Hepatoblastoma exemplifies how a multidisciplinary approach involving all stake-holders is key for appropriate management. The Pretreatment Extent of Tumor (PRETEXT) classification remains the cornerstone of staging, treatment planning, and prognostication. The 2017 revision addressed many ambiguities and improved standardization of hepatoblastoma staging, providing a common language across disciplines and institutions. However, certain interpretative and practical challenges persist in daily practice. For example, large tumors often compress the IVC, which is not well opacified on cross-sectional imaging. This makes it difficult to confidently categorize venous involvement V + or V-. The precise role of ultrasound in clarifying such equivocal cases also requires further evaluation. Classification of tumors limited to one section and tumor thrombus extending to another section is another source of confusion. The surgical plan in case the tumor thrombus resolves is also unclear. Sectional compression vs involvement, which may cause overstaging, differentiating contiguous spread from multifocality, overcalling rupture in the presence of perihepatic fluid, and more clear definition of extrahepatic extension are other examples of areas which need more clarity. Each of these can lead to staging discrepancies that impact patient management. In this exhibit, we discuss the current PREXTEXT classification, its current utility, pitfalls and limitations, and discuss future directions in PRETEXT classification updates. This educational exhibit revisits the fundamentals of the PRETEXT classification, its current utility, and its pitfalls and limitations through practical, case-based discussions. It highlights common interpretative dilemmas and provides practical strategies to enhance reproducibility and confidence in staging. Finally, it explores emerging directions for future PRETEXT updates. The ultimate goal is to make radiologists more effective members of the interdisciplinary tumor boards through a holistic understanding of PRETEXT classification and discuss areas for future updates. Read More

Meeting name: SPR 2026 Annual Meeting , 2026

Authors: Baheti Akshay, Patil Vasundhara, Towbin Alexander, Chavhan Govind, Gala Kunal, Shetty Nitin, Kulkarni Suyash, Qureshi Sajid

Keywords: Oncology, Heptoblastoma, Liver Tumor

Desmoplastic small round cell tumor (DSRCT) is a rare, aggressive sarcoma of the Ewing’s sarcoma family with the presence of EWSR1 gene mutation. It predominantly affects adolescent males. DSRCT typically arises from peritoneal or pelvic serosal surfaces and often presents at an advanced stage. Because symptoms are vague, imaging plays a crucial role in early recognition. We review the CECT findings of pediatric patients of DSRCT who were managed at our institute. Read More

Meeting name: SPR 2026 Annual Meeting , 2026

Authors: Baheti Akshay, Bhaladhare Prachi, Patil Vasundhara, Gala Kunal, Shetty Nitin, Kulkarni Suyash, Ramadwar Mukta, Panjawani Poonam, Qureshi Sajid

Keywords: Oncology, Sarcomas, Small Round Blue Cell Tumors

Pediatric hepatic neoplasms include a variety of differentials which vary with the child’s age. We evaluated the diagnostic accuracy of certain imaging features on CECT in differentiating these tumors, particularly for identifying hepatoblastoma. Read More

Meeting name: SPR 2026 Annual Meeting , 2026

Authors: Baheti Akshay, Rajasimman Aishvarya Shri, Patil Vasundhara, Gala Kunal, Shetty Nitin, Kulkarni Suyash, Ramadwar Mukta, Panjawani Poonam, Qureshi Sajid

Keywords: Abdomen CT, Liver Tumor, Heptoblastoma

Pediatric adrenocortical carcinomas (ACCs) are less common than neuroblastomas, but have worse prognosis. Early identification and differentiation from neuroblastomas helps allow prompt management. We describe the imaging features of primary and metastatic ACCs. Read More

Meeting name: SPR 2026 Annual Meeting , 2026

Authors: Baheti Akshay, Sarmah Shivali, Patil Vasundhara, Gala Kunal, Shetty Nitin, Kulkarni Suyash, Ramadwar Mukta, Panjawani Poonam, Qureshi Sajid

Keywords: Adrenal, Oncology, Adrenocortical