Degnan Andrew,  Biko David,  White Ammie,  Servaes Sabah,  Otero Hansel,  Fox William,  Shaffer Thomas,  Zhang Huayan,  Saul David

Final Pr. ID: Poster #: EDU-100

With advances in intensive care, increasing numbers of premature neonates with severe respiratory distress have led to major challenges related to prolonged mechanical ventilation and chronic bronchopulmonary dysplasia. Acute lung injury and acute respiratory distress syndrome in children still confer significant morbidity and mortality despite advances in ventilation and resuscitative therapies.

Much of the damage attributed to mechanical ventilation in critically ill infants and children is due to surface tension and ventilation of atelectatic lung. First reported clinically in neonates in 1989, partial liquid ventilation involves the endotracheal administration of an inert volatile perfluorochemical liquid. These perfluorocarbons aid in gas exchange due to their large oxygen and carbon dioxide carrying capacity. In addition, these chemicals possess low surface tension that allows for greater alveolar recruitment and improved lung compliance through clearance of debris and secretions.

Early trials in preterm neonates and neonates with congenital diaphragmatic hernia suggested a role for liquid ventilation as salvage therapy for patients not responding to conventional mechanical ventilation and extracorporeal membrane oxygenation. Currently, efforts are underway to reassess its clinical utility in bronchopulmonary dysplasia. With this renewed clinical interest, it is important for pediatric radiologists at institutions utilizing these perfluorocarbons to be familiar with the clinical use and radiographic appearance of liquid ventilation. Read More

Authors:  Degnan Andrew , Biko David , White Ammie , Servaes Sabah , Otero Hansel , Fox William , Shaffer Thomas , Zhang Huayan , Saul David

Keywords:  liquid ventilation, chest radiographs

Miyazaki Osamu,  Oguma Eiji,  Nishikawa Masanori,  Tanami Yutaka,  Kitami Masahiro,  Hosokawa Takahiro

Final Pr. ID: Poster #: SCI-026

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. Read More

Authors:  Miyazaki Osamu , Oguma Eiji , Nishikawa Masanori , Tanami Yutaka , Kitami Masahiro , Hosokawa Takahiro

Keywords:  hepatoblastoma, lung metastasis, chest CT

Orman Gunes,  Sayad Edouard,  Silvacarmona Manuel,  Vogel Tiphanie P.,  Guillerman R

Final Pr. ID: Paper #: 031

The anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are a group of autoimmune diseases characterized by vascular inflammation requiring immunosuppressive treatment. Involvement is most common of the kidneys and lungs, although there is a paucity of literature reporting the chest imaging findings in children. Our goal is to describe the salient chest imaging findings of pediatric AAV to promote recognition by radiologists. Read More

Authors:  Orman Gunes , Sayad Edouard , Silvacarmona Manuel , Vogel Tiphanie P. , Guillerman R

Keywords:  ANCA, vasculitides, chest CT

Nakagawa Motoo,  Ozawa Yoshiyuki,  Tanaka Yoshihiro,  Shibamoto Yuta

Final Pr. ID: Poster #: EDU-002

Characteristic chest radiographic findings of patients with congenital heart disease have been reported for some decades ago. For beginner, it may be hard to detect these findings and to understand reasons why these findings depict. Recently, radiologists can interpret specific findings of congenital heart disease because technique of CT have been developed. Read More

Authors:  Nakagawa Motoo , Ozawa Yoshiyuki , Tanaka Yoshihiro , Shibamoto Yuta

Keywords:  congenital heart disease, chest radiograph, dual source CT

Funaro Kimberly,  Kucera Jennifer

Final Pr. ID: Poster #: EDU-033

Congenital chest lesions encompass a wide array of pathology with overlapping imaging characteristics. With prenatal ultrasound and MRI, more congenital chest lesions are being detected sooner, and it is important for radiologists to be familiar with their imaging findings for both diagnostic and prognostic purposes. This educational exhibit reviews the spectrum of pediatric congenital chest lesions and their key imaging findings.
Read More

