It is important for radiologists to recognize and discuss with patients and families the potential risks and clinical manifestations of high Peak Skin Dose. In children undergoing complex Interventional procedures accurate Peak Skin Dose estimates are complicated and time consuming despite reference point doses being available. The availability of the Dose Structure Report (SR) on modern fluoroscopic equipment allows such estimates to be timely and consistent. The process of creating a Peak Skin Dose estimate using a validated radiation data management system (RDMS), capable of collecting detailed acquisition data and modeling will be discussed. Read More

Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019

Authors: Zhu Xiaowei, Whitaker Jayme, Shellikeri Sphoorti, Cahill Anne Marie

Keywords: Peak Skin Dose Estimation, Interventional fluoroscopic, Radiation Data Management System

To assess the rate of dislodgement of posteriorly tunneled central lines, over-the-shoulder, in children. Read More

Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019

Authors: Acord Michael, Termine Carl, Cahill Anne Marie, Escobar Fernando

Keywords: venous access, back, interventional radiology

Renal artery stenosis (RAS) is an important cause of hypertension in children. When suspected, imaging options include Doppler US, CTA and MRA. However, conventional angiography remains the gold standard. We investigate the accuracy and inter-reader reliability of CTA in children with suspected renal artery stenosis. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Smitthimedhin Anilawan, Otero Hansel, Cahill Anne Marie, Durand Rachelle

Keywords: Renal Artery Stenosis, CTA, Angiography

3D printing technology presents a unique opportunity for the creation of custom phantoms for training and simulation for pediatric interventional procedures that are complex and/or uncommonly performed. The purpose of this study was to describe the elements of designing a 3D phantom for simulation of pediatric abdominal intra -vascular procedures. Read More

Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019

Authors: Silvestro Elizabeth, Shellikeri Sphoorti, Trahan Sean, Sze Raymond, Cahill Anne Marie

Keywords: 3d printing, Simulation, Phantom

The renal artery ostial anatomy, balloon profile, and stent deployment are all challenges of complex procedural RAS planning in children. In such cases there is an increased risk of renal artery rupture secondary to angioplasty requiring placement of a covered stent. This study aims to establish the feasibility of simulating renovascular stent deployment in three 3D printed pediatric patient-specific RAS endovascular phantoms. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Smitthimedhin Anilawan, Silvestro Elizabeth, Shellikeri Sphoorti, Whitaker Jayme, Cahill Anne Marie

Keywords: 3D Printing, Stent, Simulation

Evaluate patient demographics, current imaging patterns, extent of disease, and tumor types in pediatric patients with mediastinal masses to assist with developing an imaging algorithm to streamline patient care. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

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

Keywords: Mediastinal Mass, Airway

Evaluate patient demographics, current imaging patterns, extent of disease, and tumor types in pediatric patients with mediastinal masses to assist with developing an imaging algorithm to streamline patient care. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

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

Keywords: Mediastinal Mass, Airway

Conventional Doppler US is known to have low sensitivity for the diagnosis of renal artery stenosis (RAS), in particular segmental renovascular disease. This study aims to determine if contrast-enhanced US (CEUS) can quantitatively provide assessment of renal arterial and parenchymal perfusion pre- and post- renal artery angioplasty in children and potentially be used as a follow-up imaging tool. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Smitthimedhin Anilawan, Sridharan Anush, Darge Kassa, Back Susan, Cahill Anne Marie

Keywords: CEUS, Renal Artery Stenosis, Contrast-Enhanced Ultrasound

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

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

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

Keywords: Image guided biopsy, Mediastinal Mass, Lymphoma

Intra-articular osteoid osteomas are uncommon and occur in only 10-13% of cases. Intra-articular osteoid osteomas may not demonstrate typical clinical features and feature subtle radiographic differences when compared to extra-articular osteoid osteomas. Radiofrequency ablation (RFA) has been found to be a safe and reliable method of treating osteoid osteomas. The possible complications of RFA include bleeding, muscle burn, and in cases of intra-articular osteoid osteoma, septhic arthritis. In this study, we evaluated the efficacy of radiofrequency ablation (RFA) of intra-articular osteoid osteomas at a single tertiary pediatric center. Read More

