MRI Characteristics of Pediatric Renal Tumors: A SIOP-RTSG Radiology Panel Delphi Study.

Background: The SIOP-Renal Tumor Study Group (RTSG) does not advocate invasive procedures to determine histology before the start of therapy. This may induce misdiagnosis-based treatment initiation, but only for a relatively small percentage of approximately 10% of non-Wilms tumors (non-WTs). MRI could be useful for reducing misdiagnosis, but there is no global consensus on differentiating characteristics.

Actual clinical leadership: a shadowing study of charge nurses and doctors on-call in the emergency department.

Background: The provision of safe, high quality healthcare in the Emergency Department (ED) requires frontline healthcare personnel with sufficient competence in clinical leadership. However, healthcare education curriculum infrequently features learning about clinical leadership, and there is an absence of experienced doctors and nurses as role models in EDs for younger and less experienced doctors and nurses. The purpose of this study was to explore the activities performed by clinical leaders and to identify similarities and differences between the activities performed by charge nurses and those performed by doctors on-call in the Emergency Department after completion of a Clinical Leadership course.

Relapse of Wilms' tumour and detection methods: a retrospective analysis of the 2001 Renal Tumour Study Group-International Society of Paediatric Oncology Wilms' tumour protocol database.

Background: Wilms' tumour is the most common renal cancer in childhood and about 15% of patients will relapse. There is scarce evidence about optimal surveillance schedules and methods for detection of tumour relapse after therapy.

Methods: The Renal Tumour Study Group-International Society of Paediatric Oncology (RTSG-SIOP) Wilms' tumour 2001 trial and study is an international, multicentre, prospective registration, biological study with an embedded randomised clinical trial for children with renal tumours aged between 6 months and 18 years.

Detecting inflammation in inflammatory bowel disease - how does ultrasound compare to magnetic resonance enterography using standardised scoring systems?

Background: Magnetic resonance enterography (MRE) is the current gold standard for imaging in inflammatory bowel disease, but ultrasound (US) is a potential alternative.

Objective: To determine whether US is as good as MRE for the detecting inflamed bowel, using a combined consensus score as the reference standard.

Materials And Methods: We conducted a retrospective cohort study in children and adolescents <18 years with inflammatory bowel disease (IBD) at a tertiary and quaternary centre.

Apparent diffusion coefficient as it relates to histopathology findings in post-chemotherapy nephroblastoma: a feasibility study.

Background: Nephroblastomas represent a group of heterogeneous tumours with variable proportions of distinct histopathological components.

Objective: The purpose of this study was to investigate whether direct comparison of apparent diffusion coefficient (ADC) measurements with post-resection histopathology subtypes is feasible and whether ADC metrics are related to histopathological components.

Materials And Methods: Twenty-three children were eligible for inclusion in this retrospective study.

Paediatric magnetic resonance enteroclysis under general anaesthesia - initial experience.

MR enterography is the accepted imaging reference standard for small bowel assessment in inflammatory bowel disease. There is an increasing cohort of children with inflammatory bowel disease presenting at an early age (<5 years) with severe disease. Younger children present a technical challenge for enterography because of the need for sedation/general anaesthesia to allow image optimisation and the need for oral contrast to allow adequate luminal assessment.

Whole-tumor apparent diffusion coefficient measurements in nephroblastoma: Can it identify blastemal predominance?

Purpose: To explore the potential relation between whole-tumor apparent diffusion coefficient (ADC) parameters in viable parts of tumor and histopathological findings in nephroblastoma.

Materials And Methods: Children (n = 52) with histopathologically proven nephroblastoma underwent diffusion-weighted magnetic resonance imaging (MRI) (1.5T) before preoperative chemotherapy.

Interprofessional trust in emergency department - as experienced by nurses in charge and doctors on call.

Aims And Objectives: The aim of this study was to describe that which characterises interprofessional trust in a Norwegian emergency department, as expressed by nurses in charge and doctors on call.

