Stewart Zachary,  Elmore Kate,  Thompson Allison,  Pham Huy

Final Pr. ID: Poster #: SCI-002

Delayed phase imaging increases the sensitivity of detection of injuries to the urinary tract and also assists in characterizing solid visceral organ injuries at the expense of doubling the radiation dose to the patient. If institutions can lower the rate of these examinations, the cumulative radiation exposure reduction would be substantial. Here we evaluate the rate of delayed phase imaging in the pediatric trauma population at our Level I trauma center as well as the frequency with which these patients demonstrate an indication on portal venous imaging for delayed phase acquisition. Finally, there are minimal guidelines dictating the appropriateness of delayed imaging in pediatric trauma. We include a review of the literature in order to elucidate appropriate indications and help guide clinicians to make evidenced based decisions. Read More

Authors:  Stewart Zachary,  Elmore Kate,  Thompson Allison,  Pham Huy

Keywords:  Trauma ,  ALARA ,  Protocol

Cao Joseph,  Pfeifer Cory

Final Pr. ID: Poster #: SCI-004

The principle of ALARA and its application in the pediatric population serves as the focus of the Image Gently campaign. Tertiary care institutions dedicated to the care of children are well situated to be regional leaders in maximizing the ALARA concept. This study compares the size-specific dose estimates of computed tomography (CT) studies performed at our institution to those from outside facilities referring patients for emergent care. Read More

Authors:  Cao Joseph,  Pfeifer Cory

Keywords:  ALARA ,  Radiation ,  SSDE

Finkle Joshua,  Marshall Emily,  Reiser Ingrid,  Zhang Yue,  Lu Zheng Feng,  Jones Anji,  Feinstein Kate

Final Pr. ID: Poster #: SCI-005

Global mAs reduction is accepted as being superior to bismuth breast shields in reducing breast organ dose for children undergoing CT of the chest. However, in imaging of chest, abdomen, and pelvis (CAP), globally reducing mAs degrades image quality in the abdomen and pelvis. This study compares bismuth shields to global mAs reduction including a region-specific boost feature to maintain abdominal image quality. Read More

Authors:  Finkle Joshua,  Marshall Emily,  Reiser Ingrid,  Zhang Yue,  Lu Zheng Feng,  Jones Anji,  Feinstein Kate

Keywords:  Bismuth breast shields ,  CT dose

Gould Sharon,  Harty M.,  Ostrowski John,  Tsuda Takeshi

Final Pr. ID: Poster #: SCI-008

Diseases of the coronary arteries are rare in children, but can present as unexpected catastrophic events without preceding symptoms. It is essential to identify patients at risk to prevent potentially serious cardiovascular events. Coronary CT angiography (CCTA) has been widely studied in adults, but its clinical applications are not well established in children. Read More

Authors:  Gould Sharon,  Harty M.,  Ostrowski John,  Tsuda Takeshi

Keywords:  Coronary ,  CTA ,  Pediatric

Lee Simon,  Krishnamurthy Rajesh,  Krishnamurthy Ramkumar,  Johnston Thomas,  Hor Kan

Final Pr. ID: Poster #: SCI-009

Duchenne muscular dystrophy (DMD) is a myopathy with a natural history of progressive cardiomyopathy and vasogenic edema, fatty infiltration, and myocardial fibrosis. We recently identified a group of patients with DMD who presented with acute onset of chest pain (ACP), troponin leak (TL), and new late gadolinium enhancement (LGE), similar in presentation to acute viral myocarditis (AM). It is unclear if these patients have suffered an episode of AM or if this is a different disease process. Given the presumed acute myocardial necrosis in both processes, we hypothesize that native T1 and T2 values would be elevated in AM and DMD patients with ACP compared to asymptomatic DMD patients. Read More

Authors:  Lee Simon,  Krishnamurthy Rajesh,  Krishnamurthy Ramkumar,  Johnston Thomas,  Hor Kan

Keywords:  Parametric Mapping ,  Cardiomyopathy

Hill Ann,  Hirsig Leslie,  Yazdani Milad,  Collins Heather,  Jenkins Dorothea

Final Pr. ID: Poster #: SCI-015

MRS is the best prognostic indicator for hypoxic-ischemic encephalopathy (HIE) but is difficult to obtain early after injury. We investigated whether cerebral blood flow measures of resistive indices (RI) and time average maximum velocities (TAMx) shortly after birth would relate to later degree of neural injury by MRI in hypothermic HIE newborns. We predicted that abnormally high/low blood flow would be associated with poor outcomes. Read More

