Askari Hadis,  Behzad Shima,  Askari Ali,  Gholamrezanezhad Ali

Final Pr. ID: Poster #: EDU-001

This review systematically examines diagnostic failure modes of artificial intelligence (AI) systems in pediatric imaging, analyzes root causes and clinical impact, and proposes strategies for safer deployment in pediatric radiology. Pediatric imaging poses unique challenges due to developmental anatomy, age-specific disease patterns, and technical variability that differ markedly from those in adult populations. Read More

Authors:  Askari Hadis,  Behzad Shima,  Askari Ali,  Gholamrezanezhad Ali

Keywords:  Imaging

Gauguet Jean-marc,  Tyrrell Cornelius,  Macnow Theodore,  Pandya Aniket

Final Pr. ID: Poster #: EDU-003

At our institution, a pediatric hospital within a larger academic center, radiology residents independently interpret pediatric radiology studies performed after hours. These studies are finalized by an attending pediatric radiologist and any discrepancies from the preliminary report to the final report are tracked. We wanted to develop a streamlined approach to better understand the types of discrepancies, whether there were patterns to the types of these discrepancies, and then use this information to build improved and tailored educational material for our residents.

We used MS365 Copilot/ChatGPT-5 to evaluate fully anonymized discrepancy notifications from radiology resident overnight reports. We had this large language model (LLM) categorize the types of discrepancies (musculoskeletal, abdomen, genitourinary, neuro, chest, spine, and others). We used the LLM evaluate for patterns of errors within each of these categories. Based on these patterns, educational material was designed with the use of these LLM.

Over an 8-month period (Jan 2025-August 2025) there were a total of 436 discrepancy cases identified. Most discrepancy cases involved musculoskeletal (41%), chest (27%), and spine (12%) misinterpretations. Within the musculoskeletal category, most misses involved fractures involving the elbow (20%), forearm (22%) and distal tibia (15%). In the chest category, resdients had difficulty distinguishing bronchial wall thickening from pneumonia (64%). To address the identified deficiencies, a pediatric ED lecture series has been added to the resident education. LLMs are being utilized to help design and focus these specific lecture topics. Additional, refined, and tailored didactic topics include elbow fractures, distal tibial fractures, pediatric pneumonia, and spine fractures.

Artificial intelligence and large language models can be usedl to evaluate data from overnight pediatric radiology resident discrepancy reports to help identify areas of deficiency and improve resident education through design and refinement of lecture topics. Read More

Authors:  Gauguet Jean-marc,  Tyrrell Cornelius,  Macnow Theodore,  Pandya Aniket

Keywords:  Education ,  Educational Intervention ,  Resident Training

Bee Stella,  Woon Tian Kai,  Yap Kok Hooi,  Fortier Marielle

Final Pr. ID: Poster #: EDU-004

In congenital heart disease (CHD), CT cardiac angiography (CTCA) has an important role in surgical planning and evaluating post-surgical complications, complementing echocardiography and cardiac magnetic resonance imaging (cMRI). Its strengths are in its high spatial resolution, rapid acquisition, and excellent 3D reconstruction capabilities for visualization of complex vascular and intracardiac relationships. However, unless radiologists tailor reconstructions and reports to address the surgeons’ needs, its full potential is underutilized. To do this, radiologists need to be aware of at least broad strokes of cardiac pathophysiology, as well as modern surgical approaches and potential post-surgical complications, for the most common CHDs. This will ensure that the utility of CTCA reports transcend volumetric and vascular measurements, and instead, anticipate technical challenges, identify hidden hazards, shape surgical strategy and pick up specific post-surgical complications.
We propose structured CTCA reporting framework for CHD centred on the needs of the surgeon, by prioritising specific information surgeons find most useful across various CHD conditions. The objectives of this poster are a) to review, by consensus with paediatric cardiac surgeons, the key imaging features in CTCA based on different CHD lesions. b) To propose a reporting checklist for CTCA that emphasizes those key features. c) To demonstrate application of this surgeon centric framework via illustrative cases, focusing on the tetralogy of Fallot, transposition of great arteries, total or partial anomalous pulmonary venous return, and coarctation of the aorta. Read More

Authors:  Bee Stella,  Woon Tian Kai,  Yap Kok Hooi,  Fortier Marielle

Keywords:  Cardiac CTA ,  Reporting ,  Congenital Heart Disease

Cheng Jocelyn,  Chung Taylor,  Davda Sunit,  Sridhar Shravan

Final Pr. ID: Poster #: EDU-005

Cardiovascular MRI is an invaluable tool used for clinical decision-making in children with congenital heart disease (CHD). The variable anatomy and physiology encountered in this cohort of patients challenges radiologists to integrate morphologic understanding with precise imaging metrics that drive management. Developing a solid understanding of common workflows used in CHD MRI can make the imager more confident and efficient in conducting the appropriate assessments in each case. This exhibit employs a skills-based method designed to make MRI evaluation of CHD more approachable, structured, and clinically impactful.

This course is not focused on assessment of any one congenital heart disease nor is it a simple case compendium, but rather, is aimed at teaching specific skills and demonstration of the use of MRI analytical techniques that can be applied to the spectrum of CHD ranging from simple shunts to simple obstructive lesions such as aortic coarctation to complex congenital heart diseases such as double outlet right ventricle. Learners will gain fluency with commonly employed CHD MRI workflows including morphologic characterization, angiography, volumetric analysis, gradient measurement, semilunar valve assessment, atrioventricular valve assessment, collateral flow quantification (systemic arterial, aortopulmonary, and venovenous), shunt quantification, internal consistency analysis, and myocardial tissue characterization. Each workflow will be paired with a sample case(s) that highlights the clinical utility of the associated workflow and addresses pearls and pitfalls associated with each workflow.

