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ArticlePediatric radiology2024

Accuracy of contrast-enhanced CT in liver neoplasms in children under 2 years age.

Aishvarya Shri Rajasimman, Vasundhara Patil, Kunal Bharat Gala, Nitin Shetty, Suyash Kulkarni, Mukta S Ramadwar, Sajid S Qureshi, Girish Chinnaswamy, Siddhartha Laskar, Akshay D Baheti

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Article in Pediatric radiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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10 authors.

Aishvarya Shri RajasimmanDepartment of Radiodiagnosis, Tata Memorial Centre & Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India.ORCID 0000-0002-0069-6007
Vasundhara PatilDepartment of Radiodiagnosis, Tata Memorial Centre & Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India.
Kunal Bharat GalaDepartment of Radiodiagnosis, Tata Memorial Centre & Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India.
Nitin ShettyDepartment of Radiodiagnosis, Tata Memorial Centre & Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India.
Suyash KulkarniDepartment of Radiodiagnosis, Tata Memorial Centre & Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India.
Mukta S RamadwarDepartment of Pathology, Tata Memorial Centre & Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India.
Sajid S QureshiDepartment of Surgical Oncology, Tata Memorial Centre & Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India.
Girish ChinnaswamyDepartment of Pediatric Oncology, Tata Memorial Centre & Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India.
Siddhartha LaskarDepartment of Radiation Oncology, Tata Memorial Centre & Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India.
Akshay D BahetiDepartment of Radiodiagnosis, Tata Memorial Centre & Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India. akshaybaheti@gmail.com.ORCID 0000-0002-5376-6750

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMultiple differentials exist for pediatric liver tumors under 2 years. Accurate imaging diagnosis may obviate the need for tissue sampling in most cases.

objectiveTo evaluate the imaging features and diagnostic accuracy of computed tomography (CT) in liver tumors in children under 2 years.

methodsEighty-eight children under 2 years with treatment naive liver neoplasms and baseline contrast-enhanced CT were included in this institutional review board approved retrospective study. Two blinded onco-radiologists assessed these tumors in consensus. Findings assessed included enhancement pattern, lobulated appearance, cystic change, calcifications, central scar-like appearance, and metastases. The radiologists classified the lesion as hepatoblastoma, infantile hemangioma, mesenchymal hamartoma, rhabdoid tumor, or indeterminate, first based purely on imaging and then after alpha-fetoprotein (AFP) correlation. Multivariate analysis and methods of comparing means and frequencies were used for statistical analysis wherever applicable. Diagnostic accuracy, sensitivity, and positive predictive values were analyzed.

resultsThe mean age of the sample was 11.4 months (95% CI, 10.9-11.8) with 50/88 (57%) boys. The study included 72 hepatoblastomas, 6 hemangiomas, 4 mesenchymal hamartomas, and 6 rhabdoid tumors. Presence of calcifications, multilobular pattern of arterial enhancement, lobulated morphology, and central scar-like appearance was significantly associated with hepatoblastomas (P-value < 0.05). Fourteen out of eighty-eight lesions were called indeterminate based on imaging alone; six lesions remained indeterminate after AFP correlation. Pure radiology-based diagnostic accuracy was 81.8% (95% CI, 72.2-89.2%), which increased to 92.1% (95% CI, 84.3-96.7%) (P-value > 0.05) after AFP correlation, with one hepatoblastoma misdiagnosed as a rhabdoid tumor. If indeterminate lesions were excluded for biopsy, the accuracy would be 98.8% (95% CI, 93.4-99.9%).

conclusionCT had high accuracy for diagnosing liver neoplasms in the under 2-year age population after AFP correlation. Certain imaging features were significantly associated with the diagnosis of hepatoblastoma. A policy of biopsying only indeterminate lesions after CT and AFP correlation would avoid sampling in the majority of patients.

Indexed as

Contrast MediaLiver NeoplasmsSensitivity and SpecificityTomography, X-Ray ComputedDiagnosis, DifferentialFemaleHepatoblastomaHumansInfantInfant, NewbornMaleReproducibility of ResultsRetrospective StudiesContrast MediaChildHepatoblastomaLiver neoplasmsRadiologySensitivity and specificityTomography

Identifiers

PMID38831055
PMCPMC11579165

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