Mezher Maria,  Hamel Eva,  States Lisa

Final Pr. ID: Poster #: SCI-070

68-Gallium DOTATATE PET is frequently utilized for the assessment of neuroendocrine tumors. Its application in the management of neuroblastoma has been briefly documented in the literature. We describe four years of institutional experience of its use for the evaluation and follow-up of neuroblastoma. Read More

Authors:  Mezher Maria , Hamel Eva , States Lisa

Keywords:  Neuroblastoma, Ganglioneuroblastoma, Paediatric Nuclear Medicine

Khan Muhammad

Final Pr. ID: Poster #: EDU-021

The American Board of radiology(ABR) and society for pediatric Radiology (SPR) are working to adress the shortage of pediatric radiologists in the United States. This educational exhibit presents a brief overview of the pathways to become board certified in pediatric radiologist.

1- CONVENTIONAL PATHWAY:
- Intern Year (PGY-1).
- Diagnostic Radiology Residency (PGY-2 to PGY-5): Four years of comprehensive radiology training.
- Pediatric Radiology Fellowship (1 Year): Specialized training in pediatric imaging.

2- ABR ALTERNATE PATHWAY

Designed for international medical graduates.
-Home country radiology residency
-Completed USMLEs
-Four years at a U.S. institution having ACGME accredited residency program. Four years can be completed as combination of residency/ fellowship/attending in academic program.

3- ABR 15-month pediatric radiology residency pathway
- 15 months of pediatric experience during 48 months DR residency.
- No requirement for additional pediatric radiology fellowship. Read More

Authors:  Khan Muhammad

Keywords:  Career Choice, Paediatric Radiology

Petrosyan Lilit,  Ayvazyan Sona

Final Pr. ID: Poster #: CR-008

Nasopharyngeal carcinoma (NPC) is a rare malignancy in the pediatric population, comprising less than 1% of all pediatric malignancies. NPC typically occurs in older children and adolescents, with the highest incidence between ages 10-19, and there may be a slight male predominance.
A 14-year-old boy presented with a 2-week history of earache, hearing loss, headache, fever, neck pain, and palpable enlarged lymph nodes in the neck. Ultrasound revealed bilateral cervical lymphadenitis. Upon physical examination, the throat appeared hyperemic. Blood tests showed moderately elevated inflammatory markers. Initially, the patient was diagnosed with cervical lymphadenitis, right-sided otitis, and eustachitis. Antibiotic therapy was initiated, resulting in mild improvement; however, the primary symptoms persisted.
Serological testing for Epstein-Barr virus (EBV) was negative. A contrast-enhanced CT scan was performed due to the suspicion of an abscess. The CT revealed a hypervascular mass measuring 4.3x3.3cm in the nasopharynx, extending into the parapharyngeal and retropharyngeal spaces from the right side, significantly narrowing the nasopharyngeal airway. Cervical lymphadenopathy was also noted, particularly on the right side.
Given the imaging findings, a differential diagnosis was considered between lymphoma and nasopharyngeal carcinoma. A pediatric oncology consultation was obtained, and biopsies of both the retropharyngeal mass and cervical lymph nodes were performed. Histopathological analysis confirmed the diagnosis of nasopharyngeal carcinoma.
Nasopharyngeal carcinoma in pediatric patients often presents with non-specific symptoms, contributing to diagnostic delays. Cervical lymphadenopathy is frequently the primary clinical finding, typically manifesting as painless enlarged neck lymph nodes. Other common symptoms include nasal obstruction, nasal discharge, and ear-related issues such as otitis media with effusion, hearing loss, or tinnitus due to eustachian tube dysfunction. In cases presenting with these symptoms, imaging with CT or MRI has an important role for early diagnosis. Read More

Authors:  Petrosyan Lilit , Ayvazyan Sona

Keywords:  Lymphadenopathy, Oncology, Paediatric Radiology

Galvis Ingrid,  Kvist Ola,  Jarrett Delma

Final Pr. ID: Poster #: EDU-064

Bowing of the lower extremities is a common presentation in pediatric patients and may represent either normal physiologic development or an underlying pathologic process requiring medical or surgical intervention. Radiologists play an essential role in distinguishing between benign developmental variants and serious bone disorders, including nutritional deficiencies, metabolic bone disease, and skeletal dysplasias. Conditions such as rickets, scurvy, and Blount's disease have distinct etiologies but often present with overlapping radiologic features—most notably metaphyseal abnormalities, osteopenia, and angular deformities—that can obscure diagnosis and delay appropriate treatment.

