{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T18:20:55Z","timestamp":1792693255549,"version":"4.5.0"},"reference-count":131,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T00:00:00Z","timestamp":1701216000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Malignant focal liver lesions (FLLs) are commonly reported in adults but rarely seen in the pediatric population. Due to the rarity, the understanding of these diseases is still very limited. In children, most malignant FLLs are congenital. It is very important to choose appropriate imaging examination concerning various factors. This paper will outline common pediatric malignant FLLs, including hepatoblastoma, hepatocellular carcinoma, and cholangiocarcinoma and discuss them against the background of the latest knowledge on comparable\/similar tumors in adults. Medical imaging features are of vital importance for the non-invasive diagnosis and follow-up of treatment of FLLs in pediatric patients. The use of CEUS in pediatric patients for characterizing those FLLs that remain indeterminate on conventional B mode ultrasounds may be an effective option in the future and has great potential to be integrated into imaging algorithms without the risk of exposure to ionizing radiation.<\/jats:p>","DOI":"10.3390\/diagnostics13233568","type":"journal-article","created":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T12:01:00Z","timestamp":1701259260000},"page":"3568","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Review on Pediatric Malignant Focal Liver Lesions with Imaging Evaluation: Part I"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0212-1477","authenticated-orcid":false,"given":"Yi","family":"Dong","sequence":"first","affiliation":[{"name":"Department of Ultrasound, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5893-088X","authenticated-orcid":false,"given":"Andrius","family":"Cekuolis","sequence":"additional","affiliation":[{"name":"Ultrasound Section, Department of Pediatric Radiology, Radiology and Nuclear Medicine Centre, Vilnius University Hospital Santaros Klinikos, 08661 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dagmar","family":"Schreiber-Dietrich","sequence":"additional","affiliation":[{"name":"Localinomed and Pediatric Department, Kliniken Salem, 3013 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasa","family":"Augustiniene","sequence":"additional","affiliation":[{"name":"Ultrasound Section, Department of Pediatric Radiology, Radiology and Nuclear Medicine Centre, Vilnius University Hospital Santaros Klinikos, 08661 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Schwarz","sequence":"additional","affiliation":[{"name":"Department of Neonatology and Pediatric Intensive Care Medicine, Sana Kliniken Duisburg GmbH, 47055 Duisburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"M\u00f6ller","sequence":"additional","affiliation":[{"name":"Medical Department I\/Gastroenterology, SANA Hospital Lichtenberg, 10365 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasenien","family":"Nourkami-Tutdibi","sequence":"additional","affiliation":[{"name":"Saarland University Medical Center, Hospital of General Pediatrics and Neonatology, 66421 Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8946-0609","authenticated-orcid":false,"given":"Sheng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia-Ying","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-Lin","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heike","family":"Taut","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital, Universit\u00e4tsklinikum Dresden, Technische Universit\u00e4t Dresden, 01069 Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Grevelding","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pneumology, Allergology, Infectious Diseases and Gastroenterology, University Hospital Frankfurt, Goethe University, 60323 Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6015-6347","authenticated-orcid":false,"given":"Christoph","family":"Dietrich","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China"},{"name":"Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Beau Site, Salem und Permanence, 3013 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.suronc.2007.07.002","article-title":"Tumors of the liver in children","volume":"16","author":"Meyers","year":"2007","journal-title":"Surg. Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1016\/j.cld.2018.06.008","article-title":"Pediatric Liver Tumors","volume":"22","author":"Ng","year":"2018","journal-title":"Clin. Liver Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1007\/s00330-008-1106-7","article-title":"Pediatric liver tumors\u2014A pictorial review","volume":"19","author":"Jha","year":"2009","journal-title":"Eur. Radiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1038\/modpathol.2013.80","article-title":"Towards an international pediatric liver tumor consensus classification: Proceedings of the Los Angeles COG liver tumors symposium","volume":"27","author":"Alaggio","year":"2014","journal-title":"Mod. Pathol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3980","DOI":"10.3748\/wjg.v24.i35.3980","article-title":"Pediatric hepatocellular carcinoma","volume":"24","author":"Khanna","year":"2018","journal-title":"World J. Gastroenterol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"8541","DOI":"10.3748\/wjg.v21.i28.8541","article-title":"Benign liver tumors in pediatric patients\u2013Review with emphasis on imaging features","volume":"21","author":"Chiorean","year":"2015","journal-title":"World J. Gastroenterol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1007\/s00247-018-4078-z","article-title":"2017 PRETEXT: Radiologic staging system for primary hepatic malignancies of childhood revised for the Paediatric Hepatic International Tumour Trial (PHITT)","volume":"48","author":"Towbin","year":"2018","journal-title":"Pediatr. Radiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1148\/rg.312105201","article-title":"From the archives of the AFIP: Pediatric liver masses: Radiologic-pathologic correlation. Part 2. Malignant tumors","volume":"31","author":"Chung","year":"2011","journal-title":"Radiographics"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1007\/s00247-016-3612-0","article-title":"Magnetic resonance imaging of primary pediatric liver tumors","volume":"46","author":"Pugmire","year":"2016","journal-title":"Pediatr. Radiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1097\/MPG.0b013e3182467a4b","article-title":"Targeted MRI contrast agents for pediatric hepatobiliary disease","volume":"54","author":"Courtier","year":"2012","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.1007\/s00247-019-04361-0","article-title":"Contrast-enhanced ultrasound of liver lesions in children","volume":"49","author":"Davis","year":"2019","journal-title":"Pediatr. Radiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1055\/a-1345-3626","article-title":"European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB): An Update on the Pediatric CEUS Registry on Behalf of the \u201cEFSUMB Pediatric CEUS Registry Working Group\u201d","volume":"42","author":"Dietrich","year":"2021","journal-title":"Ultraschall Der Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e20182609","DOI":"10.1542\/peds.2018-2609","article-title":"Advanced Ultrasound Techniques for Pediatric Imaging","volume":"143","author":"Hwang","year":"2019","journal-title":"Pediatrics"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"315","DOI":"10.11152\/mu-2063","article-title":"General advice in ultrasound based elastography of pediatric patients","volume":"21","author":"Dietrich","year":"2019","journal-title":"Med. Ultrason."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1097\/MPG.0b013e318249c12a","article-title":"Evaluation of risk factors for bleeding after liver biopsy in children","volume":"55","author":"Westheim","year":"2012","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_16","first-page":"33","article-title":"Role of Contrast-Enhanced Ultrasound (CEUS) in Paediatric Practice: An EFSUMB Position Statement","volume":"38","author":"Sidhu","year":"2017","journal-title":"Ultraschall Der Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2181","DOI":"10.1007\/s00247-021-04976-2","article-title":"Contrast-enhanced ultrasound of benign and malignant liver lesions in children","volume":"51","author":"Fang","year":"2021","journal-title":"Pediatr. Radiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1007\/s00247-013-2746-6","article-title":"Safety of contrast-enhanced ultrasound in children for non-cardiac applications: A review by the Society for Pediatric Radiology (SPR) and the International Contrast Ultrasound Society (ICUS)","volume":"43","author":"Darge","year":"2013","journal-title":"Pediatr. Radiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"487","DOI":"10.7863\/ultra.15.02030","article-title":"Off-Label Use of Ultrasound Contrast Agents for Intravenous Applications in Children: Analysis of the Existing Literature","volume":"35","author":"Rosado","year":"2016","journal-title":"J. Ultrasound Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"966","DOI":"10.2214\/AJR.13.12010","article-title":"Safety of ultrasound contrast agents in the pediatric oncologic population: A single-institution experience","volume":"202","author":"Coleman","year":"2014","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1007\/s11547-015-0535-z","article-title":"Accuracy of contrast-enhanced ultrasound (CEUS) in the identification and characterization of traumatic solid organ lesions in children: A retrospective comparison with baseline US and CE-MDCT","volume":"120","author":"Menichini","year":"2015","journal-title":"La Radiol. Medica"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1007\/s00247-011-2338-2","article-title":"Contrast-enhanced