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Pediatric Hepatoblastoma, Hepatocellular Carcinoma, and Other Hepatic Neoplasms: Consensus Imaging Recommendations
Gary R Schooler1, Judy H Squires1, Adina Alazraki1
1From the Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (G.R.S.); Department of Radiology, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, Pa (J.H.S.); Department of Radiology, Emory University and Children's Healthcare of Atlanta, Atlanta, Ga (A.A.); Department of Diagnostic Imaging, The Hospital for Sick Children and Department of Medical Imaging, University of Toronto, Toronto, Canada (G.B.C.); Department of Radiology, Montefiore Medical Center, Bronx, NY (V.C.); Department of Radiology, Duke University Medical Center, Durham, NC (J.T.D.); Department of Radiology, Mallinckrodt Institute of Radiology, St. Louis Children's Hospital, Washington University School of Medicine, St Louis, Mo (G.K.); Department of Radiology, Nationwide Children's Hospital, Columbus, Ohio (R.K.); Stanford University School of Medicine, Lucile Packard Children's Hospital, Stanford, Calif (M.P.L.); Department of Radiology, Texas Children's Hospital, Houston, Tex (P.M.M.); Nemours Children's Hospital, Nemours Children's Health System, University of Central Florida College of Medicine, Orlando, Fla (D.J.P.); Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, Calif (C.B.S.); Department of Radiology, Cincinnati Children's Hospital, Cincinnati, Ohio (A.J.T.); and Department of Radiology, University of Cincinnati College of Medicine, 3333 Burnet Ave, MLC 5031, Cincinnati, OH 45229 (A.J.T.).
Insights
A new Pediatric LI-RADS (Liver Imaging Reporting and Data System) provides imaging guidelines for pediatric liver cancer. This consensus aims to improve diagnosis and care for children with hepatoblastoma and hepatocellular carcinoma.
Area of Science:
- Pediatric Radiology
- Oncology
- Medical Imaging
Background:
- Primary hepatic malignancies in children, such as hepatoblastoma and hepatocellular carcinoma, require appropriate imaging evaluation.
- Existing guidelines like the American College of Radiology's Liver Imaging Reporting and Data System (LI-RADS) are designed for adults, leaving a gap in pediatric care.
- There is a lack of consensus for imaging and interpretation of pediatric liver neoplasms.
Purpose of the Study:
- To establish consensus-based imaging recommendations and interpretation standards for pediatric liver neoplasms.
- To address the absence of specific guidelines for evaluating children at risk for or with known liver neoplasms.
- To improve the quality and consistency of imaging for pediatric liver cancer.
Main Methods:
- Development of a new Pediatric Working Group within the American College of Radiology LI-RADS framework.
- Drafting guidance based on the most current information interpreted by pediatric imaging experts.
- Leveraging expert consensus from the Pediatric LI-RADS Working Group.
Main Results:
- Provides guidance on appropriate imaging modalities and protocols for pediatric liver neoplasms.
- Offers recommendations for imaging interpretation and reporting in pediatric liver cancer.
- Aims to reduce interpretation errors and enhance communication between imaging specialists and referring physicians.
Conclusions:
- The Pediatric LI-RADS Working Group offers crucial consensus for imaging pediatric liver neoplasms.
- Implementation of these guidelines is expected to enhance patient care and diagnostic accuracy.
- This initiative standardizes the approach to evaluating and reporting pediatric liver malignancies.
Abstract:
Appropriate imaging is imperative in evaluating children with a primary hepatic malignancy such as hepatoblastoma or hepatocellular carcinoma. For use in the adult patient population, the American College of Radiology created the Liver Imaging Reporting and Data System (LI-RADS) to provide consistent terminology and to improve imaging interpretation. At present, no similar consensus exists to guide imaging and interpretation of pediatric patients at risk for developing a liver neoplasm or how best to evaluate a pediatric patient with a known liver neoplasm. Therefore, a new Pediatric Working Group within American College of Radiology LI-RADS was created to provide consensus for imaging recommendations and interpretation of pediatric liver neoplasms. The article was drafted based on the most up-to-date existing information as interpreted by imaging experts comprising the Pediatric LI-RADS Working Group. Guidance is provided regarding appropriate imaging modalities and protocols, as well as imaging interpretation and reporting, with the goals to improve imaging quality, to decrease image interpretation errors, to enhance communication with referrers, and to advance patient care. An expanded version of this document that includes broader background information on pediatric hepatocellular carcinoma and rationale for recommendations can be found in Appendix E1 (online).