Authors:  Funaro Kimberly , Kucera Jennifer

Keywords:  Chest, Congenital malformations

Bedoya M. Alejandra,  Iwasaka-neder Jade,  Bixby Sarah,  Tsai Andy

Final Pr. ID: Poster #: SCI-005

Knowing the gestational status of a neonate (premature or full-term) impacts a pediatric radiologist’s ability to generate a reasonable differential diagnosis of neonatal diseases. Though crucial, this information is often unavailable at the time of the babygram interpretation. Conventional methods based on measuring the clavicular-pubic length (CPL) and the transverse diameter of the chest (TDC) from a babygram have been proposed as reliable estimators of a neonate’s gestational age. In this study, we aimed to compare these two conventional methodologies to that of a deep-learning (DL) model in determining a neonate’s gestational status. Read More

Authors:  Bedoya M. Alejandra , Iwasaka-neder Jade , Bixby Sarah , Tsai Andy

Keywords:  Artificial intelligence, Clavicular-pubic length, Chest width

Fink Adam,  Levin Terry,  Blumfield Einat,  Liszewski Mark,  Nemerofsky Sheri,  George Kandie,  Eddington K.,  Nafday Suhas,  Ushay H.

Final Pr. ID: Poster #: SCI-008

In the PICU and NICU, radiographs are frequently obtained and preliminarily interpreted by intensivists several hours before a board certified pediatric radiologist provides an official interpretation. These preliminary interpretations often result in a change in clinical management. We quantified the discrepancy rates between intensivists at different levels of training and pediatric radiologists to determine areas for intensivist improvement via an educational initiative. Read More

Authors:  Fink Adam , Levin Terry , Blumfield Einat , Liszewski Mark , Nemerofsky Sheri , George Kandie , Eddington K. , Nafday Suhas , Ushay H.

Keywords:  chest, Abdominal

Horst Kelly,  Zhongxing Zhou,  Hull Nathan,  Thacker Paul,  Thorne Jamison,  Fletcher Joel,  Mccollough Cynthia

Final Pr. ID: Poster #: SCI-001

We sought to evaluate the quality and interpretability of non-contrast chest CT images in pediatric patients for the diagnosis of airway disease at two low-dose levels with and without denoising using a deep convolutional neural network (CNN), with one of the dose levels approaching that in a standard chest radiograph. Read More

Authors:  Horst Kelly , Zhongxing Zhou , Hull Nathan , Thacker Paul , Thorne Jamison , Fletcher Joel , Mccollough Cynthia

Keywords:  reduced-dose chest CT, CNN denoising, iterative reconstruction

Turkan Yilmaz Inci,  Salman Muhammet,  Guleryuz Handan

Final Pr. ID: Poster #: EDU-066

Congenital chest lesions include a wide array of pathology with overlapping imaging characteristics. With prenatal MRI, more congenital chest lesions will be able to detect sooner. We will demonstrate the spectrum of pediatric congenital chest lesions and their key imaging findings Read More

Authors:  Turkan Yilmaz Inci , Salman Muhammet , Guleryuz Handan

Keywords:  congenital, chest

Pan Patrick,  Roth Antoinette,  Chawla Soni

Final Pr. ID: Poster #: EDU-125

Chest radiographs remain the most frequently used examination in patients presenting with acute complains, adult and children alike. In many pediatric conditions, an abnormal finding on a chest radiograph may be the first clue available. In this educational exhibit, a systematic approach in the evaluation of pediatric chest radiographs is provided. With the use of mnemonic “In the ER, Look and Listen for Most oBvious Signs!”, the reader will navigate through the essential components of the evaluation with Exposure, Rotation, Lines, Lung fields, Mediastinum, Bones and Soft tissues. Read More

Authors:  Pan Patrick , Roth Antoinette , Chawla Soni

Keywords:  Chest, Radiograph, Approach

Salman Rida

Final Pr. ID: Poster #: EDU-099

Pediatric rheumatologic diseases are common in children and can have a significant negative impact on children's health and well-being. Juvenile idiopathic arthritis is the most common type of arthritis in pediatric patients worldwide. However, multiple other entities can be encountered in these patients and can be first presenting with lung manifestations. Therefore, pediatric radiologists should consider the possibility of underlying rheumatologic disease when they see certain chest imaging findings.
The purpose of this educational exhibit is to review the imaging findings of pediatric rheumatologic diseases with a focus on chest imaging to illustrate the lung manifestions that can be seen in the presence of these diseases. Read More

