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Society for Pediatric Radiology – Poster Archive

Showing 10 Abstracts.

Tsang Brian,  Gupta Aaryan,  Takahashi Marcelo,  Ola Tolulope,  Baffi Henrique,  Doria Andrea

Final Pr. ID: Poster #: SCI-031

1) To systematically review the uses of AI for magnetic resonance (MR) imaging assessment of primary pediatric cancer and identify common literature topics and knowledge gaps. 2) To assess the adherence of the existing literature to the Checklist for Artificial Intelligence in Medical Imaging (CLAIM) guidelines. Read More

Authors:  Tsang Brian , Gupta Aaryan , Takahashi Marcelo , Ola Tolulope , Baffi Henrique , Doria Andrea

Keywords:  Artificial intelligence, Pediatric cancer, Magnetic resonance imaging

Sarrami Amir Hossein,  Wang Hongzhi,  Baratto Lucia,  Syeda-mahmood Tanveer,  Daldrup-link Heike

Final Pr. ID: Poster #: EDU-078

Medical Imaging has a crucial role in the diagnosis and management of pediatric cancer patients by providing information about tumor location and quantitative measures of tumor size and metabolic activity at baseline as well as during and after therapy. The standard imaging plan for staging and re-staging of pediatric malignancies includes a high-resolution MRI or CT scan of the local tumor and whole body staging for the detection of metastases on CT, MRI and/or PET scans. Children with lymphomas, sarcomas, germ cell tumors and a few other tumor types are referred to whole body 18F-FDG PET scanning, either coupled with CT or MRI. Artificial intelligence (AI) algorithms can facilitate staging and re-staging of cancers in children by providing 1) rapid detection and delineation of tumoral lesions, 2) automated measurements of tumoral size and metabolic activity, 3) relating tumor measurements to internal standard such as liver and blood pool, 4) assigning a score according to tumor-specific staging systems.

Detecting tumors on a whole-body scan is a challenging task, especially in children whose organs undergo changes in size and composition with increasing age. Moreover, the tumors in children can arise from almost anywhere in the body, from head to toe. With successful applications on object detection, AI methods are promising for automatic tumor detection from whole-body scans as well. In this tutorial, we will introduce a few popular AI methods for such purpose. These methods include U-Net, Vision Transformers (ViT), and the hybrid of the above methods such as O-Net Transformer or TransUNet.
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Authors:  Sarrami Amir Hossein , Wang Hongzhi , Baratto Lucia , Syeda-mahmood Tanveer , Daldrup-link Heike

Keywords:  Hybrid Imaging, Artificial Intelligence, Cancer

Snider Terry

Final Pr. ID: Paper #: 056

Increased rates of survival of patients diagnosed with childhood cancer presents an opportunity to assess long-term effects of treatments. Bone health has been identified as one of the processes impacted by cancer treatment. Bone densitometry is a tool used for patients currently undergoing treatment for childhood cancer and hematologic diseases such as sickle cell disease and those having completed therapy. This discussion will focus on the methods used to measure bone health and some of the challenges involved in doing so. Read More

Authors:  Snider Terry

Keywords:  Bone Densitometry, Childhood cancer

Malavia Mira,  Le Viet,  Rivard Douglas,  Reading Brenton

Final Pr. ID: Poster #: EDU-061

Osteoid osteomas (OO) are benign osteoblastic tumors primarily afflicting individuals aged 5 to 30 years, ranking as the third most prevalent among benign bone tumors at around 10%. Patients typically present with persistent nighttime pain that responds positively to NSAIDs, along with potential complications like progressive discomfort, tenderness, swelling, and limited joint mobility with articular involvement. OO usually forms in the cortex of long bones, measuring less than 2 cm, exhibiting a central radiolucent nidus encased by surrounding sclerosis, best visualized using CT scans. The current standard-of-care entails CT-guided radiofrequency ablation (RFA), while surgery becomes an option for complex locations like the spine, extremities, or craniofacial bones. Moreover, advanced thermoprotective techniques have expanded RFA's applicability to previously unsuitable lesions. Cryoablation is a newly indicated for pediatric OO patients and involves controlled tumor freezing, preserving adjacent healthy tissue. It offers reduced pain, shorter recovery, and minimal scarring, enhancing the quality of life for young patients. This exhibit will discuss 3 cases that underscore the diverse management approaches required for osteoid osteomas in young patients. Case 1 featured initial relief with radiofrequency ablation (RFA) but recurrence, ultimately resolved with cryoablation. In Case 2, a CT-guided cryoablation was performed for an S2 osteoid osteoma, with limited follow-up data. Case 3 highlighted the complexity of treating a C1 osteoid osteoma, initially successful with intra-operative cryoablation, but it was followed by new neck muscular pain post-operation. Cryoablation's accuracy and less invasiveness make it a preferred choice in treating OO patients.