Following completion of this educational course, the learner will have gained experience exercising both interpretive and quantitative skills needed to conduct the different workflows that may be required for a particular CHD MRI case he or she encounters, understand when a certain analysis should be considered, and be able to perform quality checks that ensure generation of accurate clinical data to help guide the patient’s management. Read More

Authors:  Cheng Jocelyn,  Chung Taylor,  Davda Sunit,  Sridhar Shravan

Keywords:  Congenital Heart Disease ,  Magnetic Resonance Imaging MRI

Navallas Maria,  Zuccarino Flavio,  Inarejos Clemente Emilio J,  Marie Eman,  Gerrie Samantha,  Ladera Gonzalez Enrique,  Barber De La Torre Ignasi

Final Pr. ID: Poster #: EDU-010

Learning objectives:
1.Review the main pediatric cardiomyopathy phenotypes.
2.Clarify the role of MRI across the care pathway.
3.Walk through the key MRI sequences we actually use in kids.
4.Recognize the essential imaging findings that help us differentiate among them.

- Introduction:
Pediatric cardiomyopathies are a rare heterogeneous group of myocardial diseases but are the first cause of heart transplantation in children.
Causes are diverse—genetic mutations, coronary anomalies, infections, toxins, arrhythmias—and sorting out phenotypes can be tricky because adult criteria are often not applicable to kids and because many kids don’t tolerate long exams.

- Imaging techniques:
Echocardiography represents the first first-line modality but it is often complemented with CMR as it allows a radiation-free differentiation between different phenotypes with unique myocardial tissue characterization, playing a key role in diagnosis, risk stratification, and treatment assessment.

- Key MRI sequences:
Conventional cardiomyopathies protocols in children may use 1.5 or 3 Tesla field strengths and include the following sequences:
Initial localizers.
Cine imaging.
Phase contrast.
Parametric mapping.
LGE.

- Dilated Cardiomyopathy:
Most common.
Leading cause of heart transplant.
Dilated chambers.
Reduced systolic function.
LGE: Patchy or longitudinal mid-wall, transmural, subepicardial, or diffuse subendocardial involvement. Presence of LGE indicates poor prognosis and increased risk of SCD.
Native T1 mapping is suggested to be the strongest independent predictor of diffuse myocardial disease, allowing for the identification of patients at risk for adverse outcomes.

- Hypertrophic Cardiomyopathy:
2nd most common.
LV hypertrophy z-score >2.5 (no family history) or >2 (with family history/genetic test).
LVOT obstruction and SAM.
LGE: Independent risk factor for SCD.
Differential diagnosis with athlete's heart.

- Arrhythmogenic Cardiomyopathy:
RV and/or LV dilatation and reduced EF.
Wall motion abnormalities – most important finding in kids.
Myocardial fibrosis.
Fatty infiltration rare in children.

- Restrictive Cardiomyopathy:
Rarest CMP.
Non-dilated biventricular failure and biatrial dilatation.
Ddx: constrictive pericarditis.

- Excessive trabeculation/NCCM:
Non-compacted/Compacted myocardium ratio > 2.3 measured in diastole.
In the absence of dilation or systolic dysfunction, can be considered a phenotypic trait not necessarily associated with CMP. Read More

Authors:  Navallas Maria,  Zuccarino Flavio,  Inarejos Clemente Emilio J,  Marie Eman,  Gerrie Samantha,  Ladera Gonzalez Enrique,  Barber De La Torre Ignasi

Keywords:  Cardiomyopathy ,  Cardiac MRI

Belmonte Joy,  Yang Yin,  Chew Lay Ee,  Wong Lee,  Fortier Marielle,  Tan Timothy Shao Ern

Final Pr. ID: Poster #: EDU-011

Midgut volvulus (MGV) is a surgical emergency with potentially devastating risks of short gut syndrome, sepsis, and death. Timely diagnosis prevents treatment delay. Although traditionally diagnosed with an upper gastrointestinal (UGI) series, ultrasound (US) offers a rapid, radiation-free alternative when performed by trained operators. As part of our institution’s transition to an “ultrasound-first” protocol for suspected malrotation/MGV, we designed and implemented a structured training program to enhance sonographer proficiency. This study presents the framework and preliminary outcomes of this training initiative. Read More

Authors:  Belmonte Joy,  Yang Yin,  Chew Lay Ee,  Wong Lee,  Fortier Marielle,  Tan Timothy Shao Ern

Keywords:  Ultrasound ,  Gastric Volvulus ,  Malrotation

Larsen Ethan,  Rios-martinez Julian,  Silvestro Elizabeth

Final Pr. ID: Poster #: EDU-014

Detecting foreign objects retained (RFO) during surgery presents unique challenges in imaging due to the growing complexity of materials and devices utilized in the operating room. This can include, but is not limited to, gauze, gloves, and suturing string. X-ray is the primary tool for detecting these objects, but the opportunity for radiologists to learn and practice can be limited. This project aimed to develop a cost-effective chest phantom and digital reconstructed radiograph (DRR) to allow for educational and practice. Read More

Authors:  Larsen Ethan,  Rios-martinez Julian,  Silvestro Elizabeth

Keywords:  3D Printing ,  Phantom ,  Foreign Body

Rivera Leida,  Tolland Marlena,  Leyva Gloria,  Chandra Tushar,  Kucera Jennifer

Final Pr. ID: Poster #: EDU-017

Our educational poster highlights the essential role of child life specialists in pediatric radiology and their impact on patient care, procedural success, and overall departmental efficiency. Through case-based examples and practical workflow integration strategies, the presentation demonstrates how child life interventions reduce patient anxiety, improve cooperation for successful exams, can help with cost saving measures for the department, and minimize the need for sedation during imaging procedures. Emphasis is placed on communication, environmental modification, and age-appropriate coping strategies that optimize the radiology experience for children and their families. Our poster also highlights the collaboration between technologists, radiologists, and child life specialists in creating a supportive, patient-centered imaging environment.
We aim to educate radiology professionals on the vital psychosocial support role of child life specialists and demonstrate how their presence and practices contribute to a more compassionate, efficient, and safe pediatric imaging environment.
Educational Objectives:
After reviewing our presentation, participants will be able to:
Describe the core responsibilities and techniques used by child life specialists in pediatric radiology.
Identify common imaging procedures where child life involvement has the greatest impact on patient outcomes.
Explain evidence-based benefits of child life interventions in reducing sedation rates, procedure times, and patient distress.
Recognize opportunities for collaboration between radiology staff and child life services to enhance the patient and family experience.
Implement practical strategies to integrate child life principles into daily radiology workflows, even in departments without dedicated specialists. Read More