This educational poster presents a structured, pattern-based approach to evaluating pediatric bowing disorders, integrating clinical presentation, age, and characteristic imaging findings. Key radiographic parameters include the metaphyseal-diaphyseal angle, tibiofemoral angle measurements, and assessment of the Drennan angle for differentiating infantile Blount's disease from physiologic bowing. Age-specific thresholds guide management: physiologic bowing typically resolves by 18-24 months, whereas progression beyond age 2 years or asymmetric involvement warrants investigation for pathologic etiologies. Age-specific diagnostic criteria and systematic assessment of metaphyseal morphology form the foundation of our approach. We highlight key differentiating features for scurvy, rickets (including hypophosphatemic forms), Blount's disease, and other mimickers such as osteogenesis imperfecta and skeletal dysplasias. Emphasis is placed on early recognition of red flags, interpretation of radiographic and MRI findings, and understanding imaging pitfalls that can lead to misdiagnosis. Using comparative imaging examples and diagnostic algorithms, this poster aims to enhance the radiologist's ability to confidently diagnose and differentiate pediatric bowing deformities, improving clinical outcomes and reducing unnecessary interventions. Read More

Authors:  Galvis Ingrid , Kvist Ola , Jarrett Delma

Keywords:  Musculoskeletal, Metabolic Disorder, Paediatric Radiology

Mannix Laura

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

A three year old child was referred to the Nuclear Medicine Department for bone scintigraphy for staging. This patient was diagnosed with hepatoblastoma. Imaging findings showed no bony disease, however, radiotracer uptake was demonstrated throughout the liver. Read More

Authors:  Mannix Laura

Keywords:  Nuclear Medicine, Heptoblastoma, Paediatric Nuclear Medicine

Tan Timothy Shao Ern

Final Pr. ID: Poster #: SCI-019

Paediatric fluoroscopy was recently incorporated into Singapore’s national FRCR aligned didactic curriculum, highlighting a growing need for structured and clinically relevant teaching in this domain. This study evaluates a novel, high-yield, case-based teaching model designed to enhance residents’ understanding, confidence, and exam preparedness in paediatric fluoroscopy. Read More

Authors:  Tan Timothy Shao Ern

Keywords:  Fluoroscopy, Paediatric Radiology, Neonatal Bowel Obstruction

Bauman Parker,  Mcdaniel Janice

Final Pr. ID: Poster #: CR-034

A 17-year-old female presents with the chief complaint of recurrent epigastric pain following the diagnosis of median arcuate ligament syndrome (MALS) confirmed via ultrasound duplex and computed tomography angiography. Subsequent laparoscopic median arcuate ligament release and resection of celiac nerve plexus were performed. The patient initially had complete resolution of pain; however, the same type of epigastric pain recurred with no sonographic evidence of recurrent MALS. This prompted the use of a celiac plexus block for diagnostic and therapeutic purposes. Using a one-sided posterior approach, the expected location of the celiac nerve plexus was localized using 3-dimensional cone-beam computed tomography-guided imaging. Using intermittent fluoroscopy with laser and iGuide graphic overlay the needle was incrementally advanced; to confirm the periaortic location of the needle tip a small amount of dilute contract was injected. Then, 80 mg (40mg/mL) of triamcinolone and 20 mL of 0.5% bupivacaine hydrochloride was administered into the periaortic space. The patient had a complete resolution of pain for two weeks. To obtain long-term pain relief, the process was repeated with an injection of 10 mL of 99% ethanol to effectively ablate the celiac nerve plexus, along with 20 mL of bupivacaine liposome. At 1 month and 3 months post-injection, the patient reports a significant reduction in epigastric pain (0-1 out of 10) following the procedure and reports being pleased she had the procedure. This case expands the use of computed tomography-guided celiac plexus ablation by showing effectiveness in reducing epigastric pain in a pediatric patient with a prior MALS diagnosis. Read More

