Pediatric Radiology

, Volume 48, Issue 12, pp 1820–1822 | Cite as

Another point of view on 2017 PRETEXT: reply to Pariente et al.

  • Alexander J. TowbinEmail author
  • Rebecka L. Meyers
  • Helen Woodley
  • Osamu Miyazaki
  • Christopher B. Weldon
  • Bruce Morland
  • Eiso Hiyama
  • Piotr Czauderna
  • Derek J. Roebuck
  • Greg M. Tiao
Letter to the Editor

Dear Editors,

We would like to thank our friends and colleagues from the French Pediatric Liver Tumor Group for their helpful critique of our paper titled “2017 PRETEXT: radiologic staging system for primary hepatic malignancies of childhood revised for the Paediatric Hepatic International Tumour Trial (PHITT)” [1, 2]. Their participation in past studies, and their collaboration and leadership in the PHITT trial are both valuable and important to the success of this trial. Each of their concerns warrants our response.

Imaging recommendations

We believe that the treating institution can and should determine the imaging modality used in children with a liver tumor. However, pediatric liver tumors are rare, and most institutions have little experience with the imaging management of these children. The 2017 version of the PRETEXT (pre-treatment extent of tumor) categorization represents a consensus statement from many of the world’s pediatric liver tumor experts [1]. The recommendations...


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.
    Pariente D, Franchi-Abella S, Cellier C et al (2018) Another point of view on 2017 PRETEXT. Pediatr Radiol.
  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.
    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
  6. 6.
    Meyers RL, Dunn S, Langham M et al (2013) Children’s Oncology Group (COG) AHEP0731: early results from PRETEXT central review in high risk patients. Paper presented at the 4th World Congress of Pediatric Surgery, BerlinGoogle Scholar
  7. 7.
    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
  8. 8.
    ClinicalTrials.Gov Paediatric Hepatic International Tumour Trial (PHITT). Accessed 7 July 2018
  9. 9.
    Paediatric Hepatic International Tumour Trial. Accessed 7 July 2018

Copyright information

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

Authors and Affiliations

  • Alexander J. Towbin
    • 1
    Email author
  • Rebecka L. Meyers
    • 2
  • Helen Woodley
    • 3
  • Osamu Miyazaki
    • 4
  • Christopher B. Weldon
    • 5
  • Bruce Morland
    • 6
  • Eiso Hiyama
    • 7
  • Piotr Czauderna
    • 8
  • Derek J. Roebuck
    • 9
  • Greg M. Tiao
    • 10
  1. 1.Department of RadiologyCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  2. 2.Division of Pediatric Surgery, Primary Children’s HospitalUniversity of UtahSalt Lake CityUSA
  3. 3.Department of RadiologyLeeds Teaching Hospitals NHS TrustLeedsUK
  4. 4.Department of RadiologyNational Center for Child Health and DevelopmentTokyoJapan
  5. 5.Departments of Surgery and OncologyBoston Children’s Hospital/Dana Farber Cancer InstituteBostonUSA
  6. 6.Department of OncologyBirmingham Women’s and Children’s HospitalBirminghamUK
  7. 7.Department of Pediatric SurgeryHiroshima University HospitalHiroshimaJapan
  8. 8.Department of Surgery and Urology for Children and AdolescentsMedical University of GdanskGdanskPoland
  9. 9.Department of RadiologyGreat Ormond Street Hospital for ChildrenLondonUK
  10. 10.Division of General and Thoracic SurgeryCincinnati Children’s Hospital Medical CenterCincinnatiUSA

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