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Han Y, Li B, Yu X, Liu J, Zhao W, Zhang D, Zhang J. Multiphase enhanced CT-based transformer for differential diagnosis and predicting surgical risk events of solid abdominal tumors in children. Transl Oncol 2024; 46:102034. [PMID: 38875936 PMCID: PMC11225889 DOI: 10.1016/j.tranon.2024.102034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 05/29/2024] [Accepted: 06/10/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND For pediatric patients with solid abdominal tumors, early diagnosis can guide clinical treatment decisions, and comprehensive preoperative evaluation is essential to reduce surgical risk. The aim of this study was to explore the feasibility of multiphase enhanced CT-based transformer in the early diagnosis of tumors and prediction of surgical risk events (SRE). METHODS A total of 496 pediatric patients with solid abdominal tumors were enrolled in the study. With Swin transformer, we constructed and trained two Swin-T models based on preoperative multiphase enhanced CT for personalized prediction of tumor type and SRE status. Subsequently, we comprehensively evaluated the performance of each model and constructed four benchmark models for performance comparison. RESULTS There was no significant difference in SRE status between tumor types. In the diagnostic task, areas under the receiver operating characteristic curves (AUC) of the Swin-T model were 0.987 (95 % CI, 0.973-0.997) and 0.844 (95 % CI, 0.730-0.940) in the training and validation cohorts, respectively. In predicting SRE, AUCs of the Swin-T model were 0.920 (95 % CI, 0.885-0.948) and 0.741 (95 % CI, 0.632-0.838) in the training and test cohorts, respectively. The Swin-T model achieved the best performance in both classification tasks compared to benchmark models. CONCLUSION The Swin-T model is a promising tool to assist pediatricians in the differential diagnosis of abdominal tumors and in comprehensive preoperative evaluation.
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Affiliation(s)
- Yahui Han
- Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Biyun Li
- Department of Pediatric Hematology Oncology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xiaokun Yu
- Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jianing Liu
- Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Wei Zhao
- Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Da Zhang
- Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jiao Zhang
- Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
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Pace E, Johnson TS, Kao SC, Parikh AK, Qi J, Rajderkar DA, Reid JR, Towbin AJ, States LJ. Imaging of pediatric extragonadal pelvic soft tissue tumors: A COG Diagnostic Imaging Committee/SPR Oncology Committee White Paper. Pediatr Blood Cancer 2023; 70 Suppl 4:e29966. [PMID: 36482882 PMCID: PMC10710207 DOI: 10.1002/pbc.29966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 08/16/2022] [Indexed: 12/13/2022]
Abstract
The most common pediatric extragonadal pelvic cancers include germ cell tumors, sacrococcygeal teratomas, and rhabdomyosarcomas (arising from the urinary bladder, prostate, paratesticular tissues, vagina, uterus, and perineum). This paper describes the radiological and nuclear medicine features of these entities and provides consensus-based recommendations for the assessment at diagnosis, during, and after treatment.
