Percutaneous biopsy for the diagnosis, risk stratification, and molecular profiling of neuroblastoma: A single-center retrospective study.

Purpose: To determine whether percutaneous core needle biopsy (PCNB) is adequate for the diagnosis and full molecular characterization of newly diagnosed neuroblastoma.

Materials And Methods: Patients with newly diagnosed neuroblastoma who underwent PCNB in interventional radiology at a single center over a 5-year period were included. Pre-procedure imaging and procedure details were reviewed.

Endovascular closure of a congenital extrahepatic portosystemic shunt for the treatment of hepatopulmonary syndrome in an infant.

Congenital portosystemic shunts may result in the development of hepatopulmonary syndrome, typically presenting with progressive hypoxemia in later childhood. We describe a case of a 5-month-old male with heterotaxy with polysplenia presenting with new onset hypoxemia. Subsequent evaluation identified an extrahepatic portosystemic shunt arising from the confluence of the main portal and superior mesenteric veins draining into the left renal vein.

Embolization for pediatric trauma.

Background: The management of pediatric trauma with trans-arterial embolization is uncommon, even in level 1 trauma centers; hence, there is a dearth of literature on this subject compared to the adult experience.

Objective: To describe a single-center, level 1 trauma center experience with arterial embolization for pediatric trauma.

Materials And Methods: A retrospective review was performed to identify demographics, transfusion requirements, pre-procedure imaging, procedural details, adverse events, and arterial embolization outcomes over a 19-year period.

Middle meningeal artery embolization in the management of chronic subdural hematoma in medically complex pediatric neurosurgical patients: technical note.

Middle meningeal artery (MMA) embolization has gained acceptance as a treatment for chronic subdural hematoma (cSDH) in adult patients but has not been well described in pediatric patients. Standard cSDH treatment has historically consisted of burr hole drainage with or without subdural drain placement. However, due to the high rate of recurrence and frequency of comorbidities within this population, as both pediatric and adult patients with cSDH frequently have concurrent cardiac disease and a need for anticoagulant therapies, MMA embolization has increasingly demonstrated its value as both an adjunctive and primary treatment.

Fostering research in pediatric interventional radiology: needs assessment and suggestions for support.

Background: Due to the rarity of pediatric diseases, collaborative research is the key to maximizing the impact of research studies. A research needs assessment survey was created to support initiatives to foster pediatric interventional radiology research.

Objective: To assess the status of pediatric interventional radiology research, identify perceived barriers, obtain community input on areas of research/education/support, and create metrics for evaluating changes/responses to programmatic initiatives.

Percutaneous Nephrostomy in Neonates and Young Infants.

Purpose: To describe a single-center experience of placing percutaneous nephrostomy (PCN) tubes in neonates and young infants aged ≤3 months.

Materials And Methods: This retrospective study evaluated PCN placement during a 19-year period. Medical records were reviewed for patient demographics, indications, procedure details, catheter-related adverse events, and outcomes.

Novel method to biopsy aneurysmal bone cysts in children.

Purpose: The thin and friable septations composing aneurysmal bone cysts (ABC) may be challenging to target for percutaneous biopsy. The purpose of this study was to describe and evaluate a novel method of ABC biopsy using endomyocardial biopsy forceps as an attempt to capture larger fragments of tissue for diagnosis.

Methods And Materials: This was a retrospective study performed over a 17-year period.

Central venous access in children: Placement trends over the last decade.

Purpose: To evaluate central venous access placement trends for radiology and non-radiology services over the last decade.

Materials And Methods: Children who had central venous access procedures included in a large administrative database of 49 pediatric institutions in the United States between 2010 and 2020 were included. Patient demographics and patient specific factors were compared between groups.

Length of Bowel Rest Does Not Predict Gastrojejunostomy Tube-Associated Intussusception Recurrence.

Objectives: One potential treatment for gastrojejunostomy (GJ) tube-related intussusception is bowel rest, whereby the GJ tube is replaced with a gastrostomy tube. The aim of this study was to determine whether bowel rest length was associated with decreased risk of re-intussusception.

Methods: Pediatric patients with GJ tube-related intussusceptions were identified during the study period of January 1, 2010 and August 1, 2021.

