Ramirez Suarez Karen,  Miranda Schaeubinger Monica,  Barton Katherine,  Riedesel Erica,  Otero Hansel

Final Pr. ID: Poster #: EDU-022

The Choosing Wisely initiative, led by the American Board of Internal Medicine (ABIM) Foundation in collaboration with over 80 medical societies and organizations, was launched in 2012 in the United States and Canada. Choosing Wisely is a response to the estimation that roughly 20% of current medical tests and therapies lack justification, provide no value, and may pose risks. The American Academy of Pediatrics (AAP) became a participant in Choosing Wisely from the start, resulting in 16 pediatric specialty-specific lists designed to assist AAP members in responsible healthcare resource management. While pediatric radiology did not develop its own list, imaging recommendations were included on fully half of the published AAP/Choosing Wisely lists. Read More

Authors:  Ramirez Suarez Karen , Miranda Schaeubinger Monica , Barton Katherine , Riedesel Erica , Otero Hansel

Keywords:  Pediatric, Imaging, Radiology

Markowitz Richard

Final Pr. ID: Poster #: EDU-011

This poster reviews the early origins of the SPR, how it came to be, and who were the leaders who were responsible for its creation. These leaders and “giants” went on to train others who carried on their work and expanded it. Today, most pediatric radiologists can trace their professional genealogy back to one of the original founders of the SPR. As the SPR has grown and developed, it has become more inclusive and diverse. Twelve outstanding women have been presidents of the SPR since 1977. From the original goal of sharing a few cases among friends, it has grown into a mature, scientifically based platform for the creation and dissemination of new and cutting-edge developments in the field of pediatric imaging. We owe a debt of gratitude to those who preceded us; we remain inspired by them; and we carry forward their commitment, wisdom, and dedication to advancing the best practices to enhance children’s health. Read More

Authors:  Markowitz Richard

Keywords:  Education, Imaging, Pediatric Radiology

Mccauley Robert,  Pierre Kevin,  Yekeler Ensar,  Sharma Priya,  Rodero Cardoso Mariana

Final Pr. ID: Poster #: CR-027

Sparganosis is a rare parasitic infection caused by the plerocercoid larvae of Spirometra spp. That is seldom encountered in humans. Clinical presentations are often nonspecific, and imaging findings can mimic other soft tissue lesions and lead to misdiagnosis. We present a case of a 14-year-old female with an abdominal wall lesion initially suspected to be cutaneous endometriosis, which was later diagnosed as sparganosis.

Case Presentation:
A 14-year-old female presented with a progressively enlarging, tender subcutaneous mass located superior and left of the umbilicus. The lesion was associated with intermittent pain, particularly exacerbated during menstruation, which raised clinical suspicion for cutaneous endometriosis. Abdominal MRI revealed a 2.5 cm subcutaneous mass with heterogeneous signal intensity on both T1- and T2-weighted images. Areas of hyperintensity suggested hemorrhagic components, which can be seen with endometriotic implants.

The patient underwent surgical excision of the mass. Intraoperatively, a well-defined subcutaneous lesion was removed without complications. Histopathological examination unexpectedly revealed a cestode consistent with Spirometra spp. (sparganosis), along with mixed inflammation, granulation tissue formation, and focal necrosis. The cystic structure corresponded to the parasite's infection site. Postoperative management included prescribing albendazole therapy following stool sample collection to rule out residual parasitic infection.

Discussion:

Sparganosis is an uncommon parasitic infection in humans that is typically acquired through ingestion of contaminated water or undercooked meat from intermediate hosts. It often presents as a slowly growing subcutaneous mass, which can be mistaken for other soft tissue lesions such as lipomas, cysts, or, as in this case, endometriosis. Imaging findings are nonspecific; MRI may show cystic or solid masses with variable enhancement patterns. In this patient, MRI findings closely resembled cutaneous endometriosis due to the presence of hemorrhagic components within the lesion.

