Children-Basel最新文献

{"title":"Video-Assisted Thoracoscopic Surgery Versus Tube Thoracostomy with Fibrinolytics for Treatment of Empyema in Children: A Meta-Analysis of Randomized Controlled Studies.","authors":"Maria Enrica Miscia, Giuseppe Lauriti, Dacia Di Renzo, Valentina Cascini, Gabriele Lisi","doi":"10.3390/children12091225","DOIUrl":"10.3390/children12091225","url":null,"abstract":"<p><p><b>Background</b>: The British Thoracic Society recommended tube thoracostomy plus intra-pleural fibrinolytics to treat empyema in children in 2005. However, numerous comparative studies have suggested Video-Assisted Thoracoscopic Surgery (VATS) as a first line of treatment for pediatric empyema due to its superior outcomes, including shorter length of hospital stay (LOS). This meta-analysis aimed to compare the following: (1) the LOS for VATS versus fibrinolytics to treat empyema in children; (2) secondary post-operative outcomes (fever, O₂ support, time taken for chest tube removal, analgesia, complications, failure, and abnormal chest X-ray at follow-up). <b>Methods</b>: The study was conducted according to PRISMA guidelines. A systematic search of PubMed, Cochrane, Web of Science, and Scopus was conducted according to PRISMA guidelines. Two independent investigators identified relevant studies, excluding case reports, opinion articles, and gray literature publications. A meta-analysis of randomized controlled trials (RCTs) was performed using RevMan 5.4, with data expressed as mean ± standard deviation (SD). <b>Results</b>: Of 1374 abstracts screened, 104 full-text articles were analyzed, and 6 RCTs (345 patients) were included in the meta-analysis. Patients undergoing VATS had significantly shorter LOS compared to those receiving fibrinolytics (9.1 ± 1.8 vs. 11.5 ± 2.5 days, <i>p</i> = 0.05). VATS patients also experienced shorter postoperative fever duration (4.2 ± 0.8 vs. 6.9 ± 4.6 days, <i>p</i> = 0.007) and earlier chest tube removal (5.0 ± 2.6 vs. 9.5 ± 3.3 days, <i>p</i> = 0.01). No significant differences were found between the two groups for other secondary outcomes. <b>Conclusions</b>: Children with empyema appear to benefit from VATS compared to tube thoracostomy plus fibrinolytics, with improved outcomes. Further RCTs are needed to corroborate these results.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145178956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bluish-Green Coloration of the Nipples: A Diagnostic Clue for Retroareolar Cysts.","authors":"Tea Curic, Francesco Bellinato, Paolo Gisondi, Giampiero Girolomoni","doi":"10.3390/children12091224","DOIUrl":"10.3390/children12091224","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Bluish-green discoloration of the nipples in pubertal girls often poses a diagnostic dilemma. <b>Methods:</b> We describe the case of an 11-year-old girl who developed bilateral and symmetrical bluish-green macules in the retroareolar area over eight months. Dermoscopic and ultrasound examinations revealed benign retroareolar cysts, with no signs of malignancy or other alarming features. Differential diagnoses such as vascular malformations, hemangiomas, hematomas, and blue nevi were carefully considered and excluded based on clinical and imaging findings. <b>Results:</b> A diagnosis of bilateral retroareolar cysts was established. The patient underwent conservative management, and ultrasound follow-ups over one year showed no changes. <b>Conclusions:</b> This case underscores the importance of thorough evaluation to avoid unnecessary invasive procedures and to protect the delicate development of the pubertal breast.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Media Engagement and Usage Patterns, Mental Health Comorbidities, and Empathic Measures in an Italian Adolescent Sample: A Comparative Study.","authors":"Ilaria Accorinti, Giulia Mutti, Pamela Fantozzi, Annarita Milone, Gianluca Sesso, Greta Tolomei, Elena Valente, Antonio Narzisi, Edoardo Martinelli, Maria Rosaria Cordella, Gabriele Masi, Stefano Berloffa","doi":"10.3390/children12091226","DOIUrl":"10.3390/children12091226","url":null,"abstract":"<p><strong>Background: </strong>The link between problematic social media (SM) use and socio-emotional deficits has limited clinical evidence. This study compares SM addiction risk and empathic abilities between psychiatric outpatients and healthy peers, exploring how SM categories and/or diagnostic category may modulate these relations.