sonography of malignant pediatric abdominal and pelvic solid tumors: Preliminary safety and feasibility data","volume":"42","author":"McCarville","year":"2012","journal-title":"Pediatr. Radiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1016\/j.ultrasmedbio.2014.11.003","article-title":"Safety of intravenous application of second-generation ultrasound contrast agent in children: Prospective analysis","volume":"41","author":"Piskunowicz","year":"2015","journal-title":"Ultrasound Med. Biol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1055\/a-1177-0530","article-title":"Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) in the Liver\u2013Update 2020\u2013WFUMB in Cooperation with EFSUMB, AFSUMB, AIUM, and FLAUS","volume":"41","author":"Dietrich","year":"2020","journal-title":"Ultraschall Der Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2161","DOI":"10.1007\/s00247-021-05223-4","article-title":"Contrast-enhanced ultrasound: A comprehensive review of safety in children","volume":"51","author":"Ntoulia","year":"2021","journal-title":"Pediatr. Radiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1560","DOI":"10.1016\/j.ejrad.2014.06.007","article-title":"Ultrasound elastography and contrast-enhanced ultrasound in infants, children and adolescents","volume":"83","author":"Stenzel","year":"2014","journal-title":"Eur. J. Radiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1007\/s00247-018-4250-5","article-title":"Contrast-enhanced ultrasound in the diagnosis of pediatric focal nodular hyperplasia and hepatic adenoma: Interobserver reliability","volume":"49","author":"Fang","year":"2019","journal-title":"Pediatr. Radiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1055\/s-0033-1355785","article-title":"Contrast enhanced ultrasound (CEUS) characterization of grey-scale sonographic indeterminate focal liver lesions in pediatric practice","volume":"34","author":"Jacob","year":"2013","journal-title":"Ultraschall Der Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1177\/0284185113476020","article-title":"Pediatric computed tomography imaging guideline","volume":"54","author":"Young","year":"2013","journal-title":"Acta Radiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.ejrad.2004.03.031","article-title":"Pediatric abdominal applications of multidetector-row CT","volume":"52","author":"Yekeler","year":"2004","journal-title":"Eur. J. Radiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1148\/radiology.215.3.r00jn34897","article-title":"Reduced frequency of sedation of young children with multisection helical CT","volume":"215","author":"Pappas","year":"2000","journal-title":"Radiology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1007\/s00247-019-04402-8","article-title":"Rare malignant liver tumors in children","volume":"49","author":"Chavhan","year":"2019","journal-title":"Pediatr. Radiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s40644-016-0083-3","article-title":"MRI of paediatric liver tumours: How we review and report","volume":"16","author":"Shelmerdine","year":"2016","journal-title":"Cancer Imaging"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"W519","DOI":"10.2214\/AJR.10.6076","article-title":"An approach to pediatric liver MRI","volume":"196","author":"Mitchell","year":"2011","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/S1470-2045(16)30598-8","article-title":"Risk-stratified staging in paediatric hepatoblastoma: A unified analysis from the Children\u2019s Hepatic tumors International Collaboration","volume":"18","author":"Meyers","year":"2017","journal-title":"Lancet Oncol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.jpedsurg.2014.10.039","article-title":"Prognostic factors in fibrolamellar hepatocellular carcinoma in young people","volume":"50","author":"Darcy","year":"2015","journal-title":"J. Pediatr. Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"30408","DOI":"10.18632\/oncotarget.8149","article-title":"Applying of pretreatment extent of disease system in patients with hepatocellular carcinoma after curative partial hepatectomy","volume":"7","author":"Qiao","year":"2016","journal-title":"Oncotarget"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2698","DOI":"10.1016\/j.ejca.2013.04.012","article-title":"Fibrolamellar variant of hepatocellular carcinoma does not have a better survival than conventional hepatocellular carcinoma\u2014Results and treatment recommendations from the Childhood Liver Tumour Strategy Group (SIOPEL) experience","volume":"49","author":"Weeda","year":"2013","journal-title":"Eur. J. Cancer"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1053\/jhep.2003.50375","article-title":"Epidemiology of primary hepatic malignancies in U.S. children","volume":"38","author":"Darbari","year":"2003","journal-title":"Hepatology"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1002\/pbc.24215","article-title":"The