1
|
Bakhuizen JJ, Postema FAM, van Rijn RR, van Schuppen J, Duijkers FAM, van Noesel CJM, Hennekam RC, Jongmans MCJ, Savci-Heijink CD, Smetsers SE, Terheggen-Lagro SWJ, Hopman SMJ, Oomen MWN, Merks JHM. No Pathogenic DICER1 Gene Variants in a Cohort Study of 28 Children With Congenital Pulmonary Airway Malformation. J Pediatr Surg 2024; 59:459-463. [PMID: 37989646 DOI: 10.1016/j.jpedsurg.2023.10.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/22/2023] [Accepted: 10/07/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Distinguishing congenital pulmonary airway malformations (CPAMs) from pleuropulmonary blastoma (PPB) can be challenging. Previously diagnosed patients with CPAM may have been misdiagnosed and we may have missed DICER1-associated PPBs, a diagnosis with important clinical implications for patients and their families. To gain insight in potential misdiagnoses, we systematically assessed somatic DICER1 gene mutation status in an unselected, retrospective cohort of patients with a CPAM diagnosis. METHODS In the Amsterdam University Medical Center (the Netherlands), it has been standard policy to resect CPAM lesions. We included all consecutive cases of children (age 0-18 years) with a diagnosis of CPAM between 2007 and 2017 at this center. Clinical and radiographic features were reviewed, and DICER1 gene sequencing was performed on DNA retrieved from CPAM tissue samples. RESULTS Twenty-eight patients with a surgically removed CPAM were included. CPAM type 1 and type 2 were the most common subtypes (n = 12 and n = 13). For 21 patients a chest CT scan was available for reassessment by two pediatric radiologists. In 9 patients (9/21, 43%) the CPAM subtype scored by the radiologists did not correspond with the subtype given at pathology assessment. No pathogenic mutations and no copy number variations of the DICER1 gene were found in the DNA extracted from CPAM tissue (0/28). CONCLUSIONS Our findings suggest that the initial CPAM diagnoses were correct. These findings should be validated through larger studies to draw conclusions regarding whether systematic DICER1 genetic testing is required in children with a pathological confirmed diagnosis of CPAM or not. LEVEL OF EVIDENCE Level IV.
Collapse
Affiliation(s)
- Jette J Bakhuizen
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Department of Genetics, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Floor A M Postema
- Department of Pediatrics, Emma Children's Hospital, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Emma Children's Hospital, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Joost van Schuppen
- Department of Radiology and Nuclear Medicine, Emma Children's Hospital, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Floor A M Duijkers
- Department of Clinical Genetics, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Carel J M van Noesel
- Department of Pathology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Raoul C Hennekam
- Department of Pediatrics, Emma Children's Hospital, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Marjolijn C J Jongmans
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Department of Genetics, University Medical Center Utrecht, Utrecht, the Netherlands
| | - C Dilara Savci-Heijink
- Department of Pathology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | | | - Suzanne W J Terheggen-Lagro
- Department of Pediatric Pulmonology and Allergy, Emma Children's Hospital, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Saskia M J Hopman
- Department of Genetics, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Matthijs W N Oomen
- Department of Pediatric Surgery, Emma Children's Hospital, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Johannes H M Merks
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
| |
Collapse
|
2
|
Chisholm J, Mandeville H, Adams M, Minard-Collin V, Rogers T, Kelsey A, Shipley J, van Rijn RR, de Vries I, van Ewijk R, de Keizer B, Gatz SA, Casanova M, Hjalgrim LL, Firth C, Wheatley K, Kearns P, Liu W, Kirkham A, Rees H, Bisogno G, Wasti A, Wakeling S, Heenen D, Tweddle DA, Merks JHM, Jenney M. Frontline and Relapsed Rhabdomyosarcoma (FAR-RMS) Clinical Trial: A Report from the European Paediatric Soft Tissue Sarcoma Study Group (EpSSG). Cancers (Basel) 2024; 16:998. [PMID: 38473359 DOI: 10.3390/cancers16050998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/22/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024] Open
Abstract
The Frontline and Relapsed Rhabdomyosarcoma (FaR-RMS) clinical trial is an overarching, multinational study for children and adults with rhabdomyosarcoma (RMS). The trial, developed by the European Soft Tissue Sarcoma Study Group (EpSSG), incorporates multiple different research questions within a multistage design with a focus on (i) novel regimens for poor prognostic subgroups, (ii) optimal duration of maintenance chemotherapy, and (iii) optimal use of radiotherapy for local control and widespread metastatic disease. Additional sub-studies focusing on biological risk stratification, use of imaging modalities, including [18F]FDG PET-CT and diffusion-weighted MRI imaging (DWI) as prognostic markers, and impact of therapy on quality of life are described. This paper forms part of a Special Issue on rhabdomyosarcoma and outlines the study background, rationale for randomisations and sub-studies, design, and plans for utilisation and dissemination of results.
Collapse
Affiliation(s)
- Julia Chisholm
- Children and Young People's Unit, Royal Marsden Hospital and Institute of Cancer Research, Sutton SM2 5PT, UK
| | - Henry Mandeville
- Children and Young People's Unit, Royal Marsden Hospital and Institute of Cancer Research, Sutton SM2 5PT, UK
| | | | | | - Timothy Rogers
- Department of Paediatric Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol BS1 3NU, UK
| | - Anna Kelsey
- Department of Paediatric Histopathology, Royal Manchester Children's Hospital, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK
| | - Janet Shipley
- The Institute of Cancer Research, London SW7 3RP, UK
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, University of Amsterdam, Amsterdam UMC, 1081 HV Amsterdam, The Netherlands
| | - Isabelle de Vries
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
| | - Roelof van Ewijk
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
| | - Bart de Keizer
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
| | - Susanne A Gatz
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham B15 2TG, UK
- Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | | | | | - Charlotte Firth
- Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Keith Wheatley
- Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Pamela Kearns
- Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Wenyu Liu
- Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Amanda Kirkham
- Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Helen Rees
- Department of Paediatric Oncology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol BS1 3NU, UK
| | - Gianni Bisogno
- Department of Women and Children's Health, University of Padova, 35122 Padua, Italy
| | - Ajla Wasti
- The Institute of Cancer Research, London SW7 3RP, UK
| | | | | | - Deborah A Tweddle
- Vivo Biobank, Translational & Clinical Research Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - Johannes H M Merks
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
| | | |
Collapse
|
3
|
Hutchinson K, van Zandwijk JP, Vester MEM, Seth A, Bilo RAC, van Rijn RR, Loeve AJ. Modeling of inflicted head injury by shaking trauma in children: what can we learn? : Update to parts I&II: A systematic review of animal, mathematical and physical models. Forensic Sci Med Pathol 2024:10.1007/s12024-023-00765-5. [PMID: 38236351 DOI: 10.1007/s12024-023-00765-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2023] [Indexed: 01/19/2024]
Abstract
Inflicted shaking trauma can cause injury in infants, but exact injury mechanisms remain unclear. Controversy exists, particularly in courts, whether additional causes such as impact are required to produce injuries found in cases of (suspected) shaking. Publication rates of studies on animal and biomechanical models of inflicted head injury by shaking trauma (IHI-ST) in infants continue rising. Dissention on the topic, combined with its legal relevance, makes maintaining an up-to-date, clear and accessible overview of the current knowledge-base on IHI-ST essential. The current work reviews recent (2017-2023) studies using models of IHI-ST, serving as an update to two previously published reviews. A systematic review was conducted in Scopus and PubMed for articles using animal, physical and mathematical models for IHI-ST. Using the PRISMA methodology, two researchers independently screened the publications. Two, five, and ten publications were included on animal, physical, and mathematical models of IHI-ST, respectively. Both animal model studies used rodents. It is unknown to what degree these can accurately represent IHI-ST. Physical models were used mostly to investigate gross head-kinematics during shaking. Most mathematical models were used to study local effects on the eye and the head's internal structures. All injury thresholds and material properties used were based on scaled adult or animal data. Shaking motions used as inputs for animal, physical and mathematical models were mostly greatly simplified. Future research should focus on using more accurate shaking inputs for models, and on developing or and validating accurate injury thresholds applicable for shaking.
Collapse
Affiliation(s)
- Kim Hutchinson
- Department of BioMechanical Engineering, Faculty of Mechanical, Maritime & Materials Engineering, Delft University of Technology, Mekelweg 2, 2628, Delft, CD, Netherlands
| | - Jan Peter van Zandwijk
- Division of Digital and Biometric Traces, Netherlands Forensic Institute, Laan Van Ypenburg 6, 2497, The Hague, GB, Netherlands
| | - Marloes E M Vester
- Care Needs Assessment Centre CIZ, Orteliuslaan 1000, 3500 GR, Utrecht, Netherlands
| | - Ajay Seth
- Department of BioMechanical Engineering, Faculty of Mechanical, Maritime & Materials Engineering, Delft University of Technology, Mekelweg 2, 2628, Delft, CD, Netherlands
| | - Rob A C Bilo
- Veilig Thuis Rotterdam Rijnmond (Center for the Reporting of Child Abuse, Domestic Violence and Elder Abuse), Paul Krugerstraat 181, 3072 GJ, Rotterdam, Netherlands
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Academic Medical Center Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, Netherlands
- Department of Forensic Medicine, Netherlands Forensic Institute, Laan Van Ypenburg 6, 2497, The Hague, GB, Netherlands
| | - Arjo J Loeve
- Department of BioMechanical Engineering, Faculty of Mechanical, Maritime & Materials Engineering, Delft University of Technology, Mekelweg 2, 2628, Delft, CD, Netherlands.
| |
Collapse
|
4
|
Schoot RA, van Ewijk R, von Witzleben AA, Kao SC, Hans Merks JHM, Morosi C, Pace E, Shulkin BL, Ferrari A, von Kalle T, van Rijn RR, Weiss AR, Sparber-Sauer M, Ter Horst SAJ, Beth McCarville M. Corrigendum to "INternational Soft Tissue saRcoma ConsorTium (INSTRuCT) consensus statement: Imaging recommendations for the management of rhabdomyosarcoma" [Eur. J. Radiol. 166 (2023) 111012]. Eur J Radiol 2023; 168:111108. [PMID: 37774530 DOI: 10.1016/j.ejrad.2023.111108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Affiliation(s)
- Reineke A Schoot
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
| | - Roelof van Ewijk
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
| | - Anna-Anais von Witzleben
- Institute of Radiology Olgahospital, Zentrum für Kinder-, Jugend- und Frauenmedizin, Klinikum Stuttgart, Stuttgart, Germany.
| | - Simon C Kao
- Department of Radiology, The University of Iowa Carver College of Medicine, Iowa City, IA, USA.
| | - J H M Hans Merks
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
| | - Carlo Morosi
- Department of Radiology, Istituto Nazionale Tumori, Milan, Italy.
| | - Erika Pace
- Department of Radiology, The Royal Marsden NHS Foundation Trust, London, England, United Kingdom.
| | - Barry L Shulkin
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN, USA.
| | - Andrea Ferrari
- Pediatric Oncology Unit, Medical Oncology and Hematology Department, Istituto Nazionale Tumori, Milan, Italy.
| | - Thekla von Kalle
- Institute of Radiology Olgahospital, Zentrum für Kinder-, Jugend- und Frauenmedizin, Klinikum Stuttgart, Stuttgart, Germany.
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
| | - Aaron R Weiss
- Department of Pediatrics, Division of Pediatric Hematology-Oncology, Maine Medical Center, Portland, ME, USA.
| | - Monika Sparber-Sauer
- Klinikum der Landeshauptstadt Stuttgart gKAöR, Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Pädiatrie 5 (Pädiatrische Onkologie, Hämatologie, Immunologie), Stuttgart, Germany; University of Medicine Tübingen, Tübingen, Germany.
| | - Simone A J Ter Horst
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Department of Radiology and Nuclear Medicine, Wilhelmina Children's Hospital/University Medical Centre Utrecht, Utrecht, the Netherlands.
| | - M Beth McCarville
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN, USA.
| |
Collapse
|
5
|
van Ewijk R, Chatziantoniou C, Adams M, Bertolini P, Bisogno G, Bouhamama A, Caro-Dominguez P, Charon V, Coma A, Dandis R, Devalck C, De Donno G, Ferrari A, Fiocco M, Gallego S, Giraudo C, Glosli H, Ter Horst SAJ, Jenney M, Klein WM, Leemans A, Leseur J, Mandeville HC, McHugh K, Merks JHM, Minard-Colin V, Moalla S, Morosi C, Orbach D, Ording Muller LS, Pace E, Di Paolo PL, Perruccio K, Quaglietta L, Renard M, van Rijn RR, Ruggiero A, Sirvent SI, De Luca A, Schoot RA. Quantitative diffusion-weighted MRI response assessment in rhabdomyosarcoma: an international retrospective study on behalf of the European paediatric Soft tissue sarcoma Study Group Imaging Committee. Pediatr Radiol 2023; 53:2539-2551. [PMID: 37682330 PMCID: PMC10635937 DOI: 10.1007/s00247-023-05745-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVE To investigate the feasibility of diffusion-weighted magnetic resonance imaging (DW-MRI) as a predictive imaging marker after neoadjuvant chemotherapy in patients with rhabdomyosarcoma. MATERIAL AND METHODS We performed a multicenter retrospective study including pediatric, adolescent and young adult patients with rhabdomyosarcoma, Intergroup Rhabdomyosarcoma Study group III/IV, treated according to the European paediatric Soft tissue sarcoma Study Group (EpSSG) RMS2005 or MTS2008 studies. DW-MRI was performed according to institutional protocols. We performed two-dimensional single-slice tumor delineation. Areas of necrosis or hemorrhage were delineated to be excluded in the primary analysis. Mean, median and 5th and 95th apparent diffusion coefficient (ADC) were extracted. RESULTS Of 134 included patients, 82 had measurable tumor at diagnosis and response and DW-MRI scans of adequate quality and were included in the analysis. Technical heterogeneity in scan acquisition protocols and scanners was observed. Mean ADC at diagnosis was 1.1 (95% confidence interval [CI]: 1.1-1.2) (all ADC expressed in * 10-3 mm2/s), versus 1.6 (1.5-1.6) at response assessment. The 5th percentile ADC was 0.8 (0.7-0.9) at diagnosis and 1.1 (1.0-1.2) at response. Absolute change in mean ADC after neoadjuvant chemotherapy was 0.4 (0.3-0.5). Exploratory analyses for association between ADC and clinical parameters showed a significant difference in mean ADC at diagnosis for alveolar versus embryonal histology. Landmark analysis at nine weeks after the date of diagnosis showed no significant association (hazard ratio 1.3 [0.6-3.2]) between the mean ADC change and event-free survival. CONCLUSION A significant change in the 5th percentile and the mean ADC after chemotherapy was observed. Strong heterogeneity was identified in DW-MRI acquisition protocols between centers and in individual patients.
Collapse
Affiliation(s)
- Roelof van Ewijk
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands.
| | - Cyrano Chatziantoniou
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Image Sciences Institute, UMC Utrecht, Utrecht, The Netherlands
| | - Madeleine Adams
- Department of Paediatric Oncology, Children's Hospital for Wales, University Hospital, Cardiff, UK
| | - Patrizia Bertolini
- Pediatric Hematology-Oncology Unit University-Hospital of Parma, Parma, Italy
| | - Gianni Bisogno
- Department of Women's and Children's Health, University of Padua, Padua, Italy
- Pediatric Hematology Oncology Division, University Hospital of Padua, Padua, Italy
| | - Amine Bouhamama
- Service de Radiologie Interventionnelle Oncologique, Centre Léon Bérard, Lyon, France
| | - Pablo Caro-Dominguez
- Pediatric Radiology Unit, Department of Radiology, Hospital Universitario Virgen del Rocío, Avenida Manuel Siurot S/N, Seville, Spain
| | | | - Ana Coma
- Paediatric Radiology Unit, Vall d´Hebron Hospital Campus, Barcelona, Spain
| | - Rana Dandis
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | | | - Giulia De Donno
- Image Sciences Institute, UMC Utrecht, Utrecht, The Netherlands
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Marta Fiocco
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Mathematical Institute, Leiden University, Leiden, The Netherlands
| | - Soledad Gallego
- Pediatric Oncology Department, Vall d'Hebron Hospital, Barcelona, Spain
| | - Chiara Giraudo
- Unit of Advanced Clinical and Translational Imaging, Department of Medicine-DIMED, University of Padova, 35122, Padua, Italy
| | - Heidi Glosli
- Department of Paediatric Research, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Simone A J Ter Horst
- Department of Radiology and Nuclear Medicine, Wilhelmina Children's Hospital, UMC Utrecht, Utrecht, The Netherlands
| | - Meriel Jenney
- Paediatric Oncology, Cardiff and Vale UHB, Cardiff, UK
| | - Willemijn M Klein
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Julie Leseur
- Service de Radiothérapie, Centre Eugène Marquis, Rennes, France
| | - Henry C Mandeville
- Department of Radiotherapy, The Royal Marsden Hospital and The Institute of Cancer Research, Sutton, UK
| | - Kieran McHugh
- Department of Radiology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Johannes H M Merks
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Veronique Minard-Colin
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Salma Moalla
- Department of Imaging, Institut Gustave Roussy, Villejuif, France
| | - Carlo Morosi
- Diagnostic and Interventional Radiology, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children and AYA With Cancer), Institut Curie, PSL Research University, Paris, France
| | - Lil-Sofie Ording Muller
- Department of Radiology and Intervention Unit for Paediatric Radiology, Oslo University Hospital, Ullevål, Norway
| | - Erika Pace
- Department of Radiology, The Royal Marsden NHS Foundation Trust, London, UK
| | - Pier Luigi Di Paolo
- Department of Radiology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Katia Perruccio
- Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria, Ospedale Santa Maria Della Misericordia, Perugia, Italy
| | - Lucia Quaglietta
- Neuro-Oncology Unit, Department of Paediatric Oncology, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Marleen Renard
- Department of Paediatric Hemato-Oncology, University Hospital Leuven, Louvain, Belgium
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
| | - Antonio Ruggiero
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Sara I Sirvent
- Pediatric Radiology Department, Hospital Niño Jesús, Madrid, Spain
| | - Alberto De Luca
- Image Sciences Institute, UMC Utrecht, Utrecht, The Netherlands
- Department of Neurology, UMC Utrecht Brain Center, UMC Utrecht, Utrecht, The Netherlands
| | - Reineke A Schoot
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| |
Collapse
|
6
|
Schoot RA, van Ewijk R, von Witzleben AA, Kao SC, Merks JHMH, Morosi C, Pace E, Shulkin BL, Ferrari A, von Kalle T, van Rijn RR, Weiss AR, Sparber-Sauer M, Ter Horst SAJ, McCarville MB. INternational Soft Tissue saRcoma ConsorTium (INSTRuCT) consensus statement: Imaging recommendations for the management of rhabdomyosarcoma. Eur J Radiol 2023; 166:111012. [PMID: 37541182 DOI: 10.1016/j.ejrad.2023.111012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/19/2023] [Accepted: 07/24/2023] [Indexed: 08/06/2023]
Abstract
Rhabdomyosarcoma is the most common soft-tissue neoplasm in the pediatric population. The survival of children with rhabdomyosarcoma has only marginally improved over the past 25 years and remains poor for those with metastatic disease. A significant challenge to advances in treatment of rhabdomyosarcoma is the relative rarity of this disease, necessitating years to complete clinical trials. Progress can be accelerated by international cooperation and sharing national experiences. This necessitates agreement on a common language to describe patient cohorts and consensus standards to guide diagnosis, treatment, and response assessment. These goals formed the premise for creating the INternational Soft Tissue saRcoma ConsorTium (INSTRuCT) in 2017. Multidisciplinary members of this consortium have since developed international consensus statements on the diagnosis, treatment, and management of pediatric soft-tissue sarcomas. Herein, members of the INSTRuCT Diagnostic Imaging Working Group present international consensus recommendations for imaging of patients with rhabdomyosarcoma at diagnosis, at staging, and during and after completion of therapy. The intent is to promote a standardized imaging approach to pediatric patients with this malignancy to create more-reliable comparisons of results of clinical trials internationally, thereby accelerating progress in managing rhabdomyosarcoma and improving survival.
