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MRI Characteristics of Pediatric Renal Tumors: A SIOP‐RTSG Radiology Panel Delphi Study

BACKGROUND: The SIOP‐Renal Tumor Study Group (RTSG) does not advocate invasive procedures to determine histology before the start of therapy. This may induce misdiagnosis‐based treatment initiation, but only for a relatively small percentage of approximately 10% of non‐Wilms tumors (non‐WTs). MRI co...

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Autores principales: van der Beek, Justine N., Watson, Tom A., Nievelstein, Rutger A.J., Brisse, Hervé J., Morosi, Carlo, Lederman, Henrique M., Coma, Ana, Gavra, Maria M., Vult von Steyern, Kristina, Lakatos, Karoly, Breysem, Luc, Varga, Edit, Ducou Le Pointe, Hubert, Lequin, Maarten H., Schäfer, Jürgen F., Mentzel, Hans‐Joachim, Hötker, Andreas M., Calareso, Giuseppina, Swinson, Sophie, Kyncl, Martin, Granata, Claudio, Aertsen, Michael, Di Paolo, Pier Luigi, de Krijger, Ronald R., Graf, Norbert, Olsen, Øystein E., Schenk, Jens‐Peter, van den Heuvel‐Eibrink, Marry M., Littooij, Annemieke S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9291546/
https://www.ncbi.nlm.nih.gov/pubmed/34363274
http://dx.doi.org/10.1002/jmri.27878
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author van der Beek, Justine N.
Watson, Tom A.
Nievelstein, Rutger A.J.
Brisse, Hervé J.
Morosi, Carlo
Lederman, Henrique M.
Coma, Ana
Gavra, Maria M.
Vult von Steyern, Kristina
Lakatos, Karoly
Breysem, Luc
Varga, Edit
Ducou Le Pointe, Hubert
Lequin, Maarten H.
Schäfer, Jürgen F.
Mentzel, Hans‐Joachim
Hötker, Andreas M.
Calareso, Giuseppina
Swinson, Sophie
Kyncl, Martin
Granata, Claudio
Aertsen, Michael
Di Paolo, Pier Luigi
de Krijger, Ronald R.
Graf, Norbert
Olsen, Øystein E.
Schenk, Jens‐Peter
van den Heuvel‐Eibrink, Marry M.
Littooij, Annemieke S.
author_facet van der Beek, Justine N.
Watson, Tom A.
Nievelstein, Rutger A.J.
Brisse, Hervé J.
Morosi, Carlo
Lederman, Henrique M.
Coma, Ana
Gavra, Maria M.
Vult von Steyern, Kristina
Lakatos, Karoly
Breysem, Luc
Varga, Edit
Ducou Le Pointe, Hubert
Lequin, Maarten H.
Schäfer, Jürgen F.
Mentzel, Hans‐Joachim
Hötker, Andreas M.
Calareso, Giuseppina
Swinson, Sophie
Kyncl, Martin
Granata, Claudio
Aertsen, Michael
Di Paolo, Pier Luigi
de Krijger, Ronald R.
Graf, Norbert
Olsen, Øystein E.
Schenk, Jens‐Peter
van den Heuvel‐Eibrink, Marry M.
Littooij, Annemieke S.
author_sort van der Beek, Justine N.
collection PubMed
description BACKGROUND: The SIOP‐Renal Tumor Study Group (RTSG) does not advocate invasive procedures to determine histology before the start of therapy. This may induce misdiagnosis‐based treatment initiation, but only for a relatively small percentage of approximately 10% of non‐Wilms tumors (non‐WTs). MRI could be useful for reducing misdiagnosis, but there is no global consensus on differentiating characteristics. PURPOSE: To identify MRI characteristics that may be used for discrimination of newly diagnosed pediatric renal tumors. STUDY TYPE: Consensus process using a Delphi method. POPULATION: Not applicable. FIELD STRENGTH/SEQUENCE: Abdominal MRI including T1‐ and T2‐weighted imaging, contrast‐enhanced MRI, and diffusion‐weighted imaging at 1.5 or 3 T. ASSESSMENT: Twenty‐three radiologists from the SIOP‐RTSG radiology panel with ≥5 years of experience in MRI of pediatric renal tumors and/or who had assessed ≥50 MRI scans of pediatric renal tumors in the past 5 years identified potentially discriminatory characteristics in the first questionnaire. These characteristics were scored in the subsequent second round, consisting of 5‐point Likert scales, ranking‐ and multiple choice questions. STATISTICAL TESTS: The cut‐off value for consensus and agreement among the majority was ≥75% and ≥60%, respectively, with a median of ≥4 on the Likert scale. RESULTS: Consensus on specific characteristics mainly concerned the discrimination between WTs and non‐WTs, and WTs and nephrogenic rest(s) (NR)/nephroblastomatosis. The presence of bilateral lesions (75.0%) and NR/nephroblastomatosis (65.0%) were MRI characteristics indicated as specific for the diagnosis of a WT, and 91.3% of the participants agreed that MRI is useful to distinguish NR/nephroblastomatosis from WT. Furthermore, all participants agreed that age influenced their prediction in the discrimination of pediatric renal tumors. DATA CONCLUSION: Although the discrimination of pediatric renal tumors based on MRI remains challenging, this study identified some specific characteristics for tumor subtypes, based on the shared opinion of experts. These results may guide future validation studies and innovative efforts. Level of Evidence: 3 Technical Efficacy Stage: 3