Definitive diagnosis of sparganosis is usually established postoperatively via histopathological identification of the parasite. This case demonstrates the importance of considering parasitic infections in the differential diagnosis of subcutaneous masses. Read More

Authors:  Mccauley Robert , Pierre Kevin , Yekeler Ensar , Sharma Priya , Rodero Cardoso Mariana

Keywords:  MRI, Infection, Pediatric Radiology

Morales-tisnés Tatiana,  Miranda Schaeubinger Monica,  Yaya Carlos,  Milla Sarah,  Heller Richard,  Otero Hansel

Final Pr. ID: Poster #: EDU-025

Access to healthcare, and in particular to pediatric subspecialties, including pediatric radiology, is limited. Increasingly limited access creates or accentuates preexisting disparities and injustices. However, because of the complexity of the issue, it is difficult to objectively study and quantify it. This exhibit will describe current barriers to pediatric radiology access, available research tools and methodologies that can help us measure the impact of such barriers. Then, we propose a research agenda to systematically approach the problem. Read More

Authors:  Morales-tisnés Tatiana , Miranda Schaeubinger Monica , Yaya Carlos , Milla Sarah , Heller Richard , Otero Hansel

Keywords:  Pediatric radiology, Access to healthcare, Research agenda

Joshi Aparna,  Kalra Kunal

Final Pr. ID: Poster #: EDU-062

The number of reconstruction surgeries of the anterior cruciate ligament (ACL) in pediatric patients has risen dramatically over the past two decades as a result of changes in treatment philosophy and perhaps frequency of injury. It is therefore important for pediatric radiologists to recognize the normal postoperative appearance of the different surgeries as well as their complications. This educational exhibit will review the types of reconstructive methods used in both skeletally immature and mature patients (physeal-sparing, partial transphyseal and transphyseal), complications (growth disturbances, graft failure, impingement, arthrofibrosis, intra-articular bodies) and relevant imaging findings on plain radiography and MRI. Read More

Authors:  Joshi Aparna , Kalra Kunal

Keywords:  Anterior cruciate ligament reconstruction, pediatric, radiology

Qi Jing,  Eutsler Eric,  Siegel Marilyn

Final Pr. ID: Poster #: EDU-068

Dual-energy CT (DECT) refers to the acquisition of CT datasets at two different energy spectra, which allows differentiation and classification of tissues. The purpose of this this poster is to describe post-processing algorithms and clinical applications of DECT in children on a dual-source CT system. Read More

Authors:  Qi Jing , Eutsler Eric , Siegel Marilyn

Keywords:  Dual energy CT, Pediatric Radiology, Clinical application

Lins De Carvalho Tiago,  Voss Stephan

Final Pr. ID: Poster #: EDU-084

This educational exhibit provides an overview of the role radiotracers play in diagnosing, staging, and treating neuroblastoma and neuroendocrine tumors (NETs) in pediatric patients, particularly those associated with certain cancer predisposition syndromes (CPS), which are linked to an increased incidence of neuroendocrine tumors, including pheochromocytoma, and paraganglioma (PPGL). Read More

Authors:  Lins De Carvalho Tiago , Voss Stephan

Keywords:  Nuclear Medicine, Neuroblastoma, Pediatric Radiology

Infante Ignacio,  Mackintosh Cecilia,  Anoni Clara,  Otero Eduardo,  Galeano Monica

Final Pr. ID: Poster #: EDU-012 (S)

The objective of this review is to summarize the earliest radiological findings of AMC (arthrogryposis multiplex congenital), detail the most frequently affected joints, identify associated syndromes, and expose the radiological findings in children whose therapy was delayed. Read More

Authors:  Infante Ignacio , Mackintosh Cecilia , Anoni Clara , Otero Eduardo , Galeano Monica

Keywords:  joint contractures, associated syndromes, pediatric radiology

Ilivitzki Anat,  Scolnik Michal

Final Pr. ID: Poster #: EDU-095

In this pictorial essay on typical and atypical lung metastases in pediatric patients, we aim to assist radiologists in identifying suspicious features on CT scans. Our goal is to guide decisions regarding follow-up imaging to ensure a timely diagnosis, enabling children to receive prompt and potentially lifesaving treatment. Read More

