scintigraphy, which has traditionally been used to evaluate split renal function and urinary drainage, functional MRU offers superior anatomical detail without exposing children to ionizing radiation. In pediatric practice, functional MRU has shown particular value in the assessment of CAKUT, especially in children with complex or bilateral anomalies, supporting surgical planning, treatment selection, and postoperative follow-up. Its ability to provide detailed functional characterization and longitudinal monitoring makes functional MRU a promising tool for personalized management. This review provides a practical guide for radiologists on the clinical applications of functional MRU in CAKUT evaluation.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930447","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":"Reproducibility and validity failures in systematic review deduplication tools: evaluation on a paediatric neuroradiology corpus.","authors":"Lakshmi Vennela Chowdary Kaza, Pallavi S R, Rayya Naffa', Shyamu Patel, Sivakumar Manickam","doi":"10.1007/s00247-026-06775-z","DOIUrl":"https://doi.org/10.1007/s00247-026-06775-z","url":null,"abstract":"<p><strong>Background: </strong>Deduplication is usually treated as a routine preprocessing step in systematic reviews, yet errors introduced at this stage are not visible in Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) flow diagrams and can propagate through evidence synthesis.</p><p><strong>Objective: </strong>To evaluate the validity and reproducibility of commonly used deduplication tools in a paediatric neuroradiology systematic review.</p><p><strong>Materials and methods: </strong>PubMed and Embase were searched for peer-reviewed literature on paediatric subacute sclerosing panencephalitis neuroimaging, yielding 603 records. Two reviewers independently deduplicated the combined corpus using Zotero (version 8.0.4) and Rayyan (updated 21 January 2026). A manual reference standard was established by dual-reviewer adjudication of potential duplicate pairs using title, publication year, author list, and Digital Object Identifier (DOI). Tool outputs were compared against this reference standard for false-positive and false-negative decisions and for reproducibility across runs.</p><p><strong>Results: </strong>Manual adjudication identified 120 true duplicate records, leaving 483 unique records. Zotero produced identical outputs across reviewers, indicating deterministic behaviour, but generated 16 false-positive duplicate decisions and 5 false negatives, predominantly related to DOI collision. Rayyan identified more true duplicates but produced non-identical outputs across independent runs, with 16-17 false positives and 1 false negative per run.</p><p><strong>Conclusion: </strong>Commonly used deduplication tools can introduce either deterministic bias or non-deterministic record loss before screening begins. In paediatric radiology evidence synthesis, the deduplication software version and verification strategy should be explicitly reported. Auditable secondary checks should be considered before records are removed.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930673","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":"Rapidly involuting congenital hemangioma of the suprasellar region.","authors":"Noman Khan, Rafaela Minguetti, Alexandra J Borst, Kimberly M Hamilton, Carolina V Guimaraes","doi":"10.1007/s00247-026-06780-2","DOIUrl":"https://doi.org/10.1007/s00247-026-06780-2","url":null,"abstract":"<p><p>Hemangiomas are the most common vascular tumors of infancy, broadly classified into infantile and congenital types. Congenital hemangiomas are fully formed at birth and are further classified into rapidly involuting congenital hemangiomas (RICH), non-involuting congenital hemangiomas (NICH), and partially involuting congenital hemangiomas (PICH). Congenital hemangiomas are common around the head and periarticular extremities. We report a rare case of a rapidly involuting congenital hemangioma in the suprasellar region with prenatal and postnatal imaging. The lesion was first detected on prenatal ultrasound and fetal MRI and was followed up with postnatal ultrasound and MRI, demonstrating rapid interval regression. Clinical course and imaging features of the lesion are described.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920627","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":"Associations between protocol-related operational factors, MRI duration, and propofol exposure in pediatric MRI.","authors":"Sergio Valencia, Suely Fazio Ferracioli, John H Nichols, Camilo Jaimes, Michael S Gee","doi":"10.1007/s00247-026-06766-0","DOIUrl":"https://doi.org/10.1007/s00247-026-06766-0","url":null,"abstract":"<p><strong>Background: </strong>Pediatric MRI frequently requires propofol anesthesia to obtain motion-free diagnostic images. Operational imaging factors may influence examination duration and anesthetic exposure, but these relationships remain incompletely characterized.</p><p><strong>Objective: </strong>To evaluate associations between operational protocol-related operational factors, MRI duration, and propofol exposure during pediatric MRI.</p><p><strong>Materials and methods: </strong>This retrospective study included 2,149 pediatric MRI examinations performed under propofol anesthesia between January 2020 and May 2025. Operational imaging variables included scanner field strength (3 T vs 1.5 T), contrast-enhanced MRI, and protocol type (multi-region vs single-region). Multivariable log-linear regression models evaluated associations between operational imaging factors and MRI duration. Multivariable linear regression models assessed associations between MRI duration and total propofol exposure (mg/kg).