Pediatric Radiology

, Volume 36, Issue 3, pp 176–182 | Cite as

Radiological staging in children with hepatoblastoma

  • Derek J. Roebuck
  • Øystein Olsen
  • Danièle Pariente


Hepatoblastoma is the most common malignant liver tumour of childhood. Accurate radiological staging is very important, especially in children who are treated according to the protocols of the International Childhood Liver Tumor Strategy Group (SIOPEL). These protocols use risk stratification, based almost entirely on imaging findings, to minimize the treatment for localized tumours and to intensify treatment for extensive tumours and those with extrahepatic spread.


Liver Tumour Hepatoblastoma MRI Children 



We thank the many radiologists, oncologists and surgeons who have sent us images for review, some of which have been used in this paper.


  1. 1.
    Couinaud C (1994) The paracaval segments of the liver. J Hepatobiliary Pancreat Surg 2:145–151CrossRefGoogle Scholar
  2. 2.
    Ishibashi Y, Sato TJ, Hirai I, et al (2001) Ramification pattern and topographical relationship between the portal and hepatic veins in the left anatomical lobe of the human liver. Okajimas Folia Anat Jpn 78:75–82PubMedGoogle Scholar
  3. 3.
    Murakami G, Hata F (2002) Human liver caudate lobe and liver segment. Anat Sci Int 77:211–224CrossRefPubMedGoogle Scholar
  4. 4.
    Onishi H, Kawarada Y, Das BC, et al (2000) Surgical anatomy of the medial segment (S4) of the liver with special reference to bile ducts and vessels. Hepatogastroenterology 47:143–150PubMedGoogle Scholar
  5. 5.
    Fischer L, Cardenas C, Thorn M, et al (2002) Limits of Couinaud’s liver segment classification: a quantitative computer-based three-dimensional analysis. J Comput Assist Tomogr 26:962–967CrossRefPubMedGoogle Scholar
  6. 6.
    Fasel JH, Selle D, Evertsz CJ, et al (1998) Segmental anatomy of the liver: poor correlation with CT. Radiology 206:151–156PubMedGoogle Scholar
  7. 7.
    Sales JP, Hannoun L, Sichez JP, et al (1984) Surgical anatomy of liver segment IV. Anat Clin 6:295–304CrossRefPubMedGoogle Scholar
  8. 8.
    Goldsmith NA, Woodburne RT (1957) The surgical anatomy pertaining to liver resection. Surg Gynecol Obstet 105:310–318PubMedGoogle Scholar
  9. 9.
    Pritchard J, Brown J, Shafford E, et al (2000) Cisplatin, doxorubicin, and delayed surgery for childhood hepatoblastoma: a successful approach—results of the first prospective study of the International Society of Pediatric Oncology. J Clin Oncol 18:3819–3828PubMedGoogle Scholar
  10. 10.
    Brown J, Perilongo G, Shafford E, et al (2000) Pretreatment prognostic factors for children with hepatoblastoma—results from the International Society of Paediatric Oncology (SIOP) study SIOPEL 1. Eur J Cancer 36:1418–1425CrossRefPubMedGoogle Scholar
  11. 11.
    Aronson DC, Schnater JM, Staalman CR, et al (2005) Predictive value of the pretreatment extent of disease system in hepatoblastoma: results from the International Society of Pediatric Oncology Liver Tumor Study Group SIOPEL-1 study. J Clin Oncol 23:1245–1252CrossRefPubMedGoogle Scholar
  12. 12.
    Ortega JA, Douglass EC, Feusner JH, et al (2000) Randomized comparison of cisplatin/vincristine/fluorouracil and cisplatin/continuous infusion doxorubicin for treatment of pediatric hepatoblastoma: a report from the Children’s Cancer Group and the Pediatric Oncology Group. J Clin Oncol 18:2665–2675PubMedGoogle Scholar
  13. 13.