Authors:  Ilivitzki Anat , Scolnik Michal

Keywords:  CT Chest, Pediatric Radiology, Oncology

Malavia Mira,  Rivard Douglas

Final Pr. ID: Poster #: EDU-068

Ischial tuberosity avulsion fractures, though not uncommon in adolescent athletes, are often overlooked or misdiagnosed. These fractures occur more frequently in males than females. Primary cause of this fracture type is usually a sudden eccentric load on the proximal hamstrings, typically seen during a kicking action in dance, football, or soccer. Due to the limited use of imaging in the evaluation of such injuries, these fractures often are misdiagnosed or underdiagnosed. Recent injuries warrant more conservative management, including rest and relative immobilization. In cases of late diagnosis, delayed healing, or persistent symptomatology, surgical intervention can be undertaken to restore normal anatomy, alleviate symptoms, and facilitate healing. Minimally invasive CT-guided percutaneous needle fenestration has been introduced for symptomatic delayed union ischial tuberosity fractures in adolescents. This percutaneous procedure involves the creation of multiple channels into the bone at the fracture site with an 18 gauge Chiba needle via image guided needle fenestration to enhance blood flow and promote healing of the target area. Following this, a tailored physical therapy program is implemented based on patient symptomatology, individual tissue healing rates, and the current literature related to proximal hamstring injuries. Outcomes to this minimally invasive approach have been promising including cases of complete pain relief, full functional recovery, and a return to sports without limitations.

Outline of Teaching Points:
Ischial tuberosity avulsion fractures are common in adolescent athletes, with a higher incidence in males, caused by sudden eccentric loads on proximal hamstrings during activities like dance, football, or soccer.
Due to limited imaging use, these fractures are often overlooked or misdiagnosed, leading to delayed healing or persistent symptoms.
Recent injuries may benefit from conservative management, involving rest and relative immobilization.
Surgical intervention becomes necessary for late diagnoses, delayed healing, or persistent symptoms to restore normal anatomy and alleviate symptoms.
Minimally invasive CT-guided percutaneous needle fenestration has shown promising outcomes, facilitating healing with complete pain relief and a return to sports without limitations. Read More

Authors:  Malavia Mira , Rivard Douglas

Keywords:  fracture, interventional radiology

Gleason Miranda,  Moredock Elisabeth,  Parish David,  Pfeifer Cory

Final Pr. ID: Poster #: SCI-021

The practice of performing dedicated breast ultrasounds in the pediatric emergency department varies according to institution. In the adult population, breast ultrasounds are commonly interpreted by dedicated breast imagers and/or radiologists appropriately qualified to interpret mammograms. Children's hospitals with dedicated pediatric radiology faculty are less likely to have such individuals on staff. This paper examines the practice of breast ultrasounds ordered in the emergency department throughout a large children's health system. Read More

Authors:  Gleason Miranda , Moredock Elisabeth , Parish David , Pfeifer Cory

Keywords:  Breast Abscess, Breast Ultrasound, Emergency Radiology

Lall Neil,  Spaeth-cook Douglas,  Ho Mai Lan,  Zucker Evan

Final Pr. ID: Poster #: EDU-002

Artificial Intelligence (AI) holds great promise in pediatric radiology, but its adoption has been slower compared to adult imaging. Although a 2022 special issue of Pediatric Radiology highlighted potential AI applications, the number of FDA-cleared AI algorithms for pediatric radiology remains limited. As of October 2024, out of 333 FDA-cleared AI Software-as-a-Medical-Device (SaMD) tools, only 26 (8%) are applicable to pediatric imaging, despite children comprising 22% of the U.S. population. More strikingly, only three (<1%) of these SaMD tools are specifically designed for pediatric use, focusing on dental cavity detection, bone age assessment, and hip dysplasia. This educational exhibit showcases the different types of FDA-cleared SaMD AI algorithms designated for use in pediatric radiology and identifies the clinical needs being served as well as those that have yet to be addressed. Additionally, the exhibit will explore the discordance in the development of AI imaging tools for the pediatric population compared to adults, highlighting risks created by this gap and addressing the reasons for such a disparity. Read More

