Juang Eric,  Collard Michael,  Katz Danielle,  Adams Megan,  Wachs Michael,  Annam Aparna,  Zavaletta Vaz

Final Pr. ID: Poster #: EDU-048

Through a series of cases, this poster demonstrates how to diagnose and treat biliary anastomotic complications with image-guided techniques in infants after liver transplant.

We present several cases to illustrate the variability of biliary anastomoses including location, type, and number of anastomoses. Pediatric interventional radiologists and image-guided procedures are critical in the successful management of post-transplant biliary anastomotic strictures and leaks and minimize the need for invasive reoperation.

The selected cases illustrate complex image-guided percutaneous management of multiple duct anastomotic strictures, anastomotic dehiscence, cut surface leaks, and removal of surgically placed stents that may be malpositioned and/or causing obstruction. The interventional methods used to percutaneously manage these cases include complex biliary access utilizing snares, multiple drain placement, stent placement, and rendezvous procedures with endoscopic retrograde cholangiopancreatography.

The use of image-guided techniques by the pediatric interventional radiologist are invaluable in the management of biliary complications post-liver transplant in infants. Read More

Authors:  Juang Eric , Collard Michael , Katz Danielle , Adams Megan , Wachs Michael , Annam Aparna , Zavaletta Vaz

Keywords:  Transplant Interventions, Biliary, Image-Guided

Alam Aisha,  Maier Pia,  Smitthimedhin Anilawan,  Acord Michael,  Cahill Anne Marie,  Vatsky Seth

Final Pr. ID: Paper #: 072

Lymphoma is the most common mediastinal mass in children. Obtaining tissue for diagnosis can be challenging due to reported low diagnostic yield and risk of cardiorespiratory collapse, especially in the setting of anesthesia. We report our experience with biopsy of mediastinal masses, report the diagnostic rate for lymphoma and biopsy/anesthetic complications related to the procedure. Read More

Authors:  Alam Aisha , Maier Pia , Smitthimedhin Anilawan , Acord Michael , Cahill Anne Marie , Vatsky Seth

Keywords:  Image guided biopsy, Mediastinal Mass, Lymphoma

Meti Shraddha,  Porter Daniel,  Ali Khalid,  Watkins Linda

Final Pr. ID: Poster #: CR-024

Aneurysmal Bone Cysts (ABCs) are benign, expansile lesions representing 2.5% of primary bone tumours, most often affecting children and adolescents. Traditional surgical approaches, such as curettage or wide local excision, carry recurrence rates of up to 70%, emphasising the need for less invasive and more effective alternatives. Image-guided sclerotherapy with agents including doxycycline has emerged as a promising interventional option. We present a case of recurrent tibial ABC successfully treated with single-session CT-guided percutaneous sclerotherapy.

A teenage boy presented with 2 month history of right ankle pain and swelling following minor trauma to the area. Radiographs demonstrated an expansile, multiloculated, cystic lesion in the distal tibial metaphysis. Subsequent MRI showed multiple fluid-fluid levels, circumferential periostitis and mid para-osseous oedema of the distal tibia. Biopsy confirmed the diagnosis of ABC. The patient underwent curettage with allograft, followed by wide local excision and external fixation after recurrence within 6 months. 1-year surveillance CT again demonstrated recurrence and following multidisciplinary tumour board discussion and repeat biopsy, CT-guided percutaneous doxycycline sclerotherapy with bone void filler was performed.

Under general anaesthesia, two 11G bone access needles were advanced into the cystic portion via a posterolateral approach. After aspiration and contrast injection with no spillage demonstrated on CT, doxycycline liquid was instilled and allowed to dwell before being aspirated and bone void filler instilled. The procedure was uncomplicated - the patient was discharged the same day. At 11-month follow-up, the patient reported no pain, had returned to full activity and demonstrated radiographic consolidation without recurrence.

This case highlights the value of CT-guided percutaneous sclerotherapy as a minimally invasive alternative for recurrent ABC, particularly in skeletally immature patients where repeat open surgery risks growth plate injury, deformity, and functional impairment. Compared with multiple-session doxycycline-albumin foam regimens reported in the literature, our case demonstrates successful consolidation with a single-session doxycycline alone injection. Read More

Authors:  Meti Shraddha , Porter Daniel , Ali Khalid , Watkins Linda

Keywords:  Aneurysmal Bone Cyst, Sclerotherapy, Image-Guided

Patel Dhruv,  Loewen Jonathan,  Richer Edward

Final Pr. ID: Paper #: 098

Ileocolic intussusception is a common cause of intestinal obstruction in young children. Most patients undergo image-guided enema reduction followed by a surgical reduction in enema fails. Many factors associated with decreased enema success have been described in the literature, although a concise scoring system to identify patients who are at risk for surgical intervention and complications does not exist. The goal of this project was to develop a scoring system to identify patients who are at increased risk for enema failure and surgical complications. Read More

Authors:  Patel Dhruv , Loewen Jonathan , Richer Edward

Keywords:  Ileocolic Intussusception, Image guided therapeutic enema