Collapse
Affiliation(s)
- Reineke A Schoot
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
| | - Roelof van Ewijk
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
| | - Anna-Anais von Witzleben
- Institute of Radiology Olgahospital, Zentrum für Kinder-, Jugend- und Frauenmedizin, Klinikum Stuttgart, Stuttgart, Germany.
| | - Simon C Kao
- Department of Radiology, The University of Iowa Carver College of Medicine, Iowa City, IA, USA.
| | - J H M Hans Merks
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
| | - Carlo Morosi
- Department of Radiology, Istituto Nazionale Tumori, Milan, Italy.
| | - Erika Pace
- Department of Radiology, The Royal Marsden NHS Foundation Trust, London, England, United Kingdom.
| | - Barry L Shulkin
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN, USA.
| | - Andrea Ferrari
- Pediatric Oncology Unit, Medical Oncology and Hematology Department, Istituto Nazionale Tumori, Milan, Italy.
| | - Thekla von Kalle
- Institute of Radiology Olgahospital, Zentrum für Kinder-, Jugend- und Frauenmedizin, Klinikum Stuttgart, Stuttgart, Germany.
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
| | - Aaron R Weiss
- Department of Pediatrics, Division of Pediatric Hematology-Oncology, Maine Medical Center, Portland, ME, USA.
| | - Monika Sparber-Sauer
- Klinikum der Landeshauptstadt Stuttgart gKAöR, Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Pädiatrie 5 (Pädiatrische Onkologie, Hämatologie, Immunologie), Stuttgart, Germany; University of Medicine Tübingen, Tübingen, Germany.
| | - Simone A J Ter Horst
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Department of Radiology and Nuclear Medicine, Wilhelmina Children's Hospital/University Medical Centre Utrecht, Utrecht, the Netherlands.
| | - M Beth McCarville
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN, USA.
| |
Collapse
|
7
|
Mankad K, Sidpra J, Mirsky DM, Oates AJ, Colleran GC, Lucato LT, Kan E, Kilborn T, Agrawal N, Teeuw AH, Kelly P, Zeitlin D, Carter J, Debelle GD, Berger RP, Christian CW, Lindberg DM, Raissaki M, Argyropoulou M, Adamsbaum C, Cain T, van Rijn RR, Silvera VM, Rossi A, Kemp AM, Choudhary AK, Offiah AC. International Consensus Statement on the Radiological Screening of Contact Children in the Context of Suspected Child Physical Abuse. JAMA Pediatr 2023; 177:526-533. [PMID: 36877504 DOI: 10.1001/jamapediatrics.2022.6184] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
Importance Physical abuse is a common but preventable cause of long-term childhood morbidity and mortality. Despite the strong association between abuse in an index child and abuse in contact children, there is no guidance outlining how to screen the latter, significantly more vulnerable group, for abusive injuries. Consequently, the radiological assessment of contact children is often omitted, or variably performed, allowing occult injuries to go undetected and increasing the risk of further abuse. Objective To report an evidence-based and consensus-derived set of best practices for the radiological screening of contact children in the context of suspected child physical abuse. Evidence Review This consensus statement is supported by a systematic review of the literature and the clinical opinion of an internationally recognized group of 26 experts. The modified Delphi consensus process comprised 3 meetings of the International Consensus Group on Contact Screening in Suspected Child Physical Abuse held between February and June 2021. Findings Contacts are defined as the asymptomatic siblings, cohabiting children, or children under the same care as an index child with suspected child physical abuse. All contact children should undergo a thorough physical examination and a history elicited prior to imaging. Contact children younger than 12 months should have neuroimaging, the preferred modality for which is magnetic resonance imaging, and skeletal survey. Contact children aged 12 to 24 months should undergo skeletal survey. No routine imaging is indicated in asymptomatic children older than 24 months. Follow-up skeletal survey with limited views should be performed if abnormal or equivocal at presentation. Contacts with positive findings should be investigated as an index child. Conclusions and Relevance This Special Communication reports consensus recommendations for the radiological screening of contact children in the context of suspected child physical abuse, establishing a recognized baseline for the stringent evaluation of these at-risk children and providing clinicians with a more resilient platform from which to advocate for them.
Collapse
Affiliation(s)
- Kshitij Mankad
- Department of Neuroradiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
- Developmental Biology and Cancer Section, University College London Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Jai Sidpra
- Department of Neuroradiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
- Developmental Biology and Cancer Section, University College London Great Ormond Street Institute of Child Health, London, United Kingdom
| | - David M Mirsky
- Department of Radiology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora
| | - Adam J Oates
- Department of Radiology, Birmingham Children's Hospital, Birmingham, United Kingdom
| | - Gabrielle C Colleran
- Department Radiology, Children's Health Ireland and The National Maternity Hospital, Dublin, Ireland
| | - Leandro T Lucato
- Department of Radiology, Universidade de São Paulo, Faculdade de Medicina, São Paulo, Brazil
| | - Elaine Kan
- Department of Radiology, Hong Kong Children's Hospital, Hong Kong
| | - Tracy Kilborn
- Department of Radiology, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Nina Agrawal
- City University of New York Graduate School of Public Health and Health Policy, New York
| | - Arianne H Teeuw
- Department of Pediatrics, Emma Children's Hospital-Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Patrick Kelly
- Te Puaruruhau, Starship Children's Health, Auckland, New Zealand
- Department of Pediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Deborah Zeitlin
- Department of Pediatrics, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Jamieson Carter
- Department of Pediatrics, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Geoff D Debelle
- Department of Pediatrics, Birmingham Children's Hospital, Birmingham, United Kingdom
| | - Rachel P Berger
- Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Cindy W Christian
- Department of Pediatrics, The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Daniel M Lindberg
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora
| | - Maria Raissaki
- Department of Radiology and Imaging, University Hospital of Heraklion, Medical School, University of Crete, Rethymno, Greece
| | - Maria Argyropoulou
- Department of Clinical Radiology, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Catherine Adamsbaum
- Paris Saclay University, Faculty of Medicine, AP-HP, Bicêtre Hospital, Department of Paediatric Radiology, Le Kremlin Bicêtre, France
| | - Timothy Cain
- Department of Medical Imaging, Royal Children's Hospital Melbourne, Parkville, Australia
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Emma Children's Hospital-Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Department of Forensic Medicine, Netherlands Forensic Institute, The Hague, the Netherlands
| | | | - Andrea Rossi
- Neuroradiology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Alison M Kemp
- Division of Population Medicine, Department of Child Health, University of Cardiff, Cardiff, United Kingdom
| | - Arabinda K Choudhary
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock
| | - Amaka C Offiah
- Department of Radiology, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, United Kingdom
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| |
Collapse
|
8
|
Ferrari A, Orbach D, Casanova M, van Noesel MM, Berlanga P, Brennan B, Corradini N, Schoot RA, Ramirez-Villar GL, Hjalgrim LL, Alaggio R, Guillen Burrieza G, Safwat A, Cameron AL, van Rijn RR, Minard-Colin V, Zanetti I, Bisogno G, Chisholm JC, Merks JHM. Metastatic adult-type non-rhabdomyosarcoma soft tissue sarcomas in children and adolescents: A cohort study from the European paediatric Soft tissue sarcoma Study Group. Cancer 2023. [PMID: 37084075 DOI: 10.1002/cncr.34814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/01/2023] [Accepted: 03/22/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND Limited data exist on the clinical behavior of pediatric non-rhabdomyosarcoma soft tissue sarcomas (NRSTS) with distant metastases at onset, and a clear standard of care has not yet been defined. METHODS This cohort study reports on pediatric adult-type metastatic NRSTS enrolled in two concurrent prospective European studies, i.e., the randomized BERNIE study and the single-arm MTS 2008 study developed by the European paediatric Soft tissue sarcoma Study Group. Treatment programs were originally designed for patients with metastatic rhabdomyosarcoma, i.e., nine courses of multidrug chemotherapy (with or without bevacizumab in the BERNIE study), followed by 12 cycles of maintenance therapy, whereas radiotherapy and/or surgery (on primary tumor and/or metastases) were delayed until after seven courses of chemotherapy had been administered. RESULTS The study included 61 patients <21 years old treated from July 2008 to December 2016. The lung was the site of metastases in 75% of the cases. All patients received multi-agent chemotherapy, 44% had local therapy to primary tumor, and 18% had treatment of metastases. Median time to progression/relapse was 6 months. A high rate of tumor progression was observed during the initial part of the chemotherapy program. With a median follow-up of 41.5 months (range, 2-111 months), 3-year event-free survival and overall survival were 15.4% (95% confidence interval [CI], 7.6-25.7) and 34.9% (95% CI, 22.7-47.5), respectively. There were no statistically significant differences in outcome depending on the type of treatment administered. CONCLUSIONS The study confirmed the overall poor outcome for patients with metastatic NRSTS, whose treatment remains a challenge. PLAIN LANGUAGE SUMMARY Pediatric non-rhabdomyosarcoma soft tissue sarcomas form a heterogeneous group of rare tumors. Although recent international studies have defined the standard of care for patients with localized disease, limited data are available on the clinical behavior of patients with distant metastases. This study on 61 metastatic cases treated on two prospective European protocols confirms that the chances of survival of such patients are often dismal and a standard treatment is still lacking.
Collapse
Affiliation(s)
- Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Daniel Orbach
- SIREDO Oncology Center, Institut Curie, PSL University, Paris, France
| | - Michela Casanova
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Max M van Noesel
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Pablo Berlanga
- Department of Pediatric and Adolescent Oncology, Gustave-Roussy, Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Bernadette Brennan
- Pediatric Oncology, Royal Manchester Children's Hospital, Manchester, UK
| | - Nadege Corradini
- Department of Pediatric Oncology, Institut d'Hematologie et d'Oncologie Pédiatrique,/Centre Léon Bérard, Lyon, France
| | - Reineke A Schoot
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | | | - Lisa Lyngsie Hjalgrim
- Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Rita Alaggio
- Pathology Department, Ospedale Pediatrico Bambino Gesù IRCCS, Rome, Italy
| | - Gabriela Guillen Burrieza
- Surgical Oncology and Neonatal Surgery, Pediatric Surgery Department, Hospital Infantil Universitari Vall d'Hebron, Barcelona, Spain
| | - Akmal Safwat
- Oncology Department and Danish Center for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Alison L Cameron
- Bristol Haematology and Oncology Centre, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, UMC University of Amsterdam, Amsterdam, Netherlands
| | - Veronique Minard-Colin
- Department of Pediatric and Adolescent Oncology, Gustave-Roussy, Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Ilaria Zanetti
- Pediatric Hematology Oncology Division, University Hospital of Padua, Padua, Italy
| | - Gianni Bisogno
- Pediatric Hematology Oncology Division, University Hospital of Padua, Padua, Italy
- Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Julia C Chisholm
- Children and Young People's Unit, The Royal Marsden Hospital and Institute of Cancer Research, Sutton, UK
| | - Johannes H M Merks
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
- Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| |
Collapse
|
9
|
Paddock M, Choudhary AK, Jeanes A, Mankad K, Mannes I, Raissaki M, Adamsbaum C, Argyropoulou MI, van Rijn RR, Offiah AC. Controversial aspects of imaging in child abuse: a second roundtable discussion from the ESPR child abuse taskforce. Pediatr Radiol 2023; 53:739-751. [PMID: 36879046 PMCID: PMC10027646 DOI: 10.1007/s00247-023-05618-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 03/08/2023]
Abstract
This second roundtable discussion was convened at the 56th European Society of Paediatric Radiology (ESPR) 2022 Annual Meeting in Marseille, France, to discuss controversial aspects of imaging in child abuse. The following topics were discussed: Fracture dating-the published literature is broadly similar with respect to the identification of the radiographic stages of bony healing. The non-expert/general radiologist is encouraged to use broad descriptors of fracture healing (acute, healing or old) within their reports, rather than attempting to date fractures. The more experienced/expert radiologist, who may provide a timeframe/range to assist the courts, should be aware that any published timeframes are not absolute and that recent research indicates that the rate of healing may differ according to the bone affected and the age of the patient. Whole spine imaging in suspected abusive head trauma-this is recommended to enable a complete assessment of the neuraxis when abusive head trauma is suspected or diagnosed, particularly in the presence of intracranial and cervical subdural haemorrhage and cervical ligamentous injury. Cranial imaging in suspected physical abuse-both computed tomography (CT) and magnetic resonance imaging (MRI) remain complimentary depending on the clinical context in which they are used with CT remaining first-line in the assessment of children with (suspected abusive) head trauma prior to an early MRI. MRI is superior in its assessment of parenchymal injury and may be employed as first-line in age appropriate asymptomatic siblings of a child with suspected physical abuse.
Collapse
Affiliation(s)
- Michael Paddock
- Medical Imaging Department, Perth Children's Hospital, Perth, WA, Australia.
- Division of Paediatrics, University of Western Australia, Perth, WA, Australia.
- Department of Oncology & Metabolism, University of Sheffield, Sheffield Children's NHS Foundation Trust, Sheffield, UK.
| | - Arabinda K Choudhary
- Department of Diagnostic Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Annmarie Jeanes
- Department of Paediatric Radiology, Leeds Children's Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Kshitij Mankad
- Department of Radiology, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Inès Mannes
- Paediatric Radiology Department, AP-HP, Bicêtre Hospital, Le Kremlin-Bicêtre, Paris, France
| | - Maria Raissaki
- Radiology Department, Medical School, University Hospital of Heraklion, University of Crete, Crete, Greece
| | - Catherine Adamsbaum
- Faculty of Medicine, Paris-Saclay University, Le Kremlin Bicêtre, Paris, France
| | - Maria I Argyropoulou
- Department of Radiology, Medical School, University of Ioannina, Ioannina, Greece
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Amaka C Offiah
- Department of Oncology & Metabolism, University of Sheffield, Sheffield Children's NHS Foundation Trust, Sheffield, UK
- Department of Radiology, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| |
Collapse
|
10
|
de Vries ISA, van Ewijk R, Adriaansen LME, Bohte AE, Braat AJAT, Fajardo RD, Hiemcke-Jiwa LS, Hol MLF, Ter Horst SAJ, de Keizer B, Knops RRG, Meister MT, Schoot RA, Smeele LE, van Scheltinga ST, Vaarwerk B, Merks JHM, van Rijn RR. Imaging in rhabdomyosarcoma: a patient journey. Pediatr Radiol 2023; 53:788-812. [PMID: 36843091 PMCID: PMC10027795 DOI: 10.1007/s00247-023-05596-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/06/2022] [Accepted: 01/10/2023] [Indexed: 02/28/2023]
Abstract
Rhabdomyosarcoma, although rare, is the most frequent soft tissue sarcoma in children and adolescents. It can present as a mass at nearly any site in the body, with most common presentations in the head and neck, genitourinary tract and extremities. The optimal diagnostic approach and management of rhabdomyosarcoma require a multidisciplinary team with multimodal treatment, including chemotherapy and local therapy. Survival has improved over the last decades; however, further improvement in management is essential with current 5-year overall survival ranging from 35% to 100%, depending on disease and patient characteristics. In the full patient journey, from diagnosis, staging, management to follow-up after therapy, the paediatric radiologist and nuclear physician are essential members of the multidisciplinary team. Recently, guidelines of the European paediatric Soft tissue sarcoma Study Group, the Cooperative Weichteilsarkom Studiengruppe and the Oncology Task Force of the European Society of Paediatric Radiology (ESPR), in an ongoing collaboration with the International Soft-Tissue Sarcoma Database Consortium, provided guidance for high-quality imaging. In this educational paper, given as a lecture during the 2022 postgraduate ESPR course, the multi-disciplinary team of our national paediatric oncology centre presents the journey of two patients with rhabdomyosarcoma and discusses the impact on and considerations for the clinical (paediatric) radiologist and nuclear physician. The key learning points of the guidelines and their implementation in clinical practice are highlighted and up-to-date insights provided for all aspects from clinical suspicion of rhabdomyosarcoma and its differential diagnosis, to biopsy, staging, risk stratification, treatment response assessment and follow-up.
Collapse
Affiliation(s)
| | - Roelof van Ewijk
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Laura M E Adriaansen
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Anneloes E Bohte
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Arthur J A T Braat
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Raquel Dávila Fajardo
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Radiotherapy, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Laura S Hiemcke-Jiwa
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Pathology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Marinka L F Hol
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Otorhinolaryngology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Simone A J Ter Horst
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Bart de Keizer
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Rutger R G Knops
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Michael T Meister
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Oncode Institute, Utrecht, the Netherlands
| | - Reineke A Schoot
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Ludi E Smeele
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute (NCI), Amsterdam, the Netherlands
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | | | - Bas Vaarwerk
- Department of Paediatrics, Amsterdam UMC - Emma Children's Hospital, University of Amsterdam, Amsterdam, the Netherlands
| | | | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Amsterdam UMC - Emma Children's Hospital, University of Amsterdam, Suite C1-423.1, Meibergdreef 9, 1105AZ, Amsterdam, the Netherlands.
| |
Collapse
|
11
|
Paddock M, Choudhary AK, Jeanes A, Mankad K, Mannes I, Raissaki M, Adamsbaum C, Argyropoulou MI, van Rijn RR, Offiah AC. Correction to: Controversial aspects of imaging in child abuse: a second roundtable discussion from the ESPR child abuse taskforce. Pediatr Radiol 2023; 53:1042. [PMID: 36932260 PMCID: PMC10156863 DOI: 10.1007/s00247-023-05646-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
Affiliation(s)
- Michael Paddock
- Medical Imaging Department, Perth Children's Hospital, Perth, WA, Australia.
- Division of Paediatrics, University of Western Australia, Perth, WA, Australia.
- Department of Oncology & Metabolism, University of Sheffield, Sheffield Children's NHS Foundation Trust, Sheffield, UK.
| | - Arabinda K Choudhary
- Department of Diagnostic Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Annmarie Jeanes
- Department of Paediatric Radiology, Leeds Children's Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Kshitij Mankad
- Department of Radiology, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Inès Mannes
- Paediatric Radiology Department, AP-HP, Bicêtre Hospital, Le Kremlin-Bicêtre, Paris, France
| | - Maria Raissaki
- Radiology Department, Medical School, University Hospital of Heraklion, University of Crete, Crete, Greece
| | - Catherine Adamsbaum
- Faculty of Medicine, Paris-Saclay University, Le Kremlin Bicêtre, Paris, France
| | - Maria I Argyropoulou
- Department of Radiology, Medical School, University of Ioannina, Ioannina, Greece
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Amaka C Offiah
- Department of Oncology & Metabolism, University of Sheffield, Sheffield Children's NHS Foundation Trust, Sheffield, UK
- Department of Radiology, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| |
Collapse
|
12
|
de Vries ISA, van Ewijk R, Adriaansen LME, Bohte AE, Braat AJAT, Fajardo RD, Hiemcke-Jiwa LS, Hol MLF, Ter Horst SAJ, de Keizer B, Knops RRG, Meister MT, Schoot RA, Smeele LE, van Scheltinga ST, Vaarwerk B, Merks JHM, van Rijn RR. Correction to: Imaging in rhabdomyosarcoma: a patient journey. Pediatr Radiol 2023; 53:1043. [PMID: 36930287 PMCID: PMC10156756 DOI: 10.1007/s00247-023-05642-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Affiliation(s)
| | - Roelof van Ewijk
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Laura M E Adriaansen
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Anneloes E Bohte
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Arthur J A T Braat
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Raquel Dávila Fajardo
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Radiotherapy, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Laura S Hiemcke-Jiwa
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Pathology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Marinka L F Hol
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Otorhinolaryngology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Simone A J Ter Horst
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Bart de Keizer
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Rutger R G Knops
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Michael T Meister
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Oncode Institute, Utrecht, the Netherlands
| | - Reineke A Schoot
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Ludi E Smeele
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute (NCI), Amsterdam, the Netherlands
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | | | - Bas Vaarwerk
- Department of Paediatrics, Amsterdam UMC - Emma Children's Hospital, University of Amsterdam, Amsterdam, the Netherlands
| | | | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Amsterdam UMC - Emma Children's Hospital, University of Amsterdam, Suite C1‑423.1, Meibergdreef 9, 1105AZ, Amsterdam, the Netherlands.
| |
Collapse
|
13
|
Schoot RA, Shulkin BL, van Rijn RR, von Kalle T. Pediatric Rhabdomyosarcoma Protocols Should Include More Detailed Imaging Guidelines to Ensure Homogeneous Response Assessment. J Clin Oncol 2023; 41:2337-2341. [PMID: 36758191 DOI: 10.1200/jco.22.02613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Affiliation(s)
- Reineke A Schoot
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Barry L Shulkin
- Department of Diagnostic Imaging, St Jude Children's Research Hospital, Memphis, TN
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Thekla von Kalle
- Radiological Institute, Olgahospital Klinikum Stuttgart, Stuttgart, Germany
| |
Collapse
|
14
|
Chambers G, Shelmerdine SC, Aertsen M, Dohna M, Goergen SK, Johnson K, Klein WM, Miller E, Pärtan G, Perry D, Rao P, Robinson C, Stegmann J, Taranath A, Whitby E, van Rijn RR, Arthurs OJ. Current and future funding streams for paediatric postmortem imaging: European Society of Paediatric Radiology survey results. Pediatr Radiol 2023; 53:273-281. [PMID: 36097227 PMCID: PMC9468234 DOI: 10.1007/s00247-022-05485-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/11/2022] [Accepted: 08/16/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Perinatal and childhood postmortem imaging has been accepted as a noninvasive alternative or adjunct to autopsy. However, the variation in funding models from institution to institution is a major factor prohibiting uniform provision of this service. OBJECTIVE To describe current funding models employed in European and non-European institutions offering paediatric postmortem imaging services and to discuss the perceived barriers to future postmortem imaging service provision. MATERIALS AND METHODS A web-based 16-question survey was distributed to members of the European Society of Paediatric Radiology (ESPR) and ESPR postmortem imaging task force over a 6-month period (March-August 2021). Survey questions related to the radiologic and autopsy services being offered and how each was funded within the respondent's institute. RESULTS Eighteen individual responses were received (13/18, 72.2% from Europe). Only one-third of the institutions (6/18, 33.3%) have fully funded postmortem imaging services, with the remainder receiving partial (6/18, 33.3%) or no funding (5/18, 27.8%). Funding (full or partial) was more commonly available for forensic work (13/18, 72%), particularly where this was nationally provided. Where funding was not provided, the imaging and reporting costs were absorbed by the institute. CONCLUSION Increased access is required for the expansion of postmortem imaging into routine clinical use. This can only be achieved with formal funding on a national level, potentially through health care commissioning and acknowledgement by health care policy makers and pathology services of the value the service provides following the death of a fetus or child. Funding should include the costs involved in training, equipment, reporting and image acquisition.
Collapse
Affiliation(s)
- Greg Chambers
- Department of Radiology, Clarindon Wing, B Floor, Leeds General Infirmary, Leeds Teaching Hospital Trust, Leeds, LS1 3EX, UK.
| | - Susan C Shelmerdine
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,UCL Great Ormond Street Institute of Child Health, London, UK.,NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - Michael Aertsen
- Department of Radiology, University Hospitals KU Leuven, Leuven, Belgium
| | - Martha Dohna
- Department of Paediatric Radiology, Hannover Medical School, Hannover, Germany
| | - Stacy K Goergen
- Monash Health Imaging, Clayton, VIC, Australia.,Department of Imaging, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - Karl Johnson
- Radiology Department, Birmingham Women's and Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - Willemijn M Klein
- Department of Medical Imaging, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Elka Miller
- Department of Medical Imaging, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada
| | - Gerald Pärtan
- Department of Radiology, Danube Hospital, Vienna, Austria
| | - David Perry
- Radiology Department, National Women's Health and Starship Children's Hospital, Auckland City Hospital, Auckland, New Zealand
| | - Padma Rao
- Department of Medical Imaging, Royal Children's Hospital, Melbourne, Australia
| | - Claire Robinson
- Department of Imaging, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Joachim Stegmann
- Department of Radiology, Children's Hospital Wilhelmstift gGmbH, Hamburg, Germany
| | - Ajay Taranath
- Department of Medical Imaging, Women's and Children's Hospital, North Adelaide, South Australia.,Faculty of Health and Medical Sciences, University of Adelaide, South Adelaide, Adelaide, Australia
| | - Elspeth Whitby
- University of Sheffield and Sheffield Teaching Hospitals Foundation Trust, Sheffield, UK
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - Owen J Arthurs
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,UCL Great Ormond Street Institute of Child Health, London, UK.,NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK
| |
Collapse
|
15
|
Chatziantoniou C, Schoot RA, van Ewijk R, van Rijn RR, ter Horst SAJ, Merks JHM, Leemans A, De Luca A. Methodological considerations on segmenting rhabdomyosarcoma with diffusion-weighted imaging-What can we do better? Insights Imaging 2023; 14:19. [PMID: 36720720 PMCID: PMC9889596 DOI: 10.1186/s13244-022-01351-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 12/04/2022] [Indexed: 02/02/2023] Open
Abstract
PURPOSE Diffusion-weighted MRI is a promising technique to monitor response to treatment in pediatric rhabdomyosarcoma. However, its validation in clinical practice remains challenging. This study aims to investigate how the tumor segmentation strategy can affect the apparent diffusion coefficient (ADC) measured in pediatric rhabdomyosarcoma. MATERIALS AND METHODS A literature review was performed in PubMed using search terms relating to MRI and sarcomas to identify commonly applied segmentation strategies. Seventy-six articles were included, and their presented segmentation methods were evaluated. Commonly reported segmentation strategies were then evaluated on diffusion-weighted imaging of five pediatric rhabdomyosarcoma patients to assess their impact on ADC. RESULTS We found that studies applied different segmentation strategies to define the shape of the region of interest (ROI)(outline 60%, circular ROI 27%), to define the segmentation volume (2D 44%, multislice 9%, 3D 21%), and to define the segmentation area (excludes edge 7%, excludes other region 19%, specific area 27%, whole tumor 48%). In addition, details of the segmentation strategy are often unreported. When implementing and comparing these strategies on in-house data, we found that excluding necrotic, cystic, and hemorrhagic areas from segmentations resulted in on average 5.6% lower mean ADC. Additionally, the slice location used in 2D segmentation methods could affect ADC by as much as 66%. CONCLUSION Diffusion-weighted MRI studies in pediatric sarcoma currently employ a variety of segmentation methods. Our study shows that different segmentation strategies can result in vastly different ADC measurements, highlighting the importance to further investigate and standardize segmentation.
Collapse
Affiliation(s)
- Cyrano Chatziantoniou
- grid.7692.a0000000090126352Image Sciences Institute, UMC Utrecht, Utrecht, The Netherlands ,grid.487647.ePrincess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Reineke A. Schoot
- grid.487647.ePrincess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Roelof van Ewijk
- grid.487647.ePrincess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Rick R. van Rijn
- grid.7177.60000000084992262Department of Radiology and Nuclear Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Simone A. J. ter Horst
- grid.487647.ePrincess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands ,grid.417100.30000 0004 0620 3132Department of Radiology and Nuclear Medicine, Wilhelmina Children’s Hospital UMC Utrecht, Utrecht, The Netherlands
| | - Johannes H. M. Merks
- grid.487647.ePrincess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Alexander Leemans
- grid.7692.a0000000090126352Image Sciences Institute, UMC Utrecht, Utrecht, The Netherlands
| | - Alberto De Luca
- grid.7692.a0000000090126352Image Sciences Institute, UMC Utrecht, Utrecht, The Netherlands ,grid.7692.a0000000090126352Department of Neurology, UMC Utrecht Brain Center, UMCUtrecht, Utrecht, The Netherlands
| |
Collapse
|
16
|
de Beaufort CM, Derikx JP, Robben SG, van Rijn RR, Gorter RR, van Heurn LE. Ultrasonography guided puncture and dilatation in membranous rectal atresia. Journal of Pediatric Surgery Case Reports 2022. [DOI: 10.1016/j.epsc.2022.102564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
|
17
|
Speelman AC, Engel-Hills PC, Martin LJ, van Rijn RR, Offiah AC. Postmortem computed tomography plus forensic autopsy for determining the cause of death in child fatalities. Pediatr Radiol 2022; 52:2620-2629. [PMID: 35732843 DOI: 10.1007/s00247-022-05406-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/06/2022] [Accepted: 05/14/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Postmortem computed tomography (CT) and magnetic resonance imaging have been gradually introduced to forensic pathology centres over the past two decades, with varying results in comparison to autopsy. OBJECTIVE The purpose of this study was to determine the accuracy of postmortem CT in determining a cause of death in children who died of unnatural causes. MATERIALS AND METHODS This was a prospective recruitment of 30 children (< 18 years) who underwent postmortem CT and a forensic autopsy. A cause of death was independently assigned by two experienced paediatric radiologists and compared to that of the forensic autopsy. RESULTS A correct cause of death was assigned by reviewers 1 and 2 in 70% (n = 21/30) and 67% (n = 20/30) of cases, respectively. For gunshot injuries and blunt force head injuries, there was 91% (n = 10/11) and 100% (n = 6/6) agreement between forensic autopsy and both reviewers, respectively. No cause of death could be assigned by reviewers 1 and 2 in 27% (n = 8) and 30% (n = 9) of cases, respectively. An incorrect cause of death was assigned by both reviewers in one case (3%). The Cohen Kappa level of agreement between the forensic autopsy and reviewers 1 and 2 was k = 0.624 (95% confidence interval [CI]: 0.45-0.80, P = 0) and k = 0.582 (95% CI 0.41-0.76, P = 0), respectively. There was near perfect agreement between reviewers 1 and 2 (k = 0.905) (95% CI 0.78-1.00, P = 0). CONCLUSION Postmortem CT has good diagnostic accuracy for identifying a cause of death related to trauma, but it has poor accuracy for children dying from causes not associated with apparent physical injury.
Collapse
Affiliation(s)
- Aladdin C Speelman
- Radiography (Diagnostic), Department of Medical Imaging and Therapeutic Sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Bellville, 7530, Cape Town, South Africa.
| | - Penelope C Engel-Hills
- Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Bellville, 7530, Cape Town, South Africa
| | - Lorna J Martin
- Division of Forensic Medicine & Toxicology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Forensic Medicine, Netherlands Forensic Institute, The Hague, The Netherlands
| | - Amaka C Offiah
- University of Sheffield and Sheffield Children's NHS Foundation Trust, Sheffield, UK
| |
Collapse
|
18
|
Schoot RA, Chisholm JC, Casanova M, Minard-Colin V, Geoerger B, Cameron AL, Coppadoro B, Zanetti I, Orbach D, Kelsey A, Rogers T, Guizani C, Elze M, Ben-Arush M, McHugh K, van Rijn RR, Ferman S, Gallego S, Ferrari A, Jenney M, Bisogno G, Merks JH. Metastatic Rhabdomyosarcoma: Results of the European Paediatric Soft Tissue Sarcoma Study Group MTS 2008 Study and Pooled Analysis With the Concurrent BERNIE Study. J Clin Oncol 2022; 40:3730-3740. [PMID: 35709412 PMCID: PMC9649279 DOI: 10.1200/jco.21.02981] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/25/2022] [Accepted: 05/11/2022] [Indexed: 12/02/2022] Open
Abstract
PURPOSE Outcome for patients with metastatic rhabdomyosarcoma (RMS) is poor. This study presents the results of the MTS 2008 study with a pooled analysis including patients from the concurrent BERNIE study. PATIENTS AND METHODS In MTS 2008, patients with metastatic RMS received four cycles of ifosfamide, vincristine, and actinomycin D (IVA) plus doxorubicin, five cycles of IVA, and 12 cycles of maintenance chemotherapy (low-dose cyclophosphamide and vinorelbine). The BERNIE study randomly assigned patients to the addition or not of bevacizumab to the same chemotherapy. Local therapy (surgery/radiotherapy) was given to the primary tumor and all metastatic sites when feasible. RESULTS MTS 2008 included 270 patients (median age, 9.6 years; range, 0.07-20.8 years). With a median follow-up of 50.3 months, 3-year event-free survival (EFS) and overall survival (OS) were 34.9% (95% CI, 29.1 to 40.8) and 47.9% (95% CI, 41.6 to 53.9), respectively. In pooled analyses on 372 patients with a median follow-up of 55.2 months, 3-year EFS and OS were 35.5% (95% CI, 30.4 to 40.6) and 49.3% (95% CI, 43.9 to 54.5), respectively. Patients with ≤ 2 Oberlin risk factors (ORFs) had better outcome than those with ≥ 3 ORFs: 3-year EFS was 46.1% versus 12.5% (P < .0001) and 3-year OS 60.0% versus 26.0% (P < .0001). Induction chemotherapy and maintenance appeared tolerable; however, about two third of patients needed dose adjustments during maintenance. CONCLUSION Outcome remains poor for patients with metastatic RMS and multiple ORFs. Because of the design of the studies, it was not possible to determine whether the intensive induction regimen and/or the addition of maintenance treatment resulted in apparent improvement of outcome compared with historical cohorts. Further studies, with novel treatment approaches are urgently needed, to improve outcome for the group of patients with adverse prognostic factors.
Collapse
Affiliation(s)
- Reineke A. Schoot
- Princess Máxima Centre for Paediatric Oncology, Utrecht, the Netherlands
| | - Julia C. Chisholm
- Children and Young Peoples Unit, Royal Marsden Hospital and Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Michela Casanova
- Paediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Veronique Minard-Colin
- Gustave-Roussy Cancer Campus, Department of Paediatric and Adolescent Oncology, Université Paris-Saclay, Villejuif, France
| | - Birgit Geoerger
- Gustave-Roussy Cancer Campus, Department of Paediatric and Adolescent Oncology, Université Paris-Saclay, Villejuif, France
- Gustave-Roussy Cancer Campus, INSERM U1015, Université Paris Saclay, Villejuif, France
| | - Alison L. Cameron
- Bristol Haematology and Oncology Centre, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - Beatrice Coppadoro
- Haematology Oncology Division, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Ilaria Zanetti
- Haematology Oncology Division, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Daniel Orbach
- SIREDO Oncology Center, Institut Curie, PSL University, Paris, France
| | - Anna Kelsey
- Department of Paediatric Histopathology, Royal Manchester Children's Hospital, Manchester, United Kingdom
| | - Timothy Rogers
- Department of Pediatric Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | | | - Markus Elze
- F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Myriam Ben-Arush
- Joan and Sanford Weill Pediatric Hematology Oncology and Bone Marrow Transplantation Division, Ruth Rappaport Children's Hospital, Rambam Medical Center, Haifa, Israel
| | - Kieran McHugh
- Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Rick R. van Rijn
- Department of Radiology and Nuclear Medicine, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Sima Ferman
- Instituto Nacional de Câncer, Pediatric Oncology Department, Rio de Janeiro, RJ, Brazil
| | - Soledad Gallego
- Pediatric Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Andrea Ferrari
- Paediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Meriel Jenney
- Department of Paediatric Oncology, Children's Hospital for Wales, Heath Park, Cardiff, United Kingdom
| | - Gianni Bisogno
- Haematology Oncology Division, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | | |
Collapse
|
19
|
van den Bunder FAIM, Derikx JPM, Kiblawi R, van Rijn RR, Dingemann J. Diagnostic accuracy of palpation and ultrasonography for diagnosing infantile hypertrophic pyloric stenosis: a systematic review and meta-analysis. Br J Radiol 2022; 95:20211251. [DOI: 10.1259/bjr.20211251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective: Although infantile hypertrophic pyloric stenosis (IHPS) is a well-known disease, there is no systematic review regarding the optimal diagnostic strategy. We conducted a systematic review and meta-analysis to obtain diagnostic accuracy of all methods to diagnose IHPS. Methods: According to the Preferred Reported Items for Systematic Reviews and Meta-Analysis guidelines, we searched MEDLINE and Embase to identify studies reporting sensitivity and specificity of all methods used to diagnose IHPS. Inclusion criteria were infants with suspicion of/or diagnosed with IHPS who underwent pyloromyotomy or had clinical follow-up. A random-effects model was used to obtain pooled estimates of sensitivity, specificity and area under the receiver operating characteristic curve. Results: After screening 5364 studies, we included 43 studies with in total 6085 infants (n = 4241 IHPS; n = 1844 controls). The diagnostic sensitivity of palpation ranged from 10.0 to 93.4% and decreased over time. Different parameters for ultrasonography were found. Most used parameters were pyloric muscle thickness (PMT) ≥ 3 mm (pooled sensitivity 97.6% and specificity 98.8%), PMT ≥ 4 mm (pooled sensitivity 94.0% and specificity 98.0%) or a combination of PMT ≥ 4 mm and/or pyloric canal length ≥16 mm (pooled sensitivity 94.0% and specificity 91.7%). The AUC showed high diagnostic accuracy (0.997, 0.966 and 0.981 respectively), but large heterogeneity exists. Due to the large differences in cut-off values no meta-analysis could be conducted for pyloric canal length and pyloric diameter. Conclusion: Palpation has limited sensitivity in diagnosing IHPS. We showed that ultrasonography has highest diagnostic accuracy to diagnose IHPS and we advise to use PMT ≥ 3 mm as cut-off. Advances in knowledge: This is the first systematic review and meta-analysis on diagnosing IHPS, which summarizes the available literature and may be used as a guideline.
Collapse
Affiliation(s)
- Fenne AIM van den Bunder
- Department of Pediatric Surgery, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam and Vrije Universiteit, Amsterdam, Netherlands
| | - Joep PM Derikx
- Department of Pediatric Surgery, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam and Vrije Universiteit, Amsterdam, Netherlands
| | - Rim Kiblawi
- Centre of Pediatric Surgery, Hannover Medical School, Hanover, Germany
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Emma Children’s Hospital, University of Amsterdam, Amsterdam, Netherlands
| | - Jens Dingemann
- Centre of Pediatric Surgery, Hannover Medical School, Hanover, Germany
| |
Collapse
|
20
|
van Wassenaer EA, van Rijn RR, Zwetsloot SLM, de Voogd FAE, van Schuppen J, Kindermann A, de Meij TGJ, van Limbergen JE, Gecse KB, D'Haens GR, Benninga MA, Koot BGP. Intestinal Ultrasound to Assess Ulcerative Colitis Disease Activity in Children: External Validation and Comparison of 2 Intestinal Ultrasound Activity Indices. Inflamm Bowel Dis 2022:6712311. [PMID: 36149272 PMCID: PMC10393203 DOI: 10.1093/ibd/izac197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND There is currently no consensus on the definition of an abnormal intestinal ultrasound (IUS) for children with ulcerative colitis (UC). This cross-sectional study aimed to externally validate and compare 2 existing IUS indices in children with UC. METHODS Children undergoing colonoscopy for UC assessment underwent IUS the day before colonoscopy, assessed with the Mayo endoscopic subscore. The UC-IUS index and the Civitelli index were compared with the Mayo endoscopic score in the ascending, transverse, and descending colon. The area under the receiver-operating characteristic curve for detecting a Mayo endoscopic score ≥2 of both scores was compared and sensitivity and specificity were calculated. RESULTS A total of 35 UC patients were included (median age 15 years, 39% female). The area under the receiver-operating characteristic curve was higher for the UC-IUS index in the ascending colon (0.82 [95% confidence interval (CI), 0.67-0.97] vs 0.76 [95% CI, 0.59-0.93]; P = .046) and transverse colon (0.88 [95% CI, 0.76-1.00] vs 0.77 [95% CI, 0.60-0.93]; P = .01). In the descending colon, there was no difference (0.84 [95% CI, 0.70-0.99] vs 0.84 [95% CI, 0.70-0.98]). The optimal cutoff for the UC-IUS was <1 point to rule out a Mayo endoscopic score ≥2 (sensitivity: 88%, 100%, and 90% in the ascending, transverse, and descending colon, respectively) and a Mayo endoscopic score ≥2 could be detected using a cutoff of >1 (specificity: 84%, 83%, and 87%, respectively). For the Civitelli index, in our cohort, the optimal cutoff was <1 to rule out a Mayo endoscopic score ≥2 (sensitivity 75%, 65%, and 80%, respectively) and a cutoff >1 to detect a Mayo endoscopic score ≥2 (specificity 89%, 89%, and 93%, respectively). CONCLUSIONS In this cohort, the UC-IUS index performed better than the Civitelli index. The UC-IUS index had both a high sensitivity and specificity in this cohort, when using 1 point as cutoff for a Mayo endoscopic score ≥2.