Authors:  Lall Neil , Spaeth-cook Douglas , Ho Mai Lan , Zucker Evan

Keywords:  Artificial Intelligence, Pediatric Radiology, Informatics

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

Mannuru Sravani,  Hui Jessica,  Lai Lillian

Final Pr. ID: Poster #: EDU-018

Extralobar pulmonary sequestration (EPS) and cystic neuroblastoma (CN) are rare pediatric thoracoabdominal masses with distinct yet sometimes overlapping imaging features, posing diagnostic challenges for radiologists. Accurate differentiation is crucial for guiding clinical management and preventing unnecessary interventions. This review focuses on comparing the imaging characteristics of EPS and CN, with emphasis on key features that aid in distinguishing between these entities. EPS typically presents as a well-defined, homogenous mass located near the lower lobes of the lung, often with systemic arterial supply visualized on contrast-enhanced imaging. It may exhibit smooth margins and is commonly identified in neonates and infants. Conversely, cystic neuroblastoma, while rarer, typically manifests as a retroperitoneal mass, often arising from the adrenal gland, with a more complex appearance, including cystic and solid components. Calcifications, which are frequently seen in neuroblastoma, may provide a critical clue for diagnosis, while the absence of systemic arterial supply differentiates it from EPS. Pitfalls arise from the potential overlap in appearance, such as fluid-filled or cystic components within both lesions, which may lead to confusion. Additionally, both lesions may be incidentally discovered on prenatal or early postnatal imaging, necessitating careful evaluation of ancillary features such as vascular supply, location, and internal characteristics to ensure accurate diagnosis. This review offers radiology residents, fellows, and attending radiologists a comprehensive comparison of EPS and CN imaging findings, with a focus on avoiding common diagnostic traps. Understanding these key differences enhances diagnostic confidence, promotes appropriate management, and improves outcomes for pediatric patients. Read More

Authors:  Mannuru Sravani , Hui Jessica , Lai Lillian

Keywords:  Pediatric Radiology, Abdominal Imaging, Chest

Diederichs Chad,  Heath Alana,  Mabee Myles,  Hareendranathan Abhilash,  Zonoobi Dornoosh,  Thompson Adrienne,  Jaremko Jacob

Final Pr. ID: Poster #: SCI-042

Developmental dysplasia of the hip (DDH) is a common congenital problem affecting up to 3% of the the population. If untreated, DDH may lead to hip dislocation and premature osteoarthritis. Current DDH diagnosis is highly operator-dependent as it relies on 2D ultrasound. 3D ultrasound offers more complete, and potentially more reliable, imaging of infant hip geometry. However, it is unclear whether 3D ultrasound images, noisy with artifacts and reconstructed by proprietary algorithms from non-parallel beams, give accurate 3D shape information. We sought to validate the fidelity of acetabular surface models obtained by 3D ultrasound by comparison with those obtained concurrently from MRI. Read More

Authors:  Diederichs Chad , Heath Alana , Mabee Myles , Hareendranathan Abhilash , Zonoobi Dornoosh , Thompson Adrienne , Jaremko Jacob

Keywords:  DDH, 3D ultrasound, MRI, pediatric radiology, hip dysplasia

Shelmerdine Susan,  Lacroix Caroline,  Chavhan Govind,  Doria Andrea

Final Pr. ID: Poster #: SCI-044

1) Determine differences in characteristics of studies published within high impact radiology and medical journals journals in comparison to a Pediatric Radiology journal.

2) Outline factors that may have contributed to differences in quality of design of studies and components that could be incorporated into the design of future pediatric radiology research studies in order to improve their quality. Read More

Authors:  Shelmerdine Susan , Lacroix Caroline , Chavhan Govind , Doria Andrea

Keywords:  Research, Publication, Study Design, Pediatric Radiology journal

Derbew Hermon Miliard,  Hailu Tigist,  Salah Fathia Omar,  Otero Hansel

Final Pr. ID: Poster #: SCI-007

Due to the COVID-19 pandemic, after more than 12 years of in-person programming, our educational collaboration with radiology trainees from Tikur Anbessa Specialized Hospital (TASH) in Ethiopia was interrupted. Similar to many US based programs, conferences were transitioned to a virtual format. Since January 2021, we have offered weekly hour-long Friday Case review sessions to residents and fellows from Addis Ababa University. After the first 4 months in which only 2 faculty members presented every week, the opportunity for additional volunteers was offered to all faculty members and the program continued. Here, we describe the results of the last 6 months of the teaching sessions. Read More

Authors:  Derbew Hermon Miliard , Hailu Tigist , Salah Fathia Omar , Otero Hansel