Authors:  Rivera Leida,  Tolland Marlena,  Leyva Gloria,  Chandra Tushar,  Kucera Jennifer

Keywords:  Approach ,  Child Life ,  Patient Care

Harris Debra,  Maniyar Jenny,  Dixon Rachel,  Turnbull Louise,  Dominiak Kate,  Kapadia Tejas

Final Pr. ID: Poster #: EDU-020

TB remains one of the most significant causes of morbidity and mortality in children worldwide. In the Northwest of England, UK we report an incidence of approximately 1.4 per 100,000 under 15 years of age. Diagnosis and management are subtle and complex. We explain the insensitivity of the screening tests currently available and widely relied upon in the adult sector.
We highlight the importance of multidisciplinary team working exemplified by our Network model in the Northwest region of England. This virtual forum meets weekly and includes radiologists, pulmonologists, specialist nurses, infectious disease specialists and local clinicians. We discuss all new TB cases across the region, present imaging findings and document all decisions.
We review these cases until discharge encompassing imaging findings in the acute disease phase, treatment phase and post infectious stage. These may go on to affect quality and length of life and include but are not limited to fibrotic scarring, bronchiectasis and intrapulmonary/pleural calcifications.
We have extensive data from our virtual network (the largest in the United Kingdom) and will use this poster to show multiple high quality cases to highlight the importance of multidisciplinary team working. Read More

Authors:  Harris Debra,  Maniyar Jenny,  Dixon Rachel,  Turnbull Louise,  Dominiak Kate,  Kapadia Tejas

Keywords:  Tuberculosis ,  Multidisciplinary Education ,  Thoracic

Khan Muhammad

Final Pr. ID: Poster #: EDU-021

The American Board of radiology(ABR) and society for pediatric Radiology (SPR) are working to adress the shortage of pediatric radiologists in the United States. This educational exhibit presents a brief overview of the pathways to become board certified in pediatric radiologist.

1- CONVENTIONAL PATHWAY:
- Intern Year (PGY-1).
- Diagnostic Radiology Residency (PGY-2 to PGY-5): Four years of comprehensive radiology training.
- Pediatric Radiology Fellowship (1 Year): Specialized training in pediatric imaging.

2- ABR ALTERNATE PATHWAY

Designed for international medical graduates.
-Home country radiology residency
-Completed USMLEs
-Four years at a U.S. institution having ACGME accredited residency program. Four years can be completed as combination of residency/ fellowship/attending in academic program.

3- ABR 15-month pediatric radiology residency pathway
- 15 months of pediatric experience during 48 months DR residency.
- No requirement for additional pediatric radiology fellowship. Read More

Authors:  Khan Muhammad

Keywords:  Career Choice ,  Paediatric Radiology

Rebollo Polo Monica,  Planas Roman Silvia,  Nadal Alfons,  Perez Cruz Miriam,  Eixarch Roca Elisenda,  Planells Mariana,  Gómez-chiari Marta

Final Pr. ID: Poster #: EDU-025

The growing body of evidence linking placental physiology and brain development has led to the emergence of a new field coined “neuroplacentology” Disease processes affecting the placenta can have a major influence on overall fetal circulatory function and specifically blood flow to the CNS. In addition, the placenta also plays an important role as an endocrine and immune protective organ.
The aim of this review is to describe the main abnormal placental phenotypes according to the 2016 Amsterdam pathological classification and the role of abnormal placenta in neurodevelopmental disorders.
The placenta-mediated mechanisms of perinatal brain injury are varied, ranging from poor protection to hypoxia. Read More

Authors:  Rebollo Polo Monica,  Planas Roman Silvia,  Nadal Alfons,  Perez Cruz Miriam,  Eixarch Roca Elisenda,  Planells Mariana,  Gómez-chiari Marta

Keywords:  Placenta ,  Fetal Brain MRI ,  IVIM

Edwards Harriet,  Mir Malaikah,  Mcpartland Jo

Final Pr. ID: Poster #: EDU-028

Post mortem imaging provides non-invasive diagnostic insight into investigating fetal loss, complementing conventional examination. When post mortem examination of the brain is limited, post mortem MRI (PM MRI) can help further evaluate intracranial abnormalities not identified antenatally or via pathology.

We present PM MRI from a small cohort of cases acquired following initiation of a post mortem imaging service at our tertiary children’s hospital in the UK, demonstrating the value of this modality in comparison to antenatal ultrasound (US), and its concordance with formal pathological examination.

Illustrating both PM MRI and pathological findings from each case, we aim to (1) review the current guidance for post mortem MR imaging of fetuses in Europe and America, (2) highlight the importance of gestational age, weight and condition of the fetus when considering the best imaging modality, (3) compare images and sequences from both 1.5Tesla and 3Tesla MRI strength scanners and consider their diagnostic value, (4) showcase the most common PM MRI intracranial findings and (5) prove positive concordance with and diagnostic value to formal pathological investigations.


Following review, we hope the reader will have the knowledge and increased confidence to implement a post mortem MRI imaging service at their institution, recognising the value it can add to formal pathology examinations and subsequent diagnoses. Radiology-pathology relations and synergy give further opportunity to understand causes of fetal death, which is critical to helping grieving families and counsel those considering future pregnancy. Read More

