Imaging of pediatric liver tumors: A COG Diagnostic Imaging Committee/SPR Oncology Committee White Paper

Area of Science:

• Pediatric Oncology
• Medical Imaging
• Hepatobiliary Diseases

Background:

• Primary hepatic malignancies are uncommon in children, representing 1-2% of all pediatric neoplasms.
• Hepatoblastoma and hepatocellular carcinoma are the predominant types in young children and older children, respectively.
• Standardized imaging protocols are crucial for accurate diagnosis and treatment assessment.

Purpose of the Study:

• To establish consensus-based imaging recommendations for primary hepatic malignancies in pediatric patients.
• To guide the evaluation of these rare tumors at initial diagnosis.
• To provide a framework for follow-up imaging during and after therapy.

Main Methods:

• A panel of pediatric oncologists and radiologists convened to develop guidelines.
• Recommendations were based on a review of current literature and clinical expertise.
• Consensus was reached through a structured Delphi-like process.

Main Results:

• Detailed imaging recommendations for diagnosis, including modality choices and sequences.
• Specific guidance for surveillance and response assessment during and after treatment.
• Emphasis on multi-disciplinary team collaboration for optimal patient management.

Conclusions:

• Standardized imaging is essential for the effective management of pediatric primary liver cancer.
• These consensus guidelines aim to improve diagnostic accuracy and treatment monitoring.
• Adherence to these recommendations can enhance outcomes for children with liver malignancies.