Keywords:  global, education, pediatric radiology

Rooks Elizabeth,  Rousslang Lee,  Meldrum Jaren,  Ishikawa Kyle,  Chen John,  Rousslang Nikki,  Nayiga Joyce,  Destigter Kristen

Final Pr. ID: Poster #: SCI-015

Resident trainees in East Africa are challenged in learning pediatric radiology due to limited access to subspecialty knowledge and mentorship. The ubiquitous use of smartphones provides the opportunity to use free instant messaging apps to deliver medical education. To test this approach, we delivered case-based modules via WhatsApp to residents to assess knowledge of pediatric radiology and elicited their feedback for evaluation. Read More

Authors:  Rooks Elizabeth , Rousslang Lee , Meldrum Jaren , Ishikawa Kyle , Chen John , Rousslang Nikki , Nayiga Joyce , Destigter Kristen

Keywords:  Pediatric Radiology, East Africa, Education

Derbew Hermon Miliard,  Yaya Carlos,  Noor Abass,  Miranda Schaeubinger Monica,  Dennis Rebecca,  Jalloul Mohammad,  Mekete Yadel,  Wang Xinmeng,  Otero Hansel

Final Pr. ID: Poster #: SCI-004

International clinical observerships in pediatric radiology offer benefits such as academic collaboration and brand recognition. However, they also introduce additional administrative burden, scheduling difficulties, increased faculty workload for the host institution, and regulatory and financial challenges for observers. In January 2021, the observer program at a US-based teaching hospital's radiology department was relaunched following a COVID-19 pandemic hiatus, providing a limited number of scholarships to medical students, residents, fellows, and other colleagues worldwide for 1-6 weeks. During their stay, observers rotated through different divisions, accessed our learning management system (LMS), and were encouraged to attend conferences and to give a lecture or case-based presentation to the department. We aim to evaluate the effectiveness of the program and the impact on the observer’s career. Read More

Authors:  Derbew Hermon Miliard , Yaya Carlos , Noor Abass , Miranda Schaeubinger Monica , Dennis Rebecca , Jalloul Mohammad , Mekete Yadel , Wang Xinmeng , Otero Hansel

Keywords:  International Observership, Pediatric Radiology, Education

Denham Chloe,  Lupo Andrew,  Sokkary Nancy,  Linam Leann

Final Pr. ID: Poster #: EDU-043

Primary amenorrhea, defined as failure to reach the first menstrual cycle by the age of 15 or 3 years after breast development, presents a complex diagnostic challenge. From congenital anomalies to endocrine disorders, there is a wide range of potential etiologies; therefore, a multidisciplinary and comprehensive approach is crucial for accurate and timely diagnosis and management. Radiologic imaging often plays an important role in this process, particularly in the identification of structural abnormalities and assessing the presence of internal reproductive structures that can guide potential management decisions. In this educational exhibit, we will review etiologies of amenorrhea and their associated radiologic imaging, utilizing examples from our institution. Additionally, we aim to provide key findings and tips that can help the pediatric radiologist have a clearer understanding of the clinical questions that gynecologists seek to answer when ordering imaging for the evaluation of primary amenorrhea. Read More

Authors:  Denham Chloe , Lupo Andrew , Sokkary Nancy , Linam Leann

Keywords:  Radiology Education, Mullerian Duct Anomalies, Pelvis

Gilyard Shenise,  Dickson Paula,  Loewen Jonathan,  Richer Edward,  Riedesel Erica,  Tuburan Smyrna

Final Pr. ID: Poster #: SCI-022

Demonstrate how a pediatric radiology division at a single institution structures short-interval feedback to residents. Describe how the division collects interval resident feedback. Demonstrate resident responses to this pilot program of instituting standardized weekly feedback. Read More

Authors:  Gilyard Shenise , Dickson Paula , Loewen Jonathan , Richer Edward , Riedesel Erica , Tuburan Smyrna

Keywords:  education, feedback, radiology resident

Gilyard Shenise,  Dickson Paula,  Loewen Jonathan,  Richer Edward,  Riedesel Erica,  Tuburan Smyrna

