Whole-Body MRI in Children: Concepts and Controversies- Expert Panel Narrative Review.

The use of whole-body MRI (WBMRI) in children, from infancy to adolescence, has expanded rapidly over the past decade, with increasing uptake and a broadening range of clinical indications. Current indications include screening for presymptomatic lesions in cancer predisposition syndromes; tumor staging in known malignancies; investigating fevers of unknown origin; as well as diagnosing and monitoring rheumatologic diseases, vascular anomalies and neuromuscular disorders. This AJR Expert Panel Narrative Review aims to offer a comprehensive discussion of WBMRI in pediatric patients, exploring protocols and other technical considerations, clinical indications, implementation challenges and troubleshooting, as well as controversies in widespread adoption, while considering emerging trends and directions.

Intra- and interobserver agreement in evaluation of image-defined risk factors on computed tomography in pediatric neuroblastoma.

Background: Image-defined risk factors (IDRFs) were introduced to provide a consensus approach for pre-treatment risk stratification on computed tomography (CT) and magnetic resonance imaging (MRI) in patients with neuroblastoma.

Objective: To assess the intra- and inter-reader agreement of radiologists in identifying IDRFs on CT.

Materials And Methods: Approval for this retrospective study was granted by our institutional research ethics board with a waiver of consent.

Imaging of pediatric gastrointestinal tumors: A tertiary center experience over 19 years.

Purpose: Gastrointestinal tract (GIT) tumors in children are rare and there is a scarcity of data on their imaging features. The purpose of this study was to determine thefrequency of various GIT tumor types in children and to identify key imaging characteristics.

Methods: This retrospective, single-center study was approved by the local ethics committee.

Radiation exposure associated with computed tomography for pediatric urolithiasis evaluation: A scoping review of the literature.

Introduction: Computed tomography (CT) imaging is used for assessment of pediatric urolithiasis in cases where ultrasound is inconclusive. The utility of CT imaging must be considered alongside the potential risks of radiation exposure in this patient population due to the increased risk of cancer development. The purpose of this review is to investigate the radiation exposure associated with standard-dose and low-dose computed tomography (CT) imaging for the assessment of pediatric urolithiasis.

Diagnostic Accuracy of 128-Slice Single-Source CT for the Detection of Dislocated Bucket Handle Meniscal Tears in the Setting of an Acute Knee Trauma-Correlation with MRI and Arthroscopy.

(1) Background: Meniscal tears are amongst the most common knee injuries. Dislocated bucket handle meniscal tears in particular should receive early intervention. The purpose of this study was to evaluate the diagnostic performance of CT in detecting dislocated bucket handle meniscal tears compared with the gold-standard MRI and arthroscopy.

State-of-the-art magnetic resonance imaging sequences for pediatric body imaging.

Longer examination time, need for anesthesia in smaller children and the inability of most children to hold their breath are major limitations of MRI in pediatric body imaging. Fortunately, with technical advances, many new and upcoming MRI sequences are overcoming these limitations. Advances in data acquisition and k-space sampling methods have enabled sequences with improved temporal and spatial resolution, and minimal artifacts.

Case Report: MRI, CEUS, and CT Imaging Features of Metanephric Adenoma with Histopathological Correlation and Literature Review.

The metanephric adenoma is an extremely rare, benign, embryonal-epithelial neoplasm of the kidney and has a good prognosis with appropriate treatment. It can present at any age and is often asymptomatic. Histologically, the lesion is well established; however, there have been only a few cases described with available detailed imaging findings, most of them with large renal masses typically depicted by computed tomography (CT).

Ultra-low dose CT for scaphoid fracture detection-a simulational approach to quantify the capability of radiation exposure reduction without diagnostic limitation.

Background: Modern CT might deliver higher image quality than necessary for fracture imaging, which would mean non-essential effective radiation exposure for patients. We simulated ultra-low dose (ULD)-CT at different dose levels and analyzed their diagnostic performance for scaphoid fracture detection.

Methods: 30 consecutive high quality CT with clinically suspected scaphoid fractures were assessed.

Improving protocols for whole-body magnetic resonance imaging: oncological and inflammatory applications.

