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Pediatric Radiology

, Volume 46, Issue 12, pp 1684–1693 | Cite as

Accuracy of pre-contrast imaging in abdominal magnetic resonance imaging of pediatric oncology patients

  • Faizah Mohd Zaki
  • Rahim Moineddin
  • Ronald Grant
  • Govind B. ChavhanEmail author
Original Article

Abstract

Background

Safety concerns are increasingly raised regarding the use of gadolinium-based contrast media for MR imaging.

Objective

To determine the accuracy of pre-contrast abdominal MR imaging for lesion detection and characterization in pediatric oncology patients.

Materials and methods

We included 120 children (37 boys and 83 girls; mean age 8.94 years) referred by oncology services. Twenty-five had MRI for the first time and 95 were follow-up scans. Two authors independently reviewed pre-contrast MR images to note the following information about the lesions: location, number, solid vs. cystic and likely nature. Pre- and post-contrast imaging reviewed together served as the reference standard.

Results

The overall sensitivity was 88% for the first reader and 90% for the second; specificity was 94% and 91%; positive predictive value was 96% and 94%; negative predictive value was 82% and 84%; accuracy of pre-contrast imaging for lesion detection as compared to the reference standard was 90% for both readers. The difference between mean number of lesions detected on pre-contrast imaging and reference standard was not significant for either reader (reader 1, P = 0.072; reader 2, P = 0.071). There was substantial agreement (kappa values of 0.76 and 0.72 for readers 1 and 2) between pre-contrast imaging and reference standard for determining solid vs. cystic lesion and likely nature of the lesion. The addition of post-contrast imaging increased confidence of both readers significantly (P < 0.0001), but the interobserver agreement for the change in confidence was poor (kappa 0.12).

Conclusion

Pre-contrast abdominal MR imaging has high accuracy in lesion detection in pediatric oncology patients and shows substantial agreement with the reference standard for characterization of lesions. Gadolinium-based contrast media administration cannot be completely eliminated but can be avoided in many cases, with the decision made on a case-by-case basis, taking into consideration location and type of tumor.

Keywords

Abdomen Children Contrast medium Gadolinium Magnetic resonance imaging Oncology 

Notes

Compliance with ethical standards

Conflicts of interest

None

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Faizah Mohd Zaki
    • 1
    • 2
  • Rahim Moineddin
    • 3
  • Ronald Grant
    • 4
  • Govind B. Chavhan
    • 1
    Email author
  1. 1.Department of Diagnostic Imaging, The Hospital for Sick Children and Medical ImagingUniversity of TorontoTorontoCanada
  2. 2.Department of RadiologyUniversiti Kebangsaan Malaysia Medical CenterKuala LumpurMalaysia
  3. 3.Department of Family and Community MedicineUniversity of TorontoTorontoCanada
  4. 4.Department of Hematology and Oncology, The Hospital for Sick Children and Medical ImagingUniversity of TorontoTorontoCanada

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