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

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

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