Venkatakrishna Shyam Sunder,  Sultan Laith,  Gabbert Morgan,  Morgan Trudy,  Anupindi Sudha

Final Pr. ID: Poster #: SCI-014

Pediatric chronic liver disease (CLD) poses a significant clinical challenge, necessitating precise diagnostic tools for comprehensive evaluation. Microvascular perfusion abnormalities play a pivotal role in disease progression. Contrast-enhanced ultrasound (CEUS) detects the flow in the micro-vessels, however, objective means are needed for better understanding. In this study we evaluate a novel quantitative method utilizing CEUS for assessing microvascular perfusion in pediatric patients with CLD. Read More

Authors:  Venkatakrishna Shyam Sunder , Sultan Laith , Gabbert Morgan , Morgan Trudy , Anupindi Sudha

Keywords:  Liver microvasculature, Contrast enhanced ultrasound, image analysis

Uribe Jesus,  Goodarzian Fariba

Final Pr. ID: Poster #: SCI-031

Gadoxetate disodium-enhanced MRI abdomen is the imaging of choice for evaluation of liver lesions. However, in patients with underlying liver dysfunction, uptake and excretion of the hepatobiliary contrast agent is impaired; standard 20-minute delay hepatobiliary phase imaging may be insufficient to characterize hepatic lesions of interest. Our study aims to evaluate the adequacy of standard 20-minute delayed phase hepatobiliary imaging after gadoxetate disodium administration in pediatric patients with liver dysfunction. A secondary objective is to assess the utility of hepatic function laboratory values as a screening tool to identify patients with impaired hepatobiliary excretion in whom hepatobiliary phase imaging at 20 minutes may be inadequate. Read More

Authors:  Uribe Jesus , Goodarzian Fariba

Keywords:  Liver, Eovist, Fontan

Greiner Barbara,  Kueck Fabian,  Hammer Simone

Final Pr. ID: Poster #: SCI-004

Bone metabolism in children who have undergone pediatric liver transplantation (pLT) can be negatively affected, particularly in the presence of biliary complications. Pediatric bone status entering adulthood is a critical determinant of bone health through adulthood. The aim of this study was to evaluate bone age (BA), a marker of skeletal maturity, and bone health index (BHI), a surrogate marker of bone density, in pLT recepients. Read More

Authors:  Greiner Barbara , Kueck Fabian , Hammer Simone

Keywords:  Liver Transplantation, Bone Expert, Bone Health Index

Supakul Nucharin

Final Pr. ID: Poster #: EDU-017

To summarize our experience using Computed Tomography Angiography (CTA) of the liver as an imaging tool for pre-living donor liver transplantation (LDLT) evaluation in biliary atresia (BA) patients. This pictorial review will illustrate and discuss several aspects of imaging techniques and the important findings that clinician need to know before LDLT.

Key imaging findings for vascular anatomy/collateral vessels will be made, emphasizing what clinicians need to know. Correlation with intraoperative findings will also be provided.
Read More

Authors:  Supakul Nucharin

Keywords:  Biliary atresia, LDLT, liver transplantation, CTA liver, Pediatric

Tsitsiou Yvonne,  Rychik Jack,  Biko David,  Cahill Anne Marie,  Serai Suraj,  Durand Rachelle,  Golberg David,  Glatz Andrew,  Rand Elizabeth,  Wilkins Benjamin,  Witschey Walter,  Dodds Kathryn,  Russo Pierre

Final Pr. ID: Paper #: 071

Fontan–associated liver disease (FALD) is associated with increased risk of liver cirrhosis and hepatocellular carcinoma. Liver biopsy is the current gold standard investigation for diagnosing liver fibrosis. Magnetic Resonance Elastography (MRE) is a non-invasive procedure assessing liver stiffness. To date, only limited published studies are available describing the correlation of MRE and biopsy in Fontan-associated pediatric patients. Further, longitudinal changes in MRE require an increase in hepatic stiffness of >22% to indicate true change in stiffness (95% CI). The purpose of this study is to determine the clinical implication of MRE in FALD.