</p><p><strong>Results: </strong>Among 2,149 pediatric MRI examinations (median age 5 years [IQR 2-8]; 1,299/2,149 [60.4%] female), multi-region MRI protocols and contrast-enhanced examinations were associated with longer MRI duration, increasing examination time by 45.4% (95% CI, 40.2-50.7%; p<0.001) and 18.6% (95% CI, 14.8-22.6%; p<0.001), respectively. Imaging at 3 T was associated with a 3.9% reduction in MRI duration compared with 1.5 T (95% CI, -6.8% to -0.9%; p=0.011). Each additional 10 min of MRI duration was associated with a 0.71 mg/kg increase in propofol exposure (95% CI, 0.59-0.84; p<0.001). Adjustment for MRI duration attenuated the associations between protocol-related operational factors and propofol exposure.</p><p><strong>Conclusion: </strong>Protocol-related operational factors significantly influenced MRI duration, which was strongly associated with propofol exposure during pediatric MRI. MRI efficiency may represent a modifiable contributor to anesthetic burden in pediatric imaging.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912747","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 Surve K.","authors":"Tjaš Žvar, Peter Slak, Domen Plut","doi":"10.1007/s00247-026-06776-y","DOIUrl":"https://doi.org/10.1007/s00247-026-06776-y","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912791","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":"Summation of ossification ratios of the distal radius, distal ulna, and proximal radius: a novel parameter for pediatric bone age assessment.","authors":"Fanlun Zeng, Xiantao Shen, Xia Xiao, Xing Wu","doi":"10.1007/s00247-026-06772-2","DOIUrl":"https://doi.org/10.1007/s00247-026-06772-2","url":null,"abstract":"<p><strong>Background: </strong>The Greulich-Pyle atlas is generally used in clinical practice; however, it involves radiation exposure. Our aim was to clarify the correlation between ultrasonic ossification ratios (ORs) and radiographic bone age, and to develop a repeatable ultrasonic parameter for assessing bone age.</p><p><strong>Objective: </strong>To determine the correlation between ultrasonic ORs and radiographic bone age, and to test the hypothesis that a summed ultrasonic ossification parameter provides a highly correlated, reproducible, radiation‑free method for pediatric bone age assessment.</p><p><strong>Materials and methods: </strong>Ultrasonic imaging was performed on seven ossification centers and epiphyses in 144 consecutive patients aged 0.1-18.0 years. The ORs were measured and compared with the radiological bone age. The correlation between ultrasonic ORs and bone age assessed by the Greulich-Pyle atlas was analyzed by the Pearson correlation coefficient. The intra-observer and inter-observer reliability were evaluated using the intraclass correlation coefficient (ICC).</p><p><strong>Results: </strong>The sum of the ORs of the distal radius, distal ulna, and proximal radius was highly correlated with radiographic bone age (boys: r=0.98; girls: r=0.97). Adding the ORs of other bones did not increase the value of Pearson's r, while summing the ORs of all assessed bones slightly reduced it (boys: r=0.97; girls: r=0.96). The reliability of the sum of the ORs of the radius, ulna, and femur and the sum of the ORs of the distal radius, distal ulna, and proximal radius was identical (intra-observer ICC=0.99 [95% confidence interval (CI) 0.98, 0.99], P<0.001; inter-observer ICC=0.99 [95% CI 0.97, 0.99] for the former and 0.99 [95% CI 0.98, 0.99] for the latter, both P<0.001), which was significantly higher than that of single sonographic parameters.</p><p><strong>Conclusion: </strong>The sum of the ORs of the distal radius, distal ulna, and proximal radius is an easy-to-operate, efficient, radiation-free, and operator-friendly bone-age indicator with a high correlation to skeletal age and excellent reproducibility. It serves as a practical alternative for pediatric screening and developmental staging.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906688","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":"Automated fetal magnetic resonance imaging lung segmentation for rapid lung volume estimation across diverse pulmonary hypoplasia phenotypes.","authors":"Jungwhan John Choi, Shruti Hegde, Jonathan Dudley, Laura A Galganski, Beth M Kline-Fath, Elanchezhian Somasundaram, Jonathan R Dillman","doi":"10.1007/s00247-026-06765-1","DOIUrl":"https://doi.org/10.1007/s00247-026-06765-1","url":null,"abstract":"<p><strong>Background: </strong>Fetal magnetic resonance imaging (MRI)-derived lung volume measurements are used for prenatal risk stratification in conditions associated with pulmonary hypoplasia, but manual segmentation is time-intensive.</p><p><strong>Objective: </strong>To evaluate whether automated fetal MRI lung segmentation enables rapid and reliable volumetric assessment across diverse pulmonary hypoplasia phenotypes.</p><p><strong>Materials and methods: </strong>In this retrospective study, fetal MRI examinations performed from 2016 to 2025 with expert-adjudicated lung segmentations obtained during clinical care were used for model development and testing. Automated segmentation pipelines were developed for total lung volume (TLV) and percent predicted lung volume (PPLV). Performance was assessed using Dice similarity coefficient (DSC), absolute percentage error (APE), Bland-Altman analysis, intraclass correlation coefficient (ICC), case-level risk-category agreement, and inference time. Lowest-performing TLV outputs were adjudicated by a fetal radiologist to simulate a human-in-the-loop workflow.</p><p><strong>Results: </strong>The final dataset included 906 fetal MRI examinations with complete and recoverable lung segmentations, acquired at a mean gestational age of 27.1 weeks, range 16-38 weeks. Automated TLV estimation showed excellent agreement with manual volumetry (ICC, 0.955; mean DSC, 0.81±0.10; median APE 11.1%). Automated PPLV estimation showed lower performance (ICC, 0.727; mean DSC, 0.76±0.12; median APE 14.5%). Mean inference time was 4 s per examination. Correction of the 25 lowest-performing TLV outputs required 3.1 min per case.</p><p><strong>Conclusion: </strong>Automated fetal MRI lung segmentation enables rapid TLV estimation across diverse pulmonary hypoplasia phenotypes and may improve clinical workflow efficiency while preserving expert oversight for challenging cases.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897686","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}