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Published on: June 21, 2024
The Role of Ultrasonography forDiagnosing Wilms Tumor in Developing Country
Aulia Rahmani1, Nur Melani Sari2, Vita Indriasari3
1Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.
Insights
Ultrasonography (USG) is a common initial test for pediatric abdominal masses, but this study found no significant link between USG results and histopathology in diagnosing Wilm's Tumor and other pediatric renal malignancies.
Area of Science:
- Pediatric Oncology
- Diagnostic Imaging
- Pathology
Background:
- Wilm's Tumor (WT) survival rates are low in developing nations, often due to delayed diagnosis.
- Ultrasonography (USG) is a cost-effective, non-invasive first-line imaging tool for suspected pediatric abdominal masses, with 76% sensitivity.
- The diagnostic accuracy of USG compared to histopathology in pediatric renal malignancies needs evaluation.
Purpose of the Study:
- To assess the relationship between ultrasonography (USG) findings and histopathological diagnoses in pediatric renal malignancies.
- To determine if USG can reliably predict histopathological outcomes for conditions like Wilm's Tumor.
Main Methods:
- A cross-sectional analytical study was conducted from 2015-2018 at Dr. Hasan Sadikin Hospital.
- Medical records of pediatric patients (0-18 years) with renal malignancy or neuroblastoma were reviewed.
- Fisher exact test was used to analyze the association between USG and histopathology results.
Main Results:
- The study included 43 pediatric patients: 33 with Wilm's Tumor, 6 with neuroblastoma, and 4 with other renal malignancies.
- Fisher exact test showed no statistically significant relationship between USG findings and histopathological diagnoses (p > 0.05).
Conclusions:
- Ultrasonography interpretation may lack a significant correlation with definitive histopathological diagnoses in pediatric renal tumors.
- Centralized interpretation of USG in pediatric oncology may improve diagnostic consistency.
Abstract:
Background: Overall five-year survival rate of Wilm's Tumor (WT) in developing countries is still poor. Delayed diagnosis is one of the contributing factors, whereas early diagnosis is an important thing for the outcome. It is caused by the WT burden in developing countries that was not comparable with the number of facilities for diagnosis and treatment. Ultrasonography (USG) is the mandatory first-line imaging modality in children with a suspected abdominal mass and an overall sensitivity of 76%. Additionally, it can be found in many health facilities at a lower cost, quick, non-invasive, and carries no risk of radiation. Therefore, the relationship between USG and histopathology should be measured. Materials and Methods: A cross-sectional study with an analytical approach was performed in pediatric (0 untill 18 year of age) renal malignancy and neuroblastoma that admitted to Dr. Hasan Sadikin Hospital, Bandung between 2015-2018. Data were collected from medical records. Statistical analyses using Fisher exact test were done to determine the significance of the relationship between USG and histopathology. Results: Forty-three samples were obtained based on inclusion criteria, such as WT (n=33), neuroblastoma (n=6), renal clear cell carcinoma (n=2) and no specific type of renal malignancy (n=2). Fisher exact test revealed no-significant relationship between USG and histopathology with p-value > 0.05 Conclusion: There is no significant relationship between USG and histopathology. Therefore, centralized unity for USG interpretation is recommended.
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