Authors:  Hill Ann,  Hirsig Leslie,  Yazdani Milad,  Collins Heather,  Jenkins Dorothea

Keywords:  Cerebral Blood Flow ,  Hypoxic Ischemic Encephalopathy (HIE) ,  Magnetic Resonance Spectroscopy (MRS)

Richer Edward,  Patel Dhruv,  Braithwaite Kiery,  Milla Sarah,  Loewen Jonathan

Final Pr. ID: Poster #: SCI-020

Determine if a simple scoring system can accurately predict the reducibility of ileocolic intussusceptions with therapeutic enema, and eventual surgical outcomes in those patients failing reduction. Read More

Authors:  Richer Edward,  Patel Dhruv,  Braithwaite Kiery,  Milla Sarah,  Loewen Jonathan

Keywords:  Intussusception ,  ultrasound

Dennis Rebecca,  Silvestro Elizabeth,  Hill Lamont,  Andronikou Savvas,  Anupindi Sudha,  Hwang Misun

Final Pr. ID: Poster #: SCI-022

To create a three dimensional (3D) ultrasound (US) bowel phantom that simulates bowel sonographic characteristics to aid in education for bowel scanning techniques and for microbubble contrast utilization in bowel. Read More

Authors:  Dennis Rebecca,  Silvestro Elizabeth,  Hill Lamont,  Andronikou Savvas,  Anupindi Sudha,  Hwang Misun

Keywords:  Bowel Phantom ,  Bowel Ultrasound ,  3D Printing

Ruess Lynne,  Samora Julie

Final Pr. ID: Poster #: SCI-026

To test radiographic diagnostic accuracy for distinguishing between stable distal radius buckle fractures (BF) from other distal radius fractures (DRF) after introducing a measurement guideline.
Background: Management of pediatric forearm fractures has become fracture specific, as treatment of the common stable BF is trending toward home management with a removable wrist splint while other potentially unstable, DRF require immobilization and orthopaedic follow-up. Diagnostic accuracy between BF and DRF is therefore imperative. We developed and suggested our radiologists use a measurement guideline to aid diagnosis with this general rule: an isolated distal radius fracture in a child > 7y is not likely to be a BF if the fracture-to-physis distance is < 1 cm. Read More

Authors:  Ruess Lynne,  Samora Julie

Keywords:  Quality Improvement ,  fracture ,  radiography

Stanescu A. Luana,  Otto Randolph,  Iyer Ramesh

Final Pr. ID: Poster #: SCI-028

Peer review is an essential component of quality improvement in radiology departments. Over the last years, several papers described a shift towards peer learning, emphasizing that feedback in the form of comments and peer learning conferences creates a more productive environment for reviewing and understanding perceptual or interpretive errors of peer radiologists, with improved diagnostic performance as the objective.
At our institution, we instituted a three-month scoreless peer review pilot period. Radiologists’ impressions regarding the current comment-enhanced numerical system and the pilot scoreless, comments-only period were collected through an online survey. Read More

Authors:  Stanescu A. Luana,  Otto Randolph,  Iyer Ramesh

Keywords:  peer review ,  scoreless ,  survey

Shah Summit,  Mcgonagill Phillip,  Hu Houchon,  Sankaran Akila,  Krishnamurthy Rajesh,  Krishnamurthy Ramkumar

Final Pr. ID: Poster #: SCI-030

The likelihood of sedation for an MRI exam in a patient under 8 years is high. Disadvantages of sedation usage include direct complications, suspected long-term effects, and higher costs. Sedation reduction techniques include the use of an MRI simulator, accelerated MRI scans, abbreviated protocols, and swaddle and sleep techniques. We evaluated the clinical image quality and cost effectiveness associated with an MRI simulator training program. Read More

Authors:  Shah Summit,  Mcgonagill Phillip,  Hu Houchon,  Sankaran Akila,  Krishnamurthy Rajesh,  Krishnamurthy Ramkumar

Keywords:  MRI Sedation ,  Quality Improvement ,  Cost

Nicholas Jennifer,  Marrocco Michael,  Shelton Peter,  Killeen Amy,  Don Steven

Final Pr. ID: Poster #: SCI-031

A button battery lodged in the esophagus is a medical emergency. This study evaluated how accurately button batteries can be distinguished from other ingested foreign bodies on radiographs and how this influences clinical management. Read More

Authors:  Nicholas Jennifer,  Marrocco Michael,  Shelton Peter,  Killeen Amy,  Don Steven

Keywords:  Button Battery ,  Emergency ,  Education

Lee Seunghyun,  Hur Saebeom,  Choi Young Hun,  Cho Yeon Jin,  Cheon Jung-eun,  Kim Woo Sun,  Kim In-one

