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Staging and Restaging Pediatric Abdominal and Pelvic Tumors: A Practical Guide
Luisa Leitão de Faria1, Carolina Ponich Clementino1, Felippe Augusto Silvestre E Véras1
1From the Radiology Department, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Rua Dr Ovídio Pires de Campos, 225 Cerqueira César, São Paulo, SP 36070-460, Brazil (L.L.d.F., C.P.C., F.A.S.e.V., D.d.C.K., D.Y.O., M.O.F., L.S.); and Department of Radiology, Boston Childrens Hospital, Harvard Medical School, Boston, Mass (M.A.B.).
Insights
This review covers key imaging strategies for diagnosing and staging common pediatric abdominal tumors like neuroblastoma and Wilms tumor. It emphasizes accurate imaging for treatment planning and monitoring patient response.
Area of Science:
- Pediatric Radiology
- Abdominal Oncology
- Diagnostic Imaging
Background:
- Pediatric abdominal malignancies require precise diagnosis and staging.
- Radiologists play a crucial role in identifying tumor characteristics and spread patterns.
- Multidisciplinary teams rely on imaging for treatment planning and prognostication.
Purpose of the Study:
- To provide a practical review of updated key points for diagnosing common pediatric abdominal tumors.
- To outline imaging methods for staging and assessing treatment response.
- To guide radiologists in selecting optimal imaging examinations.
Main Methods:
- Review of current literature and established imaging guidelines.
- Discussion of characteristic imaging findings for prevalent pediatric abdominal tumors.
- Emphasis on staging systems relevant to pediatric oncology (e.g., Ann Arbor, PRETEXT).
Main Results:
- Distinctive imaging findings aid in differentiating pediatric abdominal malignancies.
- Accurate staging through imaging is critical for treatment stratification.
- Consistent imaging evaluation is essential for monitoring therapeutic efficacy.
Conclusions:
- Radiologists must master imaging techniques for diagnosing, staging, and restaging common pediatric abdominal tumors.
- Appropriate imaging selection avoids inconclusive or unnecessary examinations.
- Effective imaging facilitates optimal patient management and prognostication.
Abstract:
The most common abdominal malignancies diagnosed in the pediatric population include neuroblastoma, Wilms tumor, hepatoblastoma, lymphoma, germ cell tumor, and rhabdomyosarcoma. There are distinctive imaging findings and patterns of spread for each of these tumors that radiologists must know for diagnosis and staging and for monitoring the patient's response to treatment. The multidisciplinary treatment group that includes oncologists, surgeons, and radiation oncologists relies heavily on imaging evaluation to identify the best treatment course and prognostication of imaging findings, such as the image-defined risk factors for neuroblastomas, the PRETreatment EXtent of Disease staging system for hepatoblastoma, and the Ann Arbor staging system for lymphomas. It is imperative for radiologists to be able to correctly indicate the best imaging methods for diagnosis, staging, and restaging of each of these most prevalent tumors to avoid inconclusive or unnecessary examinations. The authors review in a practical manner the most updated key points in diagnosing and staging disease and assessing response to treatment of the most common pediatric abdominal tumors. ©RSNA, 2024 Supplemental material is available for this article.
