Usefulness of central radiologic review in clinical trials of children with hepatoblastoma

Miyazaki, Osamu; Oguma, Eiji; Nishikawa, Masanori; Tanami, Yutaka; Hosokawa, Takahiro; Kitami, Masahiro; Aoki, Hidekazu; Hattori, Shinya; Motoori, Ken; Watanabe, Kenichiro; Ida, Kohmei; Hishiki, Tomoro; Kitamura, Masayuki; Nozawa, Kumiko; Takimoto, Tetsuya; Hiyama, Eiso

doi:10.1007/s00247-022-05530-4

Cited by 2 publications

(2 citation statements)

References 18 publications

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“…The interobserver agreement for POSTTEXT in this study was similar to or slightly higher than that previously reported for PRETEXT (kappa value 0.57–0.76), which indicates that POSTTEXT is a straightforward, robust staging system for radiologists of varying levels of experience as well as surgeons and oncologists 24,30 …”

Section: Discussionsupporting

confidence: 86%

“…The interobserver agreement for POSTTEXT in this study was similar to or slightly higher than that previously reported for PRETEXT (kappa value 0.57-0.76), which indicates that POSTTEXT is a straightforward, robust staging system for radiologists of varying levels of experience as well as surgeons and oncologists. 24,30 In determining vascular involvement with MR, both factors P and V had higher specificity than sensitivity, suggesting a number of false positives. This could be due to the limited spatial resolution of MR for pediatric patients with small vascular calibers.…”

Section: Discussionmentioning

confidence: 99%

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Pediatric Hepatoblastoma After Neoadjuvant Chemotherapy: Diagnostic Performance of MR in Staging POSTTEXT and Vascular Involvement

Gong

Feng

Zhuang

et al. 2023

Magnetic Resonance Imaging

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BackgroundThe assessment of resectability after neoadjuvant chemotherapy of hepatoblastoma is dependent on Post‐Treatment EXTENT of Disease (POSTTEXT) staging and its annotation factors P (portal venous involvement) and V (hepatic venous/inferior vena cava [IVC] involvement), but MR performance in assessing them remains unclear.PurposeTo assess the diagnostic performance of contrast‐enhanced MR imaging for preoperative POSTTEXT staging and diagnosing vascular involvement in terms of annotation factors P and V in pediatric hepatoblastoma following neoadjuvant chemotherapy.Study TypeRetrospective.SubjectsThirty‐five consecutive patients (17 males, median age, 24 months; age range, 6–98 months) with proven hepatoblastoma underwent preoperative MR imaging following neoadjuvant chemotherapy.Field Strength/Sequence3.0 T; T2‐weighted imaging (T2WI), T2WI with fat suppression, diffusion weighted imaging, radial stack‐of‐the‐star/Cartesian 3D Dixon T1‐weighted gradient echo imaging.AssessmentThree radiologists independently assessed the POSTTEXT stages and annotation factors P and V based on the 2017 PRE/POSTTEXT system. The sensitivities and specificities were calculated for 1) diagnosing each POSTTEXT stage; 2) discrimination of stages III and IV (advanced) from those stages I and II (non‐advanced) hepatoblastomas; and 3) annotation factors P and V. The combination of pathologic findings and surgical records served as the reference standard.Statistical TestsSensitivity, specificity, Fleiss kappa test.ResultsThe sensitivity and specificity ranges for discriminating advanced from non‐advanced hepatoblastomas were 73.3%–80.0% and 80.0%–90.0%, respectively. For annotation factor P, they were 66.7%–100.0% and 90.6%, respectively. For factor V, they were 75.0% and 67.7%–83.9%, respectively. There was excellent, substantial, and moderate agreement on POSTTEXT staging (Fleiss kappa = 0.82), factors P (Fleiss kappa = 0.64), and factors V (Fleiss kappa = 0.60), respectively.Data ConclusionMR POSTTEXT provides reliable discrimination between advanced and non‐advanced tumors, and MR has moderate to excellent specificity at identifying portal venous and hepatic venous/IVC involvement.Evidence Level3Technical EfficacyStage 3

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Pediatric Hepatoblastoma After Neoadjuvant Chemotherapy: Diagnostic Performance of MR in Staging POSTTEXT and Vascular Involvement

Gong

Feng

Zhuang

et al. 2023

Magnetic Resonance Imaging

View full text Add to dashboard Cite

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Imaging adjuvants in pediatric surgical oncology

Fusco,

Abdelhafeez,

Krauel

et al. 2024

Pediatric Blood & Cancer

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Surgery is a crucial component of pediatric cancer treatment, but conventional methods may lack precision. Image‐guided surgery, including fluorescent and radioguided techniques, offers promise for enhancing tumor localization and facilitating precise resection. Intraoperative molecular imaging utilizes agents like indocyanine green to direct surgeons to occult deposits of tumor and to delineate tumor margins. Next‐generation agents target tumors directly to improve specificity. Radioguided surgery, employing tracers like metaiodobenzylguanidine (MIBG), complements fluorescent techniques by allowing for detection of tumors at a greater depth. Dual‐labeled agents combining both modalities are under development. Three‐dimensional modeling and virtual/augmented reality aid in preoperative planning and intraoperative guidance. The above techniques show great promise to benefit patients with pediatric tumors, and their continued development will almost certainly improve surgical outcomes.

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Usefulness of central radiologic review in clinical trials of children with hepatoblastoma

Cited by 2 publications

References 18 publications

Pediatric Hepatoblastoma After Neoadjuvant Chemotherapy: Diagnostic Performance of MR in Staging POSTTEXT and Vascular Involvement

Pediatric Hepatoblastoma After Neoadjuvant Chemotherapy: Diagnostic Performance of MR in Staging POSTTEXT and Vascular Involvement

Imaging adjuvants in pediatric surgical oncology

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