Read More

Authors:  Tsitsiou Yvonne , Rychik Jack , Biko David , Cahill Anne Marie , Serai Suraj , Durand Rachelle , Golberg David , Glatz Andrew , Rand Elizabeth , Wilkins Benjamin , Witschey Walter , Dodds Kathryn , Russo Pierre

Keywords:  MR Elastography, Fontan, Liver Biopsy

Biyyam Deepa,  Youssfi Mostafa,  Mandell Gerald,  Taylor Steve,  Patel Mittun

Final Pr. ID: Poster #: CR-004

Calcifying nested stromal epithelial tumor (CNSET) is a very rare primary liver tumor in children. To our knowledge, about 30 cases have been reported in literature. We describe the imaging appearance and histopathologic features of this tumor detected in a 2 year old girl who presented with an incidentally detected calcified liver lesion on a chest x-ray which was obtained for cough.
Computed tomography (CT) demonstrated a 5.5 centimeter sized heterogeneous mass with large coarse calcifications. MRI better demonstrated the margins of the lesion, which was predominantly hyper-intense on T2-weighted images. Large areas of signal void were seen in the superior aspect of the lesion, corresponding to the calcifications seen on CT. The lesion demonstrated restricted diffusion. Post-contrast, the lesion demonstrated enhancement in the portal venous phase with washout on the delayed phase. Initial diagnosis based on imaging findings and patient’s age was hepatoblastoma. However, serum alpha- fetoprotein (AFP) was normal, which is unusual with hepatoblastoma. Patient underwent subsequent wedge biopsy, which was proven to represent calcifying nested stromal epithelial tumor of the liver. PET/CT, obtained to evaluate for metastatic disease, demonstrated increased FDG activity within the primary hepatic lesion, with SUV Max of 3.5, with no evidence of FDG avid metastatic disease. She then underwent right hepatectomy and cholecystectomy.

No sign of tumor recurrence has been noted to date on the follow up abdominal ultrasound examination in the past 2.5 years.

Calcifying nested stromal epithelial tumor should be considered in the differential when a large heterogeneous liver tumor with coarse/ chunky calcifications is identified at imaging in the absence of elevated serum AFP in a child. Currently the standard treatment in complete surgical excision and liver transplantation if excision is not possible. Read More

Authors:  Biyyam Deepa , Youssfi Mostafa , Mandell Gerald , Taylor Steve , Patel Mittun

Keywords:  nested stromal epithelial, tumor, liver

Venkatakrishna Shyam Sunder,  Otero Hansel,  Khrichenko Dmitry,  Serai Suraj

Final Pr. ID: Poster #: SCI-009

MRI can accurately quantify liver iron concentration (LIC) by using T2* sequences. Vendor based, commercially available 3D multi-echo Dixon sequences provide maps of liver T2*/R2* and allow automated, inline post-processing, avoiding conventional manual post-processing. The purpose of our study was to compare R2*/LIC estimates generated by automated 3D multi-echo Dixon sequence to values generated by GRE-based R2* relaxometry as the reference standard. Read More

Authors:  Venkatakrishna Shyam Sunder , Otero Hansel , Khrichenko Dmitry , Serai Suraj

Keywords:  Liver Iron Concentration, 3D multi-echo Dixon, MRI

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

Final Pr. ID: Poster #: EDU-016

Congenital portosystemic shunts represent a rare congenital malformation which diverts portal blood to the systemic circulatory system. These malformations can either be intrahepatic or extrahepatic. The intrahepatic portosystemic shunts have been classified into four types. Intrahepatic congenital portosystemic shunts demonstrates a persistent communication between the portal and hepatic venous structures, which were derived from the embryonic vitelline veins or between the vitelline and subcardinal veins. A ductus venosus, a normal structure in neonates, represents an intrahepatic congenital portosystemic shunt between the left portal vein and left hepatic vein. It typically closes between 2-17 days of postnatal life. In our institution, since April 2020, there have been five separate cases of intrahepatic congenital portosystemic shunts in newborns. We will review the imaging for each of these cases, as well as review the current literature and classification of portosystemic shunts. Read More