Final Pr. ID: Poster #: SCI-032

The recent advances of the lymphatic intervention, has prompted progress in imaging of the lymphatic system. We would describe the clinical usefulness of the dynamic contrast-enhanced (DCE) magnetic resonance (MR) lymphangiography for imaging of the lymphatic system in pediatric patients. Read More

Authors:  Lee Seunghyun,  Hur Saebeom,  Choi Young Hun,  Cho Yeon Jin,  Cheon Jung-eun,  Kim Woo Sun,  Kim In-one

Keywords:  lymphangiography ,  MRI ,  dynamic contrast-enhanced

Pezeshkpour Paymun,  Armstrong Nicholas,  Mahant Sanjay,  Muthusami Prakash,  Amaral Joao,  Parra Dimitri,  Temple Michael,  Connolly Bairbre

Final Pr. ID: Poster #: SCI-033

To analyze the use of implanted port-a-caths in Children with Medical Complexity (CMC), neurological impairment and difficult venous access. Read More

Authors:  Pezeshkpour Paymun,  Armstrong Nicholas,  Mahant Sanjay,  Muthusami Prakash,  Amaral Joao,  Parra Dimitri,  Temple Michael,  Connolly Bairbre

Keywords:  Difficult venous access ,  Technology dependence ,  Reduced morbidity

Ashton Daniel

Final Pr. ID: Poster #: SCI-034

The lateral marginal vein, a persistent embryonic vein found in Klippel-Trenaunay (KT) patients, can be a major cause of morbidity such as venous hypertension and venous thromboembolism. Our purpose is to report our experience embolizing the lateral marginal vein using the Clarivein^TM device, a pharmacomechanical embolization system. Read More

Authors:  Ashton Daniel

Keywords:  varicose vein

Silvestro Elizabeth,  Shellikeri Sphoorti,  Trahan Sean,  Sze Raymond,  Cahill Anne Marie

Final Pr. ID: Poster #: SCI-035

3D printing technology presents a unique opportunity for the creation of custom phantoms for training and simulation for pediatric interventional procedures that are complex and/or uncommonly performed. The purpose of this study was to describe the elements of designing a 3D phantom for simulation of pediatric abdominal intra -vascular procedures. Read More

Authors:  Silvestro Elizabeth,  Shellikeri Sphoorti,  Trahan Sean,  Sze Raymond,  Cahill Anne Marie

Keywords:  3d printing ,  Simulation ,  Phantom

Rees Mitch,  Milks Kathryn,  Krishnamurthy Ramkumar,  Krishnamurthy Rajesh,  Hu Houchun

Final Pr. ID: Poster #: SCI-043

There is limited understanding and utilization of dynamic contrast enhancement MRI of marrow, periosteum and cartilage for diagnosis of musculoskeletal (MSK) disease in children. This is partly due to limited availability of pediatric disease models of marrow inflammation, infection, infiltration, or involvement by tumor. Herein we explore signal intensity time curves of relevant MSK targets using a 3D Golden-angle RAdial Sparse Parallel (GRASP) MRI technique. GRASP is an accelerated, free-breathing dynamic acquisition that has been shown to reduce the need for sedation. We aim to establish a baseline for normal enhancement characteristics of marrow, cartilage, synovium and periosteum of the growing skeleton in a sheep model as a precursor to translation to children. Read More

Authors:  Rees Mitch,  Milks Kathryn,  Krishnamurthy Ramkumar,  Krishnamurthy Rajesh,  Hu Houchun

Keywords:  radial MRI ,  dynamic contrast enhancement ,  musculoskeletal

Roberts Dustin,  Chawla Soni

Final Pr. ID: Poster #: SCI-044

To date, a standard for CRD has not been established. Plain radiographs are a cost-effective, low-risk option for studying osseous structures in great detail. It is well known that bone age is superior to chronological age for determining biological and structural maturity; for decades, pediatricians have relied on plain films of the wrist and hand for assessing bone age in children (e.g. Greulich & Pyle Atlas, Tanner Whitehouse Method). However, some have proposed new approaches with greater accuracy and reliability across all ages and ethnic groups. Here, we present a new standardized radiographic dimension, CRD, as a tool to assess developmental maturity, which can be readily obtained from standard medical imaging platforms. Read More

Authors:  Roberts Dustin,  Chawla Soni

Keywords:  capitular-radial distance ,  developmental maturity ,  CRD

Bowden Jonathan,  Bowden Sasigarn,  Adler Brent,  Hu Houchun,  Krishnamurthy Rajesh,  Krishnamurthy Ramkumar