Authors:  Salman Rida

Keywords:  Rheumatology, CT, chest

Satoor Vamsish,  Marine Megan

Final Pr. ID: Poster #: SCI-034

Background/Objective:
Rib fractures are one of the most specific fractures in child abuse and are among the most common identified. Diagnosis of an unsuspected rib fracture in a young child or infant is highly concerning for child abuse. Given rib fractures, particularly acute rib fractures, can be subtle and difficult for even experienced radiologists to identify, a screening diagnostic tool to improve the detection accuracy would provide significant value. The objective of this investigation is to create a machine learning algorithm with the ability to recognize the presence or absence of rib fractures on chest radiographs in pediatric patients less than 3 years old. Read More

Authors:  Satoor Vamsish , Marine Megan

Keywords:  Machine learning, Chest x-ray, Pediatric

Ruoss Justin,  Sharma Priya,  Rajderkar Dhanashree

Final Pr. ID: Poster #: EDU-121

In this educational exhibit we will use a series of cases from our institution to review the approach to non-mediastinal solid and solid-like lesions found in the pediatric chest. We will use a multimodality approach and discuss differentials, key imaging features and the pathologic basis of these lesions. Read More

Authors:  Ruoss Justin , Sharma Priya , Rajderkar Dhanashree

Keywords:  Chest Masses, Pulmonary Tumors, Persistent Wheezing

Schat Robben,  Holm Tara,  Murati Michael

Final Pr. ID: Poster #: SCI-001

This study implements a practical collimation technique utilizing external body landmarks to produce more consistent and appropriate collimation for portable neonatal intensive care unit (NICU) chest radiographs (CXR). Read More

Authors:  Schat Robben , Holm Tara , Murati Michael

Keywords:  NICU, chest radiograph, collimation

Johansen Andrew,  Lee Jacob,  Robinson Amie,  Chan Sherwin

Final Pr. ID: Poster #: SCI-045

Foreign body (FB) ingestion can be a life threatening event for pediatric patients. The imaging for suspected FB is an esophagram. This procedure requires radiologist involvement, patient cooperation and has a higher dose of radiation than chest digital tomosynthesis (DTS). We want to describe usage of DTS in the pediatric population to aid in detection of radiolucent esophageal FB. Read More

Authors:  Johansen Andrew , Lee Jacob , Robinson Amie , Chan Sherwin

Keywords:  Digital Chest Tomosynthesis, Esophageal Foreign Body, Esophagram

Machnitz Judit,  Son Jennifer,  Dunn Emily,  Bokhari Danial,  Spevak Melissa,  Tekes-brady Aylin

Final Pr. ID: Poster #: EDU-080

Sonography is well established, effective and radiation free imaging tool in pediatric chest conditions, primarily and widely used for evaluation of pleural effusions and assessment of chest wall abnormalities. Beyond that, it can also provide valuable information in evaluation of congenital abnormalities, anatomical variations, infectious process and malignancies in the chest. Read More

Authors:  Machnitz Judit , Son Jennifer , Dunn Emily , Bokhari Danial , Spevak Melissa , Tekes-brady Aylin

Keywords:  chest ultrasound, under utilization, radiation free

Colucci Philip,  Cohen Sara,  Baad Michael,  Pomeranz Christy,  Collins Lee,  Kovanlikaya Arzu

Final Pr. ID: Poster #: EDU-037

A palpable finding along the chest wall is a frequent indication for pediatric ultrasound. Accurate identification of benign lesions can reassure families and appropriately triage patients who need follow-up, cross sectional imaging, or biopsy. The purpose of this exhibit is to review chest wall anatomy, illustrate ultrasound techniques, and discuss key ultrasound imaging features of common benign lesions and normal variants. Cases will include but are not limited to: accessory breast tissue, gynecomastia, sternalis muscle, angulated costal cartilage, rib fracture, chondral injury, ganglion cyst arising from the sternoclavicular joint, osteochondroma, neurofibroma, lipoma, myofibroma, pilomatrixoma, dermoid and epidermoid cysts, fibrous hamartoma of infancy, hemangioma, lymphatic malformation, and abscess. Each case will include the clinical presentation of the patient, classic ultrasound imaging features, and subsequent management. Read More

Authors:  Colucci Philip , Cohen Sara , Baad Michael , Pomeranz Christy , Collins Lee , Kovanlikaya Arzu

Keywords:  chest wall, ultrasound, pediatric

Kumar Soryan,  Sollee John,  Choi Una,  Lin Cheng Ting,  Bai Harrison,  Jiao Zhicheng