Authors:  Bauman Parker , Mcdaniel Janice

Keywords:  Cone-Beam CT Guidance, Paediatric Radiology, Median Arcuate Ligament Syndrome

Galvis Ingrid,  Kvist Ola,  Vo-phamhi Jenny,  Perdomo-luna Camilo,  Jarrett Delma

Final Pr. ID: Poster #: EDU-066

Learning Objectives:
-To recognize age-specific radiographic manifestations of rickets and understand how imaging features evolve from infancy through adolescence.
-To distinguish between nutritional, genetic, and systemic causes of rickets using characteristic imaging patterns.
-To identify common mimics of rickets and differentiate them from true metabolic bone disease.
-To understand the complementary roles of radiography and MRI in challenging cases.

Background: Rickets is a pediatric metabolic bone disorder characterized by imaging features that change according to the patient's age and underlying cause. Some conditions may mimic rickets due to similar radiologic features; therefore, accurate recognition of hallmark radiographic signs—including metaphyseal fraying, cupping, widening, and angular deformities—is critical for timely diagnosis, appropriate management, and differentiation from mimics. Nutritional rickets remains the most prevalent cause, particularly among exclusively breastfed infants without adequate vitamin D supplementation. However, older children with rickets frequently have genetic and systemic causes, such as renal and phosphate metabolism disorders. Although radiographs remain the principal imaging modality for evaluation, MRI may provide enhanced diagnostic precision in challenging or unclear cases. Clinical red flags warranting imaging evaluation include persistent or worsening bowing beyond expected physiologic ages, motor delays, pathologic fractures, failure to thrive, and lack of response to vitamin D supplementation in older children, which suggests genetic or renal etiologies rather than simple nutritional deficiency.

This educational poster presents an age-based approach to diagnosing rickets, illustrating classic radiographic features across different age groups and etiologies. Key imaging findings in nutritional rickets, hypophosphatemic rickets, and renal osteodystrophy are systematically compared. Common mimics—including scurvy, non-accidental trauma, Blount's disease, osteogenesis imperfecta, and physiologic variants—are reviewed with comparative imaging to enhance diagnostic accuracy. Emphasis is placed on pattern recognition, and the role of advanced imaging in equivocal cases. Read More

Authors:  Galvis Ingrid , Kvist Ola , Vo-phamhi Jenny , Perdomo-luna Camilo , Jarrett Delma

Keywords:  Metabolic Disorder, Musculoskeletal, Paediatric Radiology

Banaz Tuba,  Omaç Birinci Aysegül,  Ayaz Ercan,  Akyel Nazli Gülsüm

Final Pr. ID: Poster #: CR-038

Introduction: Hereditary spastic paraplegias (HSP) are heterogeneous neurodegenerative disorders causing progressive lower limb spasticity. MRI findings are variable but crucial for differential diagnosis. Classic radiological features include spinal cord atrophy (most common), corpus callosum thinning, and T2/FLAIR hyperintensities in the corticospinal tracts, such as the posterior limb of the internal capsule and the " ears of the lynx" sign (periventricular frontal signal). We present a case demonstrating both typical and significant atypical MRI findings.
Case Report: A 16-year-old male patient presented to our clinic with a three-year history of "finger-tip walking." Neurological examination revealed mild mental retardation, increased deep tendon reflexes (DTR) in the lower extremities, and mild spasticity in the feet. The patient's history indicated normal developmental milestones, and there was no known family history of neurological disease. Clinical findings were primarily consistent with HSP, and radiological evaluation was planned.
Radiological Findings: Cranial MRI showed findings typical for HSP: symmetric T2 hyperintensities in the posterior limbs of both internal capsules and in the frontal periventricular white matter (the " ears of the lynx" sign). The corpus callosum was markedly thin, especially the genu and body. Atypical findings were also present: diffuse symmetric T2 signal changes in the bilateral temporoparietal white matter and prominent cerebral sulcal spaces (cerebral atrophy) for his age.
Discussion and Conclusion: This case highlights the classic radiological triad of complicated HSP: corpus callosum thinning, posterior internal capsule signal changes, and the "ears of the lynx" sign, all reflecting corticospinal tract involvement. However, the presence of significant cerebral atrophy and widespread temporoparietal white matter abnormalities are atypical. These atypical features expand the differential diagnosis, necessitating clinical correlation to rule out overlapping conditions such as periventricular leukomalacia (PVL) sequelae or a hypomyelination disorder. This case underscores that while MRI can reveal characteristic signs of HSP, it may also present a mixed picture with unexpected findings, emphasizing its role in characterizing the full scope of white matter pathology.. Read More