    Ortega JA, Krailo MD, Haas JE, et al (1991) Effective treatment of unresectable or metastatic hepatoblastoma with cisplatin and continuous infusion doxorubicin chemotherapy: a report from the Children’s Cancer Study Group. J Clin Oncol 9:2167–2176PubMedGoogle Scholar
  14. 14.
    Morita K, Okabe I, Uchino J, et al (1983) The proposed Japanese TNM classification of primary liver carcinoma in infants and children. Jpn J Clin Oncol 13:361–369PubMedGoogle Scholar
  15. 15.
    Von Schweinitz D, Hecker H, Schmidt-von-Arndt G, et al (1997) Prognostic factors and staging systems in childhood hepatoblastoma. Int J Cancer 74:593–599CrossRefGoogle Scholar
  16. 16.
    Therasse P, Arbuck SG, Eisenhauer EA, et al (2000) New guidelines to evaluate the response to treatment in solid tumors. J Natl Cancer Inst 92:205–216CrossRefPubMedGoogle Scholar
  17. 17.
    Sato M, Ishida H, Konno K, et al (2000) Liver tumors in children and young patients: sonographic and color Doppler findings. Abdom Imaging 25:596–601CrossRefPubMedGoogle Scholar
  18. 18.
    Ohtsuka Y, Takahashi H, Ohnuma N, et al (1997) Detection of tumor thrombus in children using color Doppler ultrasonography. J Pediatr Surg 32:1507–1510CrossRefPubMedGoogle Scholar
  19. 19.
    Hedenstierna G, Rothen HU (2000) Atelectasis formation during anesthesia: causes and measures to prevent it. J Clin Monit Comput 16:329–335CrossRefPubMedGoogle Scholar
  20. 20.
    Siegel MJ (2002) Pediatric liver magnetic resonance imaging. Magn Reson Imaging Clin N Am 10:253–273CrossRefPubMedGoogle Scholar
  21. 21.
    Haliloglu M, Hoffer FA, Gronemeyer SA, et al (2000) 3D gadolinium-enhanced MRA: evaluation of hepatic vasculature in children with hepatoblastoma. J Magn Reson Imaging 11:65–68CrossRefPubMedGoogle Scholar
  22. 22.
    Archer D, Babyn P, Gilday D, et al (1993) Potentially misleading bone scan findings in patients with hepatoblastoma. Clin Nucl Med 18:1026–1031PubMedCrossRefGoogle Scholar
  23. 23.
    Miyagi J, Kobayashi S, Kojo N, et al (1984) Brain metastasis of hepatoblastoma—a case report and review of literature. No Shinkei Geka 12:753–758PubMedGoogle Scholar
  24. 24.
    Nagle SB, Deolekar MV, Dhamnaskar P (1996) Hepatoblastoma with complete regeneration of liver and with metastasis to lungs and brain within six months after partial hepatectomy—a case report. Indian J Pathol Microbiol 39:147–149PubMedGoogle Scholar
  25. 25.
    Robertson PL, Muraszko KM, Axtell RA (1997) Hepatoblastoma metastatic to brain: prolonged survival after multiple surgical resections of a solitary brain lesion. J Pediatr Hematol Oncol 19:168–171CrossRefPubMedGoogle Scholar
  26. 26.
    Feusner JH, Krailo MD, Haas JE, et al (1993) Treatment of pulmonary metastases of initial stage I hepatoblastoma in childhood. Report from the Children’s Cancer Group. Cancer 71:859–864PubMedCrossRefGoogle Scholar
  27. 27.
    Begemann M, Trippett TM, Lis E, et al (2004) Brain metastases in hepatoblastoma. Pediatr Neurol 30:295–297CrossRefPubMedGoogle Scholar
  28. 28.
    Kairemo KJ, Lindahl H, Merenmies J, et al (2002) Anti-alpha-fetoprotein imaging is useful for staging hepatoblastoma. Transplantation 73:1151–1154CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Derek J. Roebuck
    • 1
  • Øystein Olsen
    • 1
  • Danièle Pariente
    • 2
  1. 1.Department of RadiologyGreat Ormond Street HospitalLondonUK
  2. 2.Service de Radiologie PédiatriqueHôpital BicêtreLe Kremlin Bicêtre CedexFrance

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