Use of ultrasound for detection of midgut malrotation and volvulus has evolved and become more accepted as the first line assessment for this emergent pathology given its portability, ubiquity, and cost savings. Despite best efforts and experienced sonographers, visualization of an intraperitoneal D3 segment is both the most specific for malrotation as well as the most inconsistently seen. Contrast enhanced ultrasound (CEUS) has been used in pediatric patients for many different applications. Initially for detecting vesicoureteral reflux and subsequently expanded its utility into numerous intravascular and intracavitary applications. We aim to test the feasibility of using enteric US contrast to visualize the D3 segment. Read More

Meeting name: SPR 2026 Annual Meeting , 2026

Authors: Cao Joseph, Perkons Nicholas, Matter Gregory, Russ Megan, Fadell Michael

Keywords: Contrast Enhanced Ultrasound, Malrotation, Upper Gastrointestinal Series

Background: Conventional medullary osteosarcoma is a malignant bone-forming tumor characterized by the production of osteoid matrix by malignant mesenchymal cells. Although it is the most common primary malignant bone tumor in children, primary osteosarcoma of the spine is exceptionally rare, accounting for less than 5% of pediatric osteosarcomas. Symptoms are frequently nonspecific, and early radiographic clues may be subtle. Due to its rarity and nonspecific presentation, spinal osteosarcomas are often diagnosed late, typically after structural destruction or neurologic compromise has occurred. Case Report: A 12-year-old female presented with two months of progressive low back pain and an unintentional 15-pound weight loss. She denied weakness, sensory loss, or bowel/bladder dysfunction. Lumbar spine radiographs revealed a lucency of the left L2 pedicle, producing a “winking owl sign.” Follow-up CT demonstrated a lytic, destructive lesion with asymmetric enlargement of the left psoas and paraspinal musculature. Additionally, CT was useful in demonstrating the presence of osseous matrix within the primary tumor. MRI revealed an expansile, enhancing lesion centered in the left posterior elements of L2, with paraspinal soft-tissue extension and circumferential epidural involvement causing moderate to severe canal stenosis. Biopsy confirmed the diagnosis of conventional medullary osteosarcoma. The patient remained neurologically intact and was referred for multidisciplinary oncologic management. Read More

Meeting name: SPR 2026 Annual Meeting , 2026

Authors: Joya Sosa Yocelin, Madden Joseph, Fadell Michael, Carrico Caroline, Maxfield Charles, Cao Joseph

Keywords: Oncology, Osteosarcomas, Radiographic Findings

Pectus excavatum is the most common chest wall deformity, often causing psychosocial distress and cardiopulmonary issues when severe. The Haller Index (HI) obtained on CT remains the standard for assessing severity, despite its limitations and reproducibility on radiograph. Photon-counting detector CTs can reduce radiation dose while maintaining image quality. We hypothesize that significantly lowering radiation will not compromise presurgical evaluation of pectus excavatum. Read More

Meeting name: SPR 2026 Annual Meeting , 2026

Authors: Cao Joseph, Kuchibhatla Maragatha, Janos Sara, Gupta Ananya, Bache Steve, Solomon Justin, Kilpatrick Kayla, Fadell Michael, Gaca Ana, Maxfield Charles, Carrico Caroline

Keywords: Chest Computed Tomography (CT), Surgical Planning, Radiation Reduction

Patients with congenital cardiac disease are a vulnerable population who require early and repeat CT imaging. However, decreasing ionizing radiation dose in pediatric CT increases image noise. We evaluated a self-supervised deep learning denoising model integrating sparse coding with a modified Vision Transformer (SC-mViT) compared with a non-local means (NLM) algorithm using quantitative and qualitative metrics. Read More

Meeting name: SPR 2026 Annual Meeting , 2026

Authors: Gupta Ananya, Erkanli Alaattin, Badea Cristian, Cao Joseph, Clark Darin, Solomon Justin, Bache Steve, Janos Sara, Fadell Michael, Gaca Ana, Carrico Caroline, Morrison Samantha

Keywords: Congenital Heart, Artificial Intelligence, CT