epidemiology of hepatoblastoma","volume":"59","author":"Spector","year":"2012","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e623","DOI":"10.1542\/peds.2015-0224","article-title":"Incidence, Trends, and Survival of Children With Embryonal Tumors","volume":"136","author":"Tulla","year":"2015","journal-title":"Pediatrics"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1111\/ppe.12671","article-title":"Global trends in incidence rates of childhood liver cancers: A systematic review and meta-analysis","volume":"34","author":"Dasgupta","year":"2020","journal-title":"Paediatr. Perinat. Epidemiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1007\/s10024-005-1154-9","article-title":"Beckwith-Wiedemann syndrome: Historical, clinicopathological, and etiopathogenetic perspectives","volume":"8","author":"Cohen","year":"2005","journal-title":"Pediatr. Dev. Pathol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1186\/1750-1172-7-81","article-title":"The trisomy 18 syndrome","volume":"7","author":"Cereda","year":"2012","journal-title":"Orphanet J. Rare Dis."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/1750-1172-4-22","article-title":"Familial adenomatous polyposis","volume":"4","author":"Half","year":"2009","journal-title":"Orphanet J. Rare Dis."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1634\/theoncologist.5-6-445","article-title":"Childhood cancers: Hepatoblastoma","volume":"5","author":"Herzog","year":"2000","journal-title":"Oncologist"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1007\/s11912-022-01230-2","article-title":"Current Approaches in Hepatoblastoma-New Biological Insights to Inform Therapy","volume":"24","author":"Wu","year":"2022","journal-title":"Curr. Oncol. Rep."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1007\/s00247-017-4050-3","article-title":"Fractures in children with newly diagnosed hepatoblastoma","volume":"48","author":"Towbin","year":"2018","journal-title":"Pediatr. Radiol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/S1089-3261(05)70163-X","article-title":"Hepatic tumors in children","volume":"5","author":"Stocker","year":"2001","journal-title":"Clin. Liver Dis."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e29","DOI":"10.1016\/j.jpedsurg.2012.05.030","article-title":"Perinatal hemorrhage complicating neonatal hepatoblastoma: Case report","volume":"47","author":"Lai","year":"2012","journal-title":"J. Pediatr. Surg."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1053\/j.sempedsurg.2005.11.004","article-title":"Management of liver tumors in childhood","volume":"15","year":"2006","journal-title":"Semin. Pediatr. Surg."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"68","DOI":"10.4103\/jiaps.JIAPS_102_18","article-title":"Hepatoblastoma with Precocious Puberty","volume":"24","author":"Yhoshu","year":"2019","journal-title":"J. Indian Assoc. Pediatr. Surg."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/j.ejca.2007.11.022","article-title":"Hepatoblastoma with a low serum alpha-fetoprotein level at diagnosis: The SIOPEL group experience","volume":"44","author":"Brugieres","year":"2008","journal-title":"Eur. J. Cancer"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1148\/rg.251045156","article-title":"From the archives of the AFIP: A comprehensive review of fetal tumors with pathologic correlation","volume":"25","author":"Woodward","year":"2005","journal-title":"Radiographics"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"3130","DOI":"10.1002\/1097-0142(20011215)92:12<3130::AID-CNCR10115>3.0.CO;2-#","article-title":"Small cell undifferentiated histology in hepatoblastoma may be unfavorable","volume":"92","author":"Haas","year":"2001","journal-title":"Cancer"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1002\/pbc.24221","article-title":"Diagnosis and staging of hepatoblastoma: Imaging aspects","volume":"59","author":"McCarville","year":"2012","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Zhuang, H., Peng, Y.L., Chen, T.W., Jiang, Y., Luo, Y., Zhang, Q., and Yang, Z.G. (2011). The comparison of grey-scale ultrasonic and clinical features of hepatoblastoma and hepatocellular carcinoma in children: A retrospective study for ten years. BMC Gastroenterol., 11.","DOI":"10.1186\/1471-230X-11-78"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1016\/j.rcl.2011.05.002","article-title":"Hepatobiliary tumors","volume":"49","author":"Faingold","year":"2011","journal-title":"Radiol. Clin. N. Am."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"e11103","DOI":"10.5812\/hepatmon.11103","article-title":"Infantile hepatic hemangioendothelioma in comparison with hepatoblastoma in children: Clinical and ultrasound features","volume":"13","author":"Pan","year":"2013","journal-title":"Hepat. Mon."