Final Pr. ID: Paper #: 171

Demonstrate how the Pediatric Radiology Department at a single institution structures short-interval feedback to residents. Describe how the department collects short-interval feedback from residents regarding their experiences. Demonstrate resident responses to this pilot program of instituting standardized weekly feedback Read More

Authors:  Gilyard Shenise , Dickson Paula , Loewen Jonathan , Richer Edward , Riedesel Erica , Tuburan Smyrna

Keywords:  education, feedback, radiology resident

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

De Leon-benedetti Laura,  Lazarte Claudia,  Miranda Schaeubinger Monica,  Miliard Derbew Hermon,  Jalloul Mohammad,  Otero Hansel

Final Pr. ID: Poster #: EDU-024

Introduction:
Fluoroscopy plays an important role in pediatric diagnostic imaging. However, its use has been replaced by other imaging modalities for some applications. While fluoroscopy offers dynamic evaluations of the airway, gastrointestinal tract, and urinary system, multiple barriers exist. It is an operator-dependent modality that requires expertise and additional training. Furthermore, concerns for radiation exposure and lower reimbursement rates exist, which add safety and financial disincentives. This educational exhibit provides a side-by-side comparison of traditional fluoroscopic studies and their replacement modalities.
Fluoroscopy applications and their alternatives:

Respiratory system:
Foreign body aspiration: Radiography or CT
Tracheomalacia: CT
Diaphragmatic motion: Ultrasound or MRI

Gastrointestinal Tract:
Esophageal foreign body: Radiography
Gastrostomy tube dislodgement: Radiography
Upper GI (Malrotation and volvulus): Ultrasound
Enema for intussusception reduction: Ultrasound guided reduction
Enema for Hirschsprung diagnosis: Contrast radiograph

Urinary Tract:
Voiding cystourethrograms (VCUG): Contrast-enhanced vesicourethrosonography (CeVUS) Read More

Authors:  De Leon-benedetti Laura , Lazarte Claudia , Miranda Schaeubinger Monica , Miliard Derbew Hermon , Jalloul Mohammad , Otero Hansel

Keywords:  Radiology, Fluoroscopy

Rafful Patricia,  Alkhulaifat Dana,  Lopez Rippe Julian,  Khalkhali Vahid,  Welsh Michael,  Venkatakrishna Shyam Sunder,  Wieczkowski Sydney,  Reid Janet,  Sotardi Susan

Final Pr. ID: Poster #: EDU-044

Artificial intelligence (AI) has the potential to improve many aspects of pediatric radiology. AI solutions have emerged to perform a wide range of tasks, including facilitating the workload of radiologists, improving image quality, performing motion correction, and reducing contrast dose. While a myriad of courses for learning AI are available, most resources lack the necessary radiology perspective required for clinical application. Few interactive resources are available to teach a systematic approach for pediatric radiologists when analyzing AI literature. Since AI methodologies in pediatric radiology research fundamentally differ from classical statistical analyses, an educational poster dedicated to interpreting pediatric radiology AI literature would assist in bridging this gap.

The purpose of this education exhibit is to provide a resource for pediatric radiologists that teaches a systematic approach for the interpretation of AI research publications. Knowledge delivery will be made by eLearning slide-based presentation. The major topics regarding AI literature will focus on: problem identification; data curation; data annotation, artificial intelligence models; validation and performance. Next, we review prior literature on important criteria for AI publications, including Checklist for Artificial Intelligence in Medical Imaging (CLAIM), the AI version of the Standards for Reporting of Diagnostic Accuracy Studies (STARD-AI), Transparent Report of Multivariable Prediction Model of Individual Prognosis and Diagnosis for AI (TRIPOD-AI) and Prediction Model Risk of Bias Assessment Tool for AI (PROBAST-AI). Lastly, we present these criteria in the context of pediatric AI research applications.
AI research methodology in pediatric radiology differs from classical research methodologies. Therefore, this education exhibit is intended to teach the systematic interpretation of the primary AI literature to pediatric radiologists in order to translate scientific knowledge into meaningful clinical information. Read More

Authors:  Rafful Patricia , Alkhulaifat Dana , Lopez Rippe Julian , Khalkhali Vahid , Welsh Michael , Venkatakrishna Shyam Sunder , Wieczkowski Sydney , Reid Janet , Sotardi Susan

