Potential benefits of photon counting detector computed tomography in pediatric imaging.

Photon counting detector (PCD) CT represents the newest advance in CT technology, with improved radiation dose efficiency, increased spatial resolution, inherent spectral imaging capabilities, and the ability to eliminate electronic noise. Its design fundamentally differs from conventional energy integrating detector CT because photons are directly converted to electrical signal in a single step. Rather than converting X-rays to visible light and having an output signal that is a summation of energies, PCD directly counts each photon and records its individual energy information.

Adamantinoma-Like Ewing Sarcoma of the Mandible Evaluated on 18F-FDG PET/CT.

Ewing sarcoma is the second most common primary bone tumor in children. Typical Ewing sarcoma most frequently occurs in long bones and within the pelvis. ALES (adamantinoma-like Ewing sarcoma) is a rare subtype of Ewing sarcoma that is characterized by epithelial differentiation in addition to small round blue cells.

Cardiac hemangioma mimicking a neuroendocrine tumor on Ga Dotatate PET/CT.

Cardiac hemangioma is a rare, benign primary tumor characterized by endothelial proliferation. While reports of cardiac hemangiomas demonstrating F FDG avidity and other forms of hemangiomas showing Ga Dotatate avidity have been published, we present a rare case of primary cardiac hemangioma demonstrating Ga Dotatate avidity, mimicking a primary neuroendocrine tumor.

Asymptomatic macrocephaly: to scan or not to scan.

Background: Macrocephaly is a common finding in infants and is often idiopathic or familial. In the absence of clinical signs and symptoms, it can be difficult to determine when concern for underlying pathology is justified.

Objectives: The objectives of this study were to determine the utility of screening head ultrasound (US) in asymptomatic infants with macrocephaly and to identify clinical factors associated with significant US findings.

Pediatric appendiceal ultrasound: maintaining accuracy, increasing determinacy and improving clinical outcomes following the introduction of a standardized reporting template.

Background: Pediatric patients who underwent appendiceal US and received an equivocal interpretation had poorer clinical outcomes and higher medical costs compared to those to whom a definitive interpretation was given, either positive or negative. In an effort to reduce equivocal interpretations, we educated our group on the importance of increasing determinacy and encouraged the use of a reporting template with a definitive impression.

Objective: We hypothesized that educational sessions and implementation of an optional reporting template with only a definitive impression would reduce equivocal reporting and improve clinical outcomes without negatively impacting US diagnostic performance.

Dual-energy X-ray absorptiometry bone densitometry in pediatrics: a practical review and update.

The assessment of pediatric bone mineral content and density is an evolving field. In this manuscript we provide a practical review and update on the interpretation of dual-energy X-ray absorptiometry (DXA) in pediatrics including historical perspectives as well as a discussion of the recently published 2019 Official Position Statements of the International Society of Clinical Densitometry (ISCD) that apply to children.

PET Imaging of a Unique Case of Multiple Myeloma in an Adolescent.

Pediatric solitary plasmacytomas are extremely rare, with only 14 cases previously reported. None of these reports included PET imaging findings. We present PET/CT and PET/MRI imaging findings in a 15-year-old boy with what was initially thought to be a solitary plasmacytoma, which later developed into multiple myeloma.

Pediatric applications of Dotatate: early diagnostic and therapeutic experience.

In recent years, new somatostatin receptor agents (SSTRs) have become available for diagnostic imaging and therapy in neuroendocrine tumors. The novel SSTR ligand DOTA-DPhel-Tyr3-octreotate (Dotatate) in particular can be linked with Gallium for diagnostic imaging purposes, and with the β-emitter Lutetium for radiotherapy in the setting of neuroendocrine tumors. Dotatate imaging offers distinct advantages in the evaluation of neuroendocrine tumors compared to standard techniques, including greater target-to-background ratio and lesion conspicuity, high sensitivity/specificity, improved spatial resolution with positron emission tomography (PET)/CT or PET/MR, and decreased radiation exposure.

Mesenchymal Hamartoma in Children: A Diagnostic Challenge.

Mesenchymal hamartoma is a benign tumor of the liver with a poorly understood pathogenesis. It is uncommon in older children, especially after 2 years of age. The signs and symptoms may be nonspecific; therefore, a high index of suspicion is required for diagnosis and treatment.

