Background: Li-Fraumeni Syndrome (LFS) is an autosomal dominant disorder that predisposes individuals to cancer, associated with mutations in the P53 gene. The most common tumors associated with LFS include breast cancer, osteosarcomas and other sarcomas. Less frequent but also seen are brain tumors, adrenocortical carcinomas and leukemia. However, tumors can manifest almost anywhere in the body. Given the increased cancer risk, close surveillance is imperative for early cancer detection; guidelines recommend annual Whole Body MRI (WB-MRI) surveillance, along with a series of other imaging and laboratory studies. WB-MRI protocols vary across centers. Although the short tau inversion recovery (STIR)/T2-weighted sequence is accurate for early cancer detection, the combination of STIR/T2 and diffusion-weighted (DW) sequences further increases the diagnostic accuracy of MRI, but at the cost of increased scan time. Teaching Points: In this educational poster, we will show pediatric surveillance MRI scans in patients with LFS where the utilization of DW-MRI was essential for the diagnosis of cancer or associated conditions, not identified by STIR/T2-weighted MRI solely, along with WB-MRI protocols used in different centers with corresponding total scan time. Our objective is to demonstrate the added value of using DWI in lesion detection justifying the extended scan duration for surveillance of patients with cancer predisposition disorders. Although it may be uncommon to find lesions exclusively on DWI, the relevance of early cancer diagnosis justifies the time and resources invested in performing this sequence. Table of contents/Outline: 1. WB-MRI protocols for cancer surveillance in pediatric patients with cancer predisposition disorders. 2. Presentation of cases of: - Discordant results between DWI and STIR/T2 MRI sequences, false-negative results on STIR/T2 solely. - Concordant results between DWI and STIR/T2 MRI sequences, true-positive results. 3. Examples of artifacts in DW-MRI that may preclude an accurate diagnosis and approaches to avoid or to minimize them. Read More

Meeting name: SPR 2025 Annual Meeting , 2025

Authors: Reyes Recasens Magdalena, Arenos-abril Jesus, Doria Andrea

Keywords: Whole Body MRI, Cancer, Surveillance Imaging

Magnetic resonance imaging (MRI) is one of the essential diagnostic tools in pediatric radiology, however, obtaining high-quality, motion-free images in infants remains a challenge. Sedation or general anesthesia is often required to minimize motion artifacts, but these carry potential risks, including respiratory depression, prolonged recovery, and potential neurodevelopmental effects with repeated exposure. In addition, access to general anesthesia for MRI examinations is often limited, particularly in underdeveloped countries. The feed and wrap technique offers a safe, effective, and non-pharmacologic alternative to sedation for imaging infants, particularly those under 3 months of age. This educational poster will review the principles and practical steps of the feed and wrap technique, including patient selection, preparation, feeding strategies, swaddling methods, and optimization of MRI protocols. We will discuss environmental adjustments, such as room temperature control, noise reduction, and use of immobilization aids, to maximize success rates. In addition, we will present case examples demonstrating typical applications across brain, spine, and abdominal MRI studies, highlighting common pitfalls and troubleshooting strategies when motion or incomplete sequences occur. We will also compare diagnostic image quality between feed and wrap studies and sedated studies, review success rates reported in the literature, and provide practical guidance for implementing this technique in both community and tertiary care settings. Radiologists, technologists, and pediatricians play a key role in promoting safe, patient-centered imaging practices. Familiarity with the feed and wrap technique empowers pediatric imaging teams to reduce sedation rates, improve workflow efficiency and safety, while maintaining diagnostic quality in MRI examinations for the young patients. Read More

Meeting name: SPR 2026 Annual Meeting , 2026

Authors: Reyes Recasens Magdalena, Agarwal Nivedita, Alavi Mehvish, Gee Michael, Greer Mary-louise, Kim Hyun Gi, Kim Pyeong Hwa, Yoon Heemang, Jung Ah Young, Cho Young Ah, Lee Jin Seong, Tan Timothy Shao Ern, Atalabi Omolola Mojisola, Verhagen Martijn Vincent

Keywords: General Anesthesia, MRI Try Without Sedation, Safety