Adjunctive techniques for percutaneous enteral access in children: a pictorial review.

Primary percutaneous gastrostomy and gastrojejunostomy tube placements are fundamental procedures performed in pediatric interventional radiology, with both antegrade and retrograde techniques described. In pediatric patients, however, challenges may arise due to smaller patient size and anatomical variations. Several adjunctive techniques may facilitate safe percutaneous access in the setting of a limited percutaneous gastric access window.

Indeterminate Thyroid Fine-Needle Aspirations in Pediatrics: Exploring Clinicopathologic Features and Utility of Molecular Profiling.

Introduction: The diagnostic utility of molecular profiling for the evaluation of indeterminate pediatric thyroid nodules is unclear. We aimed to assess pediatric cases with indeterminate thyroid fine-needle aspiration (FNA) alongside clinicopathologic features and mutational analysis.

Methods: A retrospective review of 126 patients with indeterminate cytology who underwent FNA between January 2010 and December 2021 at the Children's Hospital of Philadelphia was performed.

Appendix to the Society of Interventional Radiology Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions: Pediatric Considerations.

Purpose: To provide guidance on the use of anticoagulant and antithrombotic agents in pediatric patients undergoing interventional radiology procedures.

Materials And Methods: A multidisciplinary writing group conducted a comprehensive literature search to identify studies on the topic of interest. Recommendations were developed for procedural risk and medication dosage and withholding.

Pediatric trauma and the role of the interventional radiologist.

Purpose: While interventional radiologists occupy a critical role in adult trauma management, the role of interventionalist in pediatric trauma continues to evolve. The indications for transarterial embolization (TAE) are significantly different in pediatric patients in whom non-operative management (NOM) has a much more prominent role than in adults. Contrast extravasation on imaging may not require acute surgical or interventional management as it would in an adult.

Bowel perforation following percutaneous sclerotherapy of an intra-abdominal lymphatic malformation.

Mesenteric lymphatic malformations result from abnormal proliferation of disorganized mesenteric lymphatic channels. Sclerotherapy is often preferred over surgery as it is less invasive and has lower post-procedure morbidity. Sclerotherapy has been described as durable and effective with a low complication rate.

Preoperative Arterial Coil Embolization for Temporomandibular Joint (TMJ) Surgery in Children with TMJ Ankylosis.

Temporomandibular joint (TMJ) ankylosis in children can alter facial development and affect oral hygiene and function. Surgical release of the ankylosis is the mainstay of treatment. The authors hypothesize that preoperative arterial coil embolization is safe and effective in preventing major blood loss during TMJ surgery (loss prompting blood transfusion or hemodynamic instability requiring vasoactive medication administration) in children with TMJ ankylosis.

Impact of routine chest radiographs after removal of pigtail chest tubes placed by pediatric interventional radiology.

Background: Chest radiographs are commonly obtained after chest tube removal to assess for complications. The benefit of this practice in children is uncertain.

Objective: To determine the clinical impact of a routine chest radiograph following removal of chest tubes placed by pediatric interventional radiology.

Advanced Ultrasound Techniques for Differentiation of Benign Versus Malignant Thyroid Nodules: A Review.

Grayscale ultrasound (US) is decisive in stratifying which thyroid nodules benefit from fine-needle aspiration to evaluate for malignancy. Unfortunately, a significant percentage of nodules remain indeterminate.Herein, we review the clinical considerations and diagnostic accuracy of advanced US, Doppler US, contrast-enhanced US, and US elastography techniques in the evaluation of indeterminate nodules.

Coil-Localized Laparoscopic-Assisted Resection of Symptomatic Gastrointestinal Vascular Malformations in Children and Young Adults.

Unlabelled: Gastrointestinal (GI) bleeding from pediatric vascular malformation is uncommon and difficult to diagnose and manage. The preferred treatment is surgical resection; however, it can be challenging to precisely localize the lesion, particularly if it is not serosal.

Objectives: To describe a technique of intentional preoperative coil localization of symptomatic pediatric GI vascular malformations by pediatric interventional radiology to facilitate fluoroscopically assisted laparoscopic resection.