Authors:  Edwards Harriet,  Mir Malaikah,  Mcpartland Jo

Keywords:  Postmortem ,  Perinatal ,  Fetal Brain MRI

Mousa Abeer,  Perez Rachel,  Goncalves Luis

Final Pr. ID: Poster #: EDU-035

Congenital diaphragmatic hernia (CDH) is a life-threatening fetal anomaly characterized by herniation of abdominal contents into the thoracic cavity due to a defect in the diaphragm, most commonly left-sided. Accurate prenatal diagnosis and risk stratification are essential for guiding perinatal management, parental counseling, and prognostication. While ultrasound remains the first-line modality for initial detection, fetal MRI provides superior soft tissue contrast and volumetric assessment, offering critical additional information, particularly in complex or equivocal cases. This educational exhibit serves as a practical guide for radiologists interpreting fetal MRI for CDH. We review the typical imaging features of CDH on MRI, including identification of herniated organs, mediastinal shift, and assessment of the ipsilateral and contralateral lungs. Emphasis is placed on the standardized approach to measuring total and observed-to-expected lung volumes (o/e TLV), as well as lung area to head cicumference ratio (LHR), which serve as key prognostic markers. The exhibit also addresses the significance of liver position, stomach location, and diaphragmatic defect size, all of which correlate with postnatal outcomes and surgical complexity. We illustrate how MRI findings influence the clinical decision-making process, including eligibility for fetal intervention such as fetoscopic endoluminal tracheal occlusion (FETO). Radiologists play a vital role in the multidisciplinary care of these patients by providing accurate and reproducible measurements that impact prognosis and management. This exhibit aims to equip radiologists with the essential tools and knowledge required to confidently evaluate CDH on fetal MRI and contribute meaningfully to perinatal planning. Read More

Authors:  Mousa Abeer,  Perez Rachel,  Goncalves Luis

Keywords:  Fetal ,  Congenital Diaphragmatic Hernia ,  Lung

Xu Hongmin,  Gagnon Marie-helene,  Ali Sumera,  Linam Leann

Final Pr. ID: Poster #: EDU-039

The purpose of this educational exhibit is to:
1.Review the embryology, classification, and imaging features of anorectal malformations (ARMs).
2.Review the indications and techniques of Contrast-enhanced colosonography (CeCS) in pediatric patients with ARMs.
3.Provide sample cases and clinical courses of patients with specific ARMs.

Anorectal malformations(ARMs) are a spectrum of congenital anomalies involving abnormal development of the distal rectum and anus, leading to an interruption or misconnection of the normal passage between the rectum and the perineum. The condition occurs in about 1 in 5,000 live births and can range from mild to complex. Children with ARMs require preoperative imaging to assess the presence and location of a fistula. Identifying the location of these fistulas is crucial for surgical planning.

Contrast-enhanced colosonography (ceCS) has emerged as a valuable tool in diagnosing pediatric ARMs, offering superior anatomical visualization and assessment compared to traditional imaging techniques like fluoroscopy, providing more sensitive and specific evaluation of fistula with real-time contrast filling. CeCS avoids ionizing radiation, and ultrasound contrast agents have a high safety profile with low incidence of adverse events compared to other contrast agents.

Contrast-Enhanced colosonography (CeCS) technique should include survey greyscale ultrasound examination of the pelvis to assess for adequate window. Lumason, the ultrasound contrast agent, is prepared and injected into a bag of saline, with a ratio of 1:500 mL. The mucous fistula is examined, and a small Foley catheter is inserted by the radiologist, then balloon is inflated to create a seal. Contrast is then instilled by gravity drip, and perineal structures are imaged through three standard approaches- transabdominal, transperineal and posterior sagittal approaches.

As well as reviewing the topics above, this review will also provide examples of ARM cases demonstrating high, intermediate, and low fistulas seen on CeCS.

Overall, CeCS enhances the diagnostic accuracy and management of pediatric ARMs. By providing detailed anatomical insights and allowing for accurate classification, it plays a critical role in guiding treatment strategies and improving long-term outcomes for affected patients. Read More

Authors:  Xu Hongmin,  Gagnon Marie-helene,  Ali Sumera,  Linam Leann

Keywords:  Anorectal Malformation ,  Contrast Enhanced Ultrasound ,  Pre-Surgical Planning

Kumar Tushar,  Elhussein Wala,  Kim Helen Hr

Final Pr. ID: Poster #: EDU-040

Sinusoidal obstruction syndrome (SOS), also known as veno-occlusive disease (VOD), is a potentially life-threatening hepatic complication that occurs primarily following hematopoietic stem cell transplantation (HSCT). It is characterized by obstruction of hepatic sinusoids and venules due to accumulation of cellular debris and red blood cells, leading to impaired hepatic outflow. The incidence in pediatric patients can be as high as 40%, resulting from toxic injury or activation of liver sinusoidal endothelial cells (LSECs). Common etiologic factors include myeloablative conditioning regimens for HSCT, chemotherapeutic agents such as oxaliplatin, and total body irradiation. SOS/VOD is classified into acute (80%, within 21 days post-HSCT) and late-onset forms (20%, beyond 21 days). Histopathologically, late-phase SOS shows peri-sinusoidal fibrosis and hepatocyte atrophy in addition to sinusoidal obstruction. Clinically, the disease manifests with painful hepatomegaly, conjugated hyperbilirubinemia, and rapid weight gain or ascites. While the modified Seattle and Baltimore criteria are traditionally used for adults, the European Society for Blood and Marrow Transplantation (EBMT) 2019 criteria have been specifically developed for the pediatric population, incorporating both clinical and radiologic parameters. Ultrasonography remains the first-line imaging modality, including gray-scale, color Doppler, and spectral analysis. Ultrasound elastography can detect SOS as early as 2–12 days before clinical criteria are met by quantifying increased hepatic stiffness due to portal hypertension; a ≥ 30% rise in stiffness from baseline has demonstrated high sensitivity and specificity. Characteristic sonographic findings include hepatomegaly, gallbladder wall thickening, increased portal vein diameter, ascites, paraumbilical vein visualization with altered flow, reduced portal venous velocity, and elevated hepatic artery resistive index—imaging parameters that are incorporated into the newer Hok-US scoring system (maximum 14 points). Additionally, MR elastography and hepatobiliary MRI using Eovist have shown promise for early, noninvasive detection. Early diagnosis is critical, as severe SOS carries mortality rates up to 80%, and the only approved therapy remains defibrotide, emphasizing the need for vigilant imaging surveillance and prompt management. Read More

Authors:  Kumar Tushar,  Elhussein Wala,  Kim Helen Hr

Keywords:  Abdominal Imaging ,  Venoocclusive Disease ,  Sinusoidal Obstruction Syndrome

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

Final Pr. ID: Poster #: EDU-042

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

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

Keywords:  Oncology ,  Heptoblastoma ,  Liver Tumor

Dewan Sannidhi

Final Pr. ID: Poster #: EDU-044

To illustrate the range of non-neuro pediatric emergencies evaluated by MRI, including abdominal, pelvic, and thoracic pathologies. To highlight technical and logistical considerations unique to emergency pediatric MRI. To review key diagnostic pearls and pitfalls through representative case examples.

Emergency MRI in pediatric patients is increasingly utilized as a radiation-free alternative when ultrasound or CT findings are equivocal. While neuroemergencies dominate MRI use, body MRI plays a critical role in evaluating acute conditions such as appendicitis, cholecystitis, pancreatitis, ovarian torsion and pancreatic trauma.
This exhibit presents a curated series of de-identified emergency body MRI cases, emphasizing characteristic imaging features, differential considerations, and clinical relevance. Each case demonstrates how MRI provides superior soft-tissue contrast, precise localization, and improved diagnostic confidence in urgent scenarios.
The poster also addresses practical challenges in performing emergency MRIs in children—scanner availability, need for sedation, patient motion, and interdepartmental coordination. Strategies to overcome these challenges are discussed, including abbreviated MRI protocols, feed-and-sleep methods, and child-life support to reduce sedation dependence.
Illustrative examples highlight both successful and technically challenging studies, reinforcing key teaching points such as motion artifact mitigation and protocol selection for specific clinical questions. Read More

Authors:  Dewan Sannidhi

Keywords:  MRI ,  Abdomen MRI ,  Emergencies

Kumar Tushar,  Noda Sakura,  Kim Helen Hr

Final Pr. ID: Poster #: EDU-048

Pediatric liver transplantation has evolved into a life-saving procedure since the first successful transplant, for biliary atresia, in 1967. In the United States, biliary atresia remains the leading indication, accounting for nearly half of all pediatric liver transplants, with most recipients aged five years or younger. Advances in surgical techniques, particularly the development of split-liver and living-donor transplantation, have significantly improved graft availability and patient survival, achieving one-year survival rates as high as 94%. Despite these advances, post-transplant complications remain common and are broadly categorized as vascular, biliary, infectious, and parenchymal or neoplastic. Vascular complications pose the greatest threat to graft viability. Early postoperative imaging surveillance with grayscale and Doppler ultrasound is vital for timely detection. Normal early postoperative findings include mild perihepatic fluid, subtle vascular narrowing, and heterogeneous parenchymal echotexture. Typical Doppler characteristics include brisk systolic upstroke with continuous diastolic flow in the hepatic artery, monophasic flow in portal vein, and multiphasic or dampened venous waveforms. Hepatic artery thrombosis is the most critical vascular complication, often manifested as tardus-parvus arterial waveforms, and can lead to graft ischemia or failure. Hepatic artery stenosis, occurring most often within the first 100 days, may require prompt endovascular intervention. Portal vein thrombosis or stenosis, though less frequent, can cause portal hypertension with splenomegaly and ascites. Biliary complications, including anastomotic strictures and leaks, affect approximately 12–40% of pediatric recipients, usually within the first three months post-transplant. In the longer term, neoplastic complications such as post-transplant lymphoproliferative disorder occur in up to 2-8%of pediatric liver transplant patients, necessitating vigilant radiologic and clinical follow-up. Ultrasound remains the cornerstone of early and serial postoperative evaluation, given its safety, accessibility, and high sensitivity for vascular and biliary pathology. Rapid identification of complications enables timely intervention, optimizing graft function and long-term survival in pediatric liver transplant recipients. Read More

Authors:  Kumar Tushar,  Noda Sakura,  Kim Helen Hr

Keywords:  Hepatic Transplant ,  Transplant Interventions ,  Ultrasonography

Jasinkiewicz Noah,  Newman Christopher

Final Pr. ID: Poster #: EDU-063

Cruciate ligament developmental variations are frequently encountered in pediatric musculoskeletal imaging. Some of these variations represent normal anatomic variants, whereas others result from pathological development and can result in pain and instability and may be associated with other abnormalities. The purpose of this educational poster is to review developmental variations in cruciate ligament anatomy that result in normal variants as well as congenital disease.

The normal prenatal and postnatal development of the cruciate ligaments is reviewed along with the associated stabilizing structures of the joint capsule. Several examples of normal anatomical variants are reviewed and demonstrated (e.g., triple bundle anterior cruciate ligament, variations in origin and insertion). Examples of the most common congenital anomalies are also presented (e.g., isolated absence, combined absence of both cruciate ligaments, hypoplasia, dysplasia of the intercondylar eminence) along with several associated developmental syndromes (e.g., nail-patella syndrome, tibial and fibular hemimelia, congenital knee dislocation). Several critical differential diagnoses (e.g., bucket handle meniscus tears) will be discussed given their impact on patient management.

A systematic approach is provided to help differentiate the various causes of abnormal cruciate ligament development using multimodality imaging. When available, longitudinal imaging, physical examination, and arthroscopic correlations are provided for clinical correlation. Possible complications are discussed to provide additional insight into patient care. Guidelines for reporting are provided to support patient care alongside referring providers. After viewing this module, readers will be able to better understand and differentiate cruciate ligament variants and congenital anomalies and better evaluate their impact on the patients for whom they care. Read More

Authors:  Jasinkiewicz Noah,  Newman Christopher

Keywords:  Knee ,  Knee MRI ,  Congenital

Galvis Ingrid,  Kvist Ola,  Jarrett Delma

Final Pr. ID: Poster #: EDU-064

Bowing of the lower extremities is a common presentation in pediatric patients and may represent either normal physiologic development or an underlying pathologic process requiring medical or surgical intervention. Radiologists play an essential role in distinguishing between benign developmental variants and serious bone disorders, including nutritional deficiencies, metabolic bone disease, and skeletal dysplasias. Conditions such as rickets, scurvy, and Blount's disease have distinct etiologies but often present with overlapping radiologic features—most notably metaphyseal abnormalities, osteopenia, and angular deformities—that can obscure diagnosis and delay appropriate treatment.

This educational poster presents a structured, pattern-based approach to evaluating pediatric bowing disorders, integrating clinical presentation, age, and characteristic imaging findings. Key radiographic parameters include the metaphyseal-diaphyseal angle, tibiofemoral angle measurements, and assessment of the Drennan angle for differentiating infantile Blount's disease from physiologic bowing. Age-specific thresholds guide management: physiologic bowing typically resolves by 18-24 months, whereas progression beyond age 2 years or asymmetric involvement warrants investigation for pathologic etiologies. Age-specific diagnostic criteria and systematic assessment of metaphyseal morphology form the foundation of our approach. We highlight key differentiating features for scurvy, rickets (including hypophosphatemic forms), Blount's disease, and other mimickers such as osteogenesis imperfecta and skeletal dysplasias. Emphasis is placed on early recognition of red flags, interpretation of radiographic and MRI findings, and understanding imaging pitfalls that can lead to misdiagnosis. Using comparative imaging examples and diagnostic algorithms, this poster aims to enhance the radiologist's ability to confidently diagnose and differentiate pediatric bowing deformities, improving clinical outcomes and reducing unnecessary interventions. Read More

Authors:  Galvis Ingrid,  Kvist Ola,  Jarrett Delma

Keywords:  Musculoskeletal ,  Metabolic Disorder ,  Paediatric Radiology

Mason Kevin,  Elangovan Stacey,  Meyers Arthur

Final Pr. ID: Poster #: EDU-078

The majority of cartilaginous bone lesions in children are benign, and many have a characteristic radiographic appearance, which is often diagnostic. This educational exhibit will review common (e.g., osteochondromas, enchondromas, including discussions of osteochondromatosis and enchondromatoses), less common (e.g., chondroblastoma), and rare (e.g., Trevor's disease, bizarre parosteal osteochondromatous proliferations, chondromyxoid fibroma, chondrosarcoma) cartilaginous lesions which affect the pediatric skeleton with a focus on the imaging appearance of these lesions. Furthermore, this exhibit will strive to help the pediatric radiologist distinguish between these entities, when feasible, to ensure the appropriate use of additional tools and resources, including follow-up imaging and biopsy. Read More

Authors:  Mason Kevin,  Elangovan Stacey,  Meyers Arthur

Keywords:  Cartilage ,  Bone

Amiruddin Raisa,  Yilmaz Necla Ece,  Williams L. Tyler,  Bhatia Aashim

Final Pr. ID: Poster #: EDU-085

Pediatric diffuse midline gliomas (DMG) are a leading cause of cancer-related deaths in children. Conventional proton (1H)-MRI is limited in differentiating tumor progression from radiotherapy-associated pseudoprogression (vasogenic edema), which leads to clinical uncertainty regarding treatment planning and efficacy. Sodium (23Na)-MRI is a novel imaging approach which reflects cell integrity, tissue viability, and tumor Na concentration, thereby serving as an effective marker of tumor proliferation and treatment response. Plasma liquid biopsy to measure circulating tumor DNA (ctDNA) with H3K27M mutation offers another minimally invasive method of quantifying disease burden and response to treatment. There is growing interest in the use of 23Na-MRI combined with ctDNA plasma liquid biopsy as a multimodal biomarker of tumor activity in pediatric DMGs.
Our exhibit will focus on demonstrating the clinical utility of this multimodal approach as follows:
23Na-MRI maps: Directly quantify tumor Na concentration, a marker of cell integrity and tumor viability, providing insight into cellular microenvironment
H3K27M ctDNA measurement: Molecular burden of the pathognomonic mutation of pediatric diffuse midline gliomas, providing insight into biological disease activity
Through case-based examples, we will highlight how 23Na-MRI and ctDNA levels change in tumors with positive response to radiotherapy and tumors refractory to radiotherapy. These patterns may provide radiologists with a more reliable index for differentiating true tumor progression from pseudoprogression than conventional 1H-MRI alone for pediatric glioma patients.
Take-home message:
23Na-MRI and H3K27M circulating tumor DNA are sensitive, non-invasive biomarkers to study the biological activity of pediatric diffuse midline gliomas and differentiate between true progression and pseudoprogression after radiotherapy. Read More

Authors:  Amiruddin Raisa,  Yilmaz Necla Ece,  Williams L. Tyler,  Bhatia Aashim

Keywords:  Brain Tumors ,  Brain MRI ,  Innovation

Tzarouchi Loukia,  Manopoulou Evangelia,  Oikonomoulas George,  Tagkalakis Panagiotis,  Yarmenitis Spyridon,  Papaioannou Georgia

Final Pr. ID: Poster #: EDU-093

Cranial venous anomalies including the collateral intraosseous emissary veins are commonly identified in patients with craniosynostosis, especially in syndromic cases. Our purpose was to describe the incidence and the type of abnormal venous drainage in sporadic and syndromic craniosynostosis, to demonstrate the typical imaging findings, the associated abnormalities as well as the post surgical changes. Read More

Authors:  Tzarouchi Loukia,  Manopoulou Evangelia,  Oikonomoulas George,  Tagkalakis Panagiotis,  Yarmenitis Spyridon,  Papaioannou Georgia

Keywords:  3D Images ,  Craniosynostosis

Pearson Richard,  Zbojniewicz Andrew,  Junewick Joseph

Final Pr. ID: Poster #: EDU-094

In pediatric radiology practices, we commonly encounter benign developmental aberrancies, such as urachal remnants, thyroglossal duct remnants, and branchial cleft anomalies. Understanding the embryological development and typical imaging appearances of these conditions streamlines the work-up and sometimes obviates surgical intervention. Although seen less commonly, this holds true for ectopic thymic tissue as well. In this presentation, we review the normal embryological development of the thymus with special attention to the course of the thymopharyngeal duct. We then review imaging cases resulting from aberrancies in this developmental process, such as an intra-thyroidal thymic rest, superior cervical extension of the thymus, and a thymopharyngeal duct cyst. In sharing these cases, we hope to improve familiarity with these benign developmental variants, and in doing so, to help optimize care for patients with these findings. Read More