Final Pr. ID: Poster #: SCI-037

The purpose of this study is to develop a deep learning algorithm for detecting COVID-19 in chest x-rays of pediatric patients. Read More

Authors:  Kumar Soryan , Sollee John , Choi Una , Lin Cheng Ting , Bai Harrison , Jiao Zhicheng

Keywords:  AI, X-Ray, Chest

Ferreira Da Silva Renato,  Nagpal Prashant,  Priya Sarv,  Sato T Shawn,  Sato Yutaka

Final Pr. ID: Poster #: EDU-101

Interpretation of chest radiographs requires a good understanding of anatomy, the physiology of the lungs and cardiovascular system as well as good pattern recognition. Additionally, it requires a systematic approach to search for pathologies and pertinent clinical details for interpretation. With frequent use of CT / MRI, the residents (and even practicing radiologists) have become less skilled in the interpretation of chest x-rays, making one of the most commonly ordered exams the most challenging.
With challenges of decreasing radiation exposure (especially in pediatric population), it is important that the relatively lost skill set of chest radiographs interpretation be revisited, for trainees (radiology and non-radiology services) and the practitioners.

OUTLINE
● Historical perspective.
● Overall approach towards a chest x-ray and importance of clinical details.
● PA/AP and lateral radiograph anatomy and radiographic lines and stripes.
● Fleischer society standard terminology for radiographs.
● Radiographic appearance of abnormalities and pearls for differentiation. The abnormalities to be categorized as:
○ Pneumonia
○ Effusion
○ Atelectasis
○ Big heart
○ Pulmonary vascularity (plethora and oligemia)
○ Lucencies (Pneumo: thorax, mediastinum and cardia)
○ Masses Read More

Authors:  Ferreira Da Silva Renato , Nagpal Prashant , Priya Sarv , Sato T Shawn , Sato Yutaka

Keywords:  chest, radiograph, interpretation

Siegel Marilyn,  Ramirez Giraldo Juan Carlos

Final Pr. ID: Paper #: 037

To develop diagnostic reference ranges (DRRs) for pediatric contrast-enhanced dual-energy CT (DECT) examinations as a function of patient size and radiation output of the CT scanner with comparison to conventional single energy CT (SECT). Read More

Authors:  Siegel Marilyn , Ramirez Giraldo Juan Carlos

Keywords:  Dual-Energy CT, Chest CT, Dose Reduction

Vijapura Charmi,  Kao Simon,  Amarneh Mohammad,  Sato Yutaka,  Sato T Shawn

Final Pr. ID: Poster #: EDU-014

1. Describe the variety of pathologies affecting the chest wall and breast in the pediatric male.
2. Explain the ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) characteristics of pediatric chest well including breast masses.
3. Recognize pitfalls on ultrasound imaging in evaluation of male chest wall and breast.
4. Discuss follow up and management of these lesions. Read More

Authors:  Vijapura Charmi , Kao Simon , Amarneh Mohammad , Sato Yutaka , Sato T Shawn

Keywords:  Male Breast, Chest Wall, Ultrasound

Mahomed Nasreen

Final Pr. ID: Poster #: EDU-010

Abstract: HIV is a global pandemic. According to the UNAIDS Report on the Global Aids Epidemic 2013, approximately 3.3 million children under the age of 15 years are living with HIV infection globally. Sub-Saharan Africa has the highest burden of disease with 2.9 million of HIV-infected children. HIV has affected the epidemiology of childhood pneumonia, changing the spectrum of pathogens, antimicrobial susceptibility of bacteria and prognostic outcome. More than 70% of HIV-infected children will suffer at least one episode of a pulmonary infection in the course of their illness. The pneumococcal conjugate vaccine (PCV) demonstrated vaccine efficacy of 20% in HIV-uninfected children and 13% in HIV-infected children in South African using WHO standardized chest X-ray interpretation criteria. The chest X-ray remains the most readily available and the commonest imaging modality for childhood pneumonia. A combination of clinical findings with pattern recognition on chest X-ray narrows the differential diagnosis. We present a pictorial review of chest X-ray findings in HIV-infected children due to infectious causes: pulmonary TB, bacterial pneumonia, Pneumocystis jiroveci pneumonia, viral pneumonia and non- infectious causes: immune reconstitution inflammatory syndrome (IRIS), lymphocytic interstitial pneumonia (LIP) and lymphoma.
Read More

Authors:  Mahomed Nasreen

Keywords:  chest X-rays, HIV-infected children

Guillen Gutierrez Cinthia,  Rodriguez Garza Claudia,  Elizondo Riojas Guillermo,  Hernández Grimaldo Edgar,  Garza Acosta Andrea

Final Pr. ID: Poster #: EDU-020 (S)

Cystic fibrosis (CF) is caused by autosomal-recessive mutations in the CF transmembrane regulator (CFTR) gene. Results in production of abnormally viscous mucus and secretions in the lungs of patients
It is the most common genetic disorder leading to chronic pulmonary disease in children.

