title: Impact of pelvic CT on staging, surveillance, and survival of pediatric patients with Wilms tumor and hepatoblastoma.
abstract: OBJECTIVE
  Abdominopelvic CT is often performed in children with Wilms tumor or hepatoblastoma. However, the reported incidence of recurrent disease involving the pelvis is low. This study explores the impact of abdominopelvic CT on children with Wilms tumor or hepatoblastoma.
  
  
  METHODS
  A text word database search of our radiology information system for the terms "Wilms" and "hepatoblastoma" was performed for the time interval between 1999 and 2009. The study inclusion criterion was performance of abdominopelvic CT. Tumor stage and metastases at presentation, follow-up, and impact on patient care were extracted from the medical records.
  
  
  RESULTS
  There were 224 diagnostic and surveillance abdominopelvic CT studies (mean per patient, 6.8; range, 2-20). Among Wilms tumor (n = 17) and hepatoblastoma (n = 16) patients, at presentation 11 (33%) had pelvic extension of the tumor and three (9%) had pulmonary metastases. On follow-up, three (9%) additional patients developed metastatic disease or local recurrence; however, no patient was found to have pelvic metastases or recurrence. One patient with metastatic disease at presentation died.
  
  
  CONCLUSIONS
  In our study population, abdominopelvic CT did not detect pelvic metastases to affect subsequent treatment. Given the low rate of pelvic involvement at relapse in children with Wilms tumor and hepatoblastoma, frequent abdominopelvic CT may not be necessary. Replacing these examinations with abdomen-only CT should be considered to decrease radiation burden to this population.
authors.affiliation: Department of Radiology and Radiological Sciences, Monroe Carell, Jr., Children's Hospital, Vanderbilt Medical Center, Nashville, TN 37232, USA. herman.kan@vanderbilt.edu
authors.forename: J Herman
authors.initials: JH
authors.lastname: Kan
authors.forename: Misun
authors.initials: M
authors.lastname: Hwang
authors.forename: Stefanie R
authors.initials: SR
authors.lastname: Lowas
authors.forename: Marta
authors.initials: M
authors.lastname: Hernanz-Schulman
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D018197:Hepatoblastoma / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology; D006801:Humans; D007223:Infant; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology; D008297:Male; D009367:Neoplasm Staging; D010388:Pelvis / Q000000981:diagnostic imaging*; D011159:Population Surveillance; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D009396:Wilms Tumor / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology