{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T12:08:22Z","timestamp":1779451702755,"version":"3.53.1"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"1182","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To explore the differences in clinicopathological and imaging features between pediatric adrenocortical carcinoma (ACC) and non-carcinoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The clinicopathological and imaging (CT\/MR) findings of 32 children with pathologically proven adrenocortical tumors (ACT) (10 adenomas, 10 with uncertain malignant potential, and 12 carcinomas) were reviewed and compared retrospectively. Multivariate logistic regression was used further to explore the independent predictive factors for ACC and non-carcinoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median age of children with ACC was 3\u2009years old, with an interquartile range (IQR) of 1.813-4.375\u2009years old. ACC was larger and more likely to be accompanied by extensive internal necrosis, calcification, and distant metastasis. ACC commonly showed a spoke-wheel enhanced pattern and peripheral fibrous septa with small blood-feeding arteries. There were significant statistical differences among these 3 groups in the maximum value of unenhanced CT, the maximum and skewness value in the venous phase, the minimum ADC value, and Ki-67 labeling index (P\u2009=\u2009.02, .003, .022, .002, and .000). The fibrous septa with small blood-feeding arteries and Ki-67 labeling index were independent predictive factors for the prediction of ACC and non-carcinoma, with P values and OR values of .038 and 15.62, and .011 and 1.16. And the AUC, the accuracy, the sensitivity, and specificity were 0.962 (95% CI, 0.828-0.998), 90.62%, 100%, and 85%, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pediatric ACC was larger and was commonly accompanied by extensive internal necrosis, calcification, and distant metastasis. Fibrous septa with small blood-feeding arteries and the Ki-67 labeling index were independent predictors of ACC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Advances in knowledge<\/jats:title>\n                    <jats:p>Pediatric ACC showed a spoke-wheel enhanced pattern and peripheral fibrous septa with small blood-feeding arteries. The fibrous septa with small blood-feeding arteries and Ki-67 labeling index were independent predictive factors for the differentiation of ACC and non-carcinoma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjr\/tqag067","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T17:03:57Z","timestamp":1774544637000},"page":"1202-1209","source":"Crossref","is-referenced-by-count":0,"title":["Clinicopathological and imaging features of pediatric adrenocortical carcinoma: compared with non-carcinoma"],"prefix":"10.1093","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2441-5361","authenticated-orcid":false,"given":"Peian","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Radiology, Children\u2019s Hospital of Fudan University, National Children\u2019s Medical Center , Shanghai 201102,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiology, Minhang Branch, Fudan University Shanghai Cancer Center , Shanghai 200240,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9922-1000","authenticated-orcid":false,"given":"Zhengrong","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Radiology, Minhang Branch, Fudan University Shanghai Cancer Center , Shanghai 200240,","place":["China"]},{"name":"Department of Radiology, Fudan University Shanghai Cancer Center , Shanghai 200032,","place":["China"]},{"name":"Department of Oncology, Shanghai Medical College, Fudan University , Shanghai 200032,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"2026052207311805400_tqag067-B1","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1007\/s00383-015-3708-x","article-title":"Usefulness of Wieneke criteria in assessing morphologic characteristics of adrenocortical tumors in children","volume":"31","author":"Chatterjee","year":"2015","journal-title":"Pediatr Surg Int"},{"key":"2026052207311805400_tqag067-B2","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1159\/000488855","article-title":"Adrenocortical carcinoma in children: a clinicopathological analysis of 41 patients at the Mayo clinic from 1950 to 2017","volume":"90","author":"Gupta","year":"2018","journal-title":"Horm Res Paediatr"},{"key":"2026052207311805400_tqag067-B3","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1200\/JCO.2013.52.6863","article-title":"Prevalence and functional consequence of TP53 mutations in pediatric adrenocortical carcinoma: a children\u2019s oncology group study","volume":"33","author":"Wasserman","year":"2015","journal-title":"J Clin Oncol"},{"key":"2026052207311805400_tqag067-B4","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1186\/s40001-023-01381-3","article-title":"Pediatric adrenocortical carcinoma: clinical features and application of neoadjuvant chemotherapy","volume":"28","author":"Lin","year":"2023","journal-title":"Eur J Med Res"},{"key":"2026052207311805400_tqag067-B5","doi-asserted-by":"publisher","first-page":"81","DOI":"10.5114\/pedm.2024.139271","article-title":"Adrenal cortical carcinoma: paediatric aspects - literature review. 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