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

Keywords:  Portosystem Shunt, Liver, Ultrasound

Torres-juarez Jaime,  Suarez Pilar,  Hidalgo-tobon Silvia

Final Pr. ID: Poster #: SCI-001 (S)

El hígado es el principal sitio de almacenamiento de hierro en humanos, y la concentración de hierro en el hígado se correlaciona estrechamente con las reservas de hierro en todo el cuerpo. La técnica de resonancia magnética (MR) es capaz de separar las señales de agua y grasa para cuantificar la infiltración de hierro y grasa en el hígado. Esto permite obtener una mejor cuantificación del hierro y observar la relación que existe con el índice de masa corporal (IMC). En este trabajo se propone una medición de acuerdo a lo propuesto por la divisón anatomica por Couinaud. Read More

Authors:  Torres-juarez Jaime , Suarez Pilar , Hidalgo-tobon Silvia

Keywords:  liver, mri, iron

Ruiz Martha,  Bhargava Ravi,  Marfil Braulio,  Hawkes Michael,  Shapiro James

Final Pr. ID: Poster #: SCI-008

Doppler ultrasound (DUS) is routinely used to assess graft status after liver transplantation (LT). Although early post-surgical assessment is encouraged, the exact prognostic value of DUS parameters is unknown.

The purpose of this study was to determine the prognostic value of DUS parameters obtained in the immediate postoperative period. Read More

Authors:  Ruiz Martha , Bhargava Ravi , Marfil Braulio , Hawkes Michael , Shapiro James

Keywords:  Doppler, Liver transplant, Prognosis

Shet Narendra,  Flynn John,  Maloney Ezekiel,  Iyer Ramesh

Final Pr. ID: Poster #: EDU-021

The purpose of this review is to provide an overview of applications of Eovist in the pediatric population, as well as pitfalls. We will begin with an introduction on the origins of Eovist and how it and other hepatocyte specific contrast agents (HSCAs) differ from conventional gadolinium based contrast agents (GBCAs). We will then provide a sample of imaging protocols when Eovist is used for hepatic mass evaluation and for biliary indications. We will review benefits of Eovist in characterizing a variety of pediatric hepatic neoplasms, including hepatoblastoma, hepatocellular carcinoma, focal nodular hyperplasia, hepatic adenomas, and regenerative nodules, with mention of pathologies that do not follow traditional patterns (i.e., inflammatory adenomas). After this, we will cover biliary applications, including choledochal cysts, biliary obstruction, and postoperative bile leak. Finally, we will review some limitations of Eovist; notably, we will mention several scenarios where the hepatobiliary phase could not be achieved, and recommendations for how to approach these cases. Read More

Authors:  Shet Narendra , Flynn John , Maloney Ezekiel , Iyer Ramesh

Keywords:  Liver, Biliary, MRI

Baheti Akshay,  Patil Vasundhara,  Towbin Alexander,  Chavhan Govind,  Gala Kunal,  Shetty Nitin,  Kulkarni Suyash,  Qureshi Sajid

Final Pr. ID: Poster #: EDU-042

Hepatoblastoma exemplifies how a multidisciplinary approach involving all stake-holders is key for appropriate management. The Pretreatment Extent of Tumor (PRETEXT) classification remains the cornerstone of staging, treatment planning, and prognostication. The 2017 revision addressed many ambiguities and improved standardization of hepatoblastoma staging, providing a common language across disciplines and institutions. However, certain interpretative and practical challenges persist in daily practice. For example, large tumors often compress the IVC, which is not well opacified on cross-sectional imaging. This makes it difficult to confidently categorize venous involvement V + or V-. The precise role of ultrasound in clarifying such equivocal cases also requires further evaluation. Classification of tumors limited to one section and tumor thrombus extending to another section is another source of confusion. The surgical plan in case the tumor thrombus resolves is also unclear. Sectional compression vs involvement, which may cause overstaging, differentiating contiguous spread from multifocality, overcalling rupture in the presence of perihepatic fluid, and more clear definition of extrahepatic extension are other examples of areas which need more clarity. Each of these can lead to staging discrepancies that impact patient management. In this exhibit, we discuss the current PREXTEXT classification, its current utility, pitfalls and limitations, and discuss future directions in PRETEXT classification updates. This educational exhibit revisits the fundamentals of the PRETEXT classification, its current utility, and its pitfalls and limitations through practical, case-based discussions. It highlights common interpretative dilemmas and provides practical strategies to enhance reproducibility and confidence in staging. Finally, it explores emerging directions for future PRETEXT updates. The ultimate goal is to make radiologists more effective members of the interdisciplinary tumor boards through a holistic understanding of PRETEXT classification and discuss areas for future updates. Read More

