After reviewing this educational exhibit, radiologists and trainees will have up-to-date knowledge about magnetic resonance imaging (MRI) safety in children with implanted medical devices. The following will be presented: 1) Basic MRI physics relating to safety risks in the presence of implanted (passive and active) medical devices, 2) MR Safety screening challenges specific to children, and 3) Review of newly developed or updated medical devices that present challenging pediatric MRI safety scenarios. MRI is the imaging modality of choice for assessing many pediatric conditions, providing excellent anatomic and pathologic detail without the use of ionizing radiation. However, there are significant potential hazards in the MR environment related to the static magnetic field and the spatial and time varying gradient fields, as well as the impact of radiofrequency pulses. These concerns may be further complicated/exacerbated by the presence of implanted medical devices. This educational exhibit will focus on reducing risk for children with implanted medical devices in the MR environment. Such devices may be subject to projectile/torsion forces, induced currents, and heating risks. Barriers to effective screening include limited MRI safety information for new passive and active implanted medical devices, incomplete documentation and patient/family education, and limited referring clinician awareness of potential safety risks. The use of sedation/anesthesia in pediatric patients reduces the ability to detect discomfort during MR imaging. Read More

Meeting name: SPR 2022 Annual Meeting & Postgraduate Course , 2022

Authors: Betz Lisa, Dillman Jonathan, Jones Blaise, Tkach Jean

Keywords: Implanted medical devices, Magnetic resonance imaging, Pediatric

Cystic liver lesions in the pediatric population are relatively uncommon but encompass a wide range of pathologies. It is important for radiologists to be familiar with the differential diagnosis and imaging characteristics of each entity because prognosis and treatment vary widely. This educational exhibit will review the appearance of various cystic liver lesions in the pediatric population by ultrasound, CT, and MRI and will review clinical presentation and genetic/biologic causes. Read More

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

Authors: Mcbee Morgan, Towbin Alexander, Dillman Jonathan, Trout Andrew

Keywords: hepatic cyst, Cystic mass, Fluid lesion

Ultrasound shear wave elastography (US SWE) can be used to noninvasively measure liver stiffness. US SWE is a potentially useful technique for diagnosing and monitoring liver fibrosis, obviating the need for liver biopsy in some patients. When compared to MR elastography (MRE), US SWE is lower cost, portable, and does not need sedation/anesthesia. US SWE measurements can vary by method (point vs. 2D) and vendor. Few studies have defined cut-off values for detecting fibrosis in pediatric patients using US 2D SWE. This study aims to evaluate the diagnostic performance and define cut-off values of US 2D SWE for the detection of liver fibrosis in pediatric patients, using Toshiba (Canon) Aplio 500 and Aplio i800 systems. Read More

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

Authors: Alhashmi Ghufran, Gupta Anita, Trout Andrew, Dillman Jonathan

Keywords: 2D US shear wave elastography, Liver fibrosis, Pediatric

Compressed SENSE (CS) facilitates significantly shorter MRI acquisition times. There is a paucity of data comparing quantitative MRI with regularly under-sampling schemes like SENSE to pseudorandom under-sampling schemes like CS. The purpose was to compare measurements of liver proton density fat fraction (PDFF), T2*, and stiffness between SENSE and CS techniques with identical MR acquisition parameters. Read More

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

Authors: Boyarko Alexander, Dillman Jonathan, Pednekar Amol, Tkach Jean, Trout Andrew

Keywords: Under-sampling, mDixon-Quant, Elastography

Portal hypertension is a manifestation of Fontan-related venous congestion and hepatic fibrosis. We studied the prevalence of radiologic evidence of portal hypertension (RP) and its association with Fontan hemodynamics and adverse outcomes. We also tested the validity of the VAST score, used in a prior study, in our population. Read More

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

Authors: Zafar Faizeen, Trout Andrew, Palermo Joseph, Alsaied Tarek, Dillman Jonathan

Keywords: Fontan, Portal Hypertension, Congenital Heart Disease

Multiple noninvasive magnetic resonance imaging (MRI) methods have been described to detect liver fibrosis, including diffusion-weighted imaging (DWI). The purpose of our study was to evaluate predictors of liver MRI DWI apparent diffusion coefficient (ADC) measurements in pediatric patients with autoimmune liver disease, including the relationship between ADC measurements and liver stiffness. Read More

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

Authors: Abu Ata Nadeen, Dillman Jonathan, Gandhi Deep, Dudley Jonathan, Trout Andrew, Miethke Alexander

Keywords: Liver fibrosis, Liver stiffness

To determine the diagnostic performance of renal ultrasound for diagnosing nephrolithiasis in children using a clinical effectiveness approach. Read More

