CT in children with abdominal cancer: should we routinely include the pelvis?
BACKGROUND
It has been suggested that the pelvis should not be habitually included on abdominal CT examinations, but the potential benefit of such a practice in childhood abdominal malignancies is unknown.


OBJECTIVE
To estimate the yield and potential diagnostic benefit of abnormal findings on CT of the pelvis in children with malignant primary tumours in the upper abdomen.


METHODS
From a paediatric tertiary referral hospital we retrospectively included patients having abdominal CT for primary upper abdominal tumours (1997-2004), the scan range routinely including the pelvis. We reviewed and tabulated any pelvic abnormality, and calculated group proportions with 95% confidence intervals.


RESULTS
We identified 230 children (2 days to 17 years old, median 2.9 years). Six (2.6%; 95% CI 0.5-4.7%) had abnormalities in the pelvis that would not have affected clinical management. Four (1.7%; 95% CI 0.1-3.4%) had findings that might have influenced staging, but only one was not detected by other modalities within 1 week of the CT.


CONCLUSIONS
Our data suggest that diagnostically significant findings in the pelvis are rare; consequently, the habitual inclusion of the pelvis on abdominal CT for primary malignant tumours in the abdomen is not justified.
Gnanasambandam
Sakthivel
S
Radiology Department, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London, WC1N 3JH, UK. olseno@gosh.nhs.uk
Olsen
Øystein Erlend
ØE
D000008:Abdominal Neoplasms / Q000000981:diagnostic imaging*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010388:Pelvis / Q000000981:diagnostic imaging*; D011860:Radiography, Abdominal / Q000379:methods*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed