{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T22:00:29Z","timestamp":1790200829380,"version":"4.1.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T00:00:00Z","timestamp":1717372800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T00:00:00Z","timestamp":1717372800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Tata Memorial Hospital - TMC"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Radiol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Multiple differentials exist for pediatric liver tumors under 2\u00a0years. Accurate imaging diagnosis may obviate the need for tissue sampling in most cases.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>To evaluate the imaging features and diagnostic accuracy\u00a0of computed tomography (CT)\u00a0in liver tumors in children under 2\u00a0years.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Eighty-eight children under 2\u00a0years with treatment naive liver neoplasms and baseline contrast-enhanced CT were included in this\u00a0institutional review board approved retrospective study. Two blinded onco-radiologists assessed these tumors in consensus. Findings assessed included enhancement pattern, lobulated appearance, cystic change, calcifications, central scar-like appearance, and metastases. The radiologists classified the lesion as hepatoblastoma, infantile hemangioma, mesenchymal hamartoma, rhabdoid tumor, or indeterminate, first based purely on imaging and then after alpha-fetoprotein (AFP) correlation. Multivariate analysis and methods of comparing means and frequencies were used for statistical analysis wherever applicable. Diagnostic accuracy, sensitivity, and positive predictive values were analyzed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The mean age of the sample was 11.4\u00a0months (95% CI, 10.9\u201311.8) with 50\/88 (57%) boys. The study included 72 hepatoblastomas, 6 hemangiomas, 4 mesenchymal hamartomas, and 6 rhabdoid tumors. Presence of calcifications, multilobular pattern of arterial enhancement, lobulated morphology, and central scar-like appearance was significantly associated with hepatoblastomas (<jats:italic>P<\/jats:italic>-value\u2009&lt;\u20090.05). Fourteen out of eighty-eight lesions were called indeterminate based on imaging alone; six lesions remained indeterminate after AFP correlation. Pure radiology-based diagnostic accuracy was 81.8% (95% CI, 72.2\u201389.2%), which increased to 92.1% (95% CI, 84.3\u201396.7%) (<jats:italic>P<\/jats:italic>-value\u2009&gt;\u20090.05) after AFP correlation, with one hepatoblastoma misdiagnosed as a rhabdoid tumor. If indeterminate lesions were excluded for biopsy, the accuracy would be 98.8% (95% CI, 93.4\u201399.9%).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>CT had high accuracy for diagnosing liver neoplasms in the under 2-year age population after AFP correlation. Certain imaging features were significantly associated with the diagnosis of hepatoblastoma. A policy of biopsying only indeterminate lesions after CT and AFP correlation would avoid sampling in the majority of patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical Abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00247-024-05958-w","type":"journal-article","created":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T20:13:36Z","timestamp":1717445616000},"page":"1946-1955","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Accuracy of contrast-enhanced CT in liver neoplasms in children under 2\u00a0years age"],"prefix":"10.1007","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0069-6007","authenticated-orcid":false,"given":"Aishvarya Shri","family":"Rajasimman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasundhara","family":"Patil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunal Bharat","family":"Gala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitin","family":"Shetty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suyash","family":"Kulkarni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukta S.","family":"Ramadwar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sajid S.","family":"Qureshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girish","family":"Chinnaswamy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siddhartha","family":"Laskar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5376-6750","authenticated-orcid":false,"given":"Akshay D.","family":"Baheti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,3]]},"reference":[{"key":"5958_CR1","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1016\/S1089-3261(05)70163-X","volume":"5","author":"JT Stocker","year":"2001","unstructured":"Stocker JT (2001) Hepatic tumors in children. Clin Liver Dis 5:259\u2013281","journal-title":"Clin Liver Dis"},{"key":"5958_CR2","doi-asserted-by":"publisher","first-page":"486","DOI":"10.4254\/wjh.v6.i7.486","volume":"6","author":"I Fernandez-Pineda","year":"2014","unstructured":"Fernandez-Pineda