The ability to provide quick, real-time, easily accessible and radiation free diagnostic assessment makes ultrasound (US) imaging one of the most versatile imaging modalities. With the introduction and development of microbubble based ultrasound contrast agents (UCAs) in the early 90’s the ability to detect and visualize complex vascular structures became a reality, overcoming some of the limitations that were existent with grayscale and Doppler imaging. UCA’s are used extensively in the adult population for visualization of vasculature and evaluating vascular kinetics in solid organs and lesions. Although contrast-enhanced ultrasound (CEUS) can provide a powerful alternative approach to evaluate various pathologies in the pediatric population that would otherwise require radiation-based computed tomography (CT) or strenuous magnetic resonance imaging (MRI), it is important to understand the interaction between US and the microbubbles to optimize imaging and derive clinically relevant quantitative measures of vascularity. Read More

Meeting name: SPR 2018 Annual Meeting & Postgraduate Course , 2018

Authors: Sridharan Anush, Darge Kassa

Keywords: CEUS, Ultrasound, microbubbles

ceVUS is a radiation-free and sensitive examination to detect vesicoureteral reflux and image the urethra in children using ultrasound (US) and intravesical administration of an ultrasound contrast agent (UCA). Due to the growing interest to perform ceVUS in children, a urinary bladder phantom was developed to teach the technical aspects of the ceVUS examination. Here we describe the preparation and utility of this reusable phantom as a tool to simulate the UCA administration, distribution and the effect of different US parameters on the UCA appearance in the bladder. Read More

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

Authors: Shellikeri Sphoorti, Back Susan, Poznick Laura, Darge Kassa

Keywords: Ultrasound contrast, bladder phantom, contrast enhanced voiding urosonography

Contrast enhanced voiding urosonography (ceVUS) is a radiation free, highly sensitive imaging modality for vesicoureteral reflux (VUR) detection and urethral imaging in children. CeVUS uses ultrasound (US) technology and an US contrast agent (UCA) that is instilled in the bladder via a catheter. This educational exhibit provides step-by-step instructions of our institutional protocol for performing ceVUS exams. Read More

Meeting name: SPR 2018 Annual Meeting & Postgraduate Course , 2018

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

Keywords: Ultrasound, Contrast, VoidingContrast

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

Meeting name: SPR 2018 Annual Meeting & Postgraduate Course , 2018

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

Keywords: Ultrasound, Liver, Contrast

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

ARPKD causes diffuse microcysts in the kidney parenchyma, and cyst burden cannot be quantified by standard image segmentation methods. We sought to assess whether apparent diffusion coefficient (ADC) measured by DWI could serve as a non-invasive biomarker of ARPKD severity, with the hypothesis that ADC would be higher in cystic vs. non-cystic parenchyma due to higher extracellular water content. We examined whether ADC could distinguish healthy kidneys from those affected by ARPKD, and whether a threshold ADC value could be established to differentiate cystic vs. non-cystic parenchyma. Read More

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

Authors: Heintzelman Briana, Khrichenko Dmitry, Carson Robert, Darge Kassa, Serai Suraj, Hartung Erum

Keywords: kidney, DWI, ARPKD

ARPKD causes diffuse microcysts in the kidney parenchyma, and cyst burden cannot be quantified by standard image segmentation methods. We sought to assess whether apparent diffusion coefficient (ADC) measured by DWI could serve as a non-invasive biomarker of ARPKD severity, with the hypothesis that ADC would be higher in cystic vs. non-cystic parenchyma due to higher extracellular water content. We examined whether ADC could distinguish healthy kidneys from those affected by ARPKD, and whether a threshold ADC value could be established to differentiate cystic vs. non-cystic parenchyma. Read More

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

Authors: Heintzelman Briana, Khrichenko Dmitry, Carson Robert, Darge Kassa, Serai Suraj, Hartung Erum

Keywords: kidney, DWI, ARPKD

Since 2008, the Children’s Hospital of Philadelphia (CHOP) Department of Radiology has conducted pediatric radiology international education outreach in Ethiopia. In 2008, there was not a single Ethiopian pediatric radiologist in a country of 100 million people, where 60% of the population is under the age of 20. As such, children are a major population for diagnostic imaging and the majority of radiologists are confronted with pediatric imaging. However, there was a lack of emphasis on much-needed training of pediatric imaging in radiology residencies. With an increasing number of pediatric subspecialties, the need for adequate pediatric imaging service had grown. This was particularly true at Black Lion Hospital (BLH), the country’s main referral center, affiliated with Addis Ababa University (AAU). Radiology faculty at AAU saw value in a pediatric radiology fellowship. The partnership goals between CHOP and AAU were to support and expand the pediatric radiology component in the BLH radiology residency and to carry out regular national pediatric radiology continuing medical education. The purpose of our project was to establish an accredited local pediatric radiology fellowship training in the Department of Radiology at BLH. Read More

Meeting name: SPR 2018 Annual Meeting & Postgraduate Course , 2018

Authors: Zember Jonathan, Zewdneh Daniel, Gorfu Yocabel, Reid Janet, Steenhoff Andrew, Darge Kassa