Authors:  Baheti Akshay , Patil Vasundhara , Towbin Alexander , Chavhan Govind , Gala Kunal , Shetty Nitin , Kulkarni Suyash , Qureshi Sajid

Keywords:  Oncology, Heptoblastoma, Liver Tumor

Rapp Jordan,  Anupindi Sudha,  Bellah Richard

Final Pr. ID: Poster #: SCI-033

To describe ultrasound (US) and magnetic resonance imaging (MRI) findings of giant hepatic regenerative nodules (GHRN) in pediatric patients with Alagille Syndrome (AS). Read More

Authors:  Rapp Jordan , Anupindi Sudha , Bellah Richard

Keywords:  liver mass, cirrhosis

Morgan Trudy,  Poznick Laura,  Back Susan,  Darge Kassa

Final Pr. ID: Poster #: EDU-004 (T)

Contrast enhanced ultrasound is a radiation free, highly sensitive imaging modality for detection of focal liver lesions in children. CEUS uses ultrasound (US) technology and an US contrast agent (UCA) that is administered intravenously. This educational exhibit provides step-by-step instructions of our institutional protocol for performing CEUS exams. Read More

Authors:  Morgan Trudy , Poznick Laura , Back Susan , Darge Kassa

Keywords:  Ultrasound, Liver, Contrast

Gnerre Jeffrey,  Tong Angela,  Jimenez-ocasio Jason,  Lecompte Leslie

Final Pr. ID: Poster #: CR-053

Cancer is the most common cause of disease-related mortality for adolescent patients, 13-19 years of age. Primary liver neoplasms are relatively uncommon entities in this population accounting for 0.5-2.0% of all neoplasms as per the current literature. The most common primary liver malignancy in adolescent patients is hepatoblastoma, which accounts for approximately two thirds of liver tumors. Benign tumors of the liver in the adolescent population include adenomas, focal nodular hyperplasia, hamartomas, and vascular tumors. Hepatic neoplasms in adolescent patients are typically not detected clinically until they reach a large size. While there are many exceptions, these patients generally have normal liver function as well as normal growth and development. In this case series, we examine the imaging characteristics across multiple modalities of several large primary hepatic neoplasms in the adolescent population encompassing both benign and malignant as well as common and uncommon entities. We will also review how the underlying pathophysiology of these neoplasms relates to their imaging appearances. Cross-sectional imaging with MRI or CT, similar to evaluation in adult patients, is considered the best method of evaluating the character and extent of hepatic masses. However, initial workup usually includes plain film x-ray or ultrasound. Benign and malignant hepatic neoplasms in the adolescent population share many similar radiographic features, and therefore, knowledge of these entities and their imaging appearances is essential in order to develop an appropriate differential diagnosis. Read More

Authors:  Gnerre Jeffrey , Tong Angela , Jimenez-ocasio Jason , Lecompte Leslie

Keywords:  Adolescent, Liver, Neoplasm

Chambers Greg,  Zarfati Angelo,  Malthete Cellier Cecile,  Adamsbaum Catherine,  Branchereau Sophie,  Franchi-abella Stephanie