Keywords:  Artificial Intelligence, Radiology, Research

Chitalkar Sachin,  Shet Narendra

Final Pr. ID: Poster #: EDU-055

To review the characteristic imaging findings of pediatric fibroblastic/myofibroblastic masses to aid in their diagnosis and management.
Soft tissue lesions in pediatric patients encompass a wide variety of pathologies. While a comprehensive review of all possible pathologies is beyond the scope of this poster, we aim to review one particular subset of lesions, fibroblastic lesions (including myofibroblastic neoplasms), in hopes to bring these to mind when evaluating a pediatric soft tissue mass to improve diagnosis and management of these entities.
Soft tissue masses typically present clinically on the basis of history and physical examination. US and MRI are used as first- and second-line imaging modalities, with limited roles for radiographs, CT and FDG-PET. In this poster, we will review the pertinent imaging findings of these neoplasms. Read More

Authors:  Chitalkar Sachin , Shet Narendra

Keywords:  Soft Tissue Mass, Soft-Tissue Tumors, Pediatric Radiology

Tiangco Justin Christian,  Andres Mariaem

Final Pr. ID: Poster #: SCI-014

The subspecialty of Pediatric Radiology is crucial for providing accurate diagnoses and guiding treatment for pediatric patients. This study evaluates the impact of a four-lecture series on Pediatric Radiology on the knowledge of clinical pediatric residents. It focuses on the American
College of Radiology Appropriateness Criteria (ACR-AC) and the ability to select suitable imaging modalities. Read More

Authors:  Tiangco Justin Christian , Andres Mariaem

Keywords:  Adaptive Learning, Education, Pediatric Radiology

Tran Patrick,  Kang Lisa,  Gundeti Mohan,  Long Jessica,  Brown Colin

Final Pr. ID: Poster #: CR-029

Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder resulting from mutations in genes encoding enzymes essential for adrenal hormone synthesis. It affects roughly 1 in 15,000 individuals and can present with ambiguous genitalia, salt-wasting, and virilization.

An 8-year-old girl with history of CAH and genitoplasty at age 2 presented with abdominal pain, brown perineal discharge, and fever (39°C). Labs were notable for leukocytosis (15 x 10^9/L).

Transabdominal ultrasound (TAUS) revealed a fluid-filled uterus and vagina with layering echoes. MRI confirmed a distended, fluid-filled uterus and vagina with layering debris. The ovaries were normal. Differential included imperforate or microperforate hymen, lower vaginal atresia, transverse vaginal septum, and vaginal outlet obstruction due to scarring.
On initial exam under anesthesia (EUA) findings of imperforate hymen were not present and placement of a speculum into an apparent narrowed vaginal introitus produced efflux of urine. Subsequent cystoscopy revealed that this channel led to the urinary bladder and a bladder catheter was placed.

Following discussion among pediatric gynecology, pediatric urology, and interventional radiology (IR), a joint EUA and drainage procedure was performed in the IR suite. A diminutive vaginal opening was identified and a cystoscope was advanced into the vagina under TAUS. The cystoscope was exchanged for a catheter and a fluoroscopic contrast vaginogram was performed, showing stricture of the vaginal introitus. Balloon stricturoplasty was performed, a Foley catheter was placed into the vagina, and the vaginal fluid was drained. The urinary bladder catheter was replaced and the bladder was decompressed.

After the procedure the patient's symptoms improved. Vaginal fluid culture grew E. faecalis. The patient was discharged with vaginal and bladder catheters in place and a 14-day antibiotic course.

Subsequent EUA by pediatric urology confirmed a single urogenital orifice with urethrovaginal communication, consistent with urogenital sinus anomaly and urethrovaginal fistula. Definitive surgery was deferred due to the patient’s age.

This case highlights the complexities of evaluating and treating children with urogenital anomalies and the importance of multidisciplinary collaboration in their management.