</p><p><strong>Methods: </strong>A total of 362 Italian adolescents (11-18 years; 147 cases, 215 controls) completed the Social-Media Disorder Scale (SOMEDIS), Bergen Social-Media Addiction Scale (BSMAS), Interpersonal Reactivity Index (IRI), and Reading the Mind in the Eyes test (RME). Self-reported daily online time and most used social media platforms were recorded.</p><p><strong>Results: </strong>Clinical participants showed higher mean SOMEDIS (M = 18.37) and BSMAS scores (M = 11.71) compared with controls (both <i>p</i> < 0.001). Females reported longer daily SM use (χ² = 5.4, <i>p</i> = 0.020). Positive associations were observed between SM addiction risk and age. Within the clinical group, adolescents with emotional dysregulation displayed higher problematic use scores; a modest correlation emerged with internalizing symptoms (withdrawn-depression). Regarding empathy, higher SM addiction risk correlated with lower cognitive empathy (IRI Perspective Taking, Fantasy) and higher Personal Distress. Platform type showed small differences: users of \"Profiling\" platforms reported lower empathy scores compared to \"Entertainment\" users.</p><p><strong>Conclusions: </strong>Adolescents with psychiatric conditions appear more vulnerable to problematic SM use and reduced empathic abilities. Associations were modest, and platform effects were limited. These findings should be considered exploratory; larger longitudinal studies are needed to clarify causal pathways between SM use, empathy, and adolescent mental health.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Breastfeeding Small for Gestational Age Neonates Promote a Healthier Growth Pattern? A Narrative Review.","authors":"Natalia Atzemoglou, Nikolaos P Tzavellas, Niki Dermitzaki, Maria Baltogianni, Foteini Balomenou, Anastasios Serbis, Vasileios Giapros","doi":"10.3390/children12091227","DOIUrl":"10.3390/children12091227","url":null,"abstract":"<p><p><b>Background</b>: Small for gestational age neonates represent a population at risk of growth failure or deviant growth patterns and long-term metabolic complications. Breastfeeding has been identified as a critical factor in promoting healthier growth and long-term metabolic health in both full-term and preterm appropriate for gestational age infants, but similar studies in small for gestational age infants are limited. The aim of this narrative review is to assess the impact of breastfeeding on growth and body composition in small for gestational age neonates. <b>Methods</b>: The PubMed and Google Scholar databases were screened for the relevant literature. The following terms, were used: \"low birth weight\", \"in utero growth restriction\", \"small for gestational age\", \"human milk\", and \"growth\". The initial screening identified 57 relevant studies. Thirteen of them fulfilled the eligibility criteria and were included in this narrative review. <b>Results</b>: In preterm small for gestational age neonates, human milk nutrition was associated with healthier catch-up growth without excessive fat accumulation. Fortification strategies were associated with enhanced growth outcomes without increased incidence of neonatal morbidities. In the context of full-term, small for gestational age neonates, exclusive breastfeeding has been demonstrated to be associated with healthy catch-up growth. Furthermore, human milk nutrition has been shown to mitigate the predisposition of these children to obesity and cardiometabolic complications. <b>Conclusions</b>: According to the limited extant literature, human milk feeding has been identified as a potentially protective factor for small for gestational age neonates, promoting healthier growth patterns and long-term cardiometabolic health. However, larger prospective studies are needed to evaluate human milk feeding and human milk fortification in association with growth and long-term outcomes in small for gestational age infants.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Learning for Heart Sound Abnormality of Infants: Proof-of-Concept Study of 1D and 2D Representations.","authors":"Eashita Wazed, Jimin Lee, Hieyong Jeong","doi":"10.3390/children12091221","DOIUrl":"10.3390/children12091221","url":null,"abstract":"<p><p><b>Introduction:</b> Advanced identification and intervention for Congenital Heart Defects (CHDs) in pediatric populations are crucial, as approximately 1% of neonates worldwide present with these conditions. Traditional methods of diagnosing CHDs often rely on stethoscope auscultation, which heavily depends on the clinician's expertise and may lead to the oversight of subtle acoustic indicators. <b>Objectives:</b> This study introduces an innovative deep-learning framework designed for the early diagnosis of congenital heart disease. It utilizes time-series data obtained from cardiac auditory signals captured through stethoscopes. <b>Methods:</b> The audio signals were processed into time-frequency representations using Mel-Frequency Cepstral Coefficients (MFCCs). The architecture of the model combines Convolutional Neural Networks (CNNs) for effective feature extraction with Long Short-Term Memory (LSTM) networks to accurately model temporal dependencies. Impressively, the model achieved an accuracy of 98.91% in the early detection of CHDs. <b>Results:</b> While traditional diagnostic tools like Electrocardiograms (ECG) and Phonocardiograms (PCG) remain indispensable for confirming diagnoses, many AI studies have primarily targeted ECG and PCG datasets. This approach emphasizes the potential of cardiac acoustics for the early diagnosis of CHDs, which could lead to improved clinical outcomes for infants. Notably, the dataset used in this research is publicly available, enabling wider application and model training within the research community.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of Clinical Signs in the Diagnosis of Testicular Torsion in Pediatric Age: Optimization of Timing in a Time-Sensitive Pathology.","authors":"Fabiola Cassaro, Salvatore Arena, Roberta Bonfiglio, Angela Alibrandi, Santi D'Antoni, Carmelo Romeo, Pietro Impellizzeri","doi":"10.3390/children12091220","DOIUrl":"10.3390/children12091220","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Acute scrotal pain in children and adolescents requires prompt evaluation to differentiate testicular torsion from other scrotal pathologies. Testicular torsion, a surgical emergency, can lead to irreversible testicular damage if not managed rapidly. This study aims to assess the clinical signs, diagnostic tools, and outcomes related to testicular torsion in patients presenting with acute scrotal pain. <b>Methods</b>: A retrospective analysis was conducted on 111 patients diagnosed with acute scrotal conditions. Clinical signs, presentation times, ultrasound findings, and treatment outcomes (surgical intervention, orchiectomy, or medical management) were evaluated. The statistical analysis was performed with a <i>p</i>-value < 0.05 being considered significant. Correlations between clinical signs, diagnostic imaging, and treatment modalities were assessed. <b>Results</b>: The most prevalent clinical signs were scrotal swelling (92.2%), pain on palpation (93.5%), and scrotal hyperemia (84.4%). Testicular torsion was strongly associated with the absence of the cremasteric reflex (<i>p</i> < 0.0001) and testicular retraction (<i>p</i> < 0.0001). Ultrasound findings, including absent blood flow and testicular heterogeneity, were highly predictive of surgical intervention (<i>p</i> < 0.01). Patients presenting within 8 h of symptom onset had higher success rates of detorsion and testicular preservation. <b>Conclusions</b>: Timely and accurate clinical assessment, including the identification of key signs such as the absence of the cremasteric reflex and testicular retraction, is critical for differentiating testicular torsion from other conditions. Ultrasound findings are pivotal in guiding treatment decisions in cases of clinical uncertainty. Early intervention significantly improves testicular viability and outcomes, underscoring the importance of rapid diagnosis and management.