When considering advocacy, many people think of the political fundraising form, and assume it is difficult to carry out, or that it requires a big investment of time, energy, or money. However, advocacy comes in many different forms, and can be implemented every day. A more mindful approach and a few small, but critical, steps can take our advocacy to a new, more intentional level; one that we can practice every day.
View Article and Find Full Text PDFThe ACR Intersociety Committee meeting of 2022 (ISC-2022) was convened around the theme of "Recovering From The Great Resignation, Moral Injury and Other Stressors: Rebuilding Radiology for a Robust Future." Representatives from 29 radiology organizations, including all radiology subspecialties, radiation oncology, and medical physics, as well as academic and private practice radiologists, met for 3 days in early August in Park City, Utah, to search for solutions to the most pressing problems facing the specialty of radiology in 2022. Of these, the mismatch between the clinical workload and the available radiologist workforce was foremost-as many other identifiable problems flowed downstream from this, including high job turnover, lack of time for teaching and research, radiologist burnout, and moral injury.
View Article and Find Full Text PDFMalignant renal tumors are rare in children, and Wilms tumors (WTs) are the most common subtype. Imaging plays an essential role in the diagnosis, staging, and follow-up of these patients. Initial workup for staging is mainly performed by cross-sectional imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI).
View Article and Find Full Text PDFMalignant renal tumors account for approximately 6% of pediatric malignancies, with Wilms tumor (WT) representing approximately 90% of pediatric renal tumors. This paper provides consensus-based imaging guidelines for the initial evaluation of a child with suspected WT and follow-up during and after therapy co-developed by the Children's Oncology Group (COG) Diagnostic Imaging and Society for Pediatric Radiology (SPR) oncology committees. The guidelines for Wilms Tumor Imaging in the Society of International Pediatric Oncology (SIOP) are briefly discussed to highlight some of the differences in imaging approach.
View Article and Find Full Text PDFPrimary intratesticular tumors are uncommon in children, but incidence and risk of malignancy both sharply increase during adolescence. Ultrasound is the mainstay for imaging the primary lesion, and cross-sectional modalities are often required for evaluation of regional or distant disease. However, variations to this approach are dictated by additional clinical and imaging nuances.
View Article and Find Full Text PDFOvarian tumors in children are uncommon. Like those arising in the adult population, they may be broadly divided into germ cell, sex cord, and surface epithelium subtypes; however, germ cell tumors comprise the majority of lesions in children, whereas tumors of surface epithelial origin predominate in adults. Diagnostic workup, including the use of imaging, requires an approach that often differs from that required in an adult.
View Article and Find Full Text PDFElectronic cigarette or vaping product use-associated lung injury (EVALI) is a toxic inhalational injury that surged in late 2019 and early 2020, immediately prior to the coronavirus disease 2019 (COVID-19) pandemic. Although EVALI cases have significantly decreased, they are still encountered, especially among adolescents. While several characteristic imaging findings and patterns of EVALI have been described, some of them can overlap with the imaging features of COVID-19 pneumonia.
View Article and Find Full Text PDFPrimary extrarenal Wilms tumors are rare neoplasms that are presumed to arise from metanephric or mesonephric remnants outside of the kidney. Their pathogenesis is debated but has not been studied, and there are no reports of genomic descriptions of extrarenal Wilms tumors. We describe a diffusely anaplastic extrarenal Wilms tumor that occurred in the lower abdomen and upper pelvis of a 10-year-old boy.
View Article and Find Full Text PDFOver the last decade, health care professionals in the field of radiology have experienced increasing rates of burnout. A study in 2017 showed high prevalence of burnout in pediatric radiology, and other studies have identified several drivers for burnout. An important factor in promoting wellness and mitigating burnout is leveraging diversity, equity and inclusion in the workplace.
View Article and Find Full Text PDFThe liver is responsible for many processes that maintain human metabolic homeostasis and can be affected by several pediatric systemic diseases. In this manuscript, we explore key pathological findings and imaging features across multiple modalities of a spectrum of congenital, metabolic and autoimmune disorders. Strengthening the radiologists' knowledge regarding potential hepatic manifestations of these systemic diseases will ultimately lead to improved care for pediatric patients.
View Article and Find Full Text PDFPediatric acute pancreatitis has distinct etiologic, clinical and prognostic characteristics in contrast to the adult form of the disease. This review offers a comprehensive imaging update that emphasizes the importance of recognizing specific findings that are relevant from the clinical standpoint. Knowledge of these features facilitates communication among multidisciplinary team members and ultimately could lead to the improved care of pediatric acute pancreatitis patients.