Collapse
Affiliation(s)
- Elsa A van Wassenaer
- Department of Paediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Amsterdam Gastroenterology Endocrinology Metabolism Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Sabrina L M Zwetsloot
- Department of Paediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Floris A E de Voogd
- Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlandsand
| | - Joost van Schuppen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Angelika Kindermann
- Department of Paediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Tim G J de Meij
- Department of Paediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Johan E van Limbergen
- Department of Paediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Amsterdam Gastroenterology Endocrinology Metabolism Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - K B Gecse
- Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlandsand
| | - Geert R D'Haens
- Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlandsand
| | - Marc A Benninga
- Department of Paediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Bart G P Koot
- Department of Paediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| |
Collapse
|
21
|
Kelly SM, Effeney R, Gaze MN, Bernier-Chastagner V, Blondeel A, Clementel E, Corning C, Dieckmann K, Essiaf S, Gandola L, Janssens GO, Kearns PR, Lacombe D, Lassen-Ramshad Y, Merks H, Miles E, Padovani L, Scarzello G, Schwarz R, Timmermann B, van Rijn RR, Vassal G, Boterberg T, Mandeville HC. QUARTET: A SIOP Europe project for quality and excellence in radiotherapy and imaging for children and adolescents with cancer. Eur J Cancer 2022; 172:209-220. [PMID: 35780527 DOI: 10.1016/j.ejca.2022.05.037] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/20/2022] [Accepted: 05/26/2022] [Indexed: 12/21/2022]
Abstract
The European Society for Paediatric Oncology (SIOPE) Radiation Oncology Working Group presents the QUARTET Project: a centralised quality assurance programme designed to standardise care and improve the quality of radiotherapy and imaging for international clinical trials recruiting children and adolescents with cancer throughout Europe. QUARTET combines the paediatric radiation oncology expertise of SIOPE with the infrastructure and experience of the European Organisation for Research and Treatment of Cancer to deliver radiotherapy quality assurance programmes for large, prospective, international clinical trials. QUARTET-affiliated trials include children and adolescents with brain tumours, neuroblastoma, sarcomas including rhabdomyosarcoma, and renal tumours including Wilms' tumour. With nine prospective clinical trials and two retrospective studies within the active portfolio in March 2022, QUARTET will collect one of the largest repositories of paediatric radiotherapy and imaging data, support the clinical assessment of radiotherapy, and evaluate the role and benefit of radiotherapy quality assurance for this cohort of patients within the context of clinical trials.
Collapse
Affiliation(s)
- Sarah M Kelly
- European Society for Paediatric Oncology (SIOPE), Clos Chapelle-aux-Champs 30, Brussels, Belgium; The European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Avenue E. Mounier 83, Brussels, Belgium; Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Rachel Effeney
- European Society for Paediatric Oncology (SIOPE), Clos Chapelle-aux-Champs 30, Brussels, Belgium; The European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Avenue E. Mounier 83, Brussels, Belgium
| | - Mark N Gaze
- Department of Oncology, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London, NW1 2PG, United Kingdom
| | | | - Anne Blondeel
- European Society for Paediatric Oncology (SIOPE), Clos Chapelle-aux-Champs 30, Brussels, Belgium
| | - Enrico Clementel
- The European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Avenue E. Mounier 83, Brussels, Belgium
| | - Coreen Corning
- The European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Avenue E. Mounier 83, Brussels, Belgium
| | - Karin Dieckmann
- Children's Cancer Research Institute, St Anna Kinderkrebsforschung, Medical University of Vienna, Vienna, Austria; Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria
| | - Samira Essiaf
- European Society for Paediatric Oncology (SIOPE), Clos Chapelle-aux-Champs 30, Brussels, Belgium
| | - Lorenza Gandola
- Department of Radiation Oncology, Fondazione IRCCS-Istituto Nazionale Dei Tumori, Milan, Italy
| | - Geert O Janssens
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands; Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Pamela R Kearns
- European Society for Paediatric Oncology (SIOPE), Clos Chapelle-aux-Champs 30, Brussels, Belgium; Cancer Research UK Clinical Trials Unit, National Institute for Health Research Birmingham Biomedical Research Centre, Institute of Cancer and Genomic Services, University of Birmingham, United Kingdom
| | - Denis Lacombe
- The European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Avenue E. Mounier 83, Brussels, Belgium
| | | | - Hans Merks
- Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Elizabeth Miles
- National Radiotherapy Trials Quality Assurance (RTTQA) Group, Mount Vernon Cancer Centre, United Kingdom
| | - Laetitia Padovani
- Department of Radiation Oncology, Assistance Publique Hôpitaux de Marseille, France
| | - Giovanni Scarzello
- Radiation Therapy Department, Veneto Institute of Oncology IRCCS, Padua, Italy
| | - Rudolf Schwarz
- Department of Radiation Oncology, Medical Center Hamburg-Eppendorf, Hamburg, Martinistr. 52, D 20246 Hamburg Germany
| | - Beate Timmermann
- Department of Particle Therapy, University Hospital Essen, West German Proton Therapy Centre Essen (WPE), West German Cancer Center (WTZ), Germany; German Consortium for Translational Cancer Research (DKTK), Essen, Germany
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Emma Children's Hospital - Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Gilles Vassal
- European Society for Paediatric Oncology (SIOPE), Clos Chapelle-aux-Champs 30, Brussels, Belgium; Department of Pediatric Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Tom Boterberg
- Department of Radiation Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Henry C Mandeville
- Department of Radiotherapy, The Royal Marsden Hospital and the Institute of Cancer Research, Sutton, United Kingdom
| |
Collapse
|
22
|
Ferrari A, Chisholm JC, Jenney M, Minard-Colin V, Orbach D, Casanova M, Guillen G, Glosli H, van Rijn RR, Schoot RA, Cameron AL, Rogers T, Alaggio R, Ben-Arush M, Mandeville HC, Devalck C, Defachelles AS, Coppadoro B, Bisogno G, Merks JHM. Adolescents and young adults with rhabdomyosarcoma treated in the European paediatric Soft tissue sarcoma Study Group (EpSSG) protocols: a cohort study. Lancet Child Adolesc Health 2022; 6:545-554. [PMID: 35690071 DOI: 10.1016/s2352-4642(22)00121-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/30/2022] [Accepted: 03/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Adolescent and young adult patients with rhabdomyosarcoma often have poorer outcomes than do children. We aimed to compare the findings of adolescent and young adult patients with children enrolled in two prospective clinical protocols. METHODS This retrospective observational analysis was based on data from the European paediatric Soft tissue sarcoma Study Group (EpSSG) rhabdomyosarcoma 2005 trial (phase 3 randomised trial for localised rhabdomyosarcoma, open from April, 2006, to December, 2016) and the EpSSG MTS 2008 protocol (prospective, observational, single-arm study for metastatic rhabdomyosarcoma, open from June, 2010, to December, 2016), which involved 108 centres from 14 different countries in total. For this analysis, patients were categorised according to their age into children (age 0-14 years) and adolescents and young adults (age 15-21 years). For the analysis of adherence to treatment and toxicity, only patients with high-risk localised rhabdomyosarcoma included in the randomised part of the rhabdomyosarcoma 2005 study were considered. The primary outcome of event-free survival (assessed in all participants) was defined as the time from diagnosis to the first event (eg, tumour progression, relapse) or to the latest follow-up. Secondary outcomes were overall survival, response to chemotherapy, and toxicity. FINDINGS Our analysis included 1977 patients, 1720 children (median age 4·7 years; IQR 2·6-8·4) and 257 adolescents and young adults (16·6 years; 15·8-18·0). 1719 patients were from the EpSSG rhabdomyosarcoma 2005 study (1523 aged <15 years and 196 aged 15-21 years) and 258 patients were from the EPSSG MTS 2008 study (197 aged <15 years and 61 aged 15-21 years). Adolescent and young adult patients were more likely than were children to have metastatic tumours (61 [23·7%] of 257 vs 197 [11·5%] of 1720; p<0·0001), unfavourable histological subtypes (119 [46·3%] vs 451 [26·2%]; p<0·0001), tumours larger than 5 cm (177 [68·9%] vs 891 [51·8%]; p<0·0001), and regional lymph node involvement (109 [42·4%] vs 339 [19·7%]; p<0·0001). Adolescent and young adult patients had lower 5-year event-free survival (52·6% [95% CI 46·3-58·6] vs 67·8% [65·5-70·0]; p<0·0001) and lower 5-year overall survival (57·1% [50·4-63·1] vs 77·9% [75·8-79·8]; p<0·0001) than did children. The multivariable analysis confirmed the inferior prognosis of patients aged 15-21 years (hazard ratios 1·48 [95% CI 1·20-1·83; p=0·0002] for poorer event-free survival and 1·73 [1·37-2·19; p<0·0001] for poorer overall survival). Modifications of administered chemotherapy occurred in 13 (15·3%) of 85 adolescents and young adults, and in 161 (21·4%) of 754 children. Grade 3-4 haematological toxicity and infection were observed more frequently in children than in adolescent and young adult patients. INTERPRETATION This study found better outcomes for adolescent and young adult patients than those reported in epidemiological studies (eg, the EUROCARE-5 study reported 5-year overall survival of 39·6% for patients aged 15-19 years in the 2000-07 study period), suggesting that adolescent and young adult patients, at least up to age 21 years, can be treated with intensive paediatric therapies with no major tolerability issues and should be included in paediatric rhabdomyosarcoma trials. However, the inferior outcomes in adolescent and young adult patients compared with those in children, despite receiving similar therapy, suggest that a tailored and intensive treatment strategy might be warranted for these patients. FUNDING Fondazione Città della Speranza.
Collapse
Affiliation(s)
- Andrea Ferrari
- Paediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy.
| | - Julia C Chisholm
- Children and Young People's Unit, Royal Marsden Hospital, London, UK
| | - Meriel Jenney
- Department of Paediatric Oncology, Children's Hospital for Wales, Heath Park, Cardiff, UK
| | - Veronique Minard-Colin
- Department of Paediatric and Adolescent Oncology, Gustave-Roussy, Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Daniel Orbach
- SIREDO Oncology Center, Institut Curie, PSL University, Paris, France
| | - Michela Casanova
- Paediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Gabriela Guillen
- Surgical Oncology and Neonatal Surgery, Paediatric Surgery Department, Hospital Infantil Universitari Vall d'Hebron, Barcelona, Spain
| | - Heidi Glosli
- Department of Paediatric Research, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Reineke A Schoot
- Princess Máxima Centre for Paediatric Oncology, Utrecht, The Netherlands
| | - Alison L Cameron
- Bristol Haematology and Oncology Centre, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Timothy Rogers
- Department of Paediatric Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Rita Alaggio
- Pathology Department, Ospedale Paediatrico Bambino Gesù IRCCS, Roma, Italy
| | - Myriam Ben-Arush
- Joan and Sanford Weill Paediatric Hematology Oncology and Bone Marrow Transplantation Division, Ruth Rappaport Children's Hospital, Rambam Medical Center, Haifa, Israel
| | - Henry C Mandeville
- Department of Radiotherapy, the Royal Marsden NHS Foundation Trust, and the Institute of Cancer Research, Sutton, UK
| | - Christine Devalck
- Hôpital Universitaire des Enfants Reine Fabiola ULB, Brussels, Belgium
| | | | - Beatrice Coppadoro
- Hematology Oncology Division, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Gianni Bisogno
- Hematology Oncology Division, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Johannes H M Merks
- Princess Máxima Centre for Paediatric Oncology, Utrecht, The Netherlands
| |
Collapse
|
23
|
van Rijn RR, Pajkrt D. Pediatric Abdominal US in Times of a COVID-19 Pandemic. Radiology 2022; 303:182-183. [PMID: 35312348 PMCID: PMC8961719 DOI: 10.1148/radiol.213048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
24
|
Zwetsloot SLM, de Jong JR, van Rijn RR. [A young teenager with chronic postprandial emesis]. Ned Tijdschr Geneeskd 2022; 166:D6656. [PMID: 35499608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A girl, 11 years of age, presented with progressive abdominal pain and emesis after eating since 9 months. Her blood count only showed an iron deficiency anaemia. Diagnostic work-up suggested an ileo-ileal intussusception caused by a pedunculated polyp. Diagnosis was confirmed by laparoscopic-assisted resection of the involved small bowel.
Collapse
Affiliation(s)
- Sabrina L M Zwetsloot
- Vrije Universiteit Amsterdam, Faculteit der Geneeskunde, Amsterdam
- Contact: Sabrina L.M. Zwetsloot
| | - Justin R de Jong
- Amsterdam UMC, locatie UvA, Amsterdam: Emma Kinderziekenhuis, Afd. Kinderchirurgie
| | - Rick R van Rijn
- Amsterdam UMC, locatie UvA, Amsterdam: Afd. Radiologie en Nucleaire Geneeskunde
| |
Collapse
|
25
|
Defachelles AS, Bogart E, Casanova M, Merks JHM, Bisogno G, Calareso G, Melcon SG, Gatz SA, Le Deley MC, McHugh K, Probst A, Rocourt N, van Rijn RR, Minard-Colin V, Chisholm JC. Reply to H. B et al. J Clin Oncol 2022; 40:1030-1032. [PMID: 35130027 DOI: 10.1200/jco.21.02612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Anne-Sophie Defachelles
- Anne-Sophie Defachelles, MD and Emilie Bogart, MD, Centre Oscar Lambret, Lille, France; Michela Casanova, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Johannes H.M. Merks, MD, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands; Gianni Bisogno, MD, PhD, Department of Women and Children Health, University Hospital of Padova, Padova, Italy; Giuseppina Calareso, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Soledad Gallego Melcon, MD, PhD, University Hospital Vall d'Hebron, Barcelona, Spain; Susanne Andrea Gatz, MD, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom; Marie-Cécile Le Deley, MD, Centre Oscar Lambret, Lille, France; Kieran McHugh, MD, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom; Alicia Probst, MSc, and Nathalie Rocourt, MD, Centre Oscar Lambret, Lille, France; Rick R. van Rijn, MD, PhD, Amsterdam University Medical Centers, Amsterdam, the Netherlands; Véronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM U1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Julia C. Chisholm, MD, Children and Young People's Unit, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, United Kingdom
| | - Emilie Bogart
- Anne-Sophie Defachelles, MD and Emilie Bogart, MD, Centre Oscar Lambret, Lille, France; Michela Casanova, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Johannes H.M. Merks, MD, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands; Gianni Bisogno, MD, PhD, Department of Women and Children Health, University Hospital of Padova, Padova, Italy; Giuseppina Calareso, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Soledad Gallego Melcon, MD, PhD, University Hospital Vall d'Hebron, Barcelona, Spain; Susanne Andrea Gatz, MD, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom; Marie-Cécile Le Deley, MD, Centre Oscar Lambret, Lille, France; Kieran McHugh, MD, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom; Alicia Probst, MSc, and Nathalie Rocourt, MD, Centre Oscar Lambret, Lille, France; Rick R. van Rijn, MD, PhD, Amsterdam University Medical Centers, Amsterdam, the Netherlands; Véronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM U1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Julia C. Chisholm, MD, Children and Young People's Unit, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, United Kingdom
| | - Michela Casanova
- Anne-Sophie Defachelles, MD and Emilie Bogart, MD, Centre Oscar Lambret, Lille, France; Michela Casanova, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Johannes H.M. Merks, MD, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands; Gianni Bisogno, MD, PhD, Department of Women and Children Health, University Hospital of Padova, Padova, Italy; Giuseppina Calareso, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Soledad Gallego Melcon, MD, PhD, University Hospital Vall d'Hebron, Barcelona, Spain; Susanne Andrea Gatz, MD, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom; Marie-Cécile Le Deley, MD, Centre Oscar Lambret, Lille, France; Kieran McHugh, MD, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom; Alicia Probst, MSc, and Nathalie Rocourt, MD, Centre Oscar Lambret, Lille, France; Rick R. van Rijn, MD, PhD, Amsterdam University Medical Centers, Amsterdam, the Netherlands; Véronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM U1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Julia C. Chisholm, MD, Children and Young People's Unit, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, United Kingdom
| | - Johannes H M Merks
- Anne-Sophie Defachelles, MD and Emilie Bogart, MD, Centre Oscar Lambret, Lille, France; Michela Casanova, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Johannes H.M. Merks, MD, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands; Gianni Bisogno, MD, PhD, Department of Women and Children Health, University Hospital of Padova, Padova, Italy; Giuseppina Calareso, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Soledad Gallego Melcon, MD, PhD, University Hospital Vall d'Hebron, Barcelona, Spain; Susanne Andrea Gatz, MD, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom; Marie-Cécile Le Deley, MD, Centre Oscar Lambret, Lille, France; Kieran McHugh, MD, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom; Alicia Probst, MSc, and Nathalie Rocourt, MD, Centre Oscar Lambret, Lille, France; Rick R. van Rijn, MD, PhD, Amsterdam University Medical Centers, Amsterdam, the Netherlands; Véronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM U1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Julia C. Chisholm, MD, Children and Young People's Unit, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, United Kingdom
| | - Gianni Bisogno
- Anne-Sophie Defachelles, MD and Emilie Bogart, MD, Centre Oscar Lambret, Lille, France; Michela Casanova, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Johannes H.M. Merks, MD, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands; Gianni Bisogno, MD, PhD, Department of Women and Children Health, University Hospital of Padova, Padova, Italy; Giuseppina Calareso, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Soledad Gallego Melcon, MD, PhD, University Hospital Vall d'Hebron, Barcelona, Spain; Susanne Andrea Gatz, MD, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom; Marie-Cécile Le Deley, MD, Centre Oscar Lambret, Lille, France; Kieran McHugh, MD, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom; Alicia Probst, MSc, and Nathalie Rocourt, MD, Centre Oscar Lambret, Lille, France; Rick R. van Rijn, MD, PhD, Amsterdam University Medical Centers, Amsterdam, the Netherlands; Véronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM U1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Julia C. Chisholm, MD, Children and Young People's Unit, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, United Kingdom
| | - Giuseppina Calareso
- Anne-Sophie Defachelles, MD and Emilie Bogart, MD, Centre Oscar Lambret, Lille, France; Michela Casanova, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Johannes H.M. Merks, MD, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands; Gianni Bisogno, MD, PhD, Department of Women and Children Health, University Hospital of Padova, Padova, Italy; Giuseppina Calareso, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Soledad Gallego Melcon, MD, PhD, University Hospital Vall d'Hebron, Barcelona, Spain; Susanne Andrea Gatz, MD, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom; Marie-Cécile Le Deley, MD, Centre Oscar Lambret, Lille, France; Kieran McHugh, MD, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom; Alicia Probst, MSc, and Nathalie Rocourt, MD, Centre Oscar Lambret, Lille, France; Rick R. van Rijn, MD, PhD, Amsterdam University Medical Centers, Amsterdam, the Netherlands; Véronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM U1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Julia C. Chisholm, MD, Children and Young People's Unit, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, United Kingdom
| | - Soledad Gallego Melcon
- Anne-Sophie Defachelles, MD and Emilie Bogart, MD, Centre Oscar Lambret, Lille, France; Michela Casanova, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Johannes H.M. Merks, MD, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands; Gianni Bisogno, MD, PhD, Department of Women and Children Health, University Hospital of Padova, Padova, Italy; Giuseppina Calareso, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Soledad Gallego Melcon, MD, PhD, University Hospital Vall d'Hebron, Barcelona, Spain; Susanne Andrea Gatz, MD, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom; Marie-Cécile Le Deley, MD, Centre Oscar Lambret, Lille, France; Kieran McHugh, MD, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom; Alicia Probst, MSc, and Nathalie Rocourt, MD, Centre Oscar Lambret, Lille, France; Rick R. van Rijn, MD, PhD, Amsterdam University Medical Centers, Amsterdam, the Netherlands; Véronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM U1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Julia C. Chisholm, MD, Children and Young People's Unit, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, United Kingdom
| | - Susanne Andrea Gatz
- Anne-Sophie Defachelles, MD and Emilie Bogart, MD, Centre Oscar Lambret, Lille, France; Michela Casanova, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Johannes H.M. Merks, MD, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands; Gianni Bisogno, MD, PhD, Department of Women and Children Health, University Hospital of Padova, Padova, Italy; Giuseppina Calareso, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Soledad Gallego Melcon, MD, PhD, University Hospital Vall d'Hebron, Barcelona, Spain; Susanne Andrea Gatz, MD, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom; Marie-Cécile Le Deley, MD, Centre Oscar Lambret, Lille, France; Kieran McHugh, MD, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom; Alicia Probst, MSc, and Nathalie Rocourt, MD, Centre Oscar Lambret, Lille, France; Rick R. van Rijn, MD, PhD, Amsterdam University Medical Centers, Amsterdam, the Netherlands; Véronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM U1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Julia C. Chisholm, MD, Children and Young People's Unit, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, United Kingdom
| | - Marie-Cécile Le Deley
- Anne-Sophie Defachelles, MD and Emilie Bogart, MD, Centre Oscar Lambret, Lille, France; Michela Casanova, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Johannes H.M. Merks, MD, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands; Gianni Bisogno, MD, PhD, Department of Women and Children Health, University Hospital of Padova, Padova, Italy; Giuseppina Calareso, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Soledad Gallego Melcon, MD, PhD, University Hospital Vall d'Hebron, Barcelona, Spain; Susanne Andrea Gatz, MD, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom; Marie-Cécile Le Deley, MD, Centre Oscar Lambret, Lille, France; Kieran McHugh, MD, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom; Alicia Probst, MSc, and Nathalie Rocourt, MD, Centre Oscar Lambret, Lille, France; Rick R. van Rijn, MD, PhD, Amsterdam University Medical Centers, Amsterdam, the Netherlands; Véronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM U1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Julia C. Chisholm, MD, Children and Young People's Unit, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, United Kingdom
| | - Kieran McHugh
- Anne-Sophie Defachelles, MD and Emilie Bogart, MD, Centre Oscar Lambret, Lille, France; Michela Casanova, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Johannes H.M. Merks, MD, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands; Gianni Bisogno, MD, PhD, Department of Women and Children Health, University Hospital of Padova, Padova, Italy; Giuseppina Calareso, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Soledad Gallego Melcon, MD, PhD, University Hospital Vall d'Hebron, Barcelona, Spain; Susanne Andrea Gatz, MD, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom; Marie-Cécile Le Deley, MD, Centre Oscar Lambret, Lille, France; Kieran McHugh, MD, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom; Alicia Probst, MSc, and Nathalie Rocourt, MD, Centre Oscar Lambret, Lille, France; Rick R. van Rijn, MD, PhD, Amsterdam University Medical Centers, Amsterdam, the Netherlands; Véronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM U1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Julia C. Chisholm, MD, Children and Young People's Unit, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, United Kingdom
| | - Alicia Probst
- Anne-Sophie Defachelles, MD and Emilie Bogart, MD, Centre Oscar Lambret, Lille, France; Michela Casanova, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Johannes H.M. Merks, MD, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands; Gianni Bisogno, MD, PhD, Department of Women and Children Health, University Hospital of Padova, Padova, Italy; Giuseppina Calareso, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Soledad Gallego Melcon, MD, PhD, University Hospital Vall d'Hebron, Barcelona, Spain; Susanne Andrea Gatz, MD, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom; Marie-Cécile Le Deley, MD, Centre Oscar Lambret, Lille, France; Kieran McHugh, MD, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom; Alicia Probst, MSc, and Nathalie Rocourt, MD, Centre Oscar Lambret, Lille, France; Rick R. van Rijn, MD, PhD, Amsterdam University Medical Centers, Amsterdam, the Netherlands; Véronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM U1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Julia C. Chisholm, MD, Children and Young People's Unit, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, United Kingdom
| | - Nathalie Rocourt
- Anne-Sophie Defachelles, MD and Emilie Bogart, MD, Centre Oscar Lambret, Lille, France; Michela Casanova, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Johannes H.M. Merks, MD, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands; Gianni Bisogno, MD, PhD, Department of Women and Children Health, University Hospital of Padova, Padova, Italy; Giuseppina Calareso, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Soledad Gallego Melcon, MD, PhD, University Hospital Vall d'Hebron, Barcelona, Spain; Susanne Andrea Gatz, MD, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom; Marie-Cécile Le Deley, MD, Centre Oscar Lambret, Lille, France; Kieran McHugh, MD, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom; Alicia Probst, MSc, and Nathalie Rocourt, MD, Centre Oscar Lambret, Lille, France; Rick R. van Rijn, MD, PhD, Amsterdam University Medical Centers, Amsterdam, the Netherlands; Véronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM U1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Julia C. Chisholm, MD, Children and Young People's Unit, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, United Kingdom
| | - Rick R van Rijn
- Anne-Sophie Defachelles, MD and Emilie Bogart, MD, Centre Oscar Lambret, Lille, France; Michela Casanova, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Johannes H.M. Merks, MD, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands; Gianni Bisogno, MD, PhD, Department of Women and Children Health, University Hospital of Padova, Padova, Italy; Giuseppina Calareso, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Soledad Gallego Melcon, MD, PhD, University Hospital Vall d'Hebron, Barcelona, Spain; Susanne Andrea Gatz, MD, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom; Marie-Cécile Le Deley, MD, Centre Oscar Lambret, Lille, France; Kieran McHugh, MD, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom; Alicia Probst, MSc, and Nathalie Rocourt, MD, Centre Oscar Lambret, Lille, France; Rick R. van Rijn, MD, PhD, Amsterdam University Medical Centers, Amsterdam, the Netherlands; Véronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM U1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Julia C. Chisholm, MD, Children and Young People's Unit, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, United Kingdom
| | - Véronique Minard-Colin
- Anne-Sophie Defachelles, MD and Emilie Bogart, MD, Centre Oscar Lambret, Lille, France; Michela Casanova, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Johannes H.M. Merks, MD, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands; Gianni Bisogno, MD, PhD, Department of Women and Children Health, University Hospital of Padova, Padova, Italy; Giuseppina Calareso, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Soledad Gallego Melcon, MD, PhD, University Hospital Vall d'Hebron, Barcelona, Spain; Susanne Andrea Gatz, MD, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom; Marie-Cécile Le Deley, MD, Centre Oscar Lambret, Lille, France; Kieran McHugh, MD, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom; Alicia Probst, MSc, and Nathalie Rocourt, MD, Centre Oscar Lambret, Lille, France; Rick R. van Rijn, MD, PhD, Amsterdam University Medical Centers, Amsterdam, the Netherlands; Véronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM U1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Julia C. Chisholm, MD, Children and Young People's Unit, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, United Kingdom
| | - Julia C Chisholm
- Anne-Sophie Defachelles, MD and Emilie Bogart, MD, Centre Oscar Lambret, Lille, France; Michela Casanova, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Johannes H.M. Merks, MD, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands; Gianni Bisogno, MD, PhD, Department of Women and Children Health, University Hospital of Padova, Padova, Italy; Giuseppina Calareso, MD, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Soledad Gallego Melcon, MD, PhD, University Hospital Vall d'Hebron, Barcelona, Spain; Susanne Andrea Gatz, MD, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom; Marie-Cécile Le Deley, MD, Centre Oscar Lambret, Lille, France; Kieran McHugh, MD, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom; Alicia Probst, MSc, and Nathalie Rocourt, MD, Centre Oscar Lambret, Lille, France; Rick R. van Rijn, MD, PhD, Amsterdam University Medical Centers, Amsterdam, the Netherlands; Véronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM U1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Julia C. Chisholm, MD, Children and Young People's Unit, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, United Kingdom
| |
Collapse
|
26
|
Ciancia S, van Rijn RR, Högler W, Appelman-Dijkstra NM, Boot AM, Sas TCJ, Renes JS. Osteoporosis in children and adolescents: when to suspect and how to diagnose it. Eur J Pediatr 2022; 181:2549-2561. [PMID: 35384509 PMCID: PMC9192469 DOI: 10.1007/s00431-022-04455-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 02/07/2023]
Abstract
UNLABELLED Early recognition of osteoporosis in children and adolescents is important in order to establish an appropriate diagnosis of the underlying condition and to initiate treatment if necessary. In this review, we present the diagnostic work-up, and its pitfalls, of pediatric patients suspected of osteoporosis including a careful collection of the medical and personal history, a complete physical examination, biochemical data, molecular genetics, and imaging techniques. The most recent and relevant literature has been reviewed to offer a broad overview on the topic. Genetic and acquired pediatric bone disorders are relatively common and cause substantial morbidity. In recent years, there has been significant progress in the understanding of the genetic and molecular mechanistic basis of bone fragility and in the identification of acquired causes of osteoporosis in children. Specifically, drugs that can negatively impact bone health (e.g. steroids) and immobilization related to acute and chronic diseases (e.g. Duchenne muscular dystrophy) represent major risk factors for the development of secondary osteoporosis and therefore an indication to screen for bone mineral density and vertebral fractures. Long-term studies in children chronically treated with steroids have resulted in the development of systematic approaches to diagnose and manage pediatric osteoporosis. CONCLUSIONS Osteoporosis in children requires consultation with and/or referral to a pediatric bone specialist. This is particularly relevant since children possess the unique ability for spontaneous and medication-assisted recovery, including reshaping of vertebral fractures. As such, pediatricians have an opportunity to improve bone mass accrual and musculoskeletal health in osteoporotic children. WHAT IS KNOWN • Both genetic and acquired pediatric disorders can compromise bone health and predispose to fractures early in life. • The identification of children at risk of osteoporosis is essential to make a timely diagnosis and start the treatment, if necessary. WHAT IS NEW • Pediatricians have an opportunity to improve bone mass accrual and musculoskeletal health in osteoporotic children and children at risk of osteoporosis. • We offer an extensive but concise overview about the risk factors for osteoporosis and the diagnostic work-up (and its pitfalls) of pediatric patients suspected of osteoporosis.
Collapse
Affiliation(s)
- Silvia Ciancia
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands.
| | - Rick R. van Rijn
- grid.7177.60000000084992262Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Wolfgang Högler
- grid.9970.70000 0001 1941 5140Department of Paediatrics and Adolescent Medicine, Johannes Kepler University Linz, Linz, Austria
| | - Natasha M. Appelman-Dijkstra
- grid.10419.3d0000000089452978Department of Internal Medicine, Subdivision of Endocrinology, Center for Bone Quality, Leiden University Medical Center, Leiden, The Netherlands
| | - Annemieke M. Boot
- grid.4830.f0000 0004 0407 1981Department of Pediatrics, Subdivision of Endocrinology, University Medical Center Groningen, Beatrix Children’s Hospital, University of Groningen, Groningen, The Netherlands
| | - Theo C. J. Sas
- grid.416135.40000 0004 0649 0805Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center, Sophia Children’s Hospital, Rotterdam, The Netherlands ,Diabeter, Center for Pediatric and Adult Diabetes Care and Research, Rotterdam, The Netherlands
| | - Judith S. Renes
- grid.416135.40000 0004 0649 0805Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center, Sophia Children’s Hospital, Rotterdam, The Netherlands
| |
Collapse
|
27
|
Arthurs OJ, van Rijn RR, Stafrace S, Rosendahl K. Point-of-care ultrasound: reply to Andronikou et al. and Györgyi et al. Pediatr Radiol 2022; 52:610-611. [PMID: 34559279 PMCID: PMC8461436 DOI: 10.1007/s00247-021-05183-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 08/03/2021] [Accepted: 08/11/2021] [Indexed: 12/04/2022]
Affiliation(s)
- Owen J. Arthurs
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH UK ,UCL Great Ormond Street Institute of Child Health, London, UK ,NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - Rick R. van Rijn
- Department of Radiology, Emma Children’s Hospital–Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Samuel Stafrace
- Department of Diagnostic Imaging, Sidra Medicine, Doha, Qatar ,Weill Cornell Medicine, Doha, Qatar
| | - Karen Rosendahl
- Department of Radiology, University Hospital of North Norway, Tromsø, Norway ,The Arctic University of Norway, Tromsø, Norway
| |
Collapse
|
28
|
Loos MLHJ, Bakx R, Duijst WLJM, Aarts F, de Blaauw I, Bloemers FW, Ten Bosch JA, Evers M, Greeven APA, Hondius MJ, van Hooren RLJH, Huisman E, Hulscher JBF, Keyzer-Dekker CMG, Krug E, Menke J, Naujocks T, Reijnders UJL, de Ridder VA, Spanjersberg WR, Teeuw AH, Theeuwes HP, Vervoort-Steenbakkers W, de Vries S, de Wit R, van Rijn RR. High prevalence of non-accidental trauma among deceased children presenting at Level I trauma centers in the Netherlands. Forensic Sci Med Pathol 2021; 17:621-633. [PMID: 34773580 PMCID: PMC8629892 DOI: 10.1007/s12024-021-00416-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2021] [Indexed: 11/30/2022]
Abstract
Purpose Between 0.1—3% of injured children who present at a hospital emergency department ultimately die as a result of their injuries. These events are typically reported as unnatural causes of death and may result from either accidental or non-accidental trauma (NAT). Examples of the latter include trauma that is inflicted directly or resulting from neglect. Although consultation with a forensic physician is mandatory for all deceased children, the prevalence of fatal inflicted trauma or neglect among children is currently unclear. Methods This is a retrospective study that included children (0–18 years) who presented and died at one of the 11 Level I trauma centers in the Netherlands between January 1, 2014, and January 1, 2019. Outcomes were classified based on the conclusions of the Child Abuse and Neglect team or those of forensic pathologists and/or the court in cases referred for legally mandated autopsies. Cases in which conclusions were unavailable and there was no clear accidental cause of death were reviewed by an expert panel. Results The study included 175 cases of childhood death. Seventeen (9.7%) of these children died due to inflicted trauma (9.7%), 18 (10.3%) due to neglect, and 140 (80%) due to accidents. Preschool children (< 5 years old) were significantly more likely to present with injuries due to inflicted trauma and neglect compared to older children (44% versus 6%, p < 0.001, odds ratio [OR] 5.80, 95% confidence interval [CI] 2.66–12.65). Drowning accounted for 14 of the 18 (78%) pediatric deaths due to neglect, representing 8% of the total cases. Postmortem radiological studies and autopsies were performed on 37 (21%) of all cases of childhood death. Conclusion One of every five pediatric deaths in our nationwide Level I trauma center study was attributed to NAT; 44% of these deaths were the result of trauma experienced by preschool-aged children. A remarkable number of fatal drownings were due to neglect. Postmortem radiological studies and autopsies were performed in only one-fifth of all deceased children. The limited use of postmortem investigations may have resulted in missed cases of NAT, which will result in an overall underestimation of fatal NAT experienced by children. Supplementary information The online version contains supplementary material available at 10.1007/s12024-021-00416-7.
Collapse
Affiliation(s)
- Marie-Louise H J Loos
- Amsterdam UMC, Department of Paediatric Surgery, Emma Children's Hospital, Paediatric Surgical Centre Amsterdam, University of Amsterdam & Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
| | - Roel Bakx
- Amsterdam UMC, Department of Paediatric Surgery, Emma Children's Hospital, Paediatric Surgical Centre Amsterdam, University of Amsterdam & Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Wilma L J M Duijst
- Department of Forensic Medicine, GGD IJsselland, Zwolle, the Netherlands
- Criminal Law and Criminology, Faculty of Law, Maastricht University, Maastricht, the Netherlands
| | - Francee Aarts
- Department of Forensic Medicine, GGD Nijmegen, Nijmegen, the Netherlands
| | - Ivo de Blaauw
- Department of Paediatric Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Frank W Bloemers
- Department of Trauma Surgery, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Jan A Ten Bosch
- Department of Trauma Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Martina Evers
- Department of Forensic Medicine, GGD Euregio, Enschede, the Netherlands
- Department of Surgery, Haga Teaching Hospital & Juliana Children's Hospital, The Hague, the Netherlands
| | | | | | | | - Erik Huisman
- Department of Forensic Medicine, GGD Haaglanden, The Hague, the Netherlands
- GGD Hollands-Midden, Department of Forensic Medicine, Leiden, the Netherlands
| | - Jan B F Hulscher
- Department of Surgery, Division of Paediatric Surgery, University Medical Centre Groningen, Groningen, the Netherlands
| | - Claudia M G Keyzer-Dekker
- Erasmus Medical Centre, Department of Paediatric Surgery, Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Egbert Krug
- Department of Trauma Surgery, Leiden University Medical Centre, Leiden, the Netherlands
| | - Jack Menke
- Forensisch Artsen Rotterdam-Rijnmond' (FARR), Rotterdam, the Netherlands
| | - Tatjana Naujocks
- GGD Groningen, Department of Forensic Medicine, Groningen, the Netherlands
| | - Udo J L Reijnders
- Department of Forensic Medicine, GGD Amsterdam, University of Amsterdam, Amsterdam, the Netherlands
| | - Victor A de Ridder
- Department of Paediatric Surgery, University Medical Centre Utrecht, Utrecht, the Netherlands
| | | | - Arianne H Teeuw
- Amsterdam UMC, Department of Social Paediatrics, Emma Children's Hospital, University of Amsterdam, Amsterdam, the Netherlands
| | - Hilco P Theeuwes
- Department of Trauma Surgery, Elizabeth TweeSteden Hospital, Tilburg, the Netherlands
| | | | - Selena de Vries
- Department of Forensic Medicine, Section On Forensic Paediatrics, Netherlands Forensic Institute, The Hague, The Netherlands
| | - Ralph de Wit
- Department of Trauma Surgery, Medisch Spectrum Twente, Enschede, the Netherlands
| | - Rick R van Rijn
- Department of Forensic Medicine, Section On Forensic Paediatrics, Netherlands Forensic Institute, The Hague, The Netherlands
- Amsterdam UMC, Department of Radiology and Nuclear Medicine, Emma Children's Hospital, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Center for Forensic Science and Medicine, Amsterdam, The Netherlands
| |
Collapse
|
29
|
Vaarwerk B, van Rijn RR, Merks JHM. [Follow-up imaging in children with rhabdomyosarcoma: less scans, the same yield]. Ned Tijdschr Geneeskd 2021; 165:D6044. [PMID: 34854613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Children treated for rhabdomyosarcoma are subject to protocolized follow-up imaging to detect a potential relapse earlier and to improve the chances of survival in case of a relapse. In this study we report on our findings concerning the clinical value of radiologic imaging in patients with rhabdomyosarcoma. We showed that the majority of relapses were detected by clinical symptoms, despite the frequent imaging. These results were used to define a new follow-up recommendation that was successfully implemented in the current European paediatric Soft tissue sarcoma Study Group guideline. In this new recommendation we reduced the number of radiologic imaging examinations performed after end-of-therapy by 50%, and decreased the follow-up time after end-of-therapy to 2 years.