Final Pr. ID: Poster #: SCI-046

Children with Duchene muscular dystrophy (DMD) have increased risk for osteoporosis and fragility fractures due to progressive muscle weakness with eventual loss of ambulation and chronic corticosteroid therapy. Their fracture prevalence is 40-60%, and increases with age. Bone Mineral Density (BMD) is not reflective of fracture risk. Recent studies showed that cortical thickness and area were associated with increased facture risk. Digital X-ray measurement of the cortical thickness of the metacarpal bones can be used as a marker for metacarpal cortical health. To our knowledge, this marker of bone health has not been evaluated in DMD patients. The purpose of this study was to assess bone age (BA), cortical thickness and area of metacarpal bones in relation to age in children with DMD. Read More

Authors:  Bowden Jonathan,  Bowden Sasigarn,  Adler Brent,  Hu Houchun,  Krishnamurthy Rajesh,  Krishnamurthy Ramkumar

Keywords:  Bone health ,  DMD ,  Duchenne

Parthasarathy Jayanthi,  Scharschmidt Thomas,  Rees Mitchell,  Selvaraj Bhavani

Final Pr. ID: Poster #: SCI-047

We describe a process for pre-operative virtual surgical planning and creation of patient specific surgical guides for bony tumor resection in pediatric orthopedic surgery and demonstrate a case in which this process was used for successful surgical guidance. Read More

Authors:  Parthasarathy Jayanthi,  Scharschmidt Thomas,  Rees Mitchell,  Selvaraj Bhavani

Keywords:  Patient-Specific ,  3D printing ,  Sugical Guides

Brahee Deborah,  Chan Andrea,  Emery Kathleen,  Cornwall Roger,  Maloney Thomas

Final Pr. ID: Poster #: SCI-048

Physeal injuries can result in premature physeal fusion. MR imaging is useful for mapping these bony physeal bridges. Resection of the bony bridge does not reliably restore normal physeal function. We have observed subtle loss of the normal low signal intensity line of the zone of provisional calcification (ZPC) extending beyond areas of physeal bar formation in some patients with prior growth plate fractures. This loss is a marker of disrupted endochondral ossification and likely reflects a more extensive region of physeal damage that might be used to better predict treatment outcomes. Given the subjectivity of visual ZPC assessment, we sought to develop a quantitative 3D map of the periphyseal area of the distal radius using a high resolution 3D fast/turbo spin echo sequence. Read More

Authors:  Brahee Deborah,  Chan Andrea,  Emery Kathleen,  Cornwall Roger,  Maloney Thomas

Keywords:  Physis ,  MRI ,  Imaging

Majeed Haris,  Sussman Marshall,  Feldman Brian,  Man Carina,  Blanchette Victor,  Doria Andrea

Final Pr. ID: Poster #: SCI-051

To evaluate the T2 map relaxation times in healthy male children and adolescent ankle cartilage under altered magnetic resonance image (MRI) protocols and to document trends in these T2 relaxation times with varying ages and body mass index (BMI). Read More

Authors:  Majeed Haris,  Sussman Marshall,  Feldman Brian,  Man Carina,  Blanchette Victor,  Doria Andrea

Keywords:  Hemophilia ,  Optimization Protocol ,  T2 Map MRI

Raubenheimer Lauren,  Andronikou Savvas,  Kilborn Tracy

Final Pr. ID: Poster #: SCI-053

There is little published research on the wide variation of corpus callosum (CC) morphology in children, the assessment of which is made difficult by the complex alteration of its appearance in childhood. The purpose of our study was to assess the morphology of the CC on mid-sagittal T1-weighted magnetic resonance imaging (MRI) in a large number of children and correlate the findings with demographic and clinical criteria. Read More

Authors:  Raubenheimer Lauren,  Andronikou Savvas,  Kilborn Tracy

Keywords:  children ,  magnetic resonance imaging ,  corpus callous morphology

Maleeva Aneliya,  Lim-dunham Jennifer,  Toslak Iclal,  Martin Brendan,  Bova Davide,  Kilic Aishe,  Barkan Guliz

Final Pr. ID: Poster #: SCI-054

To evaluate diagnostic performance of quantitative gray-scale ultrasound as an objective method in evaluation of pediatric thyroiditis.