Authors:  Pearson Richard,  Zbojniewicz Andrew,  Junewick Joseph

Keywords:  Thymus ,  Thymic Rest ,  Anomalies

Sahu Asutosh,  Tripathy Priyadarshini,  Kandemirli Sedat,  Prabhu Sanjay

Final Pr. ID: Poster #: EDU-096

To illustrate the developmental, genetic, and imaging spectrum of malformations of cortical development (MCD) from fetal life through adolescence by integrating principles of normal corticogenesis, key genetic pathways, and evolving MRI patterns.
This exhibit emphasizes:
1. Normal neuronal proliferation, migration, and post-migrational organization.
2. Developmental stage–specific MRI features linked to corresponding disruptions in these processes.
3. Major molecular pathways (LIS1/DCX, TUBB2B, MCPH1, CDK6, PIK3, PTEN, HEPACAM, mTOR) associated with characteristic imaging phenotypes.
4. The role of longitudinal imaging in evaluating cortical maturation, prognosis, and presurgical planning. Read More

Authors:  Sahu Asutosh,  Tripathy Priyadarshini,  Kandemirli Sedat,  Prabhu Sanjay

Keywords:  Magnetic Resonance Imaging ,  Genetics ,  Epilepsy

Abelian Khoren,  Kaleem Musa,  Mclennan Kerrie,  Edwards Harriet

Final Pr. ID: Poster #: EDU-100

Abusive head trauma (AHT) is the leading cause of death in cases of physical child abuse. It primarily affects infants under two years of age, with the highest incidence in those younger than six months. Mortality may reach 30%, and approximately half of survivors suffer long-term neurological disability. Early and accurate differentiation of AHT from other causes of brain injury is therefore essential for safeguarding and appropriate management.
We present six cases of bilateral and three cases of unilateral intracranial haemorrhage in infants and children under the age of two years with confirmed child abuse. Of these, five had associated spinal injuries, two had associated retinal haemorrhages and features of hypoxic–ischaemic injury, and one had a skull fracture.
Using illustrations and findings from each case, we aim to (1) revisit abusive head trauma guidelines and imaging recommendations in both America and Europe, (2) the varied patterns of clinical presentation, and (3) outline the associated neuroimaging features which, either in isolation or in combination, can favour a shaking mechanism of injury rather than an isolated impact injury, as is more commonly seen in accidental head trauma. (4) We shall highlight how clinical outcomes can vary between cases due to factors such as cerebral ischaemia and raised intracranial pressure, (5) consider the importance of additional findings on spinal imaging and skeletal surveys, and (6) discuss the medicolegal implications of abusive head trauma.
After review, both the paediatric and general radiologist will have increased knowledge and confidence to raise suspicion to the paediatrician of potential abusive head trauma and suggest the correct next imaging steps to protect our vulnerable patients when presented with these neuroimaging findings. Read More

Authors:  Abelian Khoren,  Kaleem Musa,  Mclennan Kerrie,  Edwards Harriet

Keywords:  Abusive Head Trauma ,  Intracranial Hemorrhage ,  Child Abuse

Kumar Tushar,  Romberg Erin,  Otjen Jeffrey

Final Pr. ID: Poster #: EDU-111

Airway and chest ultrasonography in pediatric patients encompasses a wide spectrum of diagnostic applications, broadly categorized into evaluation of vocal cords, trachea, lungs, diaphragm, and pleura. Vocal cord ultrasonography is increasingly employed for the assessment of vocal cord motion and detection of palsy, particularly in post-intubation or postoperative settings. Tracheal ultrasonography represents an evolving field, currently utilized at our institution for identification of tracheal cartilaginous sleeve—a condition characterized by replacement of segmented tracheal rings with a continuous cartilaginous sheath, often associated with craniosynostosis syndromes. Lung and pleural ultrasonography are well-established techniques increasingly familiar to radiologists and can be useful for evaluating a wide range of pathologies, including consolidation, edema, fibrosis, interstitial pneumonia, lung abscess, pleural effusion, empyema, pneumothorax, and lung tethering. Diaphragmatic ultrasonography is also routinely performed to assess diaphragmatic motion abnormalities such as paralysis, paresis, and eventration—conditions that can be challenging to differentiate by radiograph. A solid understanding of normal lung, pleural, airway, and diaphragmatic anatomy, along with mastery of proper sonographic technique, is essential for accurate diagnosis and interpretation across all levels of radiology practice. As air-filled lungs limit acoustic penetration, radiologists must also recognize common pitfalls and artifacts encountered in pediatric chest ultrasound, including reverberation artefacts, B-lines, M-mode artifacts, and misinterpretation of peritoneal fluid as effusion. Although radiography remains the first-line modality for thoracic evaluation, its utility is constrained by complex, overlapping anatomy of the mediastinum and hidden pulmonary areas. Computed tomography (CT), while diagnostically powerful, exposes young patients to ionizing radiation and should be reserved for cases in which sonography and radiography are inconclusive. This educational exhibit aims to highlight optimal techniques, review relevant anatomy, and illustrate the spectrum of airway and chest pathologies detectable by ultrasound. It further emphasizes recognition of artifacts and comparison with radiographic and CT findings, with goal to promote use of ultrasonography as a radiation-free, readily accessible, and accurate diagnostic tool for pediatric thoracic evaluation. Read More

Authors:  Kumar Tushar,  Romberg Erin,  Otjen Jeffrey

Keywords:  Chest ,  Ultrasound ,  Dynamic Ultrasound

Schmidt Magdalena,  Manson David,  Zanette Brandon,  Chiu Priscilla,  Malkin David,  Villani Anita,  Greer Mary-louise