Collapse
Affiliation(s)
- Bas Vaarwerk
- Amsterdam UMC, Emma Kinderziekenhuis, afd. Kinderoncologie, Amsterdam
- Contact: Bas Vaarwerk
| | - Rick R van Rijn
- Amsterdam UMC, Emma Kinderziekenhuis, afd. Radiologie en Nucleaire Geneeskunde, Amsterdam
| | | |
Collapse
|
30
|
Vaarwerk B, Breunis WB, Haveman LM, de Keizer B, Jehanno N, Borgwardt L, van Rijn RR, van den Berg H, Cohen JF, van Dalen EC, Merks JH. Fluorine-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) computed tomography (CT) for the detection of bone, lung, and lymph node metastases in rhabdomyosarcoma. Cochrane Database Syst Rev 2021; 11:CD012325. [PMID: 34753195 PMCID: PMC8577863 DOI: 10.1002/14651858.cd012325.pub2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Rhabdomyosarcoma (RMS) is the most common paediatric soft-tissue sarcoma and can emerge throughout the whole body. For patients with newly diagnosed RMS, prognosis for survival depends on multiple factors such as histology, tumour site, and extent of the disease. Patients with metastatic disease at diagnosis have impaired prognosis compared to those with localised disease. Appropriate staging at diagnosis therefore plays an important role in choosing the right treatment regimen for an individual patient. Fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) is a functional molecular imaging technique that uses the increased glycolysis of cancer cells to visualise both structural information and metabolic activity. 18F-FDG-PET combined with computed tomography (CT) could help to accurately stage the extent of disease in patients with newly diagnosed RMS. In this review we aimed to evaluate whether 18F-FDG-PET could replace other imaging modalities for the staging of distant metastases in RMS. OBJECTIVES To determine the diagnostic accuracy of 18F-FDG-PET/CT imaging for the detection of bone, lung, and lymph node metastases in RMS patients at first diagnosis. SEARCH METHODS We searched MEDLINE in PubMed (from 1966 to 23 December 2020) and Embase in Ovid (from 1980 to 23 December 2020) for potentially relevant studies. We also checked the reference lists of relevant studies and review articles; scanned conference proceedings; and contacted the authors of included studies and other experts in the field of RMS for information about any ongoing or unpublished studies. We did not impose any language restrictions. SELECTION CRITERIA We included cross-sectional studies involving patients with newly diagnosed proven RMS, either prospective or retrospective, if they reported the diagnostic accuracy of 18F-FDG-PET/CT in diagnosing lymph node involvement or bone metastases or lung metastases or a combination of these metastases. We included studies that compared the results of the 18F-FDG-PET/CT imaging with those of histology or with evaluation by a multidisciplinary tumour board as reference standard. DATA COLLECTION AND ANALYSIS Two review authors independently performed study selection, data extraction, and methodological quality assessement according to Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). We analysed data for the three outcomes (nodal involvement and lung and bone metastases) separately. We used data from the 2 × 2 tables (consisting of true positives, false positives, true negatives, and false negatives) to calculate sensitivity and specificity in each study and corresponding 95% confidence intervals. We did not consider a formal meta-analysis to be relevant because of the small number of studies and substantial heterogeneity between studies. MAIN RESULTS Two studies met our inclusion criteria. The diagnostic accuracy of 18F-FDG-PET/CT was reported in both studies, which included a total of 36 participants. We considered both studies to be at high risk of bias for the domain reference standard. We considered one study to be at high risk of bias for the domain index test and flow and timing. Sensitivity and specificity of 18F-FDG-PET/CT for the detection of bone metastases was 100% in both studies (95% confidence interval (CI) for sensitivity was 29% to 100% in study one and 40% to 100% in study two; 95% CI for specificity was 83% to 100% in study one and 66% to 100% in study two). The reported sensitivity of 18F-FDG-PET/CT for the detection of lung metastases was not calculated since only two participants in study two showed lung metastases, of which one was detected by 18F-FDG-PET/CT. Reported specificity was 96% in study one (95% CI 78% to 100%) and 100% (95% CI 72% to 100%) in study two. The reported sensitivity for the detection of nodal involvement was 100% (95% CI 63% to 100% in study one and 40% to 100% in study two); the reported specificity was 100% (95% CI 78% to 100%) in study one and 89% (95% CI 52% to 100%) in study two. AUTHORS' CONCLUSIONS The diagnostic accuracy of 18F-FDG-PET/CT for the detection of bone, lung, and lymph node metastases was reported in only two studies including a total of only 36 participants with newly diagnosed RMS. Because of the small number of studies (and participants), there is currently insufficient evidence to reliably determine the diagnostic accuracy of 18F-FDG-PET/CT in the detection of distant metastases. Larger series evaluating the diagnostic accuracy of 18F-FDG-PET/CT for the detection of metastases in patients with RMS are necessary.
Collapse
Affiliation(s)
- Bas Vaarwerk
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
- Department of Paediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Willemijn B Breunis
- Department of Paediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Department of Oncology and Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Lianne M Haveman
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
- Department of Paediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Bart de Keizer
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Nina Jehanno
- Department of Nuclear Medicine, Institut Curie, Paris, France
| | - Lise Borgwardt
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen , Denmark
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Henk van den Berg
- Department of Paediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Jérémie F Cohen
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre of Research in Epidemiology and Statistics (CRESS), UMR1153, Université de Paris, Paris, France
- Department of General Pediatrics and Pediatric Infectious Diseases, Necker - Enfants malades hospital, Assistance Publique - Hôpitaux de Paris, Paris Descartes University, Paris, France
| | | | - Johannes Hm Merks
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
- Department of Paediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| |
Collapse
|
31
|
Defachelles AS, Bogart E, Casanova M, Merks JHM, Bisogno G, Calareso G, Gallego Melcon S, Gatz SA, Le Deley MC, McHugh K, Probst A, Rocourt N, van Rijn RR, Wheatley K, Minard-Colin V, Chisholm JC. Randomized Phase II Trial of Vincristine-Irinotecan With or Without Temozolomide, in Children and Adults With Relapsed or Refractory Rhabdomyosarcoma: A European Paediatric Soft tissue Sarcoma Study Group and Innovative Therapies for Children With Cancer Trial. J Clin Oncol 2021; 39:2979-2990. [PMID: 34343032 DOI: 10.1200/jco.21.00124] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The VIT-0910 trial was conducted to evaluate efficacy and safety of the vincristine-irinotecan combination with and without temozolomide (VIT and VI, respectively) in relapsed or refractory rhabdomyosarcoma (RMS). METHODS In this randomized European phase II trial, patients age 0.5-50 years received 21-day cycles combining vincristine (1.5 mg/m2 once a day on day 1 and day 8) and irinotecan (50 mg/m2 once a day from day 1 to day 5) with and without temozolomide (125 mg/m2 once a day from day 1 to day 5 and 150 mg/m2 once a day from cycle 2), until progression or unacceptable toxicity. The primary end point was objective response rate after two cycles. Secondary end points included best response, progression-free survival, overall survival, and adverse events. A Simon 2-stage design was initially planned to separately analyze 40 patients/arm. After amendment, the trial sample size was increased to 120 and a comparison between arms, adjusted for confounding factors, was added to the statistical plan (ClinicalTrials.gov, NCT01355445). RESULTS Overall, 120 patients (60 per arm) were recruited in 37 European centers. The median age was 11 years (range, 0.75-45); 89% of patients had a relapsed RMS. The objective response rate was 44% (24 of 55 evaluable patients) for VIT versus 31% (18 of 58) for VI (adjusted odds ratio, 0.50; 95% CI, 0.22 to 1.12; P = .09). The VIT arm achieved significantly better overall survival (adjusted hazard ratio, 0.55; 95% CI, 0.35 to 0.84; P = .006) compared with VI, with consistent progression-free survival results (adj-hazard ratio, 0.68; 95% CI, 0.46 to 1.01; P = .059). Overall, patients experienced adverse events ≥ grade 3 more frequently with VIT than VI (98% v 78%, respectively; P = .009), including a significant excess of hematologic toxicity (81% v 61%; P = .025). CONCLUSION The addition of temozolomide to VI improved chemotherapy efficacy for patients with relapsed RMS, with manageable increase in toxicity. VIT is considered the new standard treatment in these patients in the European paediatric Soft Tissue Sarcoma Group and will be the control arm in the next randomized trial.
Collapse
Affiliation(s)
- Anne-Sophie Defachelles
- Department of Pediatric and Adolescent Oncology, INSERM U1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | | | | | | | - Gianni Bisogno
- Department of Women and Children Health, University Hospital of Padova, Padova, Italy
| | | | | | - Susanne Andrea Gatz
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom
| | | | - Kieran McHugh
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | | | | | - Rick R van Rijn
- Amsterdam University Medical Centers, Amsterdam, Netherlands
| | | | - Véronique Minard-Colin
- Department of Pediatric and Adolescent Oncology, INSERM U1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Julia C Chisholm
- Children and Young People's Unit, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, United Kingdom
| |
Collapse
|
32
|
van Wassenaer EA, Daams JG, Benninga MA, Rosendahl K, Koot BGP, Stafrace S, Arthurs OJ, van Rijn RR. Non-radiologist-performed abdominal point-of-care ultrasonography in paediatrics - a scoping review. Pediatr Radiol 2021; 51:1386-1399. [PMID: 33837798 PMCID: PMC8266706 DOI: 10.1007/s00247-021-04997-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 10/06/2020] [Accepted: 02/03/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Historically, US in the paediatric setting has mostly been the domain of radiologists. However, in the last decade, there has been an uptake of non-radiologist point-of-care US. OBJECTIVE To gain an overview of abdominal non-radiologist point-of-care US in paediatrics. MATERIALS AND METHODS We conducted a scoping review regarding the uses of abdominal non-radiologist point-of-care US, quality of examinations and training, patient perspective, financial costs and legal consequences following the use of non-radiologist point-of-care US. We conducted an advanced search of the following databases: Medline, Embase and Web of Science Conference Proceedings. We included published original research studies describing abdominal non-radiologist point-of-care US in children. We limited studies to English-language articles from Western countries. RESULTS We found a total of 5,092 publications and selected 106 publications for inclusion: 39 studies and 51 case reports or case series on the state-of-art of abdominal non-radiologist point-of-care US, 14 on training of non-radiologists, and 1 each on possible harms following non-radiologist point-of-care US and patient satisfaction. According to included studies, non-radiologist point-of-care US is increasingly used, but no standardised training guidelines exist. We found no studies regarding the financial consequences of non-radiologist point-of-care US. CONCLUSION This scoping review supports the further development of non-radiologist point-of-care US and underlines the need for consensus on who can do which examination after which level of training among US performers. More research is needed on training non-radiologists and on the costs-to-benefits of non-radiologist point-of-care US.
Collapse
Affiliation(s)
- Elsa A van Wassenaer
- Emma Children's Hospital, Amsterdam UMC, Paediatric Gastroenterology, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands. .,Amsterdam Reproduction and Development, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. .,Amsterdam Gastroenterology and Metabolism,Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| | - Joost G Daams
- Amsterdam UMC, Medical Library, University of Amsterdam, Amsterdam, The Netherlands
| | - Marc A Benninga
- Emma Children's Hospital, Amsterdam UMC, Paediatric Gastroenterology, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - Karen Rosendahl
- Department of Radiology, Section of Paediatric Radiology, University Hospital North Norway, Tromsø, Norway.,Department of Clinical Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Bart G P Koot
- Emma Children's Hospital, Amsterdam UMC, Paediatric Gastroenterology, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - Samuel Stafrace
- Division of Body imaging, Department of Diagnostic Imaging, Sidra Medicine and Weill Cornell Medicine, Doha, Qatar
| | - Owen J Arthurs
- Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,NIHR Great Ormond Street Biomedical Research Centre, London, UK
| | - Rick R van Rijn
- Amsterdam UMC, Radiology, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
33
|
Tacke CE, Terheggen-Lagro SWJ, Boot AM, Plomp AS, Polstra AM, van Rijn RR, Struijs PAA, van den Berg H, Mooij CF. Chondrodysplasia, enchondromas and a chest deformity causing severe pulmonary morbidity in a boy with a PTHLH duplication: A case report. Bone Rep 2021; 14:101067. [PMID: 33981811 PMCID: PMC8085669 DOI: 10.1016/j.bonr.2021.101067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/08/2021] [Accepted: 04/12/2021] [Indexed: 10/26/2022] Open
Abstract
Parathyroid hormone-like hormone (PTHLH) plays an important role in bone formation. Several skeletal dysplasias have been described that are associated with disruption of PTHLH functioning. Here we report on a new patient with a 898 Kb duplication on chromosome 12p11.22 including the PTHLH gene. The boy has multiple skeletal abnormalities including chondrodysplasia, lesions radiographically resembling enchondromas and posterior rib deformities leading to a severe chest deformity. Severe pulmonary symptoms were thought to be caused by limited mobility and secondary sputum evacuation problems due to the chest deformity. Imaging studies during follow-up revealed progression of the number of skeletal lesions over time. This case extends the phenotypic spectrum associated with copy number variation of PTHLH.
Collapse
Affiliation(s)
- Carline E Tacke
- Department of Pediatric Endocrinology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Suzanne W J Terheggen-Lagro
- Department of Pediatric Pulmonology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Annemieke M Boot
- Department of Pediatric Endocrinology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Astrid S Plomp
- Department of Clinical Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Abeltje M Polstra
- Department of Clinical Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Peter A A Struijs
- Department of Orthopedic Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Henk van den Berg
- Department of Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Christiaan F Mooij
- Department of Pediatric Endocrinology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| |
Collapse
|
34
|
Whitby E, Offiah AC, Shelmerdine SC, van Rijn RR, Aertsen M, Klein WM, Perry D, Goergen SK, Abel C, Taranath A, Gascho D, Miller E, Arthurs OJ. Current state of perinatal postmortem magnetic resonance imaging: European Society of Paediatric Radiology questionnaire-based survey and recommendations. Pediatr Radiol 2021; 51:792-799. [PMID: 33367939 PMCID: PMC8055569 DOI: 10.1007/s00247-020-04905-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 09/02/2020] [Accepted: 11/09/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Postmortem magnetic resonance imaging (MRI) in perinatal and childhood deaths is increasingly used as a noninvasive adjunct or alternative to autopsy. Imaging protocols vary between centres and consensus guidelines do not exist. OBJECTIVE Our aim was to develop practical, standardised recommendations for perinatal postmortem MRI. MATERIALS AND METHODS Recommendations were based on the results of two surveys regarding local postmortem MRI practices sent electronically to all 14 members of the European Society of Paediatric Radiology (ESPR) Postmortem Imaging Task Force and 17 members of the International Society of Forensic Radiology and Imaging Task Force (25 different centres). RESULTS Overall, 11/14 (78.6%) respondents from different institutions perform postmortem MRI. All of these centres perform postmortem MRI for perinatal and neonatal deaths, but only 6/11 (54.5%) perform imaging in older children. CONCLUSION We propose a clinical standard for postmortem MRI sequences plus optional sequences for neuroimaging and cardiac anatomy depending on available scanning time and referral indications.
Collapse
Affiliation(s)
- Elspeth Whitby
- University of Sheffield and Sheffield Teaching Hospitals Foundation Trust, Jessop Wing, Tree Root Walk, Sheffield, S10 1SF, UK.
| | - Amaka C. Offiah
- Academic Unit of Child Health, University of Sheffield, Sheffield, UK ,Department of Radiology, Sheffield Children’s NHS Foundation Trust, University of Sheffield, Sheffield, UK
| | - Susan C. Shelmerdine
- Department of Clinical Radiology, Great Ormond Street Hospital for Children, London, UK ,UCL Great Ormond Street Institute of Child Health, London, UK
| | - Rick R. van Rijn
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Michael Aertsen
- Department of Radiology, University Hospitals KU Leuven, Leuven, Belgium
| | - Willemijn M. Klein
- Department of Radiology and Nuclear Medicine and Anatomy, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - David Perry
- Radiology Department, National Women’s Health and Starship Children’s Hospital, Auckland City Hospital, Auckland, New Zealand
| | - Stacy K. Goergen
- Monash Imaging, Clayton, Victoria Australia ,School of Clinical Sciences, Monash University, Clayton, Victoria Australia
| | - Christian Abel
- Department of Medical Imaging, John Hunter Hospital, Newcastle, New South Wales Australia
| | - Ajay Taranath
- Department of Medical Imaging, Women’s and Children’s Hospital, North Adelaide, South Australia Australia ,University of Adelaide, Adelaide, South Australia Australia
| | - Dominic Gascho
- Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Elka Miller
- Department of Medical Imaging, Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada
| | - Owen J. Arthurs
- Department of Clinical Radiology, Great Ormond Street Hospital for Children, London, UK ,UCL Great Ormond Street Institute of Child Health, London, UK
| |
Collapse
|
35
|
van Ham K, van Delft S, Brilleslijper-Kater SN, van Rijn RR, van Goudoever JB, van der Lee JH, Teeuw AH. Reactions of non-abused children aged 3-9 years to the Sexual Knowledge Picture Instrument: an interview-based study. BMJ Paediatr Open 2021; 5:e001128. [PMID: 34595357 PMCID: PMC8424862 DOI: 10.1136/bmjpo-2021-001128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/08/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The Sexual Knowledge Picture Instrument (SKPI) is a child-friendly picture book that was developed as a diagnostic tool for sexual abuse in young children and is currently being validated. The aim of the current study was to explore the verbal and non-verbal reactions of non-abused Dutch children, aged 3-9 years, to the SKPI and to assess differences in reactions between genders and age groups. METHODS AND ANALYSIS Subject recruitment took place at preschools and primary schools. All children underwent a recorded video semi-structured interview with the SKPI. Interview recordings were scored by an independent rater who used scoring lists for verbal and non-verbal reactions. Non-parametric tests were used in statistical analyses. RESULTS Of the 90 children (median age 5 years) participating in the study, most correctly named the genitals and their non-sexual functions. Only 34 showed an understanding of the picture depicting adult sexuality, with just one child describing a sexual function. Girls (n=45) gave more correct answers (median 87%) than boys (n=45, median 78%; p=0.006). Giggling was the most frequently observed non-verbal reaction, with a total of 186 instances in 54 children. CONCLUSION Non-abused children up to 9 years of age showed only limited knowledge of the sexual function of the genitals and hardly any insight into adult sexuality.
Collapse
Affiliation(s)
- Kirsten van Ham
- Paediatrics, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands
| | - Sanne van Delft
- Paediatrics, Erasmus MC Sophia Children Hospital, Rotterdam, The Netherlands
| | | | - Rick R van Rijn
- Paediatric Radiology, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands
| | | | | | - Arianne H Teeuw
- Paediatrics, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands
| |
Collapse
|
36
|
Loos MLHJ, Allema WM, Bakx R, Stoel RD, van Rijn RR, Karst WA. Paediatric femur fractures-the value of contextual information on judgement in possible child abuse cases: are we bias? Eur J Pediatr 2021; 180:81-90. [PMID: 32556507 PMCID: PMC7782380 DOI: 10.1007/s00431-020-03704-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 05/19/2020] [Accepted: 05/22/2020] [Indexed: 12/30/2022]
Abstract
The majority of paediatric femur fractures result from accidental trauma; however, it is important to consider non-accidental trauma, especially in pre-ambulatory children. We study whether irrelevant contextual information subconsciously influences conclusions of healthcare professionals with respect to whether observations provide evidence for non-accidental trauma. A survey with nine radiographs of femur shaft fractures was designed. Two different clinical histories (vignettes) with contextual information were designed, non-abuse versus abuse context. One of both vignettes was randomly assigned to the radiograph shown to the participant, followed by a question with a 5-point answer scale, which represents a verbal expression of the likelihood ratio of the fracture regarding a non-accidental versus accidental cause. Participants were medical residents and staff members of different specialties from several Dutch hospitals. A total of 172 participants responded. The reported evidential strength of the vignettes with a non-abuse context was 0.19 (n = 784; 95%CI 0.10-0.28) and for the abuse context 0.94 (n = 764; 95%CI 0.86-1.02; p < 0.001). Women reported a stronger evidential strength than men, but both were influenced by context. Emergency department and paediatric doctors were more likely to decide that non-accidental trauma was the cause; paediatric radiologists were the least likely. Experience in years of practice and current function did not prevent participants from being bias.Conclusion: This study shows that the interpretation of medical results by healthcare professionals can be influenced by contextual information, such as low income and marital status, which are irrelevant to the decision as to whether abuse might have occurred. Given the same information about an injury, women, emergency department and paediatric doctors were more likely to decide that non-accidental trauma was the cause, while paediatric radiologists were least likely to decide this outcome. It is important to prevent contextual influence as much as possible, by recognizing it and implementing a management contextual information procedure. What is Known: • Contextual information is of possible influence on healthcare professionals in identifying non-accidental trauma. • Increased working experience is thought to be protective against this influence. What is New: • Contextual information influenced the interpretation of medical results by healthcare professionals regardless of work experience. • The interpretation of medical results by healthcare professionals is influenced by both affirmative and negative contextual information.
