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Society for Pediatric Radiology – Poster Archive
Final ID: Poster #: SCI-026
Can we ignore tiny nodules in the hepatoblastoma patient? An evaluation of diagnostic criteria for the PRETEXT staging system
Purpose or Case Report: To assess the size and number of pulmonary lesions in patients with hepatoblastoma
Diagnostic criteria of the PRETEXT (Pretreatment Extent of Disease) staging system for hepatoblastoma states that pulmonary lesions are judged to be metastases if there is one nodule greater than 10mm in diameter, or if among several nodules at least one is greater than 5mm in diameter.
Methods & Materials: Ten (14%) of 68 hepatoblastoma cases were selected from the radiology central reading system of the Japan Children’s Cancer Group’s (JCCG) liver tumor group for the period 2013–2016 (mean age: 4.3 years). Using a web-based radiology database, a retrospective review of initial chest CT images was conducted, focusing on largest diameter, number, and shape of pulmonary nodules, CT slice thickness, imaging evidence of PRETEXT stage and additional criteria scores.
Results: Nodule diameter ranged from 3 to 19mm (mean: 8.7mm). Four cases (40%) had small-sized lesions less than 5mm in diameter; therefore, these patients were categorized as no lung metastasis. The large lesion group included three patients diagnosed as PRETEXT stage IV, though no case of stage IV was found in the small lesion group. Additional criteria scores from the large lesion group were statistically higher than the small lesion group (p<0.01).
Conclusions: Using a criterion of 5mm in diameter is important when judging lung metastasis, otherwise metastasis might be overlooked.
Diagnostic criteria of the PRETEXT (Pretreatment Extent of Disease) staging system for hepatoblastoma states that pulmonary lesions are judged to be metastases if there is one nodule greater than 10mm in diameter, or if among several nodules at least one is greater than 5mm in diameter.
Methods & Materials: Ten (14%) of 68 hepatoblastoma cases were selected from the radiology central reading system of the Japan Children’s Cancer Group’s (JCCG) liver tumor group for the period 2013–2016 (mean age: 4.3 years). Using a web-based radiology database, a retrospective review of initial chest CT images was conducted, focusing on largest diameter, number, and shape of pulmonary nodules, CT slice thickness, imaging evidence of PRETEXT stage and additional criteria scores.
Results: Nodule diameter ranged from 3 to 19mm (mean: 8.7mm). Four cases (40%) had small-sized lesions less than 5mm in diameter; therefore, these patients were categorized as no lung metastasis. The large lesion group included three patients diagnosed as PRETEXT stage IV, though no case of stage IV was found in the small lesion group. Additional criteria scores from the large lesion group were statistically higher than the small lesion group (p<0.01).
Conclusions: Using a criterion of 5mm in diameter is important when judging lung metastasis, otherwise metastasis might be overlooked.
More abstracts on this topic:
How Low Can You Go? Ultra-Low Dose Chest CT for Diagnosis of Airway Disease in Children Using Deep Convolutional Neural Network Denoising
Horst Kelly, Zhongxing Zhou, Hull Nathan, Thacker Paul, Thorne Jamison, Fletcher Joel, Mccollough Cynthia
The Value of MSCT in guiding staging and treatment of hepatoblastoma in Children based on PRETEXT staging systemGuo Chen, Zhong Yumin, Zhou Ying, Hu Li-wei
Poster____SCI-026.pdf
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