Keywords: Outreach, Education

Calyceal diverticula (CD) are rare lesions which are difficult to differentiate from renal cysts. Cross sectional examination with excretory imaging facilitates diagnosis in a noninvasive fashion. Functional MR urography (fMRU) provides comprehensive morphological, functional and excretory assessment of the kidney with CD. We aim to describe the findings of CD in fMRU. Read More

Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016

Authors: Haroyan Harutyun, Ntoulia Aikaterini, Khrichenko Dmitry, Bellah Richard, Long Christopher, Darge Kassa

Keywords: Diverticulum, diverticula, MRU, MR urogram, Calyceal

Pediatric kidney abnormalities, such as urinary tract dilation (UTD), are common, and current reporting methods vary significantly. There's a need for more precise evaluation methods. Using automated 3D kidney volume measurements from ultrasound (US) offers an alterantive objective approach. Our aim is to evaluate the diagnostic potential of automated 3D kidney volume measurements for detecting and categorizing UTD, comparing their accuracy with clinical assessment. Read More

Meeting name: SPR 2024 Annual Meeting & Postgraduate Course , 2024

Authors: Sultan Laith, Morales-tisnés Tatiana, Rouet Laurence, Jago James, Sridharan Anush, Otero Hansel, Darge Kassa, Back Susan

Keywords: Urinary tract dilation, 3D ultrasound, Diagnostic model

Purpose: Created in 2011, WFPI has spent the last 5 years overcoming geographic, temporal, cultural and linguistic distances to define its added value in the global imaging arena. Have the efforts been worth it? Read More

Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016

Authors: Dehaye Amanda, Silva Cicero, Darge Kassa, Prabhu Sanjay, Andronikou Savvas, Laya Bernard, Coley Brian, Boechat Ines

Keywords: World Federation of Pediatric Imaging, Global Pediatric Imaging, International Collaboration

Infantile myofibromatosis is rare. The generalized form affects the integument and musculoskeletal system as well as multiple visceral organs and can impair organ function, thus requiring prompt diagnosis and treatment at an early age. As a disease that presents before the age of two years, minimizing use of CT and MRI is imperative to reduce radiation and gadolinium contrast use, respectively. We present a case of a neonate in whom multiple cutaneous and an appendiceal lesion raised the suspicion of infantile myofibromatosis. Multiple liver lesions were seen on gray-scale ultrasound. On contrast-enhanced ultrasound (CEUS), there were multiple, differently-enhancing liver lesions, a finding which was confirmed on MRI with hepatocyte specific contrast. These were all thought to represent myofibromas with complete involution following low dose chemotherapy. Read More

Meeting name: SPR 2024 Annual Meeting & Postgraduate Course , 2024

Authors: Davis Laura, Morales-tisnés Tatiana, Lerebo Wondwossen, Barz Leahy Allison, Ntoulia Aikaterini, Dennis Rebecca, Anupindi Sudha, Darge Kassa, Back Susan

Keywords: myofibromatosis, contrast ultrasound, CEUS

Pediatric Contrast Enhanced Ultrasound (CEUS) is a safe and patient-friendly imaging modality. It improves the diagnostic capability of gray-scale and Doppler ultrasound without sedation, ionizing radiation and no use of iodinated or gadolinium-based contrast agents. Pediatric CEUS was originally used to detect vesicoureteral reflux, evaluate indeterminate focal liver lesions, assess and follow up solid-organ injuries sustained during blunt abdominal trauma. In 2016, the approval of Lumason® (Bracco Diagnostics Inc., Monroe Township, NJ) by the United States Food and Drug Administration (FDA) marked the beginning of a new era for CEUS imaging. Since then, clinical requests for pediatric CEUS not only increased in number but also for a variety of examinations covering practically every organ system, including pediatric brain, lungs, solid organs and bowel. In addition, intracavitary applications of pediatric CEUS are now extending beyond the urinary tract, to include urogenital and anorectal malformations. Intravenous and intracavitary CEUS is used in pediatric interventional radiology, to confirm enteric tube placement, guide biopsies and drainage procedures and aide organ vascular mapping (e.g. renal, central vessels). Novel pediatric CEUS applications now used include intranodal CEUS lymphangiography for confirmation of needle position preceding MRI lymphagiography. Pediatric CEUS is performed in a number of clinical settings including inpatient units, outpatient radiology, emergency department, and intraoperative. These evolving indications and uses of CEUS combined with continuous advances in ultrasound technology, such as three-dimensional/four-dimensional ultrasound and improved contrast sensitivity, are establishing pediatric CEUS as an important alternative imaging examination that can complement or supplement fluoroscopy, CT and MRI. This presentation reviews the current wide spectrum of pediatric CEUS applications and imaging findings, according to body part, and the associated imaging findings. Read More

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

Authors: Ntoulia Aikaterini, Back Susan, Hwang Misun, Gokli Ami, Anupindi Sudha, Biko David, Srinivasan Abhay, Poznick Laura, Darge Kassa

Keywords: contrast ultrasound, pediatric applications

<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