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1632","DOI":"10.1148\/rg.2017170073","article-title":"Contrast-enhanced US Assessment of Focal Liver Lesions in Children","volume":"37","author":"Anupindi","year":"2017","journal-title":"Radiographics"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"6747","DOI":"10.1007\/s00330-021-07784-2","article-title":"Development of a pediatric liver CEUS criterion to classify benign and malignant liver lesions in pediatric patients: A pilot study","volume":"31","author":"Wang","year":"2021","journal-title":"Eur. Radiol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"S238","DOI":"10.1007\/s00247-011-2005-7","article-title":"Contrast-enhanced sonography in pediatrics","volume":"41","author":"McCarville","year":"2011","journal-title":"Pediatr. Radiol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.clinimag.2017.03.023","article-title":"Contrast-enhanced CT features of hepatoblastoma: Can we predict histopathology?","volume":"44","author":"Baheti","year":"2017","journal-title":"Clin. Imaging"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"8850","DOI":"10.1007\/s00330-021-08047-w","article-title":"Outcome of staging chest CT and identification of factors associated with lung metastasis in children with hepatoblastoma","volume":"31","author":"Kim","year":"2021","journal-title":"Eur. Radiol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1007\/s12098-021-04016-9","article-title":"Role of Diffusion Weighted MRI (DW-MR) in Detection of Satellite Lesions Not Detected with Multiphase CT Scans in Hepatoblastoma and Its Implications for Management","volume":"89","author":"Sharma","year":"2022","journal-title":"Indian J. Pediatr."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1007\/s00247-011-2148-6","article-title":"Characterization of pediatric liver lesions with gadoxetate disodium","volume":"41","author":"Meyers","year":"2011","journal-title":"Pediatr. Radiol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e449","DOI":"10.1097\/RLU.0000000000001786","article-title":"Recurrent Scapular Metastasis From Hepatoblastoma Shown on FDG PET\/CT and F-DOPA PET\/CT","volume":"42","author":"Zhang","year":"2017","journal-title":"Clin. Nucl. Med."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Yang, T., Whitlock, R.S., and Vasudevan, S.A. (2019). Surgical Management of Hepatoblastoma and Recent Advances. Cancers, 11.","DOI":"10.3390\/cancers11121944"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1053\/j.semdp.2016.12.015","article-title":"Hepatoblastoma","volume":"34","author":"Sharma","year":"2017","journal-title":"Semin. Diagn. Pathol."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Lim, I.I.P., Bondoc, A.J., Geller, J.I., and Tiao, G.M. (2018). Hepatoblastoma-The Evolution of Biology, Surgery, and Transplantation. Children, 6.","DOI":"10.3390\/children6010001"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.2741\/e460","article-title":"Liver transplantation in the management of unresectable hepatoblastoma in children","volume":"4","author":"Meyers","year":"2012","journal-title":"Front. Biosci."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1186\/s40880-019-0411-7","article-title":"Incidence trends and survival prediction of hepatoblastoma in children: A population-based study","volume":"39","author":"Feng","year":"2019","journal-title":"Cancer Commun."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"e29932","DOI":"10.1002\/pbc.29932","article-title":"A nomogram model to predict prognosis of patients with hepatoblastoma","volume":"69","author":"Ke","year":"2022","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1016\/j.ejca.2012.10.003","article-title":"Relapses in hepatoblastoma patients: Clinical characteristics and outcome--experience of the International Childhood Liver Tumour Strategy Group (SIOPEL)","volume":"49","author":"Semeraro","year":"2013","journal-title":"Eur. J. Cancer"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/j.cld.2015.01.010","article-title":"Hepatocellular carcinoma in children","volume":"19","author":"Kelly","year":"2015","journal-title":"Clin. Liver Dis."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/j.cld.2011.03.011","article-title":"Liver neoplasia in children","volume":"15","author":"Hadzic","year":"2011","journal-title":"Clin. Liver Dis."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"2798","DOI":"10.1200\/JCO.2002.06.102","article-title":"Hepatocellular carcinoma in children: Results of the first prospective study of the International Society of Pediatric Oncology group","volume":"20","author":"Czauderna","year":"2002","journal-title":"J. Clin. Oncol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1111\/1751-2980.12846","article-title":"Living-donor liver transplantation for children with tyrosinemia type I","volume":"21","author":"Liu","year":"2020","journal-title":"J. Dig. Dis."