Sudha A Anupindi1,2, Maria A Bedoya1, Robert B Lindell3, Siri J Rambhatla1,4, Kristin Zelley5, Kim E Nichols5,6, Nancy A Chauvin1,2. 1. 1 Department of Radiology, The Children's Hospital of Philadelphia, 34th St and Civic Center Blvd, Philadelphia, PA 19104. 2. 2 Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. 3. 3 Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA. 4. 4 Present address: Department of Pediatrics, Newark Beth Israel Medical Center, Newark, NJ. 5. 5 Department of Pediatrics, Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, PA. 6. 6 Department of Oncology, Division of Cancer Predisposition, St. Jude's Children's Research Hospital, Memphis, TN.
Abstract
OBJECTIVE: Children with cancer-predisposing conditions are at increased risk to develop and die of cancer. Limited data exist on the utility of whole-body MRI as a cancer screening tool in children. In this study, we examined the diagnostic performance of whole-body MRI as a mechanism of tumor surveillance for children at increased genetic risk for cancer. MATERIALS AND METHODS: Twenty-four children (six boys and 18 girls) with a mean age of 11.2 years (range, 2.1-18.2 years) underwent 50 unenhanced whole-body MRI examinations over a 5-year period. Scans were retrospectively reviewed and assessed for image quality; sequences performed; and the presence of osseous, soft-tissue, or solid organ abnormalities. Findings suggestive of a malignancy were stratified by risk as low (< 20% chance for cancer), moderate (20-80%), or high (> 80%). MRI findings were correlated with medical records, biopsy results, or additional follow-up imaging; biopsy and follow-up were considered as the reference standards. RESULTS: Forty-eight of 50 (96%) examinations were of very good quality. Nine findings suspicious for malignancy were identified, including two high-risk, two moderate-risk, and five low-risk lesions. One high-risk lesion was proven by biopsy to be a papillary thyroid carcinoma, with the remaining lesions deemed nonmalignant. The sensitivity of whole-body MRI was 100%; specificity, 94%; positive predictive value, 25%; and negative predictive value (NPV), 100%. CONCLUSION: Unenhanced whole-body MRI is safe and produces excellent images. The high sensitivity, specificity, and NPV make whole-body MRI a valuable cancer screening tool in children with a genetic predisposition for cancer.
OBJECTIVE:Children with cancer-predisposing conditions are at increased risk to develop and die of cancer. Limited data exist on the utility of whole-body MRI as a cancer screening tool in children. In this study, we examined the diagnostic performance of whole-body MRI as a mechanism of tumor surveillance for children at increased genetic risk for cancer. MATERIALS AND METHODS: Twenty-four children (six boys and 18 girls) with a mean age of 11.2 years (range, 2.1-18.2 years) underwent 50 unenhanced whole-body MRI examinations over a 5-year period. Scans were retrospectively reviewed and assessed for image quality; sequences performed; and the presence of osseous, soft-tissue, or solid organ abnormalities. Findings suggestive of a malignancy were stratified by risk as low (< 20% chance for cancer), moderate (20-80%), or high (> 80%). MRI findings were correlated with medical records, biopsy results, or additional follow-up imaging; biopsy and follow-up were considered as the reference standards. RESULTS: Forty-eight of 50 (96%) examinations were of very good quality. Nine findings suspicious for malignancy were identified, including two high-risk, two moderate-risk, and five low-risk lesions. One high-risk lesion was proven by biopsy to be a papillary thyroid carcinoma, with the remaining lesions deemed nonmalignant. The sensitivity of whole-body MRI was 100%; specificity, 94%; positive predictive value, 25%; and negative predictive value (NPV), 100%. CONCLUSION: Unenhanced whole-body MRI is safe and produces excellent images. The high sensitivity, specificity, and NPV make whole-body MRI a valuable cancer screening tool in children with a genetic predisposition for cancer.
Authors: Phuong L Mai; Payal P Khincha; Jennifer T Loud; Rosamma M DeCastro; Renée C Bremer; June A Peters; Chia-Ying Liu; David A Bluemke; Ashkan A Malayeri; Sharon A Savage Journal: JAMA Oncol Date: 2017-12-01 Impact factor: 31.777
Authors: Casey R Tak; Eman Biltaji; Wendy Kohlmann; Luke Maese; Pierre Hainaut; Anita Villani; David Malkin; Catherine M T Sherwin; Diana I Brixner; Joshua D Schiffman Journal: Pediatr Blood Cancer Date: 2019-02-04 Impact factor: 3.167
Authors: Emily S Tonorezos; Danielle Novetsky Friedman; Dana Barnea; Machteld I Bosscha; Guillermo Chantada; Charlotte J Dommering; Pim de Graaf; Ira J Dunkel; Armida W M Fabius; Jasmine H Francis; Mary-Louise C Greer; Ruth A Kleinerman; Wijnanda A Kors; Suzanne Laughlin; Annette C Moll; Lindsay M Morton; Petra Temming; Margaret A Tucker; Flora E van Leeuwen; Michael F Walsh; Kevin C Oeffinger; David H Abramson Journal: Ophthalmology Date: 2020-05-15 Impact factor: 12.079
Authors: Danielle Novetsky Friedman; Meier Hsu; Chaya S Moskowitz; Jasmine H Francis; Eric Lis; Megan Harlan Fleischut; Kevin C Oeffinger; Michael Walsh; Emily S Tonorezos; Charles A Sklar; David H Abramson; Ira J Dunkel Journal: Pediatr Blood Cancer Date: 2020-05-09 Impact factor: 3.167
Authors: Gang Peng; Jasmina Bojadzieva; Mandy L Ballinger; Jialu Li; Amanda L Blackford; Phuong L Mai; Sharon A Savage; David M Thomas; Louise C Strong; Wenyi Wang Journal: Cancer Epidemiol Biomarkers Prev Date: 2017-01-30 Impact factor: 4.254
Authors: Marta Tijerin Bueno; Claudia Martínez-Ríos; Alejandro De la Puente Gregorio; Rayan A Ahyad; Anita Villani; Harriet Druker; Kalene van Engelen; Bailey Gallinger; Laura Aronoff; Ronald Grant; David Malkin; Mary-Louise C Greer Journal: Pediatr Radiol Date: 2017-05-04
Authors: Jasmina Bojadzieva; Behrang Amini; Suzanne F Day; Tiffiny L Jackson; Parijatham S Thomas; Brandy J Willis; Whitney R Throckmorton; Najat C Daw; Therese B Bevers; Louise C Strong Journal: Fam Cancer Date: 2018-04 Impact factor: 2.375