title: Contrast-enhanced sonography of malignant pediatric abdominal and pelvic solid tumors: preliminary safety and feasibility data.
abstract: BACKGROUND
  Little information exists regarding pediatric contrast-enhanced US.
  
  
  OBJECTIVE
  To assess the safety and feasibility of contrast-enhanced US of pediatric abdominal and pelvic tumors.
  
  
  METHODS
  This prospective study included eight boys and five girls (mean age, 10.8 years) with abdominal or pelvic tumors. Cohorts of three subjects underwent US with perflutren contrast agent at escalating dose levels. Neurological and funduscopic examination, electrocardiography and continuous pulse oximetry were performed before and after contrast administration. Three radiologists independently scored six imaging parameters on pre- and postcontrast sonography. Inter-reviewer agreement was measured by the Kappa statistic.
  
  
  RESULTS
  No neurological, retinal, electrocardiographical or pulse oximetry changes were attributable to the contrast agent. Two subjects reported minor, transient symptoms. Postcontrast US parameter scores improved slightly in 8 of 12 subjects. Postcontrast ultrasound inter-reviewer agreement improved slightly for detection of tumor margins (precontrast = 0.20, postcontrast = 0.26), local tumor invasion (precontrast = -0.01, postcontrast = 0.10) and adenopathy (precontrast = 0.35, postcontrast = 0.44).
  
  
  CONCLUSIONS
  Although our sample size is small, perflutren contrast agents appear to be safe and well tolerated in children. Contrast-enhanced sonography of pediatric abdominal and pelvic tumors is feasible, but larger studies are needed to define their safety and efficacy in children.
authors.affiliation: Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, TN 38105, USA. beth.mccarville@stjude.org
authors.forename: M Beth
authors.initials: MB
authors.lastname: McCarville
authors.forename: Sue C
authors.initials: SC
authors.lastname: Kaste
authors.forename: Fredric A
authors.initials: FA
authors.lastname: Hoffer
authors.forename: Raja B
authors.initials: RB
authors.lastname: Khan
authors.forename: R Christopher
authors.initials: RC
authors.lastname: Walton
authors.forename: Bruce S
authors.initials: BS
authors.lastname: Alpert
authors.forename: Wayne L
authors.initials: WL
authors.lastname: Furman
authors.forename: Chenghong
authors.initials: C
authors.lastname: Li
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Xiong
mesh_terms: D000008:Abdominal Neoplasms / Q000000981:diagnostic imaging*; D002648:Child; D003287:Contrast Media / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D005466:Fluorocarbons / Q000009:adverse effects; D006801:Humans; D008297:Male; D010386:Pelvic Neoplasms / Q000000981:diagnostic imaging*; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media; D005466:Fluorocarbons; C042852:perflutren