In the lung, the cystic fibrosis transmembrane regulator (CFTR) is a protein responsible for efflux of chloride and inhibition of the sodium channel's activity which controls the influx of sodium. Pulmonary manifestations of CF includes
Bronchiectasis
Pneumothorax
Recurrent bacterial infection
Pulmonary arterial hypertension

Chest XRAY: is inferior to CT for the assessment of patients with known bronchiectasis. Nevertheless, radiography remains a useful modality for assessing the pulmonary complications associated with bronchiectasis, because of its low cost, availability, low radiation dose, and speed of acquisition

Brasfield scoring system
The score is based on conventional chest radiographic findings and has been reported to have good correlation with pulmonary function.
There is a maximum score of 25 with points subtracted based on the score from each of the following categories:

Air trapping: generalized pulmonary overdistension (sternal bowing, depression of diaphragms, or thoracic kyphosis)
Linear markings Linear opacification due to prominence of bronchi; may be seen as parallel line densities, branching, or “end-on” circular densities (bronchial wall thickening)
Nodular cystic lesions: multiple discrete rounded densities ≥0.5 cm in diameter, with either radiopaque or radiolucent centers (bronchiectasis); does not refer to irregular linear markings; confluent nodules not classified as large lesion
Large lesions: segmental or lobar atelectasis or consolidation, including acute pneumonia.
General severity: impression of overall severity on chest x-ray

HRCT has become indispensable in the monitoring of CF patients and is used to guide therapy and assess response to treatment, as it not only correlates with lung function tests.
Scans are repeated every 6 to 18 months depending on the clinical course.

BHALLA SCORE SYSTEM
Bhalla system can assess the degree of lung involvement and the evolution of the damages caused by lung disease based on various radiological findings. It values
Bronchiectasias
Peribronchial thickening
Extent of bronchiectasias
Extent of mucous plugs
Abscesses or sacculations
Bronchial generations affected
Number of bullae
Extent of emphysema
Collapse or consolidation Read More

Authors:  Guillen Gutierrez Cinthia , Rodriguez Garza Claudia , Elizondo Riojas Guillermo , Hernández Grimaldo Edgar , Garza Acosta Andrea

Keywords:  Chest CT, Chest Xray, Education

Barrera Christian,  Barrera Ambika,  Andronikou Savvas,  Tapia Ignacio,  Otero Hansel

Final Pr. ID: Paper #: 009 (S)

To evaluate the utility of quantitative CT in children with neuroendocrine cell hyperplasia of infancy (NEHI) Read More

Authors:  Barrera Christian , Barrera Ambika , Andronikou Savvas , Tapia Ignacio , Otero Hansel

Keywords:  Quantitative, NEHI, Chest

Rodriguez Ruiz Felipe,  Benscoter Dan,  Tiao Gregory,  Feng Christina,  Hart Catherine,  Fleck Robert

Final Pr. ID: Poster #: CR-013 (S)

Demonstrate a rare cause of respiratory distress in a full-term newborn to illustrate the importance of chest radiography (CXR) in guiding the work up. Read More

Authors:  Rodriguez Ruiz Felipe , Benscoter Dan , Tiao Gregory , Feng Christina , Hart Catherine , Fleck Robert

Keywords:  Bronchogenic Cyst, Chest MRI, hyperlucent lung

Alizadeh Houman,  Siegel Marilyn,  Ramirez Giraldo Juan Carlos

Final Pr. ID: Poster #: EDU-075

Dual-energy computed tomography (DECT) decomposition software has expanded the scope of CT post-processing. It is an efficient method in pediatric thoracic imaging to define both vascular and parenchymal abnormalities. Read More

Authors:  Alizadeh Houman , Siegel Marilyn , Ramirez Giraldo Juan Carlos

Keywords:  Dual Energy CT, chest, pediatric