Read More

Authors:  Maleeva Aneliya,  Lim-dunham Jennifer,  Toslak Iclal,  Martin Brendan,  Bova Davide,  Kilic Aishe,  Barkan Guliz

Keywords:  thyroiditis ,  grayscale ,  ultrasound

Thompson Matthew,  Davis Joseph,  Thompson Atalie,  Hull Nathan,  Schooler Gary

Final Pr. ID: Poster #: SCI-055

The purpose of this study is to determine whether a decrease in hematocrit is predictive of an intracranial hemorrhage (ICH) on neonatal head ultrasound (HUS). Read More

Authors:  Thompson Matthew,  Davis Joseph,  Thompson Atalie,  Hull Nathan,  Schooler Gary

Keywords:  intracranial hemorrhage ,  head ultrasound ,  hematocrit

Cole Elizabeth,  Pauly John,  Vasanawala Shreyas,  Cheng Joseph

Final Pr. ID: Poster #: SCI-059

Convolutional neural networks (CNNs) have proven to be valuable in the fields of image processing and computer vision. Our work applies complex-valued CNNs to magnetic resonance imaging (MRI) to reduce scan times. The reduction of scan times has widespread pediatric benefits. A typical scan requires that patients remain still for up to an hour to produce a clear image, which is difficult for children without inducing anesthesia, which carries risks. A need exists for greatly improved MRI scan times without the loss of diagnostic accuracy. This scan time can be reduced by subsampling in k-space. We use CNNs to reconstruct images from these undersampled acquisitions. Our work investigates complex-valued CNNs for image reconstruction in lieu of two-channel real-valued CNNs. Read More

Authors:  Cole Elizabeth,  Pauly John,  Vasanawala Shreyas,  Cheng Joseph

Keywords:  Magnetic Resonance Imaging ,  deep learning ,  Neural network

Aboagye Rosemond,  Bajno Lydia,  Nadel Helen,  Potts James,  Bray Heather

Final Pr. ID: Poster #: SCI-063

Purpose: ¹⁸F-FDG Positron Emission Tomography (PET-CT) has been shown to be superior to other imaging modalities in assessment of soft tissue involvement with Langerhans Cell Histiocytosis (LCH) and is now commonly included in the staging workup of LCH. Our purpose is to analyze the utility of skeletal survey in addition to PET-CT scan for detecting bone lesions in children with LCH and to evaluate if skeletal survey can be eliminated from the staging workup of LCH in order to reduce radiation exposure. Read More

Authors:  Aboagye Rosemond,  Bajno Lydia,  Nadel Helen,  Potts James,  Bray Heather

Keywords:  Langerhans Cell Histiocytosis ,  PET-CT ,  Skeletal Survey

Sodhi Kushaljit,  Gupta Pankaj,  Saxena Akshay,  Mathew Joseph,  Agarwal Ritesh

Final Pr. ID: Poster #: SCI-066

To evaluate the diagnostic performance of 3 Tesla lung magnetic resonance imaging (MRI) in children with allergic bronchopulmonary aspergillosis (ABPA). Read More

Authors:  Sodhi Kushaljit,  Gupta Pankaj,  Saxena Akshay,  Mathew Joseph,  Agarwal Ritesh

Keywords:  MRI ,  THORACIC ,  ABPA

Navallas Maria,  Daneman Alan,  Amirabadi Afsaneh,  Wasserman Jonathan

Final Pr. ID: Poster #: SCI-067

To evaluate the diagnostic accuracy of US and the most useful sonographic features for diagnosing metastatic cervical adenopathy in pediatric patients with thyroid carcinoma Read More

Authors:  Navallas Maria,  Daneman Alan,  Amirabadi Afsaneh,  Wasserman Jonathan

Keywords:  Thyroid carcinoma ,  cervical lymphadenopathy ,  ultrasound

O'donovan Julie,  Murray Becky,  Hu Houchun,  Wallihan Rebecca,  Mejias Asuncion,  Ramilo Octavio,  Krishnamurthy Rajesh

Final Pr. ID: Poster #: SCI-069

CAP is a worldwide contributor to morbidity and mortality in children. Radiogenomics is an emerging specialty which correlates imaging features to gene expression to predict disease severity, therapeutic response and clinical outcomes. A genomic score termed Molecular Distance to Health (MDTH) is a biomarker that measures the global transcriptional perturbation in blood and has been shown to correlate with disease severity in pediatric CAP (Wallihan R, Front. Cell. Infect. Microbiol. 2018). This study was undertaken to determine whether abnormalities on chest radiographs correlate with genomic and clinical markers of disease severity. Read More

Authors:  O'donovan Julie,  Murray Becky,  Hu Houchun,  Wallihan Rebecca,  Mejias Asuncion,  Ramilo Octavio,  Krishnamurthy Rajesh

Keywords:  radiogenomics ,  disease severity ,  MDTH