Final diagnosis: Vaginal outlet obstruction due to stricture managed with balloon dilation; urogenital sinus anomaly and urethrovaginal fistula secondary to CAH. Read More

Authors:  Tran Patrick , Kang Lisa , Gundeti Mohan , Long Jessica , Brown Colin

Keywords:  Interventional Radiology, Genitourinary, Urogenital Sinus

De Leon-benedetti Laura,  Martinez-rios Claudia,  Tierradentro-garcia Luis,  Kilicarslan Ozge,  Caro Domínguez Pablo,  Otero Hansel

Final Pr. ID: Poster #: EDU-079

PTEN-related hamartoma tumor syndromes (PHTS) arise from germline pathogenic variants in the Phosphatase and Tensin homolog (PTEN) gene and include a broad spectrum of autosomal dominant clinical phenotypes with overlapping features. Its diagnosis is made through genetic testing prompted by family history or clinical features. In pediatric patients the most common feature leading to genetic testing is macrocephaly, in combination with other clinical findings, presenting in early childhood.

PHTS is a multisystem disorder. Imaging findings on pediatric patients have a wide variability, but benign findings are the most common.
In this educational exhibit, we will summarize the imaging findings of pediatric patients with confirmed PTEN diagnosis, based on our experience from three large children’s hospitals.

The most common findings will be described by anatomical regions:
- Central nervous system: white matter lesions, prominence of perivascular spaces, prominence of the ventricles and extra-axial spaces, and a dysplastic gangliocytoma of the cerebellum.
- Thyroid/neck: benign lesions such as nodular goiter, follicular adenomas, colloid cysts, and features of thyroiditis and pediatric thyroid carcinoma.
- Chest/mediastinum: infrequent lesions such as sclerosing pneumocytoma or chest wall lesions.
- Nonvascular soft tissue masses: variable types of hamartomas including polyps, fibromas, and lipomas.
- Vascular soft tissue masses: hemangiomas and classic PTEN hamartoma of the soft tissues (PHOST).

At the end of our exhibit, we will include current suggested surveillance imaging protocol for these patients. Read More

Authors:  De Leon-benedetti Laura , Martinez-rios Claudia , Tierradentro-garcia Luis , Kilicarslan Ozge , Caro Domínguez Pablo , Otero Hansel

Keywords:  Radiology, Genetics, Pediatrics

Arshad Wajiha

Final Pr. ID: Poster #: EDU-051

Introduction:
Gastrostomy insertion provides essential long-term nutritional support for patients due to neurological or congenital conditions. While common in both adults and children, pediatric patients present unique challenges requiring specialized techniques. This article highlights the differences between pediatric and adult gastrostomy procedures and explores how to optimize outcomes .
Anatomical Considerations:
Pediatric patients have smaller abdominal cavities, thinner abdominal walls, and smaller stomachs, increasing the risk of injury during gastrostomy. These factors necessitate smaller instruments and specialized techniques. The pliability of the pediatric abdominal wall makes securing the gastrostomy tube crucial to prevent dislodgement or leakage. Ensuring accurate tube placement is essential to avoid trauma and complications.
Physiological Differences:
Children have higher metabolic rates and rapid growth, affecting their nutritional needs and healing after surgery. Considerations include complications such as reflux or poor feed tolerance. Smaller stomach volume also requires careful tube size and placement.
Technique Modifications:

Percutaneous Endoscopic Gastrostomy (PEG): Adjusted for smaller anatomy.
Radiologically Inserted Gastrostomy (RIG): Ideal for children with complex surgical histories; guided placement reduces injury risk, though minimizing radiation exposure is vital.
Laparoscopic Gastrostomy: Used when direct visualization is needed, particularly for complex cases.
Radiological considerations include fluoroscopic visualization of the stomach bubble and liver ultrasound to assess organ positioning.
Postoperative Considerations:
Children are more prone to complications such as infection, leakage, and tube dislodgement. Educating caregivers on tube care and recognizing complications is critical to ensure proper nutrition and tube functionality.
Optimizing Outcomes:
A multidisciplinary approach involving pediatric surgeons, gastroenterologists, and radiologists is essential. Preoperative planning must address anatomical and medical complexities, while postoperative care should include ongoing monitoring and adjustments as the child grows.
Conclusion:
Pediatric gastrostomy requires adaptations of adult techniques to account for children’s anatomical and physiological differences. A multidisciplinary approach with careful planning and specialized care is vital for minimizing complications and ensuring successful outcomes. Read More

Authors:  Arshad Wajiha

Keywords:  Interventional Radiology