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1111\/j.1399-3046.2005.00395.x","article-title":"Hepatocellular carcinoma in children and effect of living-donor liver transplantation on outcome","volume":"10","author":"Arikan","year":"2006","journal-title":"Pediatr. Transplant."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/j.jpeds.2011.03.004","article-title":"Hepatocellular carcinoma in biliary atresia: King\u2019s College Hospital experience","volume":"159","author":"Quaglia","year":"2011","journal-title":"J. Pediatr."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"2789","DOI":"10.1200\/JCO.2002.06.155","article-title":"Hepatocellular carcinoma in children and adolescents: Results from the Pediatric Oncology Group and the Children\u2019s Cancer Group intergroup study","volume":"20","author":"Katzenstein","year":"2002","journal-title":"J. Clin. Oncol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1053\/j.sempedsurg.2016.09.002","article-title":"Malignant tumors of the liver in children","volume":"25","author":"Aronson","year":"2016","journal-title":"Semin. Pediatr. Surg."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1016\/j.path.2020.09.002","article-title":"Pediatric Liver Tumors: Updates in Classification","volume":"13","author":"Cho","year":"2020","journal-title":"Surg. Pathol. Clin."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1584","DOI":"10.1002\/pbc.25094","article-title":"HCC prevalence and histopathological findings in liver explants of patients with hereditary tyrosinemia type 1","volume":"61","author":"Leite","year":"2014","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1111\/his.12312","article-title":"Childhood hepatocellular carcinoma: A clinicopathological study of 12 cases with special reference to EpCAM","volume":"64","author":"Zen","year":"2014","journal-title":"Histopathology"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1111\/j.1399-3046.2009.01062.x","article-title":"Liver transplantation in children with hepatocellular carcinoma. Do Milan criteria apply to pediatric patients?","volume":"13","author":"Ismail","year":"2009","journal-title":"Pediatr. Transplant."},{"key":"ref_87","unstructured":"Paradis, V., Fukayama, M., Park, Y.N., and Schirmacher, P. (2019). Tumours of the Liver and Intrahepatic Bile Ducts, IARC Publications. [5th ed.]. WHO Classification of Tumours."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/S0009-9260(03)00316-7","article-title":"Imaging features of hepatocellular carcinoma","volume":"59","author":"Yu","year":"2004","journal-title":"Clin. Radiol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"e27475","DOI":"10.1002\/pbc.27475","article-title":"Is hepatocellular carcinoma the same disease in children and adults? Comparison of histology, molecular background, and treatment in pediatric and adult patients","volume":"66","author":"Weeda","year":"2019","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"647","DOI":"10.2214\/AJR.22.27600","article-title":"Imaging Features of Hepatocellular Carcinoma in Children With and Without Underlying Risk Factors","volume":"219","author":"Rees","year":"2022","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"2579","DOI":"10.1016\/j.ultrasmedbio.2020.04.030","article-title":"Guidelines and Good Clinical Practice Recommendations for Contrast-Enhanced Ultrasound (CEUS) in the Liver-Update 2020 WFUMB in Cooperation with EFSUMB, AFSUMB, AIUM, and FLAUS","volume":"46","author":"Dietrich","year":"2020","journal-title":"Ultrasound Med. Biol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.2214\/AJR.21.25713","article-title":"Contrast-Enhanced Ultrasound in Children: Implementation and Key Diagnostic Applications","volume":"217","author":"Squires","year":"2021","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1007\/s00247-021-04989-x","article-title":"Imaging and clinical features of pediatric hepatocellular carcinoma","volume":"51","author":"Arias","year":"2021","journal-title":"Pediatr. Radiol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1186\/s13256-019-2099-3","article-title":"Hepatocellular carcinoma with vertebral metastasis in a child with hepatitis B virus infection: A case report","volume":"13","author":"Alemayehu","year":"2019","journal-title":"J. Med. Case Rep."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.1148\/rg.2016160017","article-title":"Liver MR Imaging in Children: Current Concepts and Technique","volume":"36","author":"Chavhan","year":"2016","journal-title":"Radiographics"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/S1089-3261(03)00070-9","article-title":"Malignant liver tumors","volume":"6","author":"Levy","year":"2002","journal-title":"Clin. Liver Dis."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1148\/radiographics.22.5.g02se061023","article-title":"Benign versus malignant hepatic nodules: MR imaging findings with pathologic correlation","volume":"22","author":"Hussain","year":"2002","journal-title":"Radiographics"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1007\/s12072-017-9799-9","article-title":"Asia-Pacific clinical practice guidelines on the management of hepatocellular carcinoma: A 2017 update","volume":"11","author":"Omata","year":"2017","journal-title":"Hepatol. Int."