{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T04:40:53Z","timestamp":1772080853569,"version":"3.50.1"},"reference-count":38,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,7,29]],"date-time":"2019-07-29T00:00:00Z","timestamp":1564358400000},"content-version":"vor","delay-in-days":28,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The rate of renal involvement in pediatric acute lymphoblastic leukemia (<jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content>) at diagnosis varies between reports because renal involvement is diagnosed on renal size larger than aged\u2010matched standards on conventional modalities. We propose a new method for precise renal involvement detection using 3\u2010D enhanced computed tomography (<jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>) reconstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010five children with <jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content> were evaluated utilizing 3\u2010D enhanced <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> reconstruction to measure renal volume before and after induction therapy, renal mass lesions and renal axis at diagnosis. Renal involvement was defined as a marked decrease of renal volume or the presence of mass lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>According to the 3D\u2010<jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> criteria, nine of 25 patients (36%) had renal involvement. All of them had bilateral mass lesions except for one who had diffuse nephromegaly alone. This method detected renal involvement more accurately than ultrasonography. When using conventional criteria based on the length of the renal axis, 19 of 25 (76%) had renal involvement, including many cases of false\u2010positive nephromegaly. Patients with renal involvement had significantly more extramedullary involvement according to the 3D\u2010<jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>\u2010based criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The use of 3D\u2010<jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> reconstruction was accurate in detecting renal involvement in childhood <jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content>, most of which consisted of piled up mass lesions. Patients with renal involvement should be worked up for the detection of other extramedullary lesions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ped.13907","type":"journal-article","created":{"date-parts":[[2019,6,7]],"date-time":"2019-06-07T15:16:05Z","timestamp":1559920565000},"page":"679-687","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Accurate detection of renal leukemic involvement in children using 3\u2010D computed tomography modeling"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3526-4618","authenticated-orcid":false,"given":"Toshihiro","family":"Fujiki","sequence":"first","affiliation":[{"name":"Department of Pediatrics Kanazawa University Kanazawa, Ishikawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryosei","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Kanazawa University Kanazawa, Ishikawa 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