Meeting name: SPR 2017 Annual Meeting & Categorical Course , 2017

Authors: Akhter Talal, Cahill Anne Marie, Vatsky Seth, Krishnamurthy Ganesh, Keller Marc, Shellikeri Sphoorti, Srinivasan Abhay

Keywords: Osteoid osteoma, Radiofrequency ablation, Musculoskeletal

Neonates with prolonged hospitalization often require PICCs. The concern for PICC-related complications, including venous thrombosis, infection, catheter migration and breakage, often prompts Doppler ultrasound (US) evaluation. However, peri-catheter thrombus in a neonate can be challenging to evaluate, as the accessed peripheral veins in neonates are small, some less than 1mm in luminal diameter. Small-bore catheters may occupy the entirety of the vessel lumen, which can produce absence of peri-catheter flow, which is confounding for thrombus. This distinction has implications for hematologic management. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Durand Rachelle, Acord Michael, Srinivasan Abhay, Krishnamurthy Ganesh, Saade-lemus Sandra, Cahill Anne Marie, Kaplan Summer

Keywords: PICC, Thrombosis, Neonate

Percutaneous interventions are increasingly being performed under MR-guidance due to the absence of ionizing radiation, the ability to visualize target lesion and the capability to monitor real-time treatment effect. Here we outline our experience with developing an interventional MRI (iMRI) service at a pediatric institution. Read More

Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019

Authors: Shellikeri Sphoorti, Setser Randolph, Acord Michael, Srinivasan Abhay, Vatsky Seth, Escobar Fernando, Whitaker Jayme, Cahill Anne Marie

Keywords: Interventional MRI, MR-guided procedures

Low dose C-arm Computed Tomography (CT), is a technology that uses flat panel detectors to acquire real-time 3D images during an interventional radiology (IR) procedure to assist with anatomic localization and procedural mapping. This study describes our low dose protocol and applications of its use at a pediatric institution. Read More

Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016

Authors: Acord Michael, Shellikeri Sphoorti, Vatsky Seth, Nazario Maricarmen, Srinivasan Abhay, Krishnamurthy Ganesh, Keller Marc, Cahill Anne Marie

Keywords: dose reduction, 3D fluoroscopy, guidance

Contrast-enhanced ultrasound (CEUS) and shear wave elastography (SWE) have been widely studied in adult thyroid disease. However, evaluation of thyroid nodules using these tools in pediatric patients has yet to be published. We aim to evaluate the feasibility and safety of CEUS and SWE for thyroid nodules in children at the time of cytologic biopsy. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Smitthimedhin Anilawan, Krishnamurthy Ganesh, Sridharan Anush, Poznick Laura, Durand Rachelle, Whitaker Jayme, Escobar Fernando, Bauer Andrew, Cahill Anne Marie

Keywords: CEUS, Elastography, Thyroid

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

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

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

<b>Pediatric radiology focuses on appropriate and safe diagnostic imaging and intervention in children of all ages. In Ethiopia, a sub-Saharan developing country in East Africa, almost 60% of the population is in the pediatric age group. In the main referral general hospital of the country children make up 48% of the patient population. Currently, there is no pediatric radiologist in the country. The aim of this presentation is to describe the undertakings of the International Outreach in Pediatric Radiology Education Program in Ethiopia of the Department of Radiology, The Children’s Hospital of Philadelphia (CHOP), which is aiming to improve the existing situation. This program is carried out under the auspices of the World Federation of Pediatric Imaging (WFPI).</b> Read More

Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016

Authors: Darge Kassa, Tomlinson Chris, Debebe Tequam, Gorfu Yocabel, Zewdneh Daniel, Bedane Alemayehu, Kebede Tesfaye, Renjen Pooja, Boechat Ines, Dehaye Amanda, Reid Janet, Cahill Anne Marie, Jaramillo Diego, Keller Marc, Mahboubi Soroosh, Mong Andrew, Servaes Sabah, Shekdar Karuna, Victoria Teresa

Keywords: Education, Fellowship, International Outreach, Continuing Medical Education, Ethiopia, Africa