{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T14:05:09Z","timestamp":1740146709913,"version":"3.37.3"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T00:00:00Z","timestamp":1618963200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R01CA185687"],"award-info":[{"award-number":["R01CA185687"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R50CA211115"],"award-info":[{"award-number":["R50CA211115"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000226","name":"Ontario Ministry of Health and Long-Term Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000226","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Children with central nervous system (CNS) tumors undergo frequent imaging for diagnosis and follow-up, but few studies have characterized longitudinal imaging patterns. We described medical imaging in children before and after malignant CNS tumor diagnosis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Procedure<\/jats:title>\n<jats:p>We conducted a retrospective cohort study of children aged 0\u201320 years diagnosed with CNS tumors between 1996\u20132016 at six U.S. integrated healthcare systems and Ontario, Canada. We collected computed topography (CT), magnetic resonance imaging (MRI), radiography, ultrasound, nuclear medicine examinations from 12 months before through 10 years after CNS diagnosis censoring six months before death or a subsequent cancer diagnosis, disenrollment from the health system, age 21 years, or December 31, 2016. We calculated imaging rates per child per month stratified by modality, country, diagnosis age, calendar year, time since diagnosis, and tumor grade.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>We observed 1,879 children with median four years follow-up post-diagnosis in the U.S. and seven years in Ontario, Canada. During the diagnosis period (\u00b115 days of diagnosis), children averaged 1.10 CTs (95% confidence interval [CI] 1.09\u20131.13) and 2.14 MRIs (95%CI 2.12\u20132.16) in the U.S., and 1.67 CTs (95%CI 1.65\u20131.68) and 1.86 MRIs (95%CI 1.85\u20131.88) in Ontario. Within one year after diagnosis, 19% of children had \u22655 CTs and 45% had \u22655 MRIs. By nine years after diagnosis, children averaged one MRI and one radiograph per year with little use of other imaging modalities.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>MRI and CT are commonly used for CNS tumor diagnosis, whereas MRI is the primary modality used during surveillance of children with CNS tumors.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0248643","type":"journal-article","created":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T17:27:38Z","timestamp":1619026058000},"page":"e0248643","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Long-term medical imaging use in children with central nervous system tumors"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6287-7391","authenticated-orcid":true,"given":"Erin J. A.","family":"Bowles","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana L.","family":"Miglioretti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marilyn L.","family":"Kwan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ute","family":"Bartels","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Furst","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie Y.","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cindy","family":"Lau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert T.","family":"Greenlee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheila","family":"Weinmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily C.","family":"Marlow","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alanna K.","family":"Rahm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasha K.","family":"Stout","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7175-9968","authenticated-orcid":true,"given":"Wes E.","family":"Bolch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Kay","family":"Theis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Smith-Bindman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason D.","family":"Pole","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,4,21]]},"reference":[{"key":"pone.0248643.ref001","unstructured":"National Brain Tumor Society [cited 2019 December 4]. Available from: www.braintumor.org."},{"key":"pone.0248643.ref002","unstructured":"American Cancer Society [cited 2019 December 4]. Available from: www.cancer.org."},{"issue":"12","key":"pone.0248643.ref003","doi-asserted-by":"crossref","first-page":"2716","DOI":"10.1158\/1055-9965.EPI-14-0207","article-title":"Childhood brain tumor epidemiology: a brain tumor epidemiology consortium review","volume":"23","author":"KJ Johnson","year":"2014","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"issue":"4","key":"pone.0248643.ref004","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1158\/1055-9965.EPI-08-0988","article-title":"Long-term survivors of childhood cancers in the United States","volume":"18","author":"AB Mariotto","year":"2009","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"issue":"suppl_4","key":"pone.0248643.ref005","doi-asserted-by":"crossref","first-page":"iv1","DOI":"10.1093\/neuonc\/noy131","article-title":"CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2011\u20132015","volume":"20","author":"QT Ostrom","year":"2018","journal-title":"Neuro Oncol."