Authors:  Banaz Tuba , Omaç Birinci Aysegül , Ayaz Ercan , Akyel Nazli Gülsüm

Keywords:  Neuroradiology, MRI Brain, Paediatric Radiology

Antil Neha,  Gatidis Sergios,  Nadel Helen

Final Pr. ID: Poster #: EDU-110

PET/MRI (Positron Emission Tomography–Magnetic Resonance Imaging) is a powerful hybrid imaging modality that has gained increasing clinical relevance in pediatric and neonatal imaging over the past decade. It combines the molecular imaging strengths of PET with the superior soft tissue contrast and functional capabilities of MRI, enabling both whole-body and targeted imaging in a single session. In pediatric imaging, where minimizing radiation exposure is critical and conditions often involve subtle functional or metabolic changes, PET/MRI has emerged as a powerful problem-solving modality. Additional advantage of PET/MRI in pediatric patients is reduction in the number of necessary single examinations and thus reducing the number of sedations and radiation exposure when compared with PET/CT.
PET/MRI has been established as a clinical imaging modality with a wide range of applications across pediatric oncology, neurology, cardiology, infectious/ inflammatory disorders, and rheumatology. It can be utilized for presurgical planning for epilepsy, detection and staging of tumors. Beyond detection and characterization of tumor lesions, PET/MRI is highly effective in providing relevant secondary information about tumor-related or therapy-related complications. Additionally, PET/MRI is helpful diagnostic tool in unusual or challenging clinical situations such as discrepant findings from other diagnostic tests, nonspecific clinical findings, or inconclusive prior imaging findings, especially in children with fever of unknown origin. In such settings, PET/MRI can be used as a problem-solving tool to provide guidance regarding patient management when identifying disease foci or biopsy targets or when ruling out the presence of macroscopic malignancy or active inflammatory processes.
This exhibit demonstrates the unique diagnostic value of hybrid PET/MRI in complex pediatric imaging and to highlight its role as a comprehensive, multiparametric tool in evaluating a wide spectrum of challenging pediatric conditions through clinical cases. The exhibit will be educational for radiologists, nuclear medicine physicians, and pediatric specialists on the strengths, clinical applications, and practical considerations of PET/MRI in children. Read More

Authors:  Antil Neha , Gatidis Sergios , Nadel Helen

Keywords:  Paediatric Nuclear Medicine, Pet/MRI, Oncology

Chotai Heena,  Varma Nisha,  Liyanage Neelika

Final Pr. ID: Poster #: EDU-059

Phalangeal micro geodic disease (PMD)/ transient phalangeal osteolysis is a rare self-limiting condition for which there are limited published case reports. There have been an increasing number of cases over the last thirteen years dating back to 2001. We present several paediatric cases diagnosed as PMD over the last ten years and their imaging features, often overlapping with inflammatory or infective arthropathy. PMD has a higher occurrence after cold exposures and thus seen in colder regions. It has also been described to favor the fingers over the toes.
This is a pictorial review that highlights the imaging findings of PMD to enable a smoother journey from presentation to diagnosis for both our Radiological and Clinical colleagues. Read More

Authors:  Chotai Heena , Varma Nisha , Liyanage Neelika

Keywords:  X-Ray, Magnetic Resonance Imaging, Paediatric Radiology

Mistry Mikesh,  Dickinson Fiona,  Shenoy Savitha

Final Pr. ID: Poster #: CR-017

DSD encompasses a wide range of conditions presenting in newborns or adolescents. The clinical features usually involve atypical genitalia in infancy or atypical pubertal development in adolescence. Those assigned female sex and later identified to have 46XY DSD pose extremely challenging and sensitive presentation to families and professionals. The assessment requires consideration of sexual identity issues among adolescents and potential for future adult sexual functioning and fertility. Radiological assessment (ultrasound and MRI) in the evaluation of these cases is paramount in providing information on the location and state of the gonads and Mullerian structures.