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spelling pubmed-92915462022-07-20 MRI Characteristics of Pediatric Renal Tumors: A SIOP‐RTSG Radiology Panel Delphi Study van der Beek, Justine N. Watson, Tom A. Nievelstein, Rutger A.J. Brisse, Hervé J. Morosi, Carlo Lederman, Henrique M. Coma, Ana Gavra, Maria M. Vult von Steyern, Kristina Lakatos, Karoly Breysem, Luc Varga, Edit Ducou Le Pointe, Hubert Lequin, Maarten H. Schäfer, Jürgen F. Mentzel, Hans‐Joachim Hötker, Andreas M. Calareso, Giuseppina Swinson, Sophie Kyncl, Martin Granata, Claudio Aertsen, Michael Di Paolo, Pier Luigi de Krijger, Ronald R. Graf, Norbert Olsen, Øystein E. Schenk, Jens‐Peter van den Heuvel‐Eibrink, Marry M. Littooij, Annemieke S. J Magn Reson Imaging Research Articles BACKGROUND: The SIOP‐Renal Tumor Study Group (RTSG) does not advocate invasive procedures to determine histology before the start of therapy. This may induce misdiagnosis‐based treatment initiation, but only for a relatively small percentage of approximately 10% of non‐Wilms tumors (non‐WTs). MRI could be useful for reducing misdiagnosis, but there is no global consensus on differentiating characteristics. PURPOSE: To identify MRI characteristics that may be used for discrimination of newly diagnosed pediatric renal tumors. STUDY TYPE: Consensus process using a Delphi method. POPULATION: Not applicable. FIELD STRENGTH/SEQUENCE: Abdominal MRI including T1‐ and T2‐weighted imaging, contrast‐enhanced MRI, and diffusion‐weighted imaging at 1.5 or 3 T. ASSESSMENT: Twenty‐three radiologists from the SIOP‐RTSG radiology panel with ≥5 years of experience in MRI of pediatric renal tumors and/or who had assessed ≥50 MRI scans of pediatric renal tumors in the past 5 years identified potentially discriminatory characteristics in the first questionnaire. These characteristics were scored in the subsequent second round, consisting of 5‐point Likert scales, ranking‐ and multiple choice questions. STATISTICAL TESTS: The cut‐off value for consensus and agreement among the majority was ≥75% and ≥60%, respectively, with a median of ≥4 on the Likert scale. RESULTS: Consensus on specific characteristics mainly concerned the discrimination between WTs and non‐WTs, and WTs and nephrogenic rest(s) (NR)/nephroblastomatosis. The presence of bilateral lesions (75.0%) and NR/nephroblastomatosis (65.0%) were MRI characteristics indicated as specific for the diagnosis of a WT, and 91.3% of the participants agreed that MRI is useful to distinguish NR/nephroblastomatosis from WT. Furthermore, all participants agreed that age influenced their prediction in the discrimination of pediatric renal tumors. DATA CONCLUSION: Although the discrimination of pediatric renal tumors based on MRI remains challenging, this study identified some specific characteristics for tumor subtypes, based on the shared opinion of experts. These results may guide future validation studies and innovative efforts. Level of Evidence: 3 Technical Efficacy Stage: 3 John Wiley & Sons, Inc. 2021-08-06 2022-02 /pmc/articles/PMC9291546/ /pubmed/34363274 http://dx.doi.org/10.1002/jmri.27878 Text en © 2021 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Research Articles
van der Beek, Justine N.
Watson, Tom A.
Nievelstein, Rutger A.J.
Brisse, Hervé J.
Morosi, Carlo
Lederman, Henrique M.
Coma, Ana
Gavra, Maria M.
Vult von Steyern, Kristina
Lakatos, Karoly
Breysem, Luc
Varga, Edit
Ducou Le Pointe, Hubert
Lequin, Maarten H.
Schäfer, Jürgen F.
Mentzel, Hans‐Joachim
Hötker, Andreas M.
Calareso, Giuseppina
Swinson, Sophie
Kyncl, Martin
Granata, Claudio
Aertsen, Michael
Di Paolo, Pier Luigi
de Krijger, Ronald R.
Graf, Norbert
Olsen, Øystein E.
Schenk, Jens‐Peter
van den Heuvel‐Eibrink, Marry M.
Littooij, Annemieke S.
MRI Characteristics of Pediatric Renal Tumors: A SIOP‐RTSG Radiology Panel Delphi Study
title MRI Characteristics of Pediatric Renal Tumors: A SIOP‐RTSG Radiology Panel Delphi Study
title_full MRI Characteristics of Pediatric Renal Tumors: A SIOP‐RTSG Radiology Panel Delphi Study
title_fullStr MRI Characteristics of Pediatric Renal Tumors: A SIOP‐RTSG Radiology Panel Delphi Study
title_full_unstemmed MRI Characteristics of Pediatric Renal Tumors: A SIOP‐RTSG Radiology Panel Delphi Study
title_short MRI Characteristics of Pediatric Renal Tumors: A SIOP‐RTSG Radiology Panel Delphi Study
title_sort mri characteristics of pediatric renal tumors: a siop‐rtsg radiology panel delphi study
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9291546/
https://www.ncbi.nlm.nih.gov/pubmed/34363274
http://dx.doi.org/10.1002/jmri.27878
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