Trout, AT; Chow, J; McNamara, ER; Darge, K; Ramirez Grueso, R; Munden, M; Rothan, S; Navarro, OM; Bueno, M; Bove, KE; Chikwava, KR; Heider, A; Hicks, MJ; Somers, GR; Zhang, B; Dillman, JR. Association between testicular microlithiasis and testicular neoplasia: Large multicenter study in a pediatric population. Radiology. 2017; 285(2):1-8.
Testicular microlithiasis is a condition in which punctate calcifications are present in one or both testicles. This is a not uncommon ultrasound finding seen in children and adults. Importantly, reports on testicular microlithiasis associates it with testicular neoplasia, although there are conflicting reports in the literature and the strength of this association is not well understood. A multi-center North America-based retrospective study, led by Drs. Andrew Trout and Jonathan Dillman of Cincinnati Children's Hospital Medical Center, of more than 37,000 subjects revealed that 2.9% of subjects had confirmed diffuse microlithiasis (more than five calcifications on a single image) by ultrasound imaging. Results suggest a strong association between testicular microlithiasis and primary testicular neoplasia in their specific pediatric population. This is the largest pediatric study to date and these data help inform and define the need for follow-up in patients with testicular microlithiasis.
Strauss, KJ; Goske, MJ; Towbin, AL; Sengupta, D; Callahan, MJ; Darge, K; Podberesky, DJ; Frush, DP; Maxfield, C; Westra, SJ; Prince, JS; Wu, H; Bhargavan-Chatfield, M. Pediatric Chest CT Diagnostic Reference Ranges: Development and Application. Radiology. 2017; 284(1):219-227.
Cincinnati Children’s Department of Radiology has long been a world leader in development and implementation of pediatric-specific computed tomography (CT) protocols. While there are efforts to reduce exposure of pediatric patients to ionizing radiation (ImageGently®) of which Cincinnati Children's is a leader, CT is still the diagnostic and prognostic imaging modality of choice for many pulmonary disorders, including cystic fibrosis. This paper reports the crucial establishment of a pediatric chest CT diagnostic reference range, led by Cincinnati Children's medical physicist Keith Strauss, MS, and radiologists Drs. Alexander Towbin and Goske, based on retrospective analysis of 111 CT studies from eight U.S.-based pediatric centers. Diagnostic reference ranges developed in this study provide target ranges of pediatric dose indexes on the basis of patient size, while the pediatric dose reduction factors of this study allow calculation of unique reference dose indexes on the basis of patient size for each of a site’s CT scanners. Utilization of these data will assist pediatric imaging radiologists worldwide to minimize the radiation exposure of countless pediatric patients.
Veldhuijzen van Zanten, SEM; Lane, A; Heymans, MW; Baugh, J; Chaney, B; Hoffman, LM; Doughman, R; Jansen, MHA; Sanchez, E; Vandertop, WP; Kaspers, GJL; van Vuurden, DG; Fouladi, M; Jones, BV; Leach, J. External validation of the diffuse intrinsic pontine glioma survival prediction model: a collaborative report from the International DIPG Registry and the SIOPE DIPG Registry. Journal of Neuro-Oncology. 2017; 134(1):231-240.
Diffuse intrinsic pontine glioma (DIPG) is a highly aggressive tumor of the pons/brainstem which almost exclusively affects children and has an extremely poor prognosis despite intensive research effort. A collaboration of researchers in the Netherlands, U.K. and Germany used radiologic and clinical data from a DIPG registry (SIOPE DIPG) to develop a prognostic tool to predict patients’ survival. In this paper, a U.S. / Canada / Australia / New Zealand-based DIPG registry (the International DPIG Registry) was similarly analyzed to validate the findings of the European report. In this external validation study, we demonstrate that the DIPG survival prediction model has acceptable cross-cohort calibration and is able to discriminate patients with short, average, and increased survival. Use of such a tool can now direct the most aggressive therapies toward patients with the highest likelihood of survival and inform clinical and family decision making.
Higano, NS; Fleck, RJ; Spielberg, DR; Walkup, LL; Hahn, AD; Thomen, RP; Merhar, SL; Kingma, PS; Tkach, JA; Fain, SB; Woods, JC. Quantification of Neonatal Lung Parenchymal Density via Ultrashort Echo Time MRI With Comparison to CT. Journal of Magnetic Resonance Imaging. 2017; 46(4):992-1000.
The reference standard for longitudinal imaging of premature infants and neonates with respiratory morbidities remains CT, with the attendant small but likely real risks of anesthesia and exposure to ionizing radiation. In this paper, the Center for Pulmonary Imaging Research (CPIR) led by Dr. Jason Woods worked with clinical neonatologists and radiologists, including Dr. Robert Fleck, to directly compare the image quality of a novel MRI method for imaging the lungs to CT in a small cohort of these fragile patients. The high image resolution and short imaging time of ultra-short echo time (UTE) MRI mean that fragile neonates and premature infants can image without sedation, and the team found that this method yields similar diagnostic information to CT. Thus, UTE-MRI has the potential to longitudinally evaluate neonatal pulmonary disease and to provide visualization of pathologies similar to CT, without sedation/anesthesia or ionizing radiation.
Mikkelsen, M; Barker, PB; Bhattacharyya, PK; Brix, MK; Buur, PF; Cecil, KM; Chan, KL; Chen, DY; Craven, AR; Cuypers, K; Dacko, M; Duncan, NW; Dydak, U; Edmondson, DA; Ende, G; Ersland, L; Gao, F; Greenhouse, I; Harris, AD; He, N; Heba, S; Hoggard, N; Hsu, TW; Jansen, JFA; Kangarlu, A; Lange, T; Lebel, RM; Li, Y; Lin, CE; Liou, JK; Lirng, JF; Liu, F; Maq, R; Maes, C; Moreno-Ortega, M; Murray, SO; Noah, S; Noeske, R; Noseworthy, MD; Oeltzschner, G; Prisciandaro, JJ; Puts, NAJ; Roberts, TPL; Sack, M; Sailasuta, N; Saleh, MG; Schallmo, MP; Simard, N; Swinnen, SP; Tegenthoff, M; Truong, P; Wang, G; Wilkinson, ID; Wittsack, HJ; Xu, H; Yan, F; Zhang, C; Zipunnikov, V; Zoellner, HJ; Edden, RAE. Big GABA: Edited MR spectroscopy at 24 research sites. Neuroimage. 2017; 159:32-45.
Non-invasive assessment of GABA, an important neurotransmitter with multiple crucial roles, is only achievable using magnetic resonance spectroscopy (MRS). Recent advances in MRS technology and capabilities have led to a surge in GABA research, however the disparate nature of the spectroscopic protocols between institutions and manufacturers meant that studies could not be directly compared, muddying the literature. This International Consortium of 24 sites brought together manufacturers and world-renowned MR spectroscopists, including Cincinnati Children's Hospital Medical Center’s Dr. Kim Cecil, to standardize GABA protocols across the research community. This study's protocol establishes a framework for future methodological standardization of GABA-edited MRS, while the results provide valuable benchmarks for the MRS community.