We report a selection of cases demonstrating the role of imaging in children and adolescents with a female phenotype and assigned female sex at birth but later identified to have 46XY DSD.

A 3 month old female presented with ambiguous genitalia and karyotyping confirmed 46XY. Ultrasound demonstrated left hydronephrosis and a bicornuate uterus with no ovarian or testicular tissue identified. MRI confirmed left hydronephrosis secondary to pelviureteric junction obstruction and a didelphys uterus with absence of ovarian and testicular tissue. Genetic tests confirmed MYRF-related cardiac urogenital syndrome and the parents opted to raise the child as female and with an early gonadectomy planned.

A 14 year old girl presented with primary amenorrhoea and deepening voice. She was noted to have 5cm phallus-like structure, unfused labioscrotal folds and a single genital orifice. Karyotyping confirmed 46XY and ultrasound demonstrated no ovarian or uterine tissue. MRI revealed bilateral testes in the inguinal canals, seminal vesicles that connected with a vaginal cavity and a small penile shaft. Genetic tests confirmed 5α-reductase deficiency and a puberty blocker was offered to allow the patient to explore her gender identity.

A 16 year old female presented with primary amenorrhoea, but had normal female external genitals and pubertal breast changes. Karyotyping confirmed 46XY and ultrasound demonstrated no ovarian, uterine or testicular tissue. Genetic tests confirmed complete androgen insensitivity and the patient opted to continue female identity and undergo gonadectomy in the future.

These cases demonstrate the vital role of imaging modalities in the evaluation of DSD by providing significant and crucial information, which is paramount in the diagnosis and ongoing management for these patients. Read More

Authors:  Mistry Mikesh , Dickinson Fiona , Shenoy Savitha

Keywords:  Paediatric Radiology, Genetics

Galvis Ingrid,  Kvist Ola,  Perdomo-luna Camilo,  Jaramillo Diego

Final Pr. ID: Poster #: EDU-065

Learning Objectives:
-To recognize characteristic MRI features of chronic recurrent multifocal osteomyelitis (CRMO) that distinguish it from infectious osteomyelitis and malignancy
-To understand common imaging mimics including focal periphyseal edema zones, developmental variants, and physiologic bone marrow changes
-To appreciate the clinical-imaging discordance in CRMO and the role of whole-body MRI in detecting subclinical disease
Background: CRMO is a rare autoinflammatory bone disorder in children that poses diagnostic challenges due to overlapping features with infection, malignancy, and benign conditions. Early recognition of characteristic imaging patterns is crucial to avoid unnecessary biopsies, inappropriate antibiotic therapy, and diagnostic delays that may lead to skeletal complications. Read More

Authors:  Galvis Ingrid , Kvist Ola , Perdomo-luna Camilo , Jaramillo Diego

Keywords:  Paediatric Radiology, Musculoskeletal, Magnetic Resonance Imaging MRI

Kohli Mandy,  Vali Reza,  Amirabadi Afsaneh,  Frankfurter Caroline Frankfurter,  Shammas Amer

Final Pr. ID: Poster #: SCI-065

In paediatric nuclear medicine the majority of the scans require intravenous (IV) access to deliver the radiotracers. Children and parents often cite procedural pain as the most distressing part of their child’s hospitalization. In our department, various pain management strategies including physical and psychological distraction methods and pharmacological intervention have been implemented for the reduction of procedural pain. The purpose of this study was to evaluate and compare different pain reduction strategies used in the paediatric Nuclear Medicine department.
Read More

Authors:  Kohli Mandy , Vali Reza , Amirabadi Afsaneh , Frankfurter Caroline Frankfurter , Shammas Amer

Keywords:  Pain management, Paediatric, Distraction method