Final Pr. ID: Poster #: SCI-009

Describe imaging features of pediatric focal nodular hyperplasia (pFNH) in a large cohort of children with clinical, radiological and surgical management with a significant follow up period. We aim to provide an algorithm to treat these patients using the evidence base we have created. Read More

Authors:  Chambers Greg , Zarfati Angelo , Malthete Cellier Cecile , Adamsbaum Catherine , Branchereau Sophie , Franchi-abella Stephanie

Keywords:  Liver, Tumor

Ro Esther,  Schooler Gary,  Morin Cara,  Khanna Geetika,  Towbin Alexander

Final Pr. ID: Poster #: EDU-029

The American College of Radiology Pediatric LI-RADS Working Group was formed in 2017 with the task of advancing the imaging work up, diagnosis, and management of pediatric liver tumors, particularly pediatric hepatic malignancies. This exhibit will present how the Pediatric LI-RADS Working Group is working towards this goal by means of advocacy, education, and research. In regard to advocacy, the Working Group is a strong proponent for the standardization of imaging practice for pediatric liver tumors. Based on expert interpretation of the literature, the Working Group established consensus imaging recommendations for children with a known or suspected liver neoplasm. This exhibit will highlight the key recommendations for choosing imaging modality and protocol for the work up of a pediatric liver tumor. Education is another major component of the Working Group’s mission. The group has presented at meetings and published manuscripts on various topics. Topics include age and indication-based imaging strategies for pediatric liver tumors and liver masses in children with predisposition syndromes. This exhibit will touch on the major teaching points of these papers. Lastly, this exhibit will present the research conducted by the Pediatric LI-RADS Working Group. Their research studied the utility of applying adult LI-RADS criteria to children. Another study analyzed the imaging features of hepatocellular carcinoma in children with and without an underlying predisposition. To summarize, through discussion of the major accomplishments of the Pediatric LI-RADS Working Group, this exhibit will provide insight, education, and resources for the radiologist interpreting pediatric liver tumors. Read More

Authors:  Ro Esther , Schooler Gary , Morin Cara , Khanna Geetika , Towbin Alexander

Keywords:  Liver Tumor, Malignancy, Abdominal Imaging

Stanescu Luana,  Kamps Shawn,  Dick Andre,  Phillips Grace

Final Pr. ID: Poster #: EDU-022

Liver transplantation is a potentially life-saving procedure for children with liver failure. Pediatric liver transplant recipients are at greater risk for complications such as vascular thrombosis than adults. In addition, children more commonly receive reduced size grafts, which alter the normal liver anatomy. While the postoperative assessment of pediatric liver transplants with sonography has been well studied, less exists in the radiology literature regarding intraoperative Doppler sonography of the graft prior to abdominal closure. We illustrate the intra- and post-operative ultrasound findings in pediatric liver transplants, with an emphasis on normal features, common pitfalls, and frequently encountered vascular complications. Read More

Authors:  Stanescu Luana , Kamps Shawn , Dick Andre , Phillips Grace

Keywords:  Liver Transplantation, Intra-operative, Doppler

Dubois Josée,  Thomas-chausse Frederic,  Ghali Rafik,  Soulez Gilles

Final Pr. ID: Poster #: CR-042

Congenital portosystemic shunt is a rare vascular malformation that leads to severe complications. Two types are described: extrahepatic and intrahepatic. Extrahepatic shunt is represented by a direct communication of the portal trunk, or one of its branches of origin, to the inferior vena cava, or one of its branches.

We present two cases of extrahepatic shunt treated with stent-graft placement.

Case 1: Two y.o. male with cutaneous telangiectasias and liver calcifications on abdominal ultrasound. An extrahepatic portosystemic shunt was detected on color Doppler examination.

MR and catheter angiography revealed a large fistula between the main portal vein and the suprarenal inferior vena cava. The fistula was closed by deploying a balloon expandable stent-graft in the retrohepatic inferior vena cava. Five years later, the liver function was normalized and no complication was observed.

Case 2: Thirteen y.o. male referred for three hepatic lesions and an extrahepatic portosystemic shunt.