Final Pr. ID: Poster #: EDU-113

Magnetic resonance imaging (MRI) has become an increasingly valuable modality for evaluating pediatric chest pathologies beyond cardiac disease. Its diagnostic spectrum now extends to mediastinal, pulmonary, pleural, and chest wall abnormalities. Although traditionally limited by long acquisition times, motion artefacts, and the challenges of lung parenchyma imaging, recent advances such as ultrashort echo time (UTE), and zero echo time (ZTE) sequences have markedly expanded its clinical utility.
This educational poster highlights the applications of MRI across a broad range of pediatric thoracic conditions, including mediastinal masses, congenital lung malformations, pulmonary tumors, infections, inflammatory diseases, and chest wall abnormalities. The mediastinal pathologies are structured according to the standard compartmental classification - prevascular, visceral, and paravertebral - to facilitate a systematic and anatomical approach to interpretation.
Drawing on our institutional experience of primary to quaternary referrals, we will present cases to:
1. Review key MRI techniques applicable to pediatric thoracic imaging, including diffusion-weighted and contrast-enhanced imaging, as well as motion-suppression strategies.
2. Demonstrate MRI findings for mediastinal, pulmonary and chest wall pathologies, focusing on lesion characterization and delineation of relationships to adjacent structures and provide pearls and pitfalls for confident interpretation.
3. Discuss the role of MRI in children, given their heightened tissue sensitivity and increased lifetime risk of radiation-induced malignancy. The advantage is even more significant in patients with cancer predisposition syndromes, in whom cumulative radiation exposure is a major concern.
4. Outline practical workflow aspects, including preparation techniques such as feed-and-sleep imaging and child-life involvement, as well as safety considerations for repeated or contrast-enhanced studies.
5. Compare MRI with CT and radiography, underscoring its diagnostic strengths, limitations, and complementary role in specific clinical scenarios.
6. Provide a structured overview and practical framework to support the use of chest MRI in pediatric imaging.
This educational overview aims to familiarize radiologists with MRI’s current and evolving role in pediatric thoracic imaging, highlight achievable image quality and diagnostic confidence, and encourage broader clinical adoption of radiation-free chest MRI in children. Read More

Authors:  Schmidt Magdalena,  Manson David,  Zanette Brandon,  Chiu Priscilla,  Malkin David,  Villani Anita,  Greer Mary-louise

Keywords:  Chest MRI ,  Lung Imaging ,  Mediastinum

Kumar Tushar,  Romberg Erin,  Otjen Jeffrey

Final Pr. ID: Poster #: EDU-114

Dynamic and four-dimensional computed tomography (4D-CT) of the airways and lungs is an advanced imaging technique designed to identify dynamic pathologies across various levels of airway, including the oropharynx, larynx, trachea, bronchi, and lungs. This modality enables detailed assessment of airway motion and functional abnormalities that are intermittently absent on conventional static imaging. At the oropharyngeal level, Robin sequence (Pierre Robin syndrome) represents congenital anomalies resulting from abnormal development of the first pharyngeal arch, leading to mandibular hypoplasia, failure of normal tongue descent, non-fusion of the palatal shelves, and resultant upper airway obstruction. At the laryngeal level, vocal cord dysfunction is a cause of feeding difficulties and vocal dysfunction in the pediatric population, most frequently resulting from prolonged intubation or iatrogenic injury to the recurrent laryngeal nerve following cardiac surgery. In such cases, dynamic CT serves as a valuable, non-invasive alternative to nasal endoscopy for evaluating glottic motion. Tracheomalacia, defined as excessive expiratory collapse of the tracheal lumen, may be congenital—such as with cystic fibrosis or Mounier-Kuhn syndrome—or acquired secondary to prolonged intubation, chronic or recurrent infections, or idiopathic. Similarly, bronchomalacia refers to the weakening of bronchial cartilage, resulting in airway collapse or significant luminal narrowing during expiration, and may also occur congenitally or as a sequela of chronic inflammation. Dynamic CT of the lung parenchyma can demonstrate areas of air trapping during the expiratory phase, such as with bronchiolitis obliterans secondary to recurrent inflammation, although the precise clinical implications of the CT findings remain undefined. Importantly, many of these entities are challenging to detect on traditional inspiratory and expiratory CT imaging. Dynamic low-dose CT protocols not only enhance diagnostic accuracy by providing real-time functional assessment but also reduce overall radiation exposure by eliminating the need for separate phase acquisitions. This pictorial essay aims to review the spectrum of airway and lung pathologies detectable by dynamic and 4D-CT, emphasizing optimal imaging techniques, interpretative considerations, and risk-based diagnostic strategies relevant to pediatric radiologists. Read More

Authors:  Kumar Tushar,  Romberg Erin,  Otjen Jeffrey

Keywords:  3D Imaging ,  Airway ,  CT Dynamic Airways

Maniyar Jenny,  Harris Debra,  Dixon Rachel,  Turnbull Louise,  Dominiak Kate,  Kapadia Tejas

Final Pr. ID: Poster #: EDU-117

As the regional referral centre for paediatric tuberculosis (TB) in Northwest England, we conducted a retrospective review of referrals to assess indications for CT imaging based on clinical presentation and chest X-ray (CXR) findings. A literature review was performed addressing latent TB detection, radiographic features in infants, the WHO End TB strategy, and NICE guidelines.
CXR sensitivity for latent TB detection is as low as 15%, whereas CT imaging, despite higher radiation exposure, offers superior diagnostic accuracy. Guidelines recommend contrast-enhanced CT when CXR findings are inconclusive or diagnostic uncertainty exists.
Our multicentre review identified CT indications including equivocal or abnormal CXRs, extrapulmonary lymphadenopathy, and suspected airway compression. Integral to our protocol is a region-wide multidisciplinary team (MDT) comprising paediatricians, radiologists, infectious disease, and respiratory specialists. The MDT convenes weekly to integrate clinical and radiological data, guiding imaging decisions and management.
This collaborative approach ensures tailored, low-dose CT protocols with expedited reporting, enhancing diagnostic confidence and patient outcomes. The MDT also facilitates consideration of differential diagnoses, including malignancy and steroid effects.
Our findings highlight the critical role of coordinated MDT discussion and protocol adherence in optimizing imaging strategies and improving paediatric TB care. Read More

Authors:  Maniyar Jenny,  Harris Debra,  Dixon Rachel,  Turnbull Louise,  Dominiak Kate,  Kapadia Tejas

Keywords:  Tuberculosis ,  Multidisciplinary Education ,  Thoracic