Collapse
Affiliation(s)
- Marie-Louise H. J. Loos
- Department of Paediatric Surgery, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam & Vrije Universiteit Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Wies M. Allema
- Department of Paediatric Surgery, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam & Vrije Universiteit Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Roel Bakx
- Department of Paediatric Surgery, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam & Vrije Universiteit Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Reinoud D. Stoel
- Division Specialist Services and Expertise, Team Forensic Statistics, Netherlands Forensic Institute, PO Box 24044, 2490 AA The Hague, The Netherlands
| | - Rick R. van Rijn
- Department of Paediatric Surgery, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam & Vrije Universiteit Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands ,Department of Forensic Medicine, Section on Forensic Paediatrics, Netherlands Forensic Institute, PO Box 24044, 2490 AA The Hague, The Netherlands
| | - Wouter A. Karst
- Department of Forensic Medicine, Section on Forensic Paediatrics, Netherlands Forensic Institute, PO Box 24044, 2490 AA The Hague, The Netherlands
| |
Collapse
|
37
|
van Rijn RR, Stafrace S, Arthurs OJ, Rosendahl K. Non-radiologist-performed point-of-care ultrasonography in paediatrics - European Society of Paediatric Radiology position paper. Pediatr Radiol 2021; 51:161-167. [PMID: 33211186 PMCID: PMC7796864 DOI: 10.1007/s00247-020-04843-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/07/2020] [Accepted: 09/07/2020] [Indexed: 12/22/2022]
Abstract
Non-radiologist point-of-care ultrasonography (US) is increasingly implemented in paediatric care because it is believed to facilitate a timely diagnosis, such as in ascites or dilated renal pelvicalyceal systems, and can be used to guide interventional procedures. To date, all policy statements have been published by non-radiologic societies. The European Society of Paediatric Radiology hereby issues a position statement on paediatric non-radiologist point-of-care US from the point of view of those leading on children's imaging, i.e. paediatric radiologists. In this position statement, we will address the boundaries, education, credentialing, quality control, reporting and storage of images in paediatric practice.
Collapse
Affiliation(s)
- Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Emma Children's Hospital-Amsterdam UMC, University of Amsterdamn, Meibergdreef 9, 1105 AZ, Amsterdam Zuid-Oost, the Netherlands.
| | - Samuel Stafrace
- Department of Diagnostic Imaging, Sidra Medicine, Doha, Qatar
- Weill Cornell Medicine, Doha, Qatar
| | - Owen J Arthurs
- Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
- UCL GOS Institute of Child Health, London, UK
- NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - Karen Rosendahl
- Department of Radiology, University Hospital of North Norway, Tromsø, Norway
- The Arctic University of Norway, Tromsø, Norway
| |
Collapse
|
38
|
De Tobel J, van Wijk M, Alberink I, Hillewig E, Phlypo I, van Rijn RR, Thevissen PW, Verstraete KL, de Haas MB. The influence of motion artefacts on magnetic resonance imaging of the clavicles for age estimation. Int J Legal Med 2020; 134:753-768. [PMID: 31915965 DOI: 10.1007/s00414-019-02230-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE To determine how motion affects stage allocation to the clavicle's sternal end on MRI. MATERIALS AND METHODS Eighteen volunteers (9 females, 9 males) between 14 and 30 years old were prospectively scanned with 3-T MRI. One resting-state scan was followed by five intentional motion scans. Additionally, a control group of 72 resting-state scans were selected from previous research. Firstly, six observers allocated developmental stages to the clavicles independently. Secondly, they re-assessed the images, allocating developmental statuses (immature, mature). Finally, the resting-state scans of the 18 volunteers were assessed in consensus to decide on the "correct" stage/status. Results were compared between groups (control, prospective resting state, prospective motion), and between staging techniques (stages/statuses). RESULTS Inter-observer agreement was low (Krippendorff α 0.23-0.67). The proportion of correctly allocated stages (64%) was lower than correctly allocated statuses (83%). Overall, intentional motion resulted in fewer assessable images and less images of sufficient evidential value. The proportion of correctly allocated stages did not differ between resting-state (64%) and motion scans (65%), while correctly allocated statuses were more prevalent in resting-state scans (83% versus 77%). Remarkably, motion scans did not render a systematically higher or lower stage/status, compared to the consensus. CONCLUSION Intentional motion impedes clavicle MRI for age estimation. Still, in case of obvious disturbances, the forensic expert will consider the MRI unsuitable as evidence. Thus, the development of the clavicle as such and the staging technique seem to play a more important role in allocating a faulty stage for age estimation.
Collapse
Affiliation(s)
- Jannick De Tobel
- Department of Diagnostic Sciences - Radiology, Ghent University, Ghent, Belgium. .,Department of Imaging and Pathology - Forensic Odontology, KU Leuven, Leuven, Belgium. .,Department of Oral Diseases and Maxillofacial Surgery, Maastricht UMC+, Maastricht, The Netherlands. .,Department of Oral and Maxillofacial Surgery, Leuven University Hospitals, Leuven, Belgium.
| | - Mayonne van Wijk
- Division of Special Services and Expertise, Section of Forensic Anthropology, Netherlands Forensic Institute, The Hague, The Netherlands
| | - Ivo Alberink
- Division of Special Services and Expertise, Section of Forensic Anthropology, Netherlands Forensic Institute, The Hague, The Netherlands
| | - Elke Hillewig
- Department of Diagnostic Sciences - Radiology, Ghent University, Ghent, Belgium
| | - Inès Phlypo
- Department of Oral Health Sciences - Special Needs in Dentistry, Ghent University, Ghent, Belgium
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | | | - Michiel Bart de Haas
- Division of Special Services and Expertise, Section of Forensic Anthropology, Netherlands Forensic Institute, The Hague, The Netherlands
| |
Collapse
|
39
|
Loos MLHJ, Ahmed T, Bakx R, van Rijn RR. Prevalence and distribution of occult fractures on skeletal surveys in children with suspected non-accidental trauma imaged or reviewed in a tertiary Dutch hospital. Pediatr Surg Int 2020; 36:1009-1017. [PMID: 32591847 PMCID: PMC7385004 DOI: 10.1007/s00383-020-04706-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/17/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE The purpose of the study was to determine the rate of occult fractures (without clinical symptoms) per presenting clinical injury i.e., children presenting with a fracture, bruise, abusive head trauma and the types of fracture most likely to be found, in a series of infants and young children suspected of being victims of NAT. METHODS Skeletal surveys done between 2008 and 2018 of children (< 5 years) were retrospectively analyzed. Both radiographs of admitted children and reassessment images from all over the country were included and reviewed by a forensic paediatric radiologist. Deceased children were excluded. Variables as gender, age, initial clinical injury and occult fractures were collected. Occult fractures on the follow-up skeletal survey were collected. RESULTS A total of 370 skeletal surveys of 296 children were included. Median age was 22 weeks (IQR 11-48), there were 172 (58%) boys. A total of 195 occult fractures were detected in 111 (32%) children. Occult fractures were detected in 37/126 (29%) children with fracture as presenting symptom, 33/90 (37%) children with head trauma and 26/50 (52%) children with bruises. Rib (n = 56, 50%) and lower leg (n = 40, 36%) fractures were most detected. CONCLUSION Occult fractures were detected in 32% of the children. Occult fractures were most prevalent if the initial clinical injury suggestive for NAT to request skeletal survey was a bruise, abusive head trauma or fracture.
Collapse
Affiliation(s)
- Marie-Louise H J Loos
- Amsterdam UMC, Department of Paediatric Surgery, Emma Children's Hospital, University of Amsterdam and Vrije Universiteit Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
| | - Tayiba Ahmed
- Amsterdam UMC, Department of Radiology and Nuclear Medicine, Emma Children's Hospital, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - Roel Bakx
- Amsterdam UMC, Department of Paediatric Surgery, Emma Children's Hospital, University of Amsterdam and Vrije Universiteit Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - Rick R van Rijn
- Amsterdam UMC, Department of Radiology and Nuclear Medicine, Emma Children's Hospital, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.,Department of Forensic Medicine, Section On Forensic Paediatrics, Netherlands Forensic Institute, PO Box 24044, 2490 AA, The Hague, The Netherlands
| |
Collapse
|
40
|
Vester MEM, Nolte KB, Hatch GM, Gerrard CY, Stoel RD, van Rijn RR. Postmortem Computed Tomography in Firearm Homicides: A Retrospective Case Series. J Forensic Sci 2020; 65:1568-1573. [PMID: 32402110 PMCID: PMC7496672 DOI: 10.1111/1556-4029.14453] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 04/16/2020] [Accepted: 04/17/2020] [Indexed: 11/30/2022]
Abstract
Postmortem computed tomography (PMCT) is integrated into the evaluation of decedents in several American medical examiner offices and medicolegal death investigative centers in many other countries. We retrospectively investigated the value of PMCT in a series of firearm homicide cases from a statewide centralized medical examiner’s office that occurred during 2016. Autopsies were performed or supervised by board‐certified forensic pathologists who reviewed the PMCT scans prior to autopsy. PMCT scans were re‐evaluated by a forensic radiologist blinded to the autopsy findings and scored by body region (head–neck, thoracoabdominal, and extremities). Injury discrepancies were scored using a modified Goldman classification and analyzed with McNemar’s test. We included 60 males and 20 females (median age 31 years, range 3–73). Based on PMCT, 56 (79.1%) cases had injuries relevant to the cause of death in a single body region (24 head–neck region, 32 thoracoabdominal region). Out of these 56 cases, 9 had a missed major diagnosis by PMCT outside that region, including 6 extremity injuries visible during standard external examination. Yet all had evident lethal firearm injury. We showed that PMCT identifies major firearm injuries in homicide victims and excludes injuries related to the cause of death in other regions when a single body region is injured. Although PMCT has a known limited sensitivity for soft tissue and vascular pathology, it can be combined with external examination to potentially reduce or focus dissections in some of these cases depending on the circumstances and medicolegal needs.
Collapse
Affiliation(s)
- Marloes E M Vester
- Department of Forensic Medicine, Netherlands Forensic Institute, Laan van Ypenburg 6, 2497 GB, The Hague, The Netherlands.,Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Kurt B Nolte
- Office of the Medical Investigator, University of New Mexico School of Medicine, 1101 Camino de Salud, Albuquerque, NM, 87102
| | - Gary M Hatch
- Office of the Medical Investigator, University of New Mexico School of Medicine, 1101 Camino de Salud, Albuquerque, NM, 87102
| | - Chandra Y Gerrard
- Office of the Medical Investigator, University of New Mexico School of Medicine, 1101 Camino de Salud, Albuquerque, NM, 87102
| | - Reinoud D Stoel
- Department of Forensic Medicine, Netherlands Forensic Institute, Laan van Ypenburg 6, 2497 GB, The Hague, The Netherlands
| | - Rick R van Rijn
- Department of Forensic Medicine, Netherlands Forensic Institute, Laan van Ypenburg 6, 2497 GB, The Hague, The Netherlands.,Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| |
Collapse
|
41
|
Ferrari A, Merks JH, Chisholm JC, Orbach D, Brennan B, Gallego S, van Noesel MM, McHugh K, van Rijn RR, Gaze MN, Martelli H, Bergeron C, Corradini N, Minard-Colin V, Bisogno G, Geoerger B, Caron HN, De Salvo GL, Casanova M. Outcomes of metastatic non-rhabdomyosarcoma soft tissue sarcomas (NRSTS) treated within the BERNIE study: a randomised, phase II study evaluating the addition of bevacizumab to chemotherapy. Eur J Cancer 2020; 130:72-80. [DOI: 10.1016/j.ejca.2020.01.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 01/09/2020] [Accepted: 01/27/2020] [Indexed: 11/16/2022]
|
42
|
Affiliation(s)
- Rick R van Rijn
- From the Department of Radiology and Nuclear Medicine, Emma Children's Hospital-Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands (R.R.v.R.); Department of Neurology, Brain Center Rudolf Magnus, UMC Utrecht, Utrecht, the Netherlands (A.D.L.); and Image Sciences Institute, UMC Utrecht, Utrecht, the Netherlands (A.D.L.)
| | - Alberto De Luca
- From the Department of Radiology and Nuclear Medicine, Emma Children's Hospital-Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands (R.R.v.R.); Department of Neurology, Brain Center Rudolf Magnus, UMC Utrecht, Utrecht, the Netherlands (A.D.L.); and Image Sciences Institute, UMC Utrecht, Utrecht, the Netherlands (A.D.L.)
| |
Collapse
|
43
|
van Wassenaer EA, de Voogd FAE, van Rijn RR, van der Lee JH, Tabbers MM, van Etten-Jamaludin FS, Kindermann A, de Meij TGJ, Gecse KB, D’Haens GR, Benninga MA, Koot BGP. Bowel ultrasound measurements in healthy children - systematic review and meta-analysis. Pediatr Radiol 2020; 50:501-508. [PMID: 31838567 PMCID: PMC7067709 DOI: 10.1007/s00247-019-04567-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 09/13/2019] [Accepted: 10/30/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Ultrasound (US) is a noninvasive method of assessing the bowel that can be used to screen for bowel pathology, such as Inflammatory Bowel Disease, in children. Knowledge about US findings of the bowel in healthy children is important for interpreting US results in cases where disease is suspected. OBJECTIVE To assess the bowel wall thickness in different bowel segments in healthy children and to assess differences in bowel wall thickness among pediatric age categories. MATERIALS AND METHODS We conducted a systematic search in the PubMed, Embase, Cochrane, and CINAHL databases for studies describing bowel wall thickness measured by transabdominal US in healthy children. We excluded studies using contrast agent. We calculated the pooled mean and standard deviation scores and assessed differences among age categories (0-4 years, 5-9 years, 10-14 years, 15-18 years), first with analysis of variance (ANOVA) and further with subsequent Student's t-tests for independent samples, corrected for multiple testing. RESULTS We identified 191 studies and included 7 of these studies in the systematic review. Reported bowel wall thickness values ranged from 0.8 mm to 1.9 mm in the small bowel and from 1.0 mm to 1.9 mm in the colon. The mean colonic bowel wall thickness is larger in children ages 15-19 years compared to 0-4 years (range in difference: 0.3-0.5 mm [corrected P<0.02]). CONCLUSION The reported upper limit of bowel wall thickness in healthy children is 1.9 mm in the small bowel and the colon, and mean thickness increases slightly with age in jejunum and colon. These values can be used as guidance when screening for bowel-related pathology in children.
Collapse
Affiliation(s)
- Elsa A. van Wassenaer
- grid.7177.60000000084992262Pediatric Gastroenterology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Floris A. E. de Voogd
- grid.7177.60000000084992262Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Rick R. van Rijn
- grid.7177.60000000084992262Radiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Johanna H. van der Lee
- grid.7177.60000000084992262Pediatric Clinical Research Office, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands ,Knowledge Institute of the Dutch Association of Medical Specialists, Utrecht, the Netherlands
| | - Merit M. Tabbers
- grid.7177.60000000084992262Pediatric Gastroenterology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | | | - Angelika Kindermann
- grid.7177.60000000084992262Pediatric Gastroenterology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Tim G. J. de Meij
- grid.12380.380000 0004 1754 9227Pediatric Gastroenterology Emma Children’s Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - K. B. Gecse
- grid.7177.60000000084992262Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Geert R. D’Haens
- grid.7177.60000000084992262Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marc A. Benninga
- grid.7177.60000000084992262Pediatric Gastroenterology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Bart G. P. Koot
- grid.7177.60000000084992262Pediatric Gastroenterology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| |
Collapse
|
44
|
van Wassenaer EA, de Voogd FAE, van Rijn RR, van der Lee JH, Tabbers MM, van Etten-Jamaludin FS, Gecse KB, Kindermann A, de Meij TGJ, D’Haens GR, Benninga MA, Koot BGP. Diagnostic Accuracy of Transabdominal Ultrasound in Detecting Intestinal Inflammation in Paediatric IBD Patients-a Systematic Review. J Crohns Colitis 2019; 13:1501-1509. [PMID: 31329839 PMCID: PMC7142400 DOI: 10.1093/ecco-jcc/jjz085] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Currently used non-invasive tools for monitoring children with inflammatory bowel disease [IBD], such as faecal calprotectin, do not accurately reflect the degree of intestinal inflammation and do not provide information on disease location. Ultrasound [US] might be of added value. This systematic review aimed to assess the diagnostic test accuracy of transabdominal US in detecting intestinal inflammation in children with IBD in both diagnostic and follow-up settings. METHODS We systematically searched PubMed, Embase [Ovid], Cochrane Library, and CINAHL [EBSCO] databases for studies assessing diagnostic accuracy of transabdominal US for detection of intestinal inflammation in patients diagnosed or suspected of IBD, aged 0-18 years, with ileo-colonoscopy and/or magnetic resonance enterography [MRE] as reference standards. Studies using US contrast were excluded. Risk of bias was assessed with QUADAS-2. RESULTS The search yielded 276 records of which 14 were included. No meta-analysis was performed, because of heterogeneity in study design and methodological quality. Only four studies gave a clear description of their definition for an abnormal US result. The sensitivity and specificity of US ranged from 39-93% and 90-100% for diagnosing de novo IBD, and 48-93% and 83-93% for detecting active disease during follow-up, respectively. CONCLUSIONS The diagnostic accuracy of US in detecting intestinal inflammation as seen on MRE and/or ileo-colonoscopy in paediatric IBD patients remains inconclusive, and there is currently no consensus on defining an US result as abnormal. Prospective studies with adequate sample size and methodology are needed before US can be used in the diagnostics and monitoring of paediatric IBD.
