{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:43:01Z","timestamp":1780360981943,"version":"3.54.1"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T00:00:00Z","timestamp":1612310400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In the EuroNet Pediatric Hodgkin Lymphoma (EuroNet\u2010PHL) trials, decision on Waldeyer's ring (WR) involvement is usually based on clinical assessment, that is, physical examination and\/or nasopharyngoscopy. However, clinical assessment only evaluates mucosal surface and is prone to interobserver variability. Modern cross\u2010sectional imaging technology may provide valuable information beyond mucosal surface, which may lead to a more accurate WR staging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients, materials, and methods<\/jats:title><jats:p>The EuroNet\u2010PHL\u2010C1 trial recruited 2102 patients, of which 1752 underwent central review including reference reading of their cross\u2010sectional imaging data. In 14 of 1752 patients, WR was considered involved according to clinical assessment. In these 14 patients, the WR was re\u2010assessed by applying an imaging\u2010based algorithm considering information from<jats:sup>18<\/jats:sup>F\u2010fluorodeoxyglucose positron emission tomography, contrast\u2010enhanced computed tomography, and\/or magnetic resonance imaging. For verification purposes, the imaging\u2010based algorithm was applied to 100 consecutive patients whose WR was inconspicuous on clinical assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The imaging\u2010based algorithm confirmed WR involvement only in four of the 14 patients. Of the remaining 10 patients, four had retropharyngeal lymph node involvement and six an inconspicuous WR. Applying the imaging\u2010based algorithm to 100 consecutive patients with physiological appearance of their WR on clinical assessment, absence of WR involvement could be confirmed in 99. However, suspicion of WR involvement was raised in one patient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The imaging\u2010based algorithm was feasible and easily applicable at initial staging of young patients with Hodgkin lymphoma. It increased the accuracy of WR staging, which may contribute to a more individualized treatment in the future.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.28903","type":"journal-article","created":{"date-parts":[[2021,2,6]],"date-time":"2021-02-06T16:47:56Z","timestamp":1612630076000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Assessment of Waldeyer's ring in pediatric and adolescent Hodgkin lymphoma patients\u2014Importance of multimodality imaging: Results from the EuroNet\u2010PHL\u2010C1 trial"],"prefix":"10.1002","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3396-4880","authenticated-orcid":false,"given":"Lars","family":"Kurch","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine University of Leipzig Leipzig 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