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145178919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Vagus Nerve Stimulation Parameters in Pediatric Drug-Resistant Epilepsy: A Retrospective Two-Center Study.","authors":"Müge Baykan, Özge Baykan Çopuroğlu, Elif Didinmez Taşkırdı, Pınar Gençpınar, Nihal Olgaç Dündar","doi":"10.3390/children12091222","DOIUrl":"10.3390/children12091222","url":null,"abstract":"<p><strong>Objectives: </strong>Drug-resistant epilepsy (DRE) remains a major challenge in pediatric neurology, as many children fail to achieve seizure control despite appropriate medications. Vagus nerve stimulation (VNS) offers an effective adjunctive treatment; however, optimal stimulation parameters for children are not well defined and are often extrapolated from adult protocols. This retrospective two-center cohort study aimed to evaluate the clinical effectiveness of VNS in pediatric DRE and to determine stimulation thresholds-particularly output current and duty cycle-most strongly associated with seizure reduction.</p><p><strong>Methods: </strong>Fifty-two pediatric patients (aged 0-18 years) with DRE who underwent VNS implantation and were followed for at least 12 months were retrospectively analyzed. Stimulation frequency and pulse width were fixed at 30 Hz and 250 µs, while output current and duty cycle were titrated based on clinical response. Seizure outcomes were derived from caregiver-maintained seizure diaries and confirmed during structured follow-up visits. Treatment response was defined as a ≥50% reduction in seizure frequency compared to baseline.</p><p><strong>Results: </strong>At 12 months post-implantation, 76.9% of patients achieved ≥ 50% seizure reduction, 32.7% experienced ≥ 90% reduction, and 11.5% attained complete seizure freedom. Optimal outcomes were associated with output currents of approximately 1.5 mA and duty cycles of 10%.</p><p><strong>Conclusions: </strong>VNS is a highly effective and well-tolerated treatment for pediatric DRE. Stabilization at an output current of 1.5 mA and a 10% duty cycle may serve as a clinically useful programming target. These findings support the use of individualized, age-specific stimulation strategies to optimize outcomes in pediatric VNS therapy.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Identification and Management of Refeeding Syndrome in Inpatient Severely Acutely Malnourished Children Aged 6 to 59 Months in Sub-Saharan African Countries: A Systematic Review and Meta-Analysis.","authors":"Tshegofatso Mogase, Annette Van Onselen, Nidia Rodriguez-Sanchez, Stuart D R Galloway","doi":"10.3390/children12091223","DOIUrl":"10.3390/children12091223","url":null,"abstract":"<p><p><b>Background:</b> Refeeding syndrome is a potentially fatal complication that occurs in inpatient, severely acutely malnourished children during the early phase of nutritional management. Its early identification and management are critical to preventing adverse outcomes. Addressing refeeding syndrome in inpatient settings is critical in Sub-Saharan Africa, where severe acute malnutrition is common and under-researched. <b>Objective:</b> To systematically review and meta-analyse current evidence on the identification and management of refeeding syndrome in hospitalised severely malnourished children (6 to 59 months) in Sub-Saharan Africa. <b>Methods</b>: A comprehensive search was conducted across academic databases such as PubMed and the Cochrane Library, from 2010 to 2024. Articles reporting on the identification and management of refeeding syndrome in inpatient children with severe acute malnutrition in Sub-Saharan Africa were included. Data extractions were performed by two reviewers using Rayyan software. A meta-analysis of proportions was conducted using STATA 19. <b>Results</b>: Nine studies were included. The identification and management of refeeding syndrome were impacted by the lack of a standardised definition. Significant heterogeneity (Q = 27.17, <i>p</i> < 0.001) was observed, indicating a significant variation in the prevalence rates ranging from 8.7% to 34.8%. Management strategies varied; most studies adhered to World Health Organisation guidelines for severe acute malnutrition but lacked specific protocols for refeeding syndrome. <b>Conclusions</b>: Evidence highlights the need for standardised, evidence-based and context-specific protocols for refeeding syndrome in children with severe acute malnutrition. Early screening, electrolyte monitoring, and cautious feeding remain important, although current evidence is of low certainty. Future prospective studies are needed to develop effective management strategies.