Collapse
Affiliation(s)
- Elsa A van Wassenaer
- Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Gastroenterology, Amsterdam, The Netherlands,Corresponding author: Elsa A. van Wassenaer, MD, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Gastroenterology, Amsterdam, The Netherlands.
| | - Floris A E de Voogd
- Amsterdam UMC, University of Amsterdam, Gastroenterology and Hepatology, Amsterdam, The Netherlands
| | - Rick R van Rijn
- Amsterdam UMC, University of Amsterdam, Radiology, Amsterdam, The Netherlands
| | - Johanna H van der Lee
- Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Clinical Research Office, Amsterdam, The Netherlands
| | - Merit M Tabbers
- Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Gastroenterology, Amsterdam, The Netherlands
| | | | - Krisztina B Gecse
- Amsterdam UMC, University of Amsterdam, Gastroenterology and Hepatology, Amsterdam, The Netherlands
| | - Angelika Kindermann
- Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Gastroenterology, Amsterdam, The Netherlands
| | - Tim G J de Meij
- Emma Children’s Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Gastroenterology, Amsterdam, The Netherlands
| | - Geert R D’Haens
- Amsterdam UMC, University of Amsterdam, Gastroenterology and Hepatology, Amsterdam, The Netherlands
| | - Marc A Benninga
- Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Gastroenterology, Amsterdam, The Netherlands
| | - Bart G P Koot
- Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Gastroenterology, Amsterdam, The Netherlands
| |
Collapse
|
45
|
Vaarwerk B, Mallebranche C, Affinita MC, van der Lee JH, Ferrari A, Chisholm JC, Defachelles AS, De Salvo GL, Corradini N, Minard-Colin V, Morosi C, Brisse HJ, McHugh K, Bisogno G, van Rijn RR, Orbach D, Merks JHM. Is surveillance imaging in pediatric patients treated for localized rhabdomyosarcoma useful? The European experience. Cancer 2019; 126:823-831. [PMID: 31750944 PMCID: PMC7027831 DOI: 10.1002/cncr.32603] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 09/26/2019] [Accepted: 09/30/2019] [Indexed: 11/30/2022]
Abstract
Background After the completion of therapy, patients with localized rhabdomyosarcoma (RMS) are subjected to intensive radiological tumor surveillance. However, the clinical benefit of this surveillance is unclear. This study retrospectively analyzed the value of off‐therapy surveillance by comparing the survival of patients in whom relapse was detected by routine imaging (the imaging group) and patients in whom relapse was first suspected by symptoms (the symptom group). Methods This study included patients with relapsed RMS after the completion of therapy for localized RMS who were treated in large pediatric oncology hospitals in France, the United Kingdom, Italy, and the Netherlands and who were enrolled in the International Society of Paediatric Oncology Malignant Mesenchymal Tumor 95 (1995‐2004) study, the Italian Paediatric Soft Tissue Sarcoma Committee Rhabdomyosarcoma 96 (1996‐2004) study, or the European Paediatric Soft Tissue Sarcoma Study Group Rhabdomyosarcoma 2005 (2005‐2013) study. The survival times after relapse were compared with a log‐rank test between patients in the imaging group and patients in the symptom group. Results In total, 199 patients with relapsed RMS were included: 78 patients (39.2%) in the imaging group and 121 patients (60.8%) in the symptom group. The median follow‐up time after relapse was 7.4 years (interquartile range, 3.9‐11.5 years) for survivors (n = 86); the 3‐year postrelapse survival rate was 50% (95% confidence interval [CI], 38%‐61%) for the imaging group and 46% (95% CI, 37%‐55%) for the symptom group (P = .7). Conclusions Although systematic routine imaging is the standard of care after RMS therapy, the majority of relapses were detected as a result of clinical symptoms. This study found no survival advantage for patients whose relapse was detected before the emergence of clinical symptoms. These results show that the value of off‐therapy surveillance is controversial, particularly because repeated imaging may also entail potential harm. This study assesses the clinical value of radiological surveillance imaging in pediatric patients with rhabdomyosarcoma, which is routinely performed after the completion of therapy. In the majority of patients, relapse is detected because of symptoms, and there is no evidence that early detection by imaging results in improved survival.
Collapse
Affiliation(s)
- Bas Vaarwerk
- Department of Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | | | - Maria C Affinita
- Hematology and Oncology Division, Department of Woman and Children's Health, Padova University Hospital, Padova, Italy
| | - Johanna H van der Lee
- Pediatric Clinical Research Office, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Andrea Ferrari
- National Cancer Institute of Milan (Scientific Institute for Research, Hospitalization, and Healthcare Foundation), Milan, Italy
| | - Julia C Chisholm
- Children and Young People's Department, Royal Marsden Hospital, Sutton, United Kingdom
| | | | - Gian Luca De Salvo
- Clinical Research Unit, Veneto Institute of Oncology (Scientific Institute for Research, Hospitalization, and Healthcare), Padova, Italy
| | - Nadège Corradini
- Institute of Pediatric Hematology and Oncology, Léon Bérard Center, Lyon, France
| | - Veronique Minard-Colin
- Department of Pediatric and Adolescent Oncology, Gustave-Roussy Institute, Villejuif, France
| | - Carlo Morosi
- National Cancer Institute of Milan (Scientific Institute for Research, Hospitalization, and Healthcare Foundation), Milan, Italy
| | - Hervé J Brisse
- SIREDO Oncology Center, PSL Research University, Curie Institute, Paris, France.,Imaging Department, Curie Institute, Paris, France
| | - Kieran McHugh
- Department of Radiology, Great Ormond Street Hospital for Children, London, United Kingdom
| | - Gianni Bisogno
- Hematology and Oncology Division, Department of Woman and Children's Health, Padova University Hospital, Padova, Italy
| | - Rick R van Rijn
- Department of Radiology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Daniel Orbach
- SIREDO Oncology Center, PSL Research University, Curie Institute, Paris, France
| | - Johannes H M Merks
- Department of Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands
| |
Collapse
|
46
|
Kox LS, Jens S, Lauf K, Smithuis FF, van Rijn RR, Maas M. Well-founded practice or personal preference: a comparison of established techniques for measuring ulnar variance in healthy children and adolescents. Eur Radiol 2019; 30:151-162. [PMID: 31392482 PMCID: PMC6890628 DOI: 10.1007/s00330-019-06354-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 06/19/2019] [Accepted: 07/01/2019] [Indexed: 11/30/2022]
Abstract
Objectives Ulnar variance is a clinical measure used to determine the relative difference in length between the radius and ulna. We aimed to examine consistency in ulnar variance measurements and normative data in children and adolescents using the perpendicular and the Hafner methods. Methods Two raters measured ulnar variance on hand radiographs of 350 healthy children. Participants’ mean calendar and skeletal ages were 12.3 ± 3.6 and 12.0 ± 3.7 years, 52% were female. Raters used the perpendicular method, an adapted version of the perpendicular method (in which the distal radial articular surface is defined as a sclerotic rim) and the Hafner method, being the distance between the most proximal points of the ulnar and radial metaphyses (PRPR) and the distance between the most distal points of both (DIDI). Intraclass correlation coefficients (ICCs) for intermethod consistency and inter- and intrarater agreement were calculated using a two-way ANOVA model. Variability and limits of agreement were determined using the Bland-Altman method. Results The interrater ICC was 0.75 (95% CI, 0.61–0.84) for the adapted perpendicular method, 0.88 (95% CI, 0.80–0.93) for PRPR, and 0.94 (95% CI, 0.90–0.97) for DIDI. The intermethod consistency ICC was 0.60 (95% CI, 0.48–0.70) for perpendicular versus PRPR and 0.60 (95% CI, 0.49–0.70) for perpendicular versus DIDI. The intrarater ICC was 0.88 (95% CI, 0.70–0.95) for perpendicular, 0.90 (95% CI, 0.83–0.94) for PRPR, and 0.81 (95% CI, 0.69–0.89) for DIDI. The perpendicular method was not useable in 38 cases (skeletal age ≤ 9 years) and the Hafner method in 79 cases (skeletal age ≥ 12 years). Conclusions The perpendicular and Hafner methods show moderate intermethod consistency. The Hafner method is preferred for children with skeletal ages < 14 years, with good to excellent inter- and intrarater agreement. The adapted perpendicular method is recommended for patients with skeletal ages ≥ 14 years. Key Points • The perpendicular method for measuring ulnar variance requires extended instructions to ensure good interrater agreement in pediatric and adolescent patients. • The Hafner method is recommended for ulnar variance measurement in children with unfused growth plates and up to a skeletal age of 13 years, and the perpendicular method is recommended for children with fused growth plates and from skeletal age 14 and older. • The mean ulnar variance measured in this study for each skeletal age group (range, 5–18 years) is provided, to serve as a reference for future ulnar variance measurements using both methods in clinical practice. Electronic supplementary material The online version of this article (10.1007/s00330-019-06354-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Laura S Kox
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. .,Academic Center for Evidence-based Sports medicine (ACES), Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. .,Amsterdam Collaboration for Health and Safety in Sports (ACHSS), International Olympic Committee (IOC) Research Center AMC/VUmc, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Sjoerd Jens
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Kenny Lauf
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Frank F Smithuis
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Mario Maas
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.,Academic Center for Evidence-based Sports medicine (ACES), Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.,Amsterdam Collaboration for Health and Safety in Sports (ACHSS), International Olympic Committee (IOC) Research Center AMC/VUmc, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| |
Collapse
|
47
|
De Tobel J, Hillewig E, van Wijk M, Fieuws S, de Haas MB, van Rijn RR, Thevissen PW, Verstraete KL. Staging Clavicular Development on MRI: Pitfalls and Suggestions for Age Estimation. J Magn Reson Imaging 2019; 51:377-388. [PMID: 31373087 DOI: 10.1002/jmri.26889] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 07/14/2019] [Accepted: 07/15/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND MRI of the clavicle's sternal end has been studied for age estimation. Several pitfalls have been noted, but how they affect age estimation performance remains unclear. PURPOSE/HYPOTHESIS To further study these pitfalls and to make suggestions for a proper use of clavicle MRI for forensic age estimation. Our hypotheses were that age estimation would benefit from 1) discarding stages 1 and 4/5; 2) including advanced substages 3aa, 3ab, and 3ac; 3) taking both clavicles into account; and 4) excluding morphological variants. STUDY TYPE Prospective cross-sectional. POPULATION Healthy Caucasian volunteers between 11 and 30 years old (524; 277 females, 247 males). FIELD STRENGTH/SEQUENCE 3T, T1 -weighted gradient echo volumetric interpolated breath-hold examination (VIBE) MR-sequence. ASSESSMENT Four observers applied the most elaborate staging technique for long bone development that has been described in the current literature (including stages, substages, and advanced substages). One of the observers repeated a random selection of the assessments in 110 participants after a 2-week interval. Furthermore, all observers documented morphological variants. STATISTICAL TESTS Weighted kappa quantified reproducibility of staging. Bayes' rule was applied for age estimation with a continuation ratio model for the distribution of the stages. According to the hypotheses, different models were tested. Mean absolute error (MAE) differences between models were compared, as were MAEs between cases with and without morphological variants. RESULTS Weighted kappa equaled 0.82 for intraobserver and ranged between 0.60 and 0.64 for interobserver agreement. Stages 1 and 4/5 were allocated interchangeably in 4.3% (54/1258). Age increased steadily in advanced substages of stage 3, but improvement in age estimation was not significant (right P = 0.596; left P = 0.313). The model that included both clavicles and discarded stages 1 and 4/5 yielded an MAE of 1.97 years, a root mean squared error of 2.60 years, and 69% correctly classified minors. Morphological variants rendered significantly higher MAEs (right 3.84 years, P = 0.015; left 2.93 years, P = 0.022). DATA CONCLUSION Our results confirmed hypotheses 3) and 4), while hypotheses 1) and 2) remain to be investigated in larger studies. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:377-388.
Collapse
Affiliation(s)
- Jannick De Tobel
- Department of Diagnostic Sciences - Radiology, Ghent University, Ghent, Belgium.,Department of Imaging and Pathology - Forensic Odontology, KU Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, Leuven University Hospitals, Leuven, Belgium
| | - Elke Hillewig
- Department of Diagnostic Sciences - Radiology, Ghent University, Ghent, Belgium
| | - Mayonne van Wijk
- Division of Special Services and Expertise, Section of Forensic Anthropology, Netherlands Forensic Institute, The Hague, The Netherlands
| | - Steffen Fieuws
- KU Leuven - Leuven University & Hasselt University, Department Public Health and Primary Care, I-BioStat, Leuven, Belgium
| | - Michiel Bart de Haas
- Division of Special Services and Expertise, Section of Forensic Anthropology, Netherlands Forensic Institute, The Hague, The Netherlands
| | - Rick R van Rijn
- Amsterdam UMC, University of Amsterdam, Department of Radiology and Nuclear Medicine, Amsterdam, The Netherlands
| | | | | |
Collapse
|
48
|
Arthurs OJ, van Rijn RR, Granata C, Porto L, Hirsch FW, Rosendahl K. European Society of Paediatric Radiology 2019 strategic research agenda: improving imaging for tomorrow's children. Pediatr Radiol 2019; 49:983-989. [PMID: 31115616 PMCID: PMC6598945 DOI: 10.1007/s00247-019-04406-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 04/05/2019] [Indexed: 11/02/2022]
Abstract
The European Society of Paediatric Radiology (ESPR) research committee was established to initiate, drive forward and foster excellence in paediatric imaging, paediatric image-guided intervention and radiation protection research, by facilitating more evidence-based standards, protocols and multi-institutional collaborations. The ESPR Strategic Research Agenda outlines our current research approach, highlighting several areas of paediatric imaging where the society can help guide current and future research, and emphasizing those areas where early research ("seed") funding may need to be allocated by this and other societies as precursors to larger grant applications. The key aims are to evaluate normal variation in order to be able to confidently diagnose disease states, develop robust image-based classification systems to aid diagnosis and treatment monitoring, and help develop evidence-based clinical guidelines using current literature and experience to identify knowledge gaps. For this reason, the development of evidence-based imaging pipelines, broken down step-by-step to include diagnosis, classification and clinical effectiveness, should be the end goal for each disease entity for each affected child. Here, we outline the 2019 ESPR Strategic Research Agenda along three points in the clinical imaging pipeline: clinical referral, disease diagnosis and evolution, and clinical therapeutic evaluation and effectiveness. Through multicentre trials, using existing high-level experience and expertise, and nurturing the next generation of researchers, we will be able to achieve these aims.
Collapse
Affiliation(s)
- Owen J Arthurs
- Department of Radiology, Great Ormond Street Hospital, London, UK. .,NIHR UCL Great Ormond Street Institute of Child Health Biomedical Research Centre, London, UK.
| | - Rick R van Rijn
- Department of Radiology, Emma Children's Hospital - Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Claudio Granata
- Service of Radiology, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Luciana Porto
- Department of Paediatric Neurology, Hospital of Goethe University, Frankfurt am Main, Germany
| | - F Wolfgang Hirsch
- Department of Paediatric Radiology, University Leipzig, Leipzig, Germany
| | - Karen Rosendahl
- Department of Radiology, Haukeland University Hospital, 5020, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| |
Collapse
|
49
|
Defachelles AS, Bogart E, Casanova M, Merks H, Bisogno G, Calareso G, Gallego Melcon S, Gatz S, Le Deley MC, McHugh K, Probst A, Rocourt N, van Rijn RR, Wheatley K, Minard-Colin V, Chisholm J. Randomized phase 2 trial of the combination of vincristine and irinotecan with or without temozolomide, in children and adults with refractory or relapsed rhabdomyosarcoma (RMS). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.10000] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10000 Background: Vincristine with Irinotecan (VI) is effective in patients with relapsed RMS but outcomes remain poor. The addition of temozolomide to VI (VIT) is attractive owing to different resistance mechanisms and distinct toxicity profiles. Methods: The VIT-0910 trial, an EpSSG-ITCC randomized phase 2 trial, evaluated efficacy and safety of VI and VIT in patients (pts) aged 0.5-50 years with relapsed/refractory RMS. Pts received Vincristine 1.5 mg/m2 d1, d8, Irinotecan 50mg/m2 d1-d5 +/- Temozolomide 125 mg/m² d1-d5 (150 mg/m² from cycle 2 if no toxicity > grade 2); 21-day cycles were given until progression/unacceptable toxicity. The primary endpoint was centrally reviewed objective response rate (ORR) after 2 cycles (primary lesion, WHO response criteria: metastatic sites, RECIST 1.1 ). Secondary endpoints included progression-free survival (PFS), overall survival (OS) and adverse events (NCI-CTCAE v4). Initially a Simon 2-stage design was used to analyse separately 40 pts/arm. After amendment, the trial sample size was increased to 120, and a comparison between arms, adjusted for confounding factors, was added to the statistical plan. Results: 120 pts (60 VIT, 60 VI) were recruited in 37 European centers from 03/2012-04/2018. Median age was 11 years (0.75-46), 89% pts relapsed RMS. ORR was 24/55 (44%) for VIT vs 18/58 (31%) for VI; adjusted odds ratio =0.50, 95%CI, 0.22-1.12, p=0.09. The VIT arm achieved significantly better PFS (adjusted Hazard Ratio (HR)=0.65, 95%Cl, 0.43-0.97, p=0.036) and OS (HR=0.53, 95%CI, 0.33-0.83, p=0.005) compared to VI. PFS and OS results were similar when only relapsed patients were included. Adverse events ≥ grade 3 were more frequent in VIT compared to VI, but only hematological toxicity was significantly increased (81% for VIT, 59% for VI, odds ratio=1.36, 95%CI, 1.06-1.76, P=0.02). Conclusions: The addition of temozolomide to VI improves PFS and OS of pts with relapsed/refractory RMS. VIT is now standard treatment for relapsed RMS in Europe. Clinical trial information: NCT01355445.
Collapse
Affiliation(s)
| | | | - Michela Casanova
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Hans Merks
- Princess Maxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Gianni Bisogno
- Department of Women and Children Health, University Hospital of Padova, Padova, Italy
| | - Giuseppina Calareso
- Radiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Susanne Gatz
- The Institute of Cancer Research, London, United Kingdom
| | | | - Kieran McHugh
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | | | | | | | | | | | - Julia Chisholm
- Children and Young People’s Unit, The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| |
Collapse
|
50
|
Vaarwerk B, Bisogno G, McHugh K, Brisse HJ, Morosi C, Corradini N, Jenney M, Orbach D, Chisholm JC, Ferrari A, Zanetti I, De Salvo GL, van Rijn RR, Merks JH. Indeterminate Pulmonary Nodules at Diagnosis in Rhabdomyosarcoma: Are They Clinically Significant? A Report From the European Paediatric Soft Tissue Sarcoma Study Group. J Clin Oncol 2019; 37:723-730. [DOI: 10.1200/jco.18.01535] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Purpose To evaluate the clinical significance of indeterminate pulmonary nodules at diagnosis (defined as ≤ 4 pulmonary nodules < 5 mm or 1 nodule measuring ≥ 5 and < 10 mm) in patients with pediatric rhabdomyosarcoma (RMS). Patients and Methods We selected patients with supposed nonmetastatic RMS treated in large pediatric oncology centers in the United Kingdom, France, Italy, and the Netherlands, who were enrolled in the European Soft Tissue Sarcoma Study Group (E pSSG) RMS 2005 study. Patients included in the current study received a diagnosis between September 2005 and December 2013, and had chest computed tomography scans available for review that were done at time of diagnosis. Local radiologists were asked to review the chest computed tomography scans for the presence of pulmonary nodules and to record their findings on a standardized case report form. In the E pSSG RMS 2005 Study, patients with indeterminate pulmonary nodules were treated identically to patients without pulmonary nodules, enabling us to compare event-free survival and overall survival between groups by log-rank test. Results In total, 316 patients were included; 67 patients (21.2%) had indeterminate pulmonary nodules on imaging and 249 patients (78.8%) had no pulmonary nodules evident at diagnosis. Median follow-up for survivors (n = 258) was 75.1 months; respective 5-year event-free survival and overall survival rates (95% CI) were 77.0% (64.8% to 85.5%) and 82.0% (69.7% to 89.6%) for patients with indeterminate nodules and 73.2% (67.1% to 78.3%) and 80.8% (75.1% to 85.3%) for patients without nodules at diagnosis ( P = .68 and .76, respectively). Conclusion Our study demonstrated that indeterminate pulmonary nodules at diagnosis do not affect outcome in patients with otherwise localized RMS. There is no need to biopsy or upstage patients with RMS who have indeterminate pulmonary nodules at diagnosis.
Collapse
Affiliation(s)
- Bas Vaarwerk
- University of Amsterdam, Amsterdam, the Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | | | - Kieran McHugh
- Great Ormond Street Hospital for Children, London, United Kingdom
| | | | | | | | - Meriel Jenney
- Children's Hospital for Wales, Heath Park, Cardiff, United Kingdom
| | | | | | | | | | | | | | - Johannes H.M. Merks
- University of Amsterdam, Amsterdam, the Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | | |
Collapse
|