},{"issue":"1","key":"pone.0248643.ref006","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1007\/s00247-015-3454-1","article-title":"Imaging of acute and subacute toxicities of cancer therapy in children","volume":"46","author":"GB Chavhan","year":"2016","journal-title":"Pediatr Radiol"},{"issue":"Suppl 2","key":"pone.0248643.ref007","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1007\/s00247-011-2108-1","article-title":"Oncological imaging: tumor surveillance in children","volume":"41","author":"SC Kaste","year":"2011","journal-title":"Pediatr Radiol"},{"issue":"12","key":"pone.0248643.ref008","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1159\/000484936","article-title":"Late Effects and Long-Term Follow-Up after Cancer in Childhood","volume":"40","author":"T Langer","year":"2017","journal-title":"Oncol Res Treat"},{"issue":"8","key":"pone.0248643.ref009","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1001\/archpedi.161.8.798","article-title":"Guidelines for identification of, advocacy for, and intervention in neurocognitive problems in survivors of childhood cancer: a report from the Children\u2019s Oncology Group","volume":"161","author":"PC Nathan","year":"2007","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"8","key":"pone.0248643.ref010","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1002\/pbc.24533","article-title":"Imaging in childhood cancer: a Society for Pediatric Radiology and Children\u2019s Oncology Group Joint Task Force report","volume":"60","author":"DA Weiser","year":"2013","journal-title":"Pediatr Blood Cancer"},{"issue":"11","key":"pone.0248643.ref011","doi-asserted-by":"crossref","first-page":"e27311","DOI":"10.1002\/pbc.27311","article-title":"Surveillance imaging for high-grade childhood brain tumors: What to do 10 years after completion of treatment?","volume":"65","author":"M Otth","year":"2018","journal-title":"Pediatr Blood Cancer"},{"key":"pone.0248643.ref012","unstructured":"Children\u2019s Oncology Group: Long-term follow-up guidelines for survivors of childhood, adolescent, and young adult cancers [cited 2019 December 4]. Available from: http:\/\/survivorshipguidelines.org\/pdf\/2018\/COG_LTFU_Guidelines_v5.pdf."},{"key":"pone.0248643.ref013","unstructured":"National Comprehensive Cancer Network [Available from: https:\/\/www.nccn.org\/."},{"key":"pone.0248643.ref014","unstructured":"Scottish Intercollegiate Guidelines Network 132\u2014Long term follow up of survivors of childhood cancer [cited 2019 December 4]. Available from: https:\/\/www.sign.ac.uk\/assets\/sign132.pdf."},{"key":"pone.0248643.ref015","unstructured":"Guidelines from the Dutch Childhood Oncology Group (DCOG) \/ SKION\u2014Guidelines for follow-up in survivors of childhood cancer 5 years after diagnosis [cited 2019 December 4]. Available from: https:\/\/www.skion.nl\/workspace\/uploads\/vertaling-richtlijn-LATER-versie-final-okt-2014_2.pdf."},{"key":"pone.0248643.ref016","unstructured":"International Guideline Harmonization Group [cited 2019 December 4]. Available from: http:\/\/www.ighg.org\/guidelines\/topics\/central-nervous-system-malignancies\/."},{"issue":"27","key":"pone.0248643.ref017","doi-asserted-by":"crossref","first-page":"3055","DOI":"10.1200\/JCO.2014.59.8052","article-title":"Collaborative Research in Childhood Cancer Survivorship: The Current Landscape","volume":"33","author":"S Bhatia","year":"2015","journal-title":"J Clin Oncol"},{"issue":"4","key":"pone.0248643.ref018","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1002\/pbc.24445","article-title":"A worldwide collaboration to harmonize guidelines for the long-term follow-up of childhood and young adult cancer survivors: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group","volume":"60","author":"LC Kremer","year":"2013","journal-title":"Pediatr Blood Cancer"},{"issue":"9","key":"pone.0248643.ref019","doi-asserted-by":"crossref","first-page":"1324","DOI":"10.1007\/s00247-018-4162-4","article-title":"Staging and following common pediatric malignancies: MRI versus CT versus functional imaging","volume":"48","author":"SD Voss","year":"2018","journal-title":"Pediatr Radiol."