View Article and Find Full Text PDFMagnetic resonance imaging (MRI) is a powerful diagnostic tool that can be optimized to display a wide range of clinical conditions. An MRI system consists of four major components: a main magnet formed by superconducting coils, gradient coils, radiofrequency (RF) coils, and computer systems. Each component has safety considerations.
View Article and Find Full Text PDFThe use of sedation and general anesthesia has facilitated the significant growth of MRI use among children over the last years. While sedation and general anesthesia are considered to be relatively safe, their use poses potential risks in the short term and in the long term. This manuscript reviews the reasons why MRI examinations require sedation and general anesthesia more commonly in the pediatric population, summarizes the safety profile of sedation and general anesthesia, and discusses an amalgam of strategies that can be implemented and can ultimately lead to the optimization of sedation and general anesthesia care within pediatric radiology departments.
View Article and Find Full Text PDFThe three most common pediatric solid tumors of the abdomen are neuroblastoma, Wilms tumor, and hepatoblastoma. These embryonal tumors most commonly present in the first decade of life. Each tumor has unique imaging findings, including locoregional presentation and patterns of distant spread.
View Article and Find Full Text PDFIntroduction: The standard imaging modality for hemodynamically stable blunt abdominal trauma patients is a contrast enhanced CT scan, which is reflected in the current AUA urotrauma guidelines. This comes, however, with radiation exposure and the potential sequalae of IV contrast administration in the pediatric patient.
Objective: We hypothesize that ultrasound imaging would be able to diagnose and rule out clinically significant renal injuries when compared to the gold standard of CT scan in the setting of pediatric blunt abdominal trauma.
Background: In the United States in 2019, there was an outbreak of electronic cigarette, or vaping, product use-associated lung injury (EVALI). The manifestations of EVALI in adolescents are not well characterized. We describe the diagnosis, evaluation, and management of EVALI in adolescents hospitalized at a tertiary care, university-affiliated children's hospital.
View Article and Find Full Text PDFBackground Electronic cigarette or vaping product use-associated lung injury (EVALI) is a serious public health concern with substantial morbidity and mortality, particularly in young individuals. Purpose To evaluate chest radiographic and chest CT findings of EVALI in the pediatric population. Materials and Methods This was a retrospective study of children who presented to a tertiary pediatric hospital from December 2018 to December 2019.
View Article and Find Full Text PDFEpipericardial fat necrosis is a benign, self-limited entity increasingly recognized as a cause of chest pain in adults. Epipericardial fat necrosis typically presents with acute pleuritic chest pain or abdominal pain and affects otherwise healthy individuals who characteristically have negative physical exams, laboratory tests and other ancillary tests such as electrocardiograms. We report the imaging findings of epipericardial fat necrosis in a 15-year-old boy and additional images of a case in an 8-year-old boy.
View Article and Find Full Text PDFBackground: Glenoid version angles are measured to objectively follow changes related to glenohumeral dysplasia in the setting of brachial plexus birth palsy. Measuring glenoid version on cross-sectional imaging was initially described by Friedman et al. in 1992.
View Article and Find Full Text PDFPapillary fibroelastomas are benign primary cardiac tumors that usually arise from the valve apparatus and are rare in the pediatric population. Involvement of the tricuspid valve is even less common with only a few cases reported in the literature. Cardiac magnetic resonance imaging is a valuable examination that aids in differentiating a tumor from a thrombus.
View Article and Find Full Text PDFBiliptysis is an important clinical feature to recognize as it is associated with bronchobiliary fistula, a rare entity. Bronchobiliary fistulas have been diagnosed with planar cholescintigraphy. However, cholescintigraphy with single-photon emission computed tomography (SPECT) can better spatially localize a bronchobiliary fistula as compared to planar cholescintigraphy alone, and is useful for preoperative planning if surgical treatment is required.
View Article and Find Full Text PDFObjective: To assess patient outcome and imaging findings of patients with pulmonary embolism of fluid silicone.
Methods: Medical records and imaging examinations of 10 patients with respiratory distress after illicit injection of fluid silicone were reviewed. Population consisted of 8 male (6 male-to-female transsexuals) and 2 female subjects.
The objective of this study is to measure the accuracy of multidetector CT angiography (MD CTA) in the detection of vascular abnormalities in patients