Learning Objectives:
Grasp cryoablation principles for pediatric osteoid osteoma.
Recognize indications and contraindications.
Assess benefits and risks in pediatric cases.
Comprehend the pathophysiology of osteoid osteoma and cryoablation's role in treatment for pediatric patients.
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Authors:  Malavia Mira , Le Viet , Rivard Douglas , Reading Brenton

Keywords:  cancer, pain management, ablation

Martinez-rios Claudia,  Bajno Lydia,  Daneman Alan,  Moineddin Rahim,  Van Der Kaay Danielle Cm,  Wasserman Jonathan

Final Pr. ID: Poster #: EDU-109

High-resolution ultrasonography (US) is a valuable and accessible imaging tool to assess and characterize the thyroid gland in children. Pediatric thyroid nodules are infrequent. However, the incidence of thyroid carcinoma in children is near twice the adult population, where the risk of malignancy is up to 15%. Children also have an increased risk for recurrence (39%) as compared to adults, justifying further work and a more aggressive approach. Prompt recognition of the common and uncommon sonographic features of thyroid cancer in children will allow radiologist to identify this malignancy in early stages of the disease, expediting appropriate treatment improving the standard of patient care. The purpose of this exhibit is to 1. To illustrate the spectrum of sonographic findings of thyroid cancer in a pediatric population. 2. To describe the typical sonographic characteristics of malignant thyroid nodules in children. 3. To identify the uncommon features of pediatric thyroid cancer. 4. To describe an appropriate approach to deal with uncertain diagnosis. Read More

Authors:  Martinez-rios Claudia , Bajno Lydia , Daneman Alan , Moineddin Rahim , Van Der Kaay Danielle Cm , Wasserman Jonathan

Keywords:  Thyroid, cancer, children, ultrasound

Farrell Crystal,  Pareek Anuj,  Muehe Anne,  Pribnow Allison,  Steffner Robert,  Avedian Raffi,  Daldrup-link Heike

Final Pr. ID: Poster #: EDU-088

PET/MR is a valuable and growing imaging method for the assessment and management of pediatric bone tumors. Although plain radiography remains the first line modality for initial evaluation, cross sectional imaging is often required for further characterization of indeterminate or aggressive appearing lesions. Due to its superior soft tissue contrast resolution compared to CT, MR has become the mainstay in tissue characterization, locoregional staging, and surgical planning of pediatric bone tumors. By adding functional and metabolic information, FDG-PET imaging is useful for “one stop” local tumor and whole-body staging, evaluating response to therapy and surveillance. 18F-FDG PET/MR scans have the benefit of lower radiation and increased patient convenience compared to 18F-FDG PET/CT scans. However, due to the relatively recent development of this technology, many radiologists may be unfamiliar with the technical considerations and interpretation pearls and pitfalls of PET/MR. This educational exhibit reviews the imaging technique, reporting requirements, and imaging characteristics of the most common pediatric bone tumors with 18F-FDG PET/MR. Read More

Authors:  Farrell Crystal , Pareek Anuj , Muehe Anne , Pribnow Allison , Steffner Robert , Avedian Raffi , Daldrup-link Heike

Keywords:  PET/MR, bone tumor, cancer

Patel Arjun,  Sarma Asha,  Krishnasarma Rekha,  Benedetti Daniel,  Pruthi Sumit,  Snyder Elizabeth

Final Pr. ID: Poster #: EDU-057

The prevalence of pediatric cancers attributable to hereditary cancer predisposition syndromes (CPS) has grown in recent years due to the increasing recognition of links between germline mutations and pediatric cancers. As a result, a rapidly increasing population of patients with CPS are being seen in pediatric radiology practice. In collaboration with oncologists, surgeons, and other specialists, the radiologist plays an essential role in the management of these patients. For example, they may be the first to recognize the constellation of findings leading to the diagnosis of a CPS. In addition, the radiologist who is knowledgeable about pediatric CPS plays a pivotal role in the planning of imaging evaluations, which may need to be concise or comprehensive depending on the clinical situation, with judicious use of ionizing radiation, procedural sedation, and contrast. This is especially important because, although there are consensus screening and surveillance guidelines for the most common CPS, such guidelines have not been established for less common syndromes.