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1148\/radiol.2018181494","article-title":"Liver Imaging Reporting and Data System (LI-RADS) Version 2018: Imaging of Hepatocellular Carcinoma in At-Risk Patients","volume":"289","author":"Chernyak","year":"2018","journal-title":"Radiology"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1148\/radiol.2021203559","article-title":"Diagnostic Performance of LI-RADS Version 2018 for Evaluation of Pediatric Hepatocellular Carcinoma","volume":"299","author":"Khanna","year":"2021","journal-title":"Radiology"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"e14135","DOI":"10.1111\/petr.14135","article-title":"Long-term survival after choriocarcinoma transmitted by liver graft: A successful report in pediatric transplantation","volume":"26","author":"Pessanha","year":"2022","journal-title":"Pediatr. Transplant."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1148\/radiographics.19.2.g99mr09453","article-title":"Fibrolamellar carcinoma of the liver: Radiologic-pathologic correlation","volume":"19","author":"McLarney","year":"1999","journal-title":"Radiographics"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1055\/a-1110-7124","article-title":"Imaging Features of Fibrolamellar Hepatocellular Carcinoma with Contrast-Enhanced Ultrasound","volume":"42","author":"Dong","year":"2021","journal-title":"Ultraschall Der Med."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"3340","DOI":"10.1007\/s00261-018-1657-2","article-title":"Fibrolamellar hepatocellular carcinoma: Multiphasic CT features of the primary tumor on pre-therapy CT and pattern of distant metastases","volume":"43","author":"Ganeshan","year":"2018","journal-title":"Abdom. Radiol."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1111\/his.13297","article-title":"Hepatocellular malignant neoplasm, NOS: A clinicopathological study of 11 cases from a single institution","volume":"71","author":"Zhou","year":"2017","journal-title":"Histopathology"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"59","DOI":"10.21037\/tgh.2018.09.05","article-title":"Hepatocellular carcinoma in children: Hepatic resection and liver transplantation","volume":"3","author":"Angelico","year":"2018","journal-title":"Transl. Gastroenterol. Hepatol."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"15","DOI":"10.2147\/JHC.S94008","article-title":"Pediatric hepatocellular carcinoma: Challenges and solutions","volume":"4","author":"Schmid","year":"2017","journal-title":"J. Hepatocell. Carcinoma"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"670728","DOI":"10.1155\/2015\/670728","article-title":"Hepatocellular Carcinoma in the Pediatric Population: A Population Based Clinical Outcomes Study Involving 257 Patients from the Surveillance, Epidemiology, and End Result (SEER) Database (1973\u20132011)","volume":"2015","author":"Lau","year":"2015","journal-title":"HPB Surg."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1002\/pbc.22893","article-title":"Critical review of controversial issues in the management of advanced pediatric liver tumors","volume":"56","author":"Gupta","year":"2011","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1002\/pbc.23295","article-title":"Sorafenib and cisplatin\/doxorubicin (PLADO) in pediatric hepatocellular carcinoma","volume":"58","author":"Schmid","year":"2012","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"e13007","DOI":"10.1111\/petr.13007","article-title":"Management of pediatric hepatocellular carcinoma: A multimodal approach","volume":"21","author":"Kohorst","year":"2017","journal-title":"Pediatr. Transplant."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"e27293","DOI":"10.1002\/pbc.27293","article-title":"Surgical management of children and adolescents with upfront completely resected hepatocellular carcinoma","volume":"65","author":"Shah","year":"2018","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1007\/s11605-017-3420-3","article-title":"Hepatocellular Carcinoma in Children and Adolescents: Clinical Characteristics and Treatment","volume":"21","author":"Wang","year":"2017","journal-title":"J. Gastrointest. Surg."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1111\/petr.12144","article-title":"Surgical treatment of primary liver tumors in children: Outcomes analysis of resection and transplantation in the SEER database","volume":"17","author":"McAteer","year":"2013","journal-title":"Pediatr. Transplant."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1002\/lt.24994","article-title":"Survival of children after liver transplantation for hepatocellular carcinoma","volume":"24","author":"Baumann","year":"2018","journal-title":"Liver Transplant."