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

Authors: Roberson Nathaniel, Dillman Jonathan, O'hara Sara, Defoor William, Reddy Pramod, Giordano Richard, Trout Andrew

Keywords: nephrolithiasis

There is little data describing imaging sedation and anesthesia practice patterns in pediatric radiology. The purpose of this study was to understand current imaging sedation and anesthesia practice patterns based on a survey of member institutions of the Society of Chairs of Radiology at Children’s Hospitals (SCORCH) in conjunction with the American College of Radiology’s Pediatric Imaging Sedation and Anesthesia Committee. Read More

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

Authors: Dillman Jonathan, Gee Michael, Ward Christopher, Drum Elizabeth, Servaes Sabah, Jaimes Camilo, States Lisa

Keywords: Imaging, Anesthesia, Sedation

The use of feed and swaddle (FS) technique in infants has increased in popularity due to the concern for neurotoxicity from medications used for anesthesia or sedation. The purpose for evaluating the age group < 6 months of age was to understand current imaging sedation and anesthesia practice patterns based on a survey of member institutions of the Society of Chairs of Radiology at Children’s Hospitals (SCORCH) in conjunction with the American College of Radiology’s Pediatric Imaging Sedation and Anesthesia Committee. Read More

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

Authors: States Lisa, Gee Michael, Servaes Sabah, Jaimes Camilo, Ward Christopher, Drum Elizabeth, Dillman Jonathan

Keywords: Feed and Swaddle, sedation, anesthesia

Acute kidney injury (AKI) remains a concern in hospitalized children undergoing computed tomography (CT) examinations with intravenous (IV) iodinated contrast material (ICM). Adult studies have shown frequencies of AKI after CT with IV ICM to be similar to propensity score-matched ICM unexposed cohorts. The purpose of this study is to evaluate the association between IV ICM exposure and AKI in hospitalized pediatric patients with stable kidney function undergoing computed tomography (CT). Read More

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

Authors: Gilligan Leah, Davenport Matthew, Trout Andrew, Su Weizhe, Zhang Bin, Goldstein Stuart, Dillman Jonathan

Keywords: contrast induced nephropathy, acute kidney injury, iodinated contrast material

The Fontan operation, used to palliate single ventricle congenital heart disease, increases venous pressure in the liver and is associated with Fontan associated liver disease (FALD), for which liver fibrosis is the final common pathway. Elastography (ultrasound [US] or MRI) can be used to non-invasively measure liver stiffness associated with liver fibrosis. However, these measures are confounded in Fontan patients due to venous congestion. The purpose of this study was to prospectively document the stiffening effect of passive hepatic congestion following the Fontan operation and track changes in liver stiffness over the post-operative period. Read More

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

Authors: Trout Andrew, Dillman Jonathan, Alsaied Tarek, Lubert Adam, Palermo Joseph, Lorts Angela, Khoury Philip

Keywords: Fontan, Liver, Ultrasound

At our institution, airway radiographs are routinely checked by the radiologist to ensure diagnostic image quality prior to the technologist completing the examination. These checks interrupt the workflow for both the technologist and radiologist. In this study, we develop and validate a deep learning algorithm to detect non-diagnostic lateral airway radiographs. Read More

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

Authors: Somasundaram Elanchezhian, Brady Samuel, Crotty Eric, Trout Andrew, Anton Christopher, Towbin Alexander, Coley Brian, Dillman Jonathan

Keywords: Deep learning, Airway, Xray

To compare liver shear stiffness estimates obtained by Automatic Liver Elasticity Calculation (ALEC) processing of two-dimensional (2D) gradient-recalled echo (GRE) magnetic resonance elastography (MRE) data to stiffness values obtained from standard-of-care manual processing. Read More

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

Authors: Gandhi Deep, Lake David, Dillman Jonathan, Braimah Adebayo, Dudley Jonathan, Tkach Jean, Pednekar Amol, Trout Andrew, Miethke Alexander, Heilman Jeremiah, Dzyubak Bogdan

Keywords: Elastography, MRI, Elasticity

MR elastography (MRE) is increasingly being used to non-invasively assess diffuse liver disease in children. However, there are limited normal liver stiffness data for MRE in children. The purpose of this study was to determine normal liver stiffness measured by MRE for children and assess for associations with demographic factors, MRI field strength and MRI vendor. Read More

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

Authors: Trout Andrew, Zhang Bin, Dillman Jonathan, Anupindi Sudha, Gee Michael, Khanna Geetika, Xanthakos Stavra, Baikpour Masoud, Calle-toro Juan, Ozturk Arinc, Serai Suraj

Keywords: Elastography, MR, Liver