The bolus guide recommendation based on carbohydrate range selection is substantially similar to the calculator based on carbohydrate point estimation and appears to be highly accepted by type 1 diabetes insulin pump users.

Purely cystic neuroblatomas are often discovered prenatally. As the main differential diagnosis is adrenal hemorrhage, follow-up sonography is warranted after birth. Cystic neuroblastomas are expected to evolve into lesions of mixed echogenicity with cystic and solid components. We present a rare case of a purely cystic left-sided adrenal lesion in a newborn, suggesting an adrenal hemorrhage, which on follow-up sonography evolved into a purely solid mass with poor vascularization, diagnosed as a cystic neuroblastoma. We suggest that even purely cystic adrenal masses in the newborn should be closely followed up with sonography, as they may represent purely cystic neuroblastomas.

Pancreatic tumors are uncommon in children and rarely result in biliary obstruction. Primary pancreatic Burkitt's lymphoma is an exceptionally rare entity with only a few cases described in the literature. We present a case of a bifocal primary pancreatic Burkitt's lymphoma in a 4-year-old child presenting with jaundice. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:171-174, 2017.

Introduction Surveillance FDG PET, commonly employed in patients with diffuse large B cell lymphoma (DLBCL) who achieve remission following induction, is very sensitive but not sufficiently specific, and is associated with a high false positive (FP) rate. The current study was aimed to investigate whether the employment of specific CT morphologic measurements could reduce FP incidence and improve the positive predictive value (PPV) and clinical applicability of surveillance FDG PET/CT in detecting DLBCL relapse. Methods The study was approved by the Institutional Review Board (IRB) of the Rambam Health Care Campus (Haifa, Israel). The study population included patients with DLBCL who participated in the previous surveillance PET study (n=119) (Avivi I, Am J Hematol, 2013), and had at least one positive PET scan, suggestive of disease relapse (n=83). A PET scan was defined as positive in the presence of increased FDG uptake unrelated to physiological bio-distribution of the tracer or to a known benign process. CT-derived features of PET positive sites, including long and short diameters (mm), the presence of calcification and fatty hilum within lymph nodes, were assessed. Patient's outcome, focusing on relapse development, confirmed either by tissue biopsy or by consecutive imaging demonstrating progression in the presence of compatible clinical symptoms, was recorded. The performance of surveillance PET scans, with and without concurrent employment of CT-derived measurements, was compared, focusing on FP rate and PPV of these two approaches to relapse detection. Results Eighty three follow-up PETs (FU-PETs) interpreted as positive for relapse, were reviewed. Seventy studies performed in 51 patients were included in final analysis, 13 studies were excluded as CT quality did not allow adequate morphologic evaluation. Twenty five of 70 FU-PET studies (36%) were true positive (TP) and 45 (64%) false positive, which is compatible with a PPV of 36%. Evaluation of CT-related parameters of PET positive sites showed that the employment of either long axis ≥15 mm or short axis ≥10 mm, significantly improved the prediction of relapse by PET (Table 1). The ratio between long and short axis measurements was not found to efficiently discriminate between FP and TP scans. Likewise, the presence of calcification or fatty hilum did not affect this discrimination. Multivariate analysis found IPI ≥2, lack of prior rituximab therapy and long or short axis measurements ≥15 and 10 mm, respectively, to be independent predictors of true positivity of FU-PET scans (odds ratio=9.84 ,8.5, and 7.67, P< 0.05, respectively). Conclusions Complementary application of long and short axis measurements ≥15 and 10 mm, respectively may allow the beneficial use of PET/CT in detection of DLBCL relapse, significantly improving the PPV of this follow-up modality. Disclosures: No relevant conflicts of interest to declare.

Neurocentral synchondroses (NCS) are growth plates that contribute to the transverse growth of the vertebra. Fractures through these NCS are very rare and none have been reported in the lumbar spine. We present a