This educational exhibit seeks to provide an overview of various CPS, emphasizing 1) genetic underpinnings and mechanisms related to cancer predisposition, 2) the common and uncommon imaging findings, 3) preferred imaging techniques, and 4) currently available screening and surveillance recommendations. Pediatric CPS that will be discussed here include Li-Fraumeni syndrome, neurofibromatosis type I, von Hippel Lindau disease, Beckwith-Wiedemann syndrome, DICER-1 related conditions, Familial adenomatous polyposis, and Gorlin syndrome, as well as neuroendocrine syndromes (e.g., multiple endocrine neoplasia). Less common cancer predisposition syndromes, including DNA-repair related syndromes such as Ataxia-telangectasia, as well as Rubenstein-Taybi syndrome, and PTEN hamartoma tumor syndrome will also be discussed.
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Authors:  Patel Arjun , Sarma Asha , Krishnasarma Rekha , Benedetti Daniel , Pruthi Sumit , Snyder Elizabeth

Keywords:  cancer predisposition syndrome, hereditary cancer

Mirza Sobia,  Sanchez Ramon,  Ma Grace,  Cielma Tara,  Vaidyanathan Priya

Final Pr. ID: Poster #: EDU-067

Thyroid hemiagenesis (TH) is a rare congenital abnormality associated with a higher incidence of thyroid disease. It is often asymptomatic and an incidental finding. However, TH may present as a palpable thyroid nodule, prompting sonography and thyroid function testing. Ultrasound (US) can differentiate between total absence of the thyroid lobe and severe hypoplasia. It is also useful for guiding fine needle aspiration when warranted. Scintigraphy is useful for determining the presence of ectopic thyroid tissue and to further characterize focal nodular thyroid lesions. Despite their respective roles, imaging findings on both US and scintigraphy can pose diagnostic challenges to the pediatric radiologist.

This educational poster will review the embryology of the thyroid gland, frequency of TH, clinical presentation and associations with additional thyroid anomalies such as malignancy, thyroiditis and abnormal gland function. Imaging features of TH will be reviewed with focus on (US) and scintigraphy.

The goals of this exhibit are:
1. Review the incidence and clinical presentation of pediatric patients with TH
2. Describe the imaging findings and role of ultrasound and scintigraphy in the diagnosis and follow-up of TH
3. Discuss prognosis and outcomes of TH in children
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Authors:  Mirza Sobia , Sanchez Ramon , Ma Grace , Cielma Tara , Vaidyanathan Priya

Keywords:  thyroid, hemiagenesis, cancer

Alsarhani Haifa,  Somerville Scott,  Ahmet Alexandra,  Sawyer Sarah,  Tomiak Eva,  Martinez-rios Claudia

Final Pr. ID: Paper #: 145

Cancer predisposition syndromes (CPS) are rare genetic disorders with increased risk of benign and malignant neoplasms. A few of these syndromes predispose to thyroid gland pathology, including thyroid carcinoma. The purpose of this study is to review the spectrum of diagnostic outcomes of thyroid abnormalities in pediatric patients diagnosed with a CPS at a tertiary care pediatric hospital. Read More

Authors:  Alsarhani Haifa , Somerville Scott , Ahmet Alexandra , Sawyer Sarah , Tomiak Eva , Martinez-rios Claudia

Keywords:  Cancer predisposition syndromes, Neck

Retamal Caro Andres,  Pérez-marrero Lizbet,  Horvath Eleonora,  Silva Claudio,  Rojas Paula

Final Pr. ID: Poster #: SCI-088

To determine the percentage of malignancy for the different TIRADS categories and the ultrasound patterns in children and adolescents.
To calculate the interobserver variability in the use of TIRADS classification in this group.
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Authors:  Retamal Caro Andres , Pérez-marrero Lizbet , Horvath Eleonora , Silva Claudio , Rojas Paula

Keywords:  TIRADS, thyroid cancer, thyroid node in children and adolescent, thyroid cancer in children and adolescent, sonographic patterns of thyroid node