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Executive Functions and Child Psychopathology: Contextual Differences and Predictors for Detection and Psychoeducational Intervention.","authors":"Juan Manuel Núñez, Ana Soto-Rubio, Marián Pérez-Marín","doi":"10.3390/children12091217","DOIUrl":"10.3390/children12091217","url":null,"abstract":"<p><strong>Background/objectives: </strong>Executive functions (EFs) play a fundamental role in children's cognitive and emotional regulation and have been identified as key transdiagnostic predictors of psychopathology. Children with Special Educational Needs (SENs) are particularly vulnerable to difficulties with EFs and emotional-behavioural adjustment. This study aimed to examine the differences in the psychopathological symptoms between pupils with and without SENs and to explore the predictive ability of dimensions of EFs for psychopathology detection in both school and family contexts.</p><p><strong>Methods: </strong>A total of 123 primary school children (aged 6-12 years) participated in the study. Their psychopathology was assessed using the SPECI questionnaire completed by their teachers, while their EFs were measured using the BRIEF-2 from school and family perspectives. The analyses included mean difference tests and a backward stepwise multiple regression using the predictors that showed significant Pearson's correlations with the psychopathological dimensions.</p><p><strong>Results: </strong>The students with SENs showed significantly higher levels of psychopathological symptoms, particularly in their attention, anxiety, and clinical global scores. The regression models revealed that several dimensions of EFs, such as inhibition, planning, task monitoring, and cognitive regulation, significantly predicted internalising, externalising, and total symptoms. The school-based models demonstrated greater explanatory power compared to the family-based models, suggesting that school contexts may be more sensitive for detecting EF-related difficulties.</p><p><strong>Conclusions: </strong>The results underline the transdiagnostic relevance of EFs in child psychopathology and support their integration into early detection and intervention strategies, especially in educational contexts. Strengthening the assessment of EFs in schools could contribute to a more accurate identification of at-risk pupils and inform targeted support for children with SENs.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unique Bone Marrow Findings of FDG-PET/CT in Acute Leukemia in Children: Comparison to Inflammatory Diseases.","authors":"Yuta Suenaga, Kazuo Kubota, Motohiro Matsui, Atsushi Makimoto, Junko Yamanaka, Shinji Mochizuki, Masatoshi Hotta, Miyako Morooka Chikanishi, Hiroyuki Shichino","doi":"10.3390/children12091218","DOIUrl":"10.3390/children12091218","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is a valuable imaging modality for detecting malignancies and diagnosing fever of unknown origin (FUO). However, data regarding FDG accumulation in bone marrow among pediatric acute leukemia (AL) cases are limited. In this study, we aimed to compare FDG-PET/CT findings between children with AL and those with inflammatory diseases (IDs), including FUO, and develop a scoring system for differential diagnoses. <b>Methods:</b> We retrospectively analyzed FDG-PET/CT findings in six children with AL and 22 with IDs. The maximum standardized uptake value (SUV max), visual score (VS), and spread score (SS) were evaluated across various bone marrow sites, including vertebrae, pelvic bone, humerus, forearm, and femur. Statistical analysis consisted of Mann-Whitney U test for group comparisons and receiver operating characteristic curve (ROC)/area under the curve (AUC) analyses to assess diagnostic performance. <b>Results:</b> SUV max, VS, and SS were significantly higher in children with AL across all evaluated sites. The combined VS + SS scoring system yielded the highest diagnostic accuracy. A simplified version using only the VS of the middle humerus and femur plus the SS showed comparable effectiveness. <b>Conclusions:</b> FDG-PET/CT in children with AL showed high FDG accumulation in bone marrow areas in the whole body. The simple scoring system, which comprises FDG accumulation in the middle portion of the extremities and the whole body, appears to be helpful in distinguishing AL from IDs in children. FDG-PET/CT-based visual scoring may provide supportive information alongside conventional diagnostics in pediatric acute leukemia.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}