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Objective: Pituitary lesions are rare in the pediatric population. They consist of a heterogenous group of neoplasms including pituitary adenomas (PA) and Rathke cleft cysts (RCC). Their natural history, management strategies, and long-term outcomes are mostly extrapolated from adult experience. Neurosurgical intervention may be necessary for large and/or symptomatic lesions. Of note, the likelihood of their spontaneous regression is uncommon. We report 2 interesting cases of such a phenomenon for these lesions and discuss our findings in corroboration with current literature. Methods and results: Two cases of spontaneous regression of pituitary lesions observed on serial neuroimaging are described. Based on their clinical history and radiological characteristics, the working diagnoses were that of a non-functioning PA and RCC, respectively. A systematic search of relevant publications in the English language is performed in PubMed and Google Scholar. Our findings show that there are 14 reported cases (including 1 of our patients) of spontaneous regression of non-functioning PA with good outcomes. Pertaining to RCCs, the limited evidence suggests that the incidence of their spontaneous regression is approximately 30%, similar to what is reported in the adult population. A separate discussion on the possible differential diagnosis of lymphocytic hypophysitis is also highlighted. Conclusion: Pediatric pituitary lesions may present with unpredictable natural histories, as highlighted in our case examples. We advocate an extended period of follow-up by a cohesive multidisciplinary team. In meantime, collaborative efforts should focus on the establishing clinical practice guidelines to optimize the management of pituitary lesions in children. [ABSTRACT FROM AUTHOR]

Background: MRI guidelines have been created to help clinicians order scans appropriately. Some scans in children are carried out under general anesthesia (GA) / sedation. Purpose: To evaluate if the requirement for GA/sedation influences the way MRI brain scans are ordered. Study Type: Retrospective. Population: Children with MRI brain scans in 2015 to 2017. Field Strength: 3T, 1.5T. Assessment: Institutional Review Board approval for waiver of consent was obtained. Clinical MRI brain reports for children were classified into whether they conformed to the American College of Radiology (ACR) 2013 guidelines by research assistants under supervision of a pediatric radiologist. Scans were sorted into those with normal brains or abnormality. Statistical Test: The statistical difference between groups was assessed using t‐test for continuous variables and chi‐square test for categorical variables with IBM SPSS 19. Results: Of the total 1893 MRI scans, 431 were performed under GA and six under sedation. Of the 431 cases performed under GA/sedation, 383 (87.6%) were ordered according to guidelines. Of the 1456 cases that did not require GA/sedation, 710 (48.8%) conformed to guidelines. The percentage of scans ordered according to guidelines was 38.8% higher in those who had scans performed under GA/sedation (P < 0.001). MRI scans were normal in 635 (58.0%) out of the 1093 cases ordered according to guidelines and normal in 638 (79.8%) out of the 800 cases that did not follow guidelines. Scans not ordered according to guidelines had higher proportion of normal scans (21.8%) compared with those ordered according to guidelines (P < 0.001). Data Conclusion: Higher adherence to imaging guidelines is seen in younger patients who were exposed to the risks of GA/sedation for the MRI. Scans not adhering to guidelines had a higher percentage of having no brain abnormality detected. Level of Evidence: 3 Technical Efficacy: Stage 6 J. Magn. Reson. Imaging 2019;49:e250–e255. [ABSTRACT FROM AUTHOR]

Introduction: A previous prospective, randomised controlled trial showed that animated videos shown to children before magnetic resonance imaging (MRI) scan reduced the proportion of children needing repeated MRI sequences and improved confidence of the children staying still for at least 30 min. Children preferred the interactive video. We hypothesised that the interactive video is non-inferior to showing two videos (regular and interactive) in improving children's cooperativeness during MRI scans., Methods: In this Institutional Review Board-approved prospective, randomised, non-inferiority trial, 558 children aged 3-20 years scheduled for elective MRI scan from June 2017 to March 2019 were randomised into the interactive video only group and combined (regular and interactive) videos group. Children were shown the videos before their scan. Repeated MRI sequences, general anaesthesia (GA) requirement and improvement in confidence of staying still for at least 30 min were assessed., Results: In the interactive video group ( n = 277), 86 (31.0%) children needed repeated MRI sequences, two (0.7%) needed GA and the proportion of children who had confidence in staying still for more than 30 min increased by 22.1% after the video. In the combined videos group ( n = 281), 102 (36.3%) children needed repeated MRI sequences, six (2.1%) needed GA and the proportion of children who had confidence in staying still for more than 30 min increased by 23.2% after the videos; the results were not significantly different between the two groups., Conclusion: The interactive video group demonstrated non-inferiority to the combined videos group., (Copyright © 2024 Copyright: © 2024 Singapore Medical Journal.)

Competing Interests: None

Background: Endometrial cancer is the most common gynecological cancer among women in developed countries. Sono-elastography is an extended ultrasonographic technique that has been shown to be useful in a wide range of conditions ranging from breast, prostate, and thyroid nodules to chronic liver disease and musculoskeletal conditions. The aim of this study is to compare the sonoelastographic features of endometrial malignancy and normal endometrium., Methods: This case-control observational study was conducted at a single institution. Participants with histologically proven endometrial cancer according to the results from microcurettage or hysteroscopic biopsy and scheduled for total hysterectomy were included as cases, while asymptomatic women scheduled for routine screening ultrasound examination were recruited as controls. Both cases and controls underwent conventional B-mode transvaginal ultrasonography and strain elastography. Demographic, ultrasonographic, and histopathologic findings were analyzed., Results: A total of 29 endometrial cancer patients (cases) and 28 normal females (controls) were included in the analysis. There was no significant difference in the mean age between the two groups, but the mean body weight was significantly higher in the case group ( P < 0.001). The strain ratio and elastographic thickness ratio of the endometrium were statistically significantly different between the case and the control group ( P ≤ 0.05) due to increased endometrial stiffness in cancer patients as compared to the normal group., Conclusion: Our results suggest that endometrial cancer can result in increased stiffness that is detectable by transvaginal sonoelastography. Sonoelastography may serve as an adjunct to conventional ultrasound in evaluating the endometrium of women with abnormal uterine bleeding., Competing Interests: Dr. Chiou Li Ong, an editorial board member at Journal of Medical Ultrasound, had no role in the peer review process of or decision to publish this article. The other authors declared no conflicts of interest in writing this paper., (Copyright: © 2022 Journal of Medical Ultrasound.)