Correction to: Pediatric ileocolic intussusception: new observations and unexpected implications.

In this article, the fourth author's name is misspelled. The correct spelling, as shown above, should be "Nadia F. Mahmood.

Pediatric ileocolic intussusception: new observations and unexpected implications.

Background: Ileocolic intussusception occurs when the terminal ileum "telescopes" into the colon. We observed that ileocolic intussusception lengths are similar regardless of location in the colon.

Objective: To examine the uniformity of ileocolic intussusception length and its relationship to colon location, symptom duration and reducibility.

18F-FDG PET/CT Equivalent of the Hepatic Hot Spot Sign With CT Correlation.

A 43-year-old woman presented with an FDG-avid mediastinal Ewing sarcoma invading and nearly occluding the superior vena cava. Geographic increased FDG uptake in hepatic segment IVA was the only other site of nonphysiologic FDG activity. This focal activity was without an underlying mass, had atypical morphology for a hepatic metastasis, and correlated well with prior CT findings of abnormal segment IVA enhancement resulting from the recruitment of portocaval collaterals.

Correction to: Chest computed tomography angiography in children on extracorporeal membrane oxygenation (ECMO).

The published version of this article incorrectly lists the authors' affiliations. The correct affiliations are given below. The Publisher regrets this mistake.

Chest computed tomography angiography in children on extracorporeal membrane oxygenation (ECMO).

Performing chest CT angiography on pediatric patients on extracorporeal membrane oxygenation (ECMO) can be challenging. Successfully performing CT angiography in these children requires substantial communication and coordination between the radiologists and clinical care providers. Additionally, the radiologist must understand the child's anatomy and disease pathophysiology, flow dynamics of the ECMO circuit, image acquisition timing, contrast injection site, and volume, rate and duration of contrast administration.

Nuss bar migrations: occurrence and classification.

Background: Pectus excavatum results from dorsal deviation of the sternum causing narrowing of the anterior-posterior diameter of the chest. It can result in significant cosmetic deformities and cardiopulmonary compromise if severe. The Nuss procedure is a minimally invasive technique that involves placing a thin horizontally oriented metal bar below the dorsal sternal apex for correction of the pectus deformity.

¹¹C-Choline PET/CT in Recurrent Prostate Cancer and Nonprostatic Neoplastic Processes.

Choline positron emission tomography (PET)/computed tomography (CT), with both carbon 11 ((11)C) choline and fluorine 18 ((18)F) choline, is an increasingly used tool in the evaluation of patients with biochemically recurrent prostate cancer. It has allowed detection and localization of locally recurrent and metastatic lesions that were difficult or impossible to identify using more conventional modalities. Many of the patients followed for their prostate cancer are elderly and have a higher rate of nonprostate cancer lesions or malignancies.

Pediatric appendiceal ultrasound: accuracy, determinacy and clinical outcomes.

Background: Ultrasonography is considered the most appropriate initial imaging study in the evaluation of acute appendicitis in children but has recently come under criticism with reports of low specificity and high indeterminate study rates, particularly when used in obese patients and patients early in the course of their disease, or when performed by sonographers with limited experience.

Objective: To (1) assess the impact of patient factors (gender, age, body mass index, and symptom duration) and system factors (call status or year of exam) on pediatric appendiceal US accuracy and indeterminate study rate, (2) assess the impact of indeterminate study results on follow-up CT and negative laparotomy rates and (3) present strategies to reduce the rate of indeterminate US studies and improve accuracy.

Materials And Methods: We retrospectively reviewed all US reports performed for the assessment of acute appendicitis in children <18 years old at Mayo Clinic Rochester from January 2010 to June 2014.

Upright Biplanar Slot Scanning in Pediatric Orthopedics: Applications, Advantages, and Artifacts.

Objective: Digital slot scanning is a relatively new technology that has been used for imaging of pediatric orthopedic conditions such as scoliosis and leg-length discrepancies. This article will review the clinical applications, advantages, and unique artifacts of this new technology.

Conclusion: Upright biplanar slot scanners acquire high-resolution radiographs simultaneously in two orthogonal planes with reduced radiation dose.