},{"issue":"1","key":"pone.0248643.ref020","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1097\/MPH.0000000000000915","article-title":"Variability in Imaging Practices and Comparative Cumulative Effective Dose for Neuroblastoma and Nephroblastoma Patients at 6 Pediatric Oncology Centers","volume":"40","author":"B Morel","year":"2018","journal-title":"J Pediatr Hematol Oncol"},{"issue":"7","key":"pone.0248643.ref021","doi-asserted-by":"crossref","first-page":"e197249","DOI":"10.1001\/jamanetworkopen.2019.7249","article-title":"Trends in Medical Imaging During Pregnancy in the United States and Ontario, Canada, 1996 to 2016","volume":"2","author":"ML Kwan","year":"2019","journal-title":"JAMA Netw Open"},{"issue":"9","key":"pone.0248643.ref022","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1001\/jama.2019.11456","article-title":"Trends in Use of Medical Imaging in US Health Care Systems and in Ontario, Canada, 2000\u20132016","volume":"322","author":"R Smith-Bindman","year":"2019","journal-title":"JAMA"},{"key":"pone.0248643.ref023","unstructured":"International Classification of Childhood Cancer, version 3 [cited 2019 December 4]. Available from: https:\/\/seer.cancer.gov\/iccc\/iccc3.html."},{"issue":"6","key":"pone.0248643.ref024","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1007\/s00401-016-1545-1","article-title":"The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary","volume":"131","author":"DN Louis","year":"2016","journal-title":"Acta Neuropathol"},{"key":"pone.0248643.ref025","unstructured":"WHO Classification of Tumours of the Central Nervous System. Revised 4th Edition ed2016."},{"issue":"8","key":"pone.0248643.ref026","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1016\/S0009-9260(03)00129-6","article-title":"Imaging findings of paediatric oncology patients presenting with acute neurological symptoms","volume":"58","author":"WC Chu","year":"2003","journal-title":"Clin Radiol"},{"key":"pone.0248643.ref027","unstructured":"The Image Gently Alliance [cited 2019 December 4]. Available from: https:\/\/www.imagegently.org\/."},{"issue":"11","key":"pone.0248643.ref028","doi-asserted-by":"crossref","DOI":"10.1093\/jnci\/dju287","article-title":"An action plan for translating cancer survivorship research into care","volume":"106","author":"CM Alfano","year":"2014","journal-title":"J Natl Cancer Inst"},{"issue":"3","key":"pone.0248643.ref029","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1200\/JOP.2015.009258","article-title":"Identification of Key Gaps in Cancer Survivorship Research: Findings From the American Society of Clinical Oncology Survey","volume":"12","author":"PB Jacobsen","year":"2016","journal-title":"J Oncol Pract"},{"issue":"14","key":"pone.0248643.ref030","doi-asserted-by":"crossref","first-page":"2308","DOI":"10.1200\/JCO.2009.22.3339","article-title":"The Childhood Cancer Survivor Study: a National Cancer Institute-supported resource for outcome and intervention research","volume":"27","author":"LL Robison","year":"2009","journal-title":"J Clin Oncol"},{"key":"pone.0248643.ref031","unstructured":"National Cancer Institute Childhood Cancer Data Initiative [cited 2019 December 4]. Available from: https:\/\/www.cancer.gov\/research\/areas\/childhood\/childhood-cancer-data-initiative."},{"issue":"7","key":"pone.0248643.ref032","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/j.jclinane.2014.03.013","article-title":"Effect of one anesthetic exposure on long-term behavioral changes in children","volume":"26","author":"M Chemaly","year":"2014","journal-title":"J Clin Anesth"},{"issue":"2","key":"pone.0248643.ref033","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1097\/ALN.0000000000001735","article-title":"Association between Exposure of Young Children to Procedures Requiring General Anesthesia and Learning and Behavioral Outcomes in a Population-based Birth Cohort","volume":"127","author":"D Hu","year":"2017","journal-title":"Anesthesiology"},{"issue":"4","key":"pone.0248643.ref034","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1097\/ANA.0000000000000121","article-title":"Neurodevelopmental outcomes after initial childhood anesthetic exposure between ages 3 and 10 years","volume":"26","author":"CH Ing","year":"2014","journal-title":"J Neurosurg Anesthesiol"},{"key":"pone.0248643.ref035","unstructured":"U.S. Food & Drug Administration Safety Communication: FDA warns that gadolinium-based contrast agents (GBCAs) are retained in the body; requires new class of warnings [cited 2020 April 15]. Available from: https:\/\/www.fda.gov\/drugs\/drug-safety-and-availability\/fda-drug-safety-communication-fda-warns-gadolinium-based-contrast-agents-gbcas-are-retained-body."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0248643","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T17:28:40Z","timestamp":1619026120000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0248643"}},"subtitle":[],"editor":[{"given":"Roland A.","family":"Ammann","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,4,21]]},"references-count":35,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,4,21]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0248643","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2021,4,21]]}}}