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Affiliation(s)
- Erika Pace
- Department of Radiology, The Royal Marsden NHS Foundation Trust, London, England, United Kingdom
| | - Tatum S. Johnson
- Department of Radiology, Brenner Children’s Wake Forest Baptist Health, Winston-Salem, North Carolina, USA
| | - Simon C. Kao
- Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Ashish K. Parikh
- Department of Radiology, Emory University Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Jing Qi
- Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Dhanashree A. Rajderkar
- Department of Radiology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Janet R. Reid
- Department of Radiology, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Alexander J. Towbin
- Department of Radiology, Cincinnati Children’s Hospital, Cincinnati, Ohio, USA
| | - Lisa J. States
- Department of Radiology, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Lucena IRS, Chedid MF, Isolan PS, Takamatu EE, Lucena RA, Feier FH, Furtado ÁPA, de Fraga JCS. A comparison between ultrasonography and single-phase computed tomography for preoperative assessment of solid abdominal tumors in children. J Pediatr (Rio J) 2023; 99:17-22. [PMID: 35718001 PMCID: PMC9875229 DOI: 10.1016/j.jped.2022.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 04/26/2022] [Accepted: 05/18/2022] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE This study aimed to estimate the performance of single-phase-enhanced computed tomography and ultrasonography examinations in the preoperative evaluation of solid abdominal tumors and their relationship with relevant adjacent structures in children. METHODS This retrospective study included 50 pediatric patients with malignant solid abdominal tumors treated with surgical resection between 2009-2017. Preoperative computed tomography and ultrasonography were compared to operative findings (gold standard) in the diagnosis of invasion or encasement of adjacent structures. Accuracy, sensitivity, specificity, and positive and negative predictive values were evaluated. RESULTS Renal (20.4%) and neuroblastic (19.4%) tumors were the most common. Complete surgical resection with negative margins was achieved in 44 (88%) patients. The comparison between single-phase-enhanced computed tomography and ultrasonography findings showed the following results: sensitivity = 90.3% vs 86.6%, specificity = 86.8% vs 94.6%, negative predictive value = 95.3% vs 94.4%, positive predictive value = 75.3% vs 86.9%, and accuracy = 87.9% vs 92.2%. The correlation (kappa index) between computed tomography and ultrasonography examinations was 0.72 (p < 0.001). In 14% (7/50) of the patients, the invasion of adjacent structures was diagnosed by ultrasonography but not by computed tomography (1 patient had 2 invaded structures). CONCLUSION Ultrasonography can be considered a complementary method to single-phase-enhanced computed tomography in the preoperative evaluation of children with an abdominal tumor. The present study showed that ultrasonography and single-phase-enhanced computed tomography each possess a high accuracy in the preoperative planning of resection of solid abdominal tumors in children. Thus, it seems that the combination of both imaging methods would be enough for the evaluation of most abdominal tumors in the pediatric population.
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Affiliation(s)
- Iara Regina Siqueira Lucena
- Hospital de Clínicas de Porto Alegre (HCPA), Programa de Pós-Gradução em Cirurgia, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Divisão de Radiologia, Porto Alegre, RS, Brazil.
| | - Márcio Fernandes Chedid
- Hospital de Clínicas de Porto Alegre (HCPA), Programa de Pós-Gradução em Cirurgia, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Divisão de Cirurgia Gastrointestinal, Porto Alegre, RS, Brazil
| | - Paola Santis Isolan
- Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Divisão de Cirurgia Pediátrica, Porto Alegre, RS, Brazil
| | - Eliziane Emy Takamatu
- Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Divisão de Cirurgia Pediátrica, Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Ronaldo Albé Lucena
- Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Divisão de Radiologia, Porto Alegre, RS, Brazil
| | - Flavia Heinz Feier
- Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Divisão de Cirurgia Gastrointestinal, Porto Alegre, RS, Brazil
| | - Álvaro Porto Alegre Furtado
- Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Divisão de Radiologia, Porto Alegre, RS, Brazil
| | - Jose Carlos Soares de Fraga