I, Cabello-Laureano R (2014) Differential diagnosis and management of liver tumors in infants. World J Hepatol 6:486\u2013495","journal-title":"World J Hepatol"},{"key":"5958_CR3","doi-asserted-by":"publisher","first-page":"333","DOI":"10.3390\/diagnostics11020333","volume":"11","author":"B Lucas","year":"2021","unstructured":"Lucas B, Ravishankar S, Pateva I (2021) Pediatric primary hepatic tumors: diagnostic considerations. Diagnostics 11:333","journal-title":"Diagnostics"},{"key":"5958_CR4","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1186\/s40880-019-0411-7","volume":"39","author":"J Feng","year":"2019","unstructured":"Feng J, Polychronidis G, Heger U et al (2019) Incidence trends and survival prediction of hepatoblastoma in children: a population-based study. Cancer Commun 39:62","journal-title":"Cancer Commun"},{"key":"5958_CR5","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1016\/j.clinimag.2018.08.009","volume":"52","author":"AD Baheti","year":"2018","unstructured":"Baheti AD, Chapman T, Rudzinski E et al (2018) Diagnosis, histopathologic correlation and management of hepatoblastoma: what the radiologist needs to know. Clin Imaging 52:273\u2013279","journal-title":"Clin Imaging"},{"key":"5958_CR6","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1016\/j.clinimag.2018.06.017","volume":"51","author":"M Xu","year":"2018","unstructured":"Xu M, Pan FS, Wang W et al (2018) The value of clinical and ultrasound features for the diagnosis of infantile hepatic hemangioma: comparison with contrast-enhanced CT\/MRI. Clin Imaging 51:311\u2013317","journal-title":"Clin Imaging"},{"key":"5958_CR7","doi-asserted-by":"publisher","first-page":"68","DOI":"10.4103\/jiaps.JIAPS_102_18","volume":"24","author":"E Yhoshu","year":"2019","unstructured":"Yhoshu E, Lone YA, Mahajan JK, Singh UB (2019) Hepatoblastoma with precocious puberty. J Indian Assoc Pediatr Surg 24:68\u201371","journal-title":"J Indian Assoc Pediatr Surg"},{"key":"5958_CR8","doi-asserted-by":"publisher","first-page":"536","DOI":"10.1007\/s00247-018-4078-z","volume":"48","author":"AJ Towbin","year":"2018","unstructured":"Towbin AJ, Meyers RL, Woodley H et al (2018) 2017 PRETEXT: radiologic staging system for primary hepatic malignancies of childhood revised for the Paediatric Hepatic International Tumour Trial (PHITT). Pediatr Radiol 48:536\u2013554","journal-title":"Pediatr Radiol"},{"key":"5958_CR9","doi-asserted-by":"publisher","first-page":"135","DOI":"10.2214\/ajr.180.1.1800135","volume":"180","author":"H-J Jang","year":"2003","unstructured":"Jang H-J, Kim TK, Lim HK et al (2003) Hepatic hemangioma: atypical appearances on CT, MR imaging, and sonography. Am J Roentgenol 180:135\u2013141","journal-title":"Am J Roentgenol"},{"key":"5958_CR10","doi-asserted-by":"publisher","first-page":"1324","DOI":"10.1007\/s00247-018-4162-4","volume":"48","author":"SD Voss","year":"2018","unstructured":"Voss SD (2018) Staging and following common pediatric malignancies: MRI versus CT versus functional imaging. Pediatr Radiol 48:1324\u20131336","journal-title":"Pediatr Radiol"},{"key":"5958_CR11","doi-asserted-by":"publisher","first-page":"1944","DOI":"10.3390\/cancers11121944","volume":"11","author":"T Yang","year":"2019","unstructured":"Yang T, Whitlock RS, Vasudevan SA (2019) Surgical management of hepatoblastoma and recent advances. Cancers (Basel) 11:1944","journal-title":"Cancers (Basel)"},{"key":"5958_CR12","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1148\/radiology.169.3.2847233","volume":"169","author":"MI Boechat","year":"1988","unstructured":"Boechat MI, Kangarloo H, Ortega J et al (1988) Primary liver tumors in children: comparison of CT and MR imaging. Radiology 169:727\u2013732","journal-title":"Radiology"},{"key":"5958_CR13","doi-asserted-by":"publisher","first-page":"793","DOI":"10.2214\/ajr.160.4.8384403","volume":"160","author":"SJ King","year":"1993","unstructured":"King SJ, Babyn PS, Greenberg ML et al (1993) Value of CT in determining the resectability of hepatoblastoma before and after chemotherapy. Am J Roentgenol 160:793\u2013798","journal-title":"Am J Roentgenol"},{"key":"5958_CR14","doi-asserted-by":"publisher","first-page":"233","DOI":"10.4103\/jiaps.jiaps_113_22","volume":"28","author":"A Mitra","year":"2023","unstructured":"Mitra A, Bhatnagar V, Agarwala S et al (2023) Preoperative triple-phase three-dimensional-multi-detector computed tomography imaging of the hepatic vascular tree: an accurate road map prior to tumor resection in hepatoblastoma. J Indian Assoc Pediatr Surg 28:233","journal-title":"J Indian Assoc Pediatr Surg"},{"key":"5958_CR15","first-page":"64494","volume":"11","author":"Y Jiang","year":"2021","unstructured":"Jiang Y, Sun J, Xia Y et al (2021) Preoperative assessment for event-free survival with hepatoblastoma in pediatric patients by developing a CT-based radiomics model. Front Oncol 11:64494","journal-title":"Front