Pediatric Radiology

, Volume 48, Issue 12, pp 1817–1819 | Cite as

Another point of view on 2017 PRETEXT

  • Danièle ParienteEmail author
  • Stéphanie Franchi-Abella
  • Cécile Cellier
  • Sophie Branchereau
  • Sophie Taque
  • Véronique Laithier
  • Isabelle Aerts
  • Christophe Chardot
  • Laurence Brugières
Letter to the Editor

Dear Editors,

We would like to congratulate Towbin et al. [ 1] for their nice paper on the revision of the radiologic staging system for the future Paediatric Hepatic International Tumour Trial. However, on behalf of the French Paediatric Liver Tumour Group (the French members of the International Childhood Liver Tumours Strategy Group), we would like to express our disagreement on a few points and therefore explain why we have decided to decline to be included among the authors.
  1. (1)
    Imaging recommendations: the authors recommend performing MRI with injection of a hepatocyte-specific contrast agent at diagnosis and at every time point, rather than CT. This recommendation, in a tumour that mainly develops in very young children (median age at diagnosis 1.4 years), deserves discussion [ 2].
    1. a)

      The risk of a prolonged MRI examination under general anaesthesia, in an infant with a voluminous abdominal tumour, must be balanced with the risk of ionising radiation from a CT performed only with...


Compliance with ethical standards

Conflicts of interest



  1. 1.
    Towbin AJ, Meyers RL, Woodley H et al (2018) 2017 PRETEXT: radiologic staging system for primary hepatic malignancies of childhood revised for the Paediatric Hepatic International Tumour Trial (PHITT). Pediatr Radiol 48:536–554CrossRefGoogle Scholar
  2. 2.
    Czauderna P, Haeberle B, Hiyama E et al (2016) The Children's Hepatic Tumors International Collaboration (CHIC): novel global rare tumor database yields new prognostic factors in hepatoblastoma and becomes a research model. Eur J Cancer 52:92–101CrossRefGoogle Scholar
  3. 3.
    Callahan MJ, MacDougall RD, Bixby SD et al (2018) Ionizing radiation from computed tomography versus anesthesia for magnetic resonance imaging in infants and children: patient safety considerations. Pediatr Radiol 48:21–30CrossRefGoogle Scholar
  4. 4.
    Kolbe AB, Podberesky DJ, Zhang B, Towbin AJ (2015) The impact of hepatocyte phase imaging from infancy to young adulthood in patients with a known or suspected liver lesion. Pediatr Radiol 45:354–365CrossRefGoogle Scholar
  5. 5.
    Seale MK, Catalano OA, Saini S et al (2009) Hepatobiliary-specific MR contrast agents: role in imaging the liver and biliary tree. Radiographics 29:1725–1748CrossRefGoogle Scholar
  6. 6.
    Ramalho J, Semelka RC, Ramalho M et al (2016) Gadolinium-based contrast agent accumulation and toxicity: an update. AJNR Am J Neuroradiol 37:1192–1198CrossRefGoogle Scholar
  7. 7.
    Roebuck DJ, Aronson D, Clapuyt P et al (2007) 2005 PRETEXT: a revised staging system for primary malignant liver tumours of childhood developed by the SIOPEL group. Pediatr Radiol 37:123–132CrossRefGoogle Scholar
  8. 8.
    Maibach R, Roebuck D, Brugieres L et al (2012) Prognostic stratification for children with hepatoblastoma: the SIOPEL experience. Eur J Cancer 48:1543–1549CrossRefGoogle Scholar
  9. 9.
    O’Neill AF, Towbin AJ, Krailo MD et al (2017) Characterization of pulmonary metastases in children with hepatoblastoma treated on Children’s Oncology Group protocol AHEP0731 (the treatment of children with all stages of hepatoblastoma): a report from the Children’s Oncology Group. J Clin Oncol 35:3465–3473CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Danièle Pariente
    • 1
    Email author
  • Stéphanie Franchi-Abella
    • 1
  • Cécile Cellier
    • 1
  • Sophie Branchereau
    • 2
  • Sophie Taque
    • 3
  • Véronique Laithier
    • 4
  • Isabelle Aerts
    • 5
  • Christophe Chardot
    • 6
  • Laurence Brugières
    • 7
  1. 1.Department of Paediatric Radiology, Hôpital BicêtreAPHP, Hôpitaux Universitaires Paris SudLe Kremlin BicêtreFrance
  2. 2.Paediatric Surgery, Hôpital BicetreAPHP, Hôpitaux Universitaires Paris SudLe Kremlin-BicêtreFrance
  3. 3.Paediatric Hematology and OncologyHôpital UniversitaireRennesFrance
  4. 4.Paediatric Hematology and OncologyHôpital UniversitaireBesançonFrance
  5. 5.Institut Curie, SIREDO Oncology Center (Care, innovation and research for children and AYA with cancer)PSL Research UniversityParisFrance
  6. 6.Paediatric SurgeryHôpital Universitaire Necker Enfants Malades, APHPParisFrance
  7. 7.Department of Children and Adolescent OncologyGustave Roussy Cancer CampusVillejuifFrance

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