MR and angiography revealed a large fistula between the left portal vein and the inferior vena cava. It was closed by deploying a custom self-expandable stent-graft (Zenith, Cook Medical, Bloomington, IN) in the inferior vena cava. At five years follow-up, the patient is asymptomatic with a resolution of the liver lesions. Read More

Authors:  Dubois Josée , Thomas-chausse Frederic , Ghali Rafik , Soulez Gilles

Keywords:  Stent, Portosystemic shunt, Liver, Embolization, Children

Chilukuri Sanjeev,  Molleston Jean,  Karmazyn Boaz

Final Pr. ID: Poster #: EDU-013

Management of incidentally discovered pediatric liver lesions can be challenging. As compared with adults, no formal guidelines exist on this subject. Our purpose is to suggest an approach to the management of incidental pediatric liver lesions based on review of the literature and our institutional multidisciplinary experience.

Outline:
- Main considerations when evaluating incidental liver lesions in children (including age, alpha fetoprotein level, lesion size, imaging characteristics differentiating benign and malignant tumors, role of contrast-enhanced US, role of hepatobiliary contrast MRI)
- Suggested approach to the management of incidental liver lesions detected by US, CT, and MRI
- Examples of common incidental liver lesions (cyst, hemangioma, focal nodular hyperplasia, hepatocellular adenoma, focal fatty infiltration and sparing) Read More

Authors:  Chilukuri Sanjeev , Molleston Jean , Karmazyn Boaz

Keywords:  Incidental, Liver, Lesion

Arenos-abril Jesus,  Moreira Maricela,  Barnes Navarro Daniel,  Padros Fornieles Cristina,  Molino Gahete Jose Andres,  Riaza Lucía

Final Pr. ID: Poster #: EDU-047

Cavernous transformation of the portal vein (CTPV) is characterized by the formation of venous channels within and around a previously stenosed or occluded portal vein, serving as portoportal collateral vessels. It is a major cause of portal hypertension in children and requires a multifaceted management approach, including medical therapy, interventional procedures such as portal recanalization, and surgical treatments ranging from shunt creation to liver transplantation in end-stage cases.
CT-angiography, in combination with portal venography, is the key imaging modality for determining the optimal treatment strategy. It is essential not only for assessing liver cirrhosis and secondary signs of portal hypertension—such as portosystemic collaterals, splenomegaly, and ascites—but also for providing detailed anatomical mapping critical for surgical planning.
This presentation will illustrate various pediatric cases of CTPV and discuss the optimal management approach based on factors including the presence or absence of liver cirrhosis, dominant portal collaterals, intrahepatic portal flow, proper superior mesenteric vein communicating with the porta hepatis, and splenorenal shunts, among others. For each scenario a therapeutic plan will be suggested based upon clinical and imaging criteria.
By the end of this presentation, readers will be able to: Optimize CT protocols for evaluating CTPV; enhance reporting using a structured checklist of key findings; and support clinical decision-making in collaboration with multidisciplinary teams. Read More

Authors:  Arenos-abril Jesus , Moreira Maricela , Barnes Navarro Daniel , Padros Fornieles Cristina , Molino Gahete Jose Andres , Riaza Lucía

Keywords:  Liver, Portal Vein Thrombosis, Portal Hypertension

Hanquinet Sylviane,  Morice Claire,  Merlini Laura,  Cousin Vladimir,  Mclin Valérie,  Anooshiravani Mehrak

Final Pr. ID: Poster #: SCI-008

The diagnosis of hepatic encephalopathy is mainly detected by neuropsychological tests. These tests, however, do not always apply depending on the status of the child (age, social and cultural environment) and are therfore not reliable for subtle changes. We propose to detect minimal hepatic encephalopathy (minHE) in children with chronic liver disease and/or porto-systemic shunting, using MRI with Diffusion-weighted (ADC) and ¹H- spectroscopy in the globus pallidum. Read More

Authors:  Hanquinet Sylviane , Morice Claire , Merlini Laura , Cousin Vladimir , Mclin Valérie , Anooshiravani Mehrak