Oncol"},{"key":"5958_CR16","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1007\/s00383-016-3864-7","volume":"32","author":"L Su","year":"2016","unstructured":"Su L, Dong Q, Zhang H et al (2016) Clinical application of a three-dimensional imaging technique in infants and young children with complex liver tumors. Pediatr Surg Int 32:387\u2013395","journal-title":"Pediatr Surg Int"},{"key":"5958_CR17","doi-asserted-by":"publisher","first-page":"746","DOI":"10.1007\/s00247-019-04358-9","volume":"49","author":"DR Ludwig","year":"2019","unstructured":"Ludwig DR, Romberg EK, Fraum TJ et al (2019) Diagnostic performance of Liver Imaging Reporting and Data System (LI-RADS) v2017 in predicting malignant liver lesions in pediatric patients: a preliminary study. Pediatr Radiol 49:746\u2013758","journal-title":"Pediatr Radiol"},{"key":"5958_CR18","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1166\/jmihi.2018.2371","volume":"8","author":"J Li","year":"2018","unstructured":"Li J, Wang J, Wang H et al (2018) Comparison of computed tomography and ultrasonography in the assessment of hepatoblastoma. J Med Imaging Health Inform 8:676\u2013681","journal-title":"J Med Imaging Health Inform"},{"key":"5958_CR19","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1148\/radiology.164.1.3035605","volume":"164","author":"AH Dachman","year":"1987","unstructured":"Dachman AH, Pakter RL, Ros PR et al (1987) Hepatoblastoma: radiologic-pathologic correlation in 50 cases. Radiology 164:15\u201319","journal-title":"Radiology"},{"key":"5958_CR20","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1186\/s40644-016-0083-3","volume":"16","author":"SC Shelmerdine","year":"2016","unstructured":"Shelmerdine SC, Roebuck DJ, Towbin AJ, McHugh K (2016) MRI of paediatric liver tumours: how we review and report. Cancer Imaging 16:21","journal-title":"Cancer Imaging"},{"key":"5958_CR21","first-page":"695","volume":"53","author":"E Cecen","year":"2011","unstructured":"Cecen E, Cakmakci H, Olguner M, Culhaci N (2011) Challenges of radiological assessment in an infant with giant calcified hepatoblastoma. Turk J Pediatr 53:695\u2013698","journal-title":"Turk J Pediatr"},{"key":"5958_CR22","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1089\/jayao.2017.0125","volume":"7","author":"K De Bree","year":"2018","unstructured":"De Bree K, Westermann AM, Kl\u00fcmpen HJ et al (2018) Two cases of hepatoblastoma in young adults. J Adolesc Young Adult Oncol 7:404\u2013408","journal-title":"J Adolesc Young Adult Oncol"},{"key":"5958_CR23","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1053\/j.sult.2009.07.004","volume":"30","author":"T Kim","year":"2009","unstructured":"Kim T, Hori M, Onishi H (2009) Liver masses with central or eccentric scar. Semin Ultrasound CT MRI 30:418\u2013425","journal-title":"Semin Ultrasound CT MRI"},{"key":"5958_CR24","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1148\/radiol.2020200751","volume":"296","author":"GR Schooler","year":"2020","unstructured":"Schooler GR, Squires JH, Alazraki A et al (2020) Pediatric hepatoblastoma, hepatocellular carcinoma, and other hepatic neoplasms: consensus imaging recommendations from American College of Radiology Pediatric Liver Reporting and Data System (LI-RADS) Working Group. Radiology 296:493\u2013497","journal-title":"Radiology"},{"key":"5958_CR25","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1053\/j.sempedsurg.2011.10.011","volume":"21","author":"D Von Schweinitz","year":"2012","unstructured":"Von Schweinitz D (2012) Hepatoblastoma: recent developments in research and treatment. Semin Pediatr Surg 21:21\u201330","journal-title":"Semin Pediatr Surg"}],"container-title":["Pediatric Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00247-024-05958-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00247-024-05958-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00247-024-05958-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T09:44:54Z","timestamp":1732095894000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00247-024-05958-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,3]]},"references-count":25,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["5958"],"URL":"https:\/\/doi.org\/10.1007\/s00247-024-05958-w","relation":{},"ISSN":["1432-1998"],"issn-type":[{"value":"1432-1998","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,3]]},"assertion":[{"value":"31 January 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 May 2024","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 May 2024","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 June 2024","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The project was done after the permission from the Institutional Ethics Committee.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"Waiver of consent was taken since it is a retrospective study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent"}},{"value":"None","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}]}}