Whole-body MRI is increasingly used in the evaluation of a range of oncological and non-oncological diseases in infants, children and adolescents. Technical innovation in MRI scanners, coils and sequences have enabled whole-body MRI to be performed more rapidly, offering large field-of-view imaging suitable for multifocal and multisystem disease processes in a clinically useful timeframe. Together with a lack of ionizing radiation, this makes whole-body MRI especially attractive in the pediatric population.

Population-based cohort imaging: skeletal muscle mass by magnetic resonance imaging in correlation to bioelectrical-impedance analysis.

Background: Skeletal muscle mass is subjected to constant changes and is considered a good predictor for outcome in various diseases. Bioelectrical-impedance analysis (BIA) and magnetic resonance imaging (MRI) are approved methodologies for its assessment. However, muscle mass estimations by BIA may be influenced by excess intramuscular lipids and adipose tissue in obesity.

Effectiveness of Chest CT in Children: CT Findings in Relation to the Clinical Question.

Purpose: To estimate the effectiveness and efficiency of chest CT in children based on the suspected diagnosis in relation to the number of positive, negative, and inconclusive CT results.

Materials And Methods: In this monocentric retrospective study at a university hospital with a division of pediatric radiology, 2019 chest CT examinations (973 patients; median age: 10.5 years; range: 2 days to 17.

Radiation Dose Reduction in CT Torsion Measurement of the Lower Limb: Introduction of a New Ultra-Low Dose Protocol.

This study analyzed the radiation exposure of a new ultra-low dose (ULD) protocol compared to a high-quality (HQ) protocol for CT-torsion measurement of the lower limb. The analyzed patients ( = 60) were examined in the period March to October 2019. In total, 30 consecutive patients were examined with the HQ and 30 consecutive patients with the new ULD protocol comprising automatic tube voltage selection, automatic exposure control, and iterative image reconstruction algorithms.

Impact of F-FDG-PET/CT on Clinical Management in Patients with Cholangiocellular Carcinoma.

Objective: To determine the impact of F-FDG-PET/CT on clinical management of patients with cholangiocellular carcinoma (CCA).

Methods: Patients with CCA undergoing clinically indicated F-FDG-PET/CT between 04/2013 and 08/2018 were prospectively included in a local PET/CT registry study. Intended clinical management ("non-treatment" such as watchful-waiting or additional diagnostic tests, and "palliative" or "curative treatment") was recorded before and after PET/CT.

Distribution patterns of intramyocellular and extramyocellular fat by magnetic resonance imaging in subjects with diabetes, prediabetes and normoglycaemic controls.

Aim: To evaluate the distribution of intramyocellular lipids (IMCLs) and extramyocellular lipids (EMCLs) as well as total fat content in abdominal skeletal muscle by magnetic resonance imaging (MRI) using a dedicated segmentation algorithm in subjects with type 2 diabetes (T2D), prediabetes and normoglycaemic controls.

Materials And Methods: Subjects from a population-based cohort were classified with T2D, prediabetes or as normoglycaemic controls. Total myosteatosis, IMCLs and EMCLs were quantified by multiecho Dixon MRI as proton-density fat-fraction (in %) in abdominal skeletal muscle.

[Osseous variations in radiological diagnostics of the wrist].

Clinical/methodical Issue: The carpal joint is one of the most complex joints in the body comprising multiple bones that allow flexibility while simultaneously providing stability. Variations in osseous structures that may be either cause or result of pathological changes may make radiological reporting challenging. Only the knowledge of important osseous variations allows a reliable assessment of carpal imaging studies.

Differing Pulmonary Structural Abnormalities Detected on Pulmonary MR Imaging in Cystic Fibrosis Patients with Varying Pancreatic Function.

Purpose:  In cystic fibrosis (CF) the phenotypic expression of complaints varies widely. Genotypes with sufficient pancreatic function (PS) exhibit milder lung disease compared to CF patients with insufficient pancreatic function (PI). The purpose of this study was to evaluate structural lung disease (SLD) in CF patients with differing pancreatic status but similar results on pulmonary function testing using a pulmonary magnetic resonance imaging score (MR-CF score).

New severity assessment in cystic fibrosis: signal intensity and lung volume compared to LCI and FEV: preliminary results.

Objectives: Magnetic resonance imaging (MRI) aids diagnosis in cystic fibrosis (CF) but its use in quantitative severity assessment is under research. This study aims to assess changes in signal intensity (SI) and lung volumes (Vol) during functional MRI and their use as a severity assessment tool in CF patients.