Keywords:  hepatic encephalopathy, 1H- spectroscopy, brain MRI, chronic liver disease, porto-systemic shunting

Loo Jerry,  Iskander Paul,  Chen Johnathan,  Hall Theodore,  Boechat Ines,  Ghahremani Shahnaz

Final Pr. ID: Poster #: EDU-010

Intestinal failure is a rare but devastating condition in pediatric patients that is often caused by short bowel syndrome (SBS) secondary to necrotizing enterocolitis, volvulus, or intestinal atresia. Patients require the use of total parenteral nutrition (TPN) to survive, which can lead to cholestasis and end stage liver disease (ESLD). Treatment of intestinal failure in pediatric patients who have developed subsequent liver failure from TPN with multivisceral (MVTx) transplantation has progressed dramatically in the past two decades as a result of improvements in immunosuppression, surgical technique, and post-transplant care. The number of transplantations has always been relatively low due to a lack of appropriate donors and the rarity of intestinal failure. However, given the high acuity of patients that do ultimately undergo these procedures, recognition of post-operative complications is critical for graft survival and improved outcomes. This educational exhibit will review the indications and relevant anatomy for these types of transplantations. Magnetic resonance (MR) findings related to post-transplantation complications will be presented with imaging correlates from other modalities (CT, PET/CT, US) as needed. Read More

Authors:  Loo Jerry , Iskander Paul , Chen Johnathan , Hall Theodore , Boechat Ines , Ghahremani Shahnaz

Keywords:  intestinal, liver, magnetic resonance

Hwang Sook Min

Final Pr. ID: Poster #: SCI-018

To evaluate the diagnostic performance of attenuation imaging (ATI) with an ultrasound scanner (US) in the detection of pediatric hepatic steatosis. Read More

Authors:  Hwang Sook Min

Keywords:  Obesity, Non Alcoholic Fatty Liver Disease, Ultrasound

Trout Andrew,  Zhang Bin,  Dillman Jonathan,  Anupindi Sudha,  Gee Michael,  Khanna Geetika,  Xanthakos Stavra,  Baikpour Masoud,  Calle-toro Juan,  Ozturk Arinc,  Serai Suraj

Final Pr. ID: Paper #: 008

MR elastography (MRE) is increasingly being used to non-invasively assess diffuse liver disease in children. However, there are limited normal liver stiffness data for MRE in children. The purpose of this study was to determine normal liver stiffness measured by MRE for children and assess for associations with demographic factors, MRI field strength and MRI vendor. Read More

Authors:  Trout Andrew , Zhang Bin , Dillman Jonathan , Anupindi Sudha , Gee Michael , Khanna Geetika , Xanthakos Stavra , Baikpour Masoud , Calle-toro Juan , Ozturk Arinc , Serai Suraj

Keywords:  Elastography, MR, Liver

Baheti Akshay,  Rajasimman Aishvarya Shri,  Patil Vasundhara,  Gala Kunal,  Shetty Nitin,  Kulkarni Suyash,  Ramadwar Mukta,  Panjawani Poonam,  Qureshi Sajid

Final Pr. ID: Poster #: SCI-030

Pediatric hepatic neoplasms include a variety of differentials which vary with the child’s age. We evaluated the diagnostic accuracy of certain imaging features on CECT in differentiating these tumors, particularly for identifying hepatoblastoma. Read More

Authors:  Baheti Akshay , Rajasimman Aishvarya Shri , Patil Vasundhara , Gala Kunal , Shetty Nitin , Kulkarni Suyash , Ramadwar Mukta , Panjawani Poonam , Qureshi Sajid

Keywords:  Abdomen CT, Liver Tumor, Heptoblastoma

Din Farah,  Hadian Fatemeh,  Chavhan Govind

Final Pr. ID: Poster #: EDU-028

Imaging is crucial in the staging of primary pediatric liver tumors. Hepatoblastoma, pediatric HCC and transitional-type lesions (HCC/hepatoblastoma) should be pre-operatively staged at the time of diagnosis using the PRETEXT system. The PRETEXT (PRE-Treatment EXTent of tumor) criteria were first described in 1992 and updated most recently following an international consensus in 2017, and provide reproducible imaging-based prognostic information for patient survival prior to treatment.

