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Abstract:

Background: most accurate visualization of tumor, determination of stage and spread of tumor process is substantially significant for children who undergo treatment in accordance to protocols of the international SIOPEL group. According to SIOPEL criteria, patients with hepatoblastoma are stratified into risk groups based on diagnostic results. The allocation of patients into risk groups is based on the definition of the stage of the disease in the PRETEXT system (Pre-Treatment Extent of Disease - the spread of the tumor before treatment) and the level of alpha-fetoprotein (AFP)

Aim: was to present the main criteria of PRETEXT hepatoblastoma staging, based on results of magnetic resonance imaging (MRI).

Material and methods: study includes 74 patients with diagnosed hepatoblastoma aged 1 month to 14 years (median 3.1 years). All patients underwent MRI of the abdominal cavity before and after polychemotherapy (PCT) courses. MRI studies were performed on the scaner Magnetom Avanto (Siemens Healthcare) with a magnetic field strength of 1.5T

Results: hepatoblastoma staging was performed according to PRETEXT criteria. Stage I of the Pretext with lesion of one liver sector was revealed in 3 (4%) cases. Stage II of the Pretext - the presence of a tumor in two adjacent sectors was revealed in 26(35,1%) cases. Pretext III - the presence of a tumor in three adjacent sectors of the liver or in two non-adjacent liver sectors was identified in 23(31%) cases. Pretext IV - lesion of all liver sectors, was revealed in 22(29,7%) cases. Conclusions: MRI is a significantly informative method that allows to achieve data not only location, size, prevalence of the tumor process, but it also enables to give an accurate pre-operative stage evaluation using the PRETEXT system. Surgical removal of the tumor is the only way to achieve a complete cure, thus it is important to get an accurate image of the tumor, its anatomical location and determine the prevalence of the tumor process.

 

 

 

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