- Hospital de Clínicas de Porto Alegre (HCPA), Programa de Pós-Gradução em Cirurgia, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Divisão de Cirurgia Pediátrica, Porto Alegre, RS, Brazil
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Wilms Tumor-Follow-up Tailored Abdominal CT Examination. CURRENT RADIOLOGY REPORTS 2017. [DOI: 10.1007/s40134-017-0206-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jawaid A, Arif K, Brown N, Fadoo Z. Clinical characteristics of childhood cancer in emergency room in a tertiary hospital in Pakistan. World J Emerg Med 2016; 7:300-302. [PMID: 27965725 DOI: 10.5847/wjem.j.1920-8642.2016.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Amna Jawaid
- Department of Emergency Medicine, Aga Khan University Hospital, Karachi 74800, Pakistan
| | - Khubaib Arif
- Department of Emergency Medicine, Aga Khan University Hospital, Karachi 74800, Pakistan
| | - Nick Brown
- Visiting faculty, Salisbury District Hospital, Salisbury, United Kingdom
| | - Zehra Fadoo
- Department of Oncology and Pediatrics, Aga Khan University Hospital, Karachi 74800, Pakistan
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Petit S, Vallin C, Morel B, Bertrand P, Blouin P, Lardy H, Sirinelli D. A single enhanced phase is sufficient for the initial computed tomography evaluation of retroperitoneal tumors in children. Diagn Interv Imaging 2016; 98:73-78. [PMID: 27687832 DOI: 10.1016/j.diii.2016.03.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 02/27/2016] [Accepted: 03/14/2016] [Indexed: 11/25/2022]
Abstract
PURPOSE The goal of this study was to evaluate the incremental value of unenhanced phase in the initial evaluation of retroperitoneal tumors in children by comparison with an enhanced phase alone using computed tomography (CT). MATERIALS AND METHODS A total of 53 patients (26 girls, 27 boys) with a total of 53 tumors who had CT examination of the abdomen and pelvis for the initial assessment of retroperitoneal tumor were retrospectively included. All CT examinations were obtained with an unenhanced set of CT images and a set of CT images obtained after intravenous administration of iodinated contrast material. One junior and one senior radiologist independently evaluated the two sets in two separate reading sessions. CT images were analyzed for tumor calcifications, tumor location, vascular encasement, local invasion and tumor content. RESULTS Calcifications were present in 24/53 tumors (45%). On the enhanced set, the senior radiologist was able to detect calcifications in 22/24 tumors (92%) and the junior radiologist in 20/24 tumors (83%), yielding sensitivities of 92% and 83%, and specificities of 96.5% and 100%, respectively. Inter-observer agreement was excellent (Kappa=0.89). Tumor location was correctly determined by the senior radiologist in 53/53 tumors (100%) and 37/53 tumors (70%) by the junior radiologist. Using the unenhanced set, the senior radiologist was able to assess vascular encasement in 26/53 tumors (49%) against 21/53 (39%) for the junior radiologist. For tumor content, agreement between the enhanced and combined unenhanced and enhanced CT was 77% for both radiologists. CONCLUSION Enhanced CT performs as well as unenhanced CT for evidencing calcifications and is therefore sufficient for the initial assessment of retroperitoneal tumor in children.
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Affiliation(s)
- S Petit
- Department of pediatric radiology, hôpital Clocheville, CHRU de Tours, 49, boulevard Béranger, 37000 Tours, France
| | - C Vallin
- Department of pediatric radiology, hôpital Clocheville, CHRU de Tours, 49, boulevard Béranger, 37000 Tours, France
| | - B Morel
- Department of pediatric radiology, hôpital Clocheville, CHRU de Tours, 49, boulevard Béranger, 37000 Tours, France.
| | - P Bertrand
- Department of medical imaging, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnellé, 37000 Tours, France
| | - P Blouin
- Department of pediatric hematology-oncology, hôpital Clocheville, CHRU de Tours, 49, boulevard Béranger, 37000 Tours, France
| | - H Lardy
- Department of visceral and plastic surgery, hôpital Clocheville, CHRU de Tours, 49, boulevard Béranger, 37000 Tours, France
| | - D Sirinelli
- Department of pediatric radiology, hôpital Clocheville, CHRU de Tours, 49, boulevard Béranger, 37000 Tours, France
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Heo SH, Kim JW, Shin SS, Jeong SI, Lim HS, Choi YD, Lee KH, Kang WD, Jeong YY, Kang HK. Review of Ovarian Tumors in Children and Adolescents: Radiologic-Pathologic Correlation. Radiographics 2014; 34:2039-55. [DOI: 10.1148/rg.347130144] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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