Introduction

We all got to pediatric radiology by following circuitous paths. In my case, I never thought I would be a radiologist; images of caves and vampires were always associated with the word “radiologist.” It was during a medical school surgery rotation in which the patient swore that her appendix had been removed and the radiologist claimed that the patient had acute appendicitis, while the surgeon pondered the conundrum, that I learned that the radiologist can become a puzzle solver and diagnostic detective. I was sold on radiology.

During residency an attending exalted the wonders of the pediatric radiologist. Not for all the gold in the world, I thought. Then I did a rotation in my current pediatric hospital and became entranced with the good nature and disposition of the pediatric radiologist — inquisitive yet playful; driven to find the diagnostic answer yet empathic to the child’s problem.

During fellowship I encountered the world of the fetus, and my academic pursuits were then completely defined. I met a group of interested people at my academic institution and around the United States and the rest of the world who became “fetal dreamers.” Beth Kline-Fath was an inspiration when I heard her talk about fetal MR way back at the Society for Pediatric Radiology (SPR)’s 2007 annual meeting in Miami; Dorothy Bulas showed us what leadership was, not only in the fetal world; Chris Cassady taught me that only if you kindly push forward will things get done, and was able to help organize the fetal SPR meeting; Judy Estroff was always there to mentor and encourage. It is on the shoulders of these fetal giants that we constructed and designed the most recent SPR fetal meeting in 2019, one of the last “normal” meetings before coronavirus disease 2019 (COVID-19) struck.

Organizing the meeting was exhilarating. Along with then vice chair and now chair of the SPR fetal committee Mariana Meyers and vice chair Brandon Brown, we designed a meeting that introduced, in addition to the usual topics, other important matters including the maternal perspective (what do parents go through when they learn their fetus will die shortly after birth? And when their fetus will have to undergo surgery in utero, or right after birth?). We also learned from the physician’s perspective how the radiologist/obstetrician/palliative expert conveys devastating news in an empathic way, and how he/she copes with relaying such news. We heard from the excellent Larry Wald and Ellen Grant on how to improve our fetal techniques and what comes next in imaging the fetus. And we did it all in a fun and collegial way that sometimes required getting dressed as (gulp!) a peanut butter or jelly sandwich (Fig. 1).

Fig. 1

Team Peanut Butter and Team Jelly, after a ruthless competition on fetal knowledge. Someone won but we do not remember who. Of note, no peanut butter or jelly was harmed in the making of this portion of the fetal meeting

In this issue of Pediatric Radiology we have compiled some of the talks presented during that conference. David Mirsky tells us about ventriculomegaly, Michael Seed teaches us about fetal cardiac MR, Mariana Meyers instructs us on the differences between multicystic dysplastic kidney and renal cystic disease. Usha Nagaraj tells us about the state of the art in fetal neural tube defects and prenatal repair, while Carolina Guimaraes teaches us about the fascinating link between genotype and postnatal phenotype. Camilo Jaimes takes fetal imaging one step further to demonstrate fetal imaging motion correction, while Michael Gee’s team tells us how to improve the imaging of the highly mobile fetus. Krista Birkeimer and Patricia Cornejo help us to differentiate among fetal tumors and the diagnostic quandary they might represent, while Megan Marine demonstrates gastrointestinal pathology. Ailish Coblentz, a now brand-new attending at Sick Children’s, goes back to Fetal 101 and presents a primer on how to read and look at a fetal MR for the first time. Niamh Adams, now back in her natal Ireland helping Gabrielle Colleran build a strong fetal MR program, discusses the always mysterious and sometimes contentious world of fetal lung masses.

We hope you enjoy this issue as much as we have enjoyed putting it together. This issue comes under the umbrella of Pediatric Radiology, with Peter Strouse as editor. We thank him for incisive editorial guidance and drive to make our journal a strong source of pediatric radiology knowledge and new research.

The reins of the SPR fetal committee are now in the able hands of Mariana Meyers and Brandon Brown. We look forward to their leadership and bright ideas in the always fascinating world of prenatal imaging.

In the meantime, we hope you enjoy this fetal imaging issue.