Methods: The CF intra-hospital standard chest 1.

CT-morphologic and CT-textural patterns of response in inoperable soft tissue sarcomas treated with pazopanib-a preliminary retrospective cohort study.

Objective: To analyze patterns of response in soft tissue sarcomas exposed to pazopanib using CT-morphologic and textural features and their suitability for evaluating therapeutic response.

Methods: Retrospective evaluation of CT response and texture patterns in 33 patients (23 female; mean age: 61.2 years, range, 30-85 years) with soft tissue sarcomas treated with pazopanib from October 2008 to July 2017.

Advanced Virtual Monoenergetic Imaging: Improvement of Visualization and Differentiation of Intramuscular Lesions in Portal-Venous-phase Contrast-enhanced Dual-energy CT.

Purpose: To evaluate the effect of advanced monoenergetic imaging (MEI+) postprocessing algorithm on the visualization of various intramuscular lesions on portal-venous-phase contrast-enhanced dual-energy computed tomography (DECT).

Material And Methods: Thirty-nine patients (64.3 ± 11.

Diffusion kurtosis imaging histogram parameter metrics predicting survival in integrated molecular subtypes of diffuse glioma: An observational cohort study.

Purpose: The aim of the study was to assess the predictive value of preoperatively assessed diffusion kurtosis imaging (DKI) metrics as prognostic factors in the 2016 World Health Organization Classification of Tumors of the Central Nervous System integrated glioma groups.

Material And Methods: Seventy-seven patients with histopathologically confirmed treatment-naïve glioma were retrospectively assessed between 08/2013 and 10/2017 using mean kurtosis (MK) and mean diffusivity (MD) histogram parameters from DKI, overall and progression-free survival, and relevant prognostic molecular data (isocitrate dehydrogenase, [IDH]; alpha-thalassemia/mental retardation syndrome X-linked, [ATRX]; chromosome 1p/19q loss of heterozygosity). Receiver operating characteristic (ROC) analysis was performed on metric variables to determine the optimal cutoff-values.

Virtual non-enhanced dual-energy CT reconstruction may replace true non-enhanced CT scans in the setting of suspected active hemorrhage.

Objective: To assess virtual non-enhanced dual energy computed tomography (DECT) reconstruction as a potential alternative to true non-enhanced thoracic and abdominal CT scans in patients with suspected active hemorrhage.

Methods And Materials: Ninety-seven consecutive patients with suspected active bleeding, who underwent routine triphasic CT with intravenous contrast, were included. All patients underwent single energy non-enhanced (TNE) and arterial phase CT as well as venous DECT.

Radiation Dose Optimization in Pediatric Chest CT: Major Indicators of Dose Exposure in 1695 CT Scans over Seven Years.

Purpose:  To analyze possible influencing factors on radiation exposure in pediatric chest CT using different approaches for radiation dose optimization and to determine major indicators for dose development.

Materials And Methods:  In this retrospective study at a clinic with maximum care facilities including pediatric radiology, 1695 chest CT examinations in 768 patients (median age: 10 years; range: 2 days to 17.9 years) were analyzed.

Assessment of the degree of abdominal myosteatosis by magnetic resonance imaging in subjects with diabetes, prediabetes and healthy controls from the general population.

Objectives: Intra- and intermyocellular lipid deposition and adipose tissue are part of glucose homeostasis and insulin resistance; however, their role in type 2 diabetes mellitus (T2DM) remains unclear. We assessed differences in the degree of abdominal myosteatosis among subjects with T2DM and prediabetes.

Materials And Methods: Asymptomatic subjects from the general population were classified as subjects with T2DM, prediabetes or healthy controls and underwent multi-echo Dixon magnetic resonance imaging (MRI) (TR 8.

Inter- and intra-observer variability of an anatomical landmark-based, manual segmentation method by MRI for the assessment of skeletal muscle fat content and area in subjects from the general population.

Objectives: Changes in skeletal muscle composition, such as fat content and mass, may exert unique metabolic and musculoskeletal risks; however, the reproducibility of their assessment is unknown. We determined the variability of the assessment of skeletal muscle fat content and area by MRI in a population-based sample.

Methods: A random sample from a prospective, community-based cohort study (KORA-FF4) was included.