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Osteonecrosis is a well-recognized complication in patients treated with corticosteroids. The incidence of osteonecrosis in children treated for Hodgkin lymphoma is unknown because prospective whole-body magnetic resonance imaging (MRI) studies are lacking in this patient population. Paediatric patients with newly diagnosed Hodgkin lymphoma who were treated according to a uniform paediatric Hodgkin protocol were eligible for inclusion in this prospective study. Whole-body MRI was performed in all 24 included patients (mean age 15·1 years, 12 girls) both before treatment and after 2 cycles of chemotherapy, and in 16 patients after completion of chemotherapy. Osteonecrosis was identified in 10 patients (41·7%, 95% confidence interval: 22·0-61·4%), with a total of 56 osteonecrotic sites. Osteonecrosis was detected in 8 patients after 2 cycles of OEPA (vincristine, etoposide, prednisone, doxorubicin), and in 2 additional patients after completion of chemotherapy. Epiphyseal involvement of long bones was seen in 4 of 10 children. None of the patients with osteonecrosis had any signs of bone collapse at the times of scanning. Whole-body MRI demonstrates osteonecrosis to be a common finding occurring during therapy response assessment of paediatric Hodgkin lymphoma. Detection of early epiphyseal osteonecrosis could allow for treatment before bone collapse and joint damage may occur., (© 2016 John Wiley & Sons Ltd.)

Purpose To determine if hepatic gadolinium deposition occurs in pediatric patients with iron overload but normal renal and hepatic function who undergo gadolinium-based contrast agent (GBCA)-enhanced magnetic resonance (MR) imaging. Materials and Methods Design and execution of this study was approved by the Ethical Committee of Institute for Research in Maternal and Child Health Burlo Garofolo of Trieste (reference no. 1105/2015). Because of the retrospective nature of the study, the requirement to obtain informed consent was waived. Twenty-one recipients of allogeneic hematopoietic stem cell transplants who underwent GBCA-enhanced MR imaging for suspected infection or relapse followed by liver biopsy comprised the study group. The number of GBCA-enhanced MR examinations and cumulative gadolinium dose for each patient was analyzed by comparing liver histologic analysis and iron and gadolinium liver concentration (GLC). Eight patients had siderosis and underwent chelation therapy. The study group was compared with four control patients who were never exposed to GBCA. Statistical analysis was performed with Spearman rank coefficient for correlation. Results All 21 patients had positive correlations between GLC and total GBCA dose (r = 0.4486; P < .05) and between GLC and liver iron concentration (r = 0.56; P < .05). Patients who underwent deferoxamine therapy had a significant reduction of GLC (from 0.64 μg/g ± 0.29 to 0.20 μg/g ± 0.17 [standard deviation]; P < .05). Conclusion In the presence of siderosis, a transmetallation mechanism may be set off between ferric ion and gadoterate meglumine. Deferoxamine appears capable of binding to gadolinium ion. Further studies of the safety of GBCAs in severe siderosis are needed. Chelation should be considered in patients with iron overload and a history of GBCA exposure. © RSNA, 2016.

Teleradiology is a useful practice to provide remote consultation from specialists or senior staff, when no staff is available "on-site", and a quick consultation or a second opinion is necessary. Recently smartphones with high quality display have been marketed. The aim of our study was to determine if these devices could be used for paediatric radiologic remote consultation without loss of diagnostic information. Ninety-three paediatric exams were evaluated. CT and MRI examinations were randomly chosen among performed exams and sent to two different smartphones (Apple iPhone and Nexus One -Android OS-) using a VPN encrypted connection. Two independent radiologists evaluated the images prospectively. Results were collected in a database and compared with the gold standard result (PACS system, EBIT Aet DICOMed Review v.4.1, and monitors officially certified for radiologic interpretation). Concordance between diagnostic interpretation using smartphones and the golden standard was 97.52%. Values of specificity and sensitivity were respectively 100% and 96.3%, with a PPV of 100% and a NPV of 93.0%. Missing findings were only minor ones, while the overall diagnostic interpretation was essentially the same. These preliminary results show that diagnostic accuracy of radiologic paediatric interpretation using smartphones is overall acceptable. Although such system is not suitable for long consultation sessions, they can be used for quick remote consultation on single cases. [ABSTRACT FROM AUTHOR]

An abstract of the article "Prenatal diagnosis of left lung agenesis. MRI advantages on early diagnosis and prognosis," by G. Pelizzo, G. d'Ottavio and F. Zennaro, is presented.