},{"key":"ref_116","first-page":"6828037","article-title":"Cholangiocarcinoma in a Child with Progressive Abdominal Distension and Secondary Hypercalcemia","volume":"2018","author":"Monsereenusorn","year":"2018","journal-title":"Case Rep. Pediatr."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"e12","DOI":"10.1097\/MPG.0000000000001749","article-title":"Cholangiocarcinoma Among Children and Adolescents: A Review of the Literature and Surveillance, Epidemiology, and End Results Program Database Analysis","volume":"66","author":"Newsome","year":"2018","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1093\/annonc\/10.suppl_4.S94","article-title":"Choledochal cystic malignancies","volume":"10","author":"Bismuth","year":"1999","journal-title":"Ann. Oncol."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"e113","DOI":"10.1016\/j.crad.2013.10.017","article-title":"Hepatic tumours in children with biliary atresia: Single-centre experience in 13 cases and review of the literature","volume":"69","author":"Yoon","year":"2014","journal-title":"Clin. Radiol."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"2320","DOI":"10.1007\/s10620-014-3152-0","article-title":"Cholangiocarcinoma and high-grade dysplasia in young patients with primary sclerosing cholangitis","volume":"59","author":"Liu","year":"2014","journal-title":"Dig. Dis. Sci."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"1677","DOI":"10.1111\/j.1572-0241.2007.01220.x","article-title":"Cholangiocarcinoma in young individuals with and without primary sclerosing cholangitis","volume":"102","author":"Angulo","year":"2007","journal-title":"Am. J. Gastroenterol."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1097\/MPG.0b013e3181f9a5d2","article-title":"Cholangiocarcinoma in a 17-year-old boy with primary sclerosing cholangitis and inflammatory bowel disease","volume":"52","author":"Deneau","year":"2011","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"977","DOI":"10.4049\/jimmunol.158.2.977","article-title":"Cholangiopathy and tumors of the pancreas, liver, and biliary tree in boys with X-linked immunodeficiency with hyper-IgM","volume":"158","author":"Hayward","year":"1997","journal-title":"J. Immunol."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1258\/ijsa.2008.008078","article-title":"Cholangiocarcinoma presenting in an adolescent with vertically acquired HIV infection","volume":"19","author":"Mangeya","year":"2008","journal-title":"Int. J. STD AIDS"},{"key":"ref_125","first-page":"395","article-title":"Cholangiocarcinoma occurring after childhood radiotherapy for Wilm\u2019s tumor","volume":"37","author":"Cunningham","year":"1990","journal-title":"Hepato-Gastroenterology"},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.bpg.2015.02.006","article-title":"Pathologic classification of cholangiocarcinoma: New concepts","volume":"29","author":"Nakanuma","year":"2015","journal-title":"Best Pract. Res. Clin. Gastroenterol."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1177\/10935266221119769","article-title":"Solid-Tubulocystic Variant of Intrahepatic Cholangiocarcinoma: Report of a Pediatric Case With Molecular Characterization","volume":"25","author":"Linn","year":"2022","journal-title":"Pediatr. Dev. Pathol."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"1212","DOI":"10.1016\/j.jhep.2021.01.035","article-title":"Combined hepatocellular-cholangiocarcinoma: An update","volume":"74","author":"Calderaro","year":"2021","journal-title":"J. Hepatol."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.1016\/j.jpedsurg.2005.10.066","article-title":"An 11-year-old male patient demonstrating cholangiocarcinoma associated with congenital biliary dilatation","volume":"41","author":"Tanaka","year":"2006","journal-title":"J. Pediatr. Surg."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.ultrasmedbio.2018.08.014","article-title":"Enhancement Patterns of Intrahepatic Cholangiocarcinoma on Contrast-Enhanced Ultrasound: Correlation with Clinicopathologic Findings and Prognosis","volume":"45","author":"Yuan","year":"2019","journal-title":"Ultrasound Med. Biol."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"e333","DOI":"10.1097\/MPH.0000000000000335","article-title":"A Sporadic Case of Advanced Metastatic Cholangiocarcinoma in a Child: A Case Report and Review of Literature","volume":"37","author":"Hall","year":"2015","journal-title":"J. Pediatr. Hematol.\/Oncol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/23\/3568\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:33:56Z","timestamp":1760132036000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/23\/3568"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,29]]},"references-count":131,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["diagnostics13233568"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics13233568","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,29]]}}}