Background: Interprofessional trust requires knowledge of and skills in interprofessional collaboration. It also requires established trust in fellow collaborators, as well as in the work environment and in the more comprehensive system in which the work is conducted.

Impact of clinical leadership in teams' course on quality, efficiency, responsiveness and trust in the emergency department: study protocol of a trailing research study.

Introduction: Clinical leadership has long been recognised as critical for optimising patient safety, quality of care and interprofessional teamwork in busy and stressful healthcare settings. There is a need to compensate for the absence of the conventional mentor-to-apprentice transfer of clinical leadership knowledge and skills. While young doctors and nurses are increasingly proficient in medical, surgical and technical skills, their training in, and knowledge of clinical leadership skills, is not adequate to meet the demands for these non-technical skills in the emergency department.

Intra-Tumor Genetic Heterogeneity in Wilms Tumor: Clonal Evolution and Clinical Implications.

The evolution of pediatric solid tumors is poorly understood. There is conflicting evidence of intra-tumor genetic homogeneity vs. heterogeneity (ITGH) in a small number of studies in pediatric solid tumors.

Access and utilisation of healthcare services in rural Tanzania: A comparison of public and non-public facilities using quality, equity, and trust dimensions.

This study compared the access and utilisation of health services in public and non-public health facilities in terms of quality, equity and trust in the Mbarali district, Tanzania. Interviews, focus group discussions, and informal discussions were used to generate data. Of the 1836 respondents, 1157 and 679 respondents sought healthcare services on their last visit at public or non-public health facilities, respectively.

Comparison of diagnostic performance for perinatal and paediatric post-mortem imaging: CT versus MRI.

Objectives: To compare the diagnostic yield of whole-body post-mortem computed tomography (PMCT) imaging to post-mortem magnetic resonance (PMMR) imaging in a prospective study of fetuses and children.

Methods: We compared PMCT and PMMR to conventional autopsy as the gold standard for the detection of (a) major pathological abnormalities related to the cause of death and (b) all diagnostic findings in five different body organ systems.

Results: Eighty two cases (53 fetuses and 29 children) underwent PMCT and PMMR prior to autopsy, at which 55 major abnormalities were identified.

A multi-Gaussian model for apparent diffusion coefficient histogram analysis of Wilms' tumour subtype and response to chemotherapy.

Wilms' tumours (WTs) are large heterogeneous tumours, which typically consist of a mixture of histological cell types, together with regions of chemotherapy-induced regressive change and necrosis. The predominant cell type in a WT is assessed histologically following nephrectomy, and used to assess the tumour subtype and potential risk. The purpose of this study was to develop a mathematical model to identify subregions within WTs with distinct cellular environments in vivo, determined using apparent diffusion coefficient (ADC) values from diffusion-weighted imaging (DWI).

Intra- and interobserver variability of whole-tumour apparent diffusion coefficient measurements in nephroblastoma: a pilot study.

Background: The apparent diffusion coefficient (ADC) is potentially useful for assessing treatment response in nephroblastoma (Wilms tumour). However the precision of ADC measurements in these heterogeneous lesions is unknown.

Objective: To assess intra- and interobserver variability of whole-tumour ADC measurements in viable parts of nephroblastomas at diagnosis and after preoperative chemotherapy.

Why measure tumours?

This article questions the scientific justification of ingrained radiologic practices exemplified by size measurements of childhood solid tumours. This is approached by a critical review of staging systems from a selection of paediatric oncological treatment protocols. Local staging remains size-dependent for some tumour types.

Fusion and subtraction post-processing in body MRI.

Interpreting complex paediatric body MRI studies requires the integration of information from multiple sequences. Image processing software, some freely available, allows the radiologist to use simple and rapid post-processing techniques that may aid diagnosis. We demonstrate the use of fusion and subtraction post-processing techniques with examples from four areas of application: enterography, oncological imaging, musculoskeletal imaging and MR fistulography.