The PRETEXT system consists of two criteria; the group and annotation factors. The PRETEXT stage (I-IV) describes the anatomical extent of tumor within the liver, categorized according to contiguous lesion-free liver sections, whilst the annotation factors describe associated features such as vascular involvement, extrahepatic disease and metastases. These are combined and patients are divided into two risk stratified groups. The standard risk group, mostly including Stage I and II tumors, are more likely to be managed by partial hepatectomy whilst higher risk groups including stage IV tumors are often unresectable and require liver transplantation. Its ultimate goal is to determine the feasibility of surgical resection.

At our institution, our hepatobiliary surgeons use the PRETEXT criteria for prognostication and patient management. International use of these consensus criteria is essential in order to unify management of this rare pediatric tumor subtype.

Our objective is to discuss pearls and pitfalls from our experience of using the PRETEXT criteria. Relevant imaging examples from our large specialist pediatric institute will be provided with discussion of variability of scoring between CT and MRI as well as technical challenges. Selected multi-modality case-based examples will be provided with reference to patient management and operative findings where available. Read More

Authors:  Din Farah , Hadian Fatemeh , Chavhan Govind

Keywords:  Liver tumours, PRETEXT, staging

Tang Elizabeth,  Zavaletta Vaz,  Acord Michael,  Escobar Fernando,  Monroe Eric,  Gill Anne

Final Pr. ID: Poster #: EDU-052

The role of locoregional therapy options (percutaneous thermal ablation, chemoembolization, and/or radioembolization) continues to gain traction in the pediatric oncology world, particularly with the management of primary and metastatic liver lesions. Post-treatment imaging of the liver must clearly differentiate between treatment response, residual untreated disease and progressive disease in order to guide the future therapeutic options.
The post-treatment imaging appearance of pediatric liver lesions can be affected by multiple factors (tumor type, tumor vascularity, radiation vs non-radiation therapy, background liver characteristics, time lapse from the interventional oncology procedure, imaging technique, e.g.). The understanding and interpretation of such factors continues to evolve, as seen with the most recent ACR LI-RADS Treatment Response Assessment Update in 2024. This case cohort presents illustrative examples from multiple pediatric interventional oncology programs, using various imaging modalities to demonstrate post-treatment liver imaging findings following locoregional therapy for both primary and metastatic liver lesions in pediatric patients. Read More

Authors:  Tang Elizabeth , Zavaletta Vaz , Acord Michael , Escobar Fernando , Monroe Eric , Gill Anne

Keywords:  Liver, Pediatric MRI, Interventional Oncology

Abu Ata Nadeen,  Dillman Jonathan,  Gandhi Deep,  Dudley Jonathan,  Trout Andrew,  Miethke Alexander

Final Pr. ID: Paper #: 095

Multiple noninvasive magnetic resonance imaging (MRI) methods have been described to detect liver fibrosis, including diffusion-weighted imaging (DWI). The purpose of our study was to evaluate predictors of liver MRI DWI apparent diffusion coefficient (ADC) measurements in pediatric patients with autoimmune liver disease, including the relationship between ADC measurements and liver stiffness.
Read More

Authors:  Abu Ata Nadeen , Dillman Jonathan , Gandhi Deep , Dudley Jonathan , Trout Andrew , Miethke Alexander

Keywords:  Liver fibrosis, Liver stiffness

Roman Martinez Angelica Viridiana,  Suarez Pilar,  Hidalgo-tobon Silvia

Final Pr. ID: Poster #: SCI-007 (S)

demonstrate that using the anatomical division of the liver suggested by Couinaud allows a more accurate quantification of the amount of fat. Read More

Authors:  Roman Martinez Angelica Viridiana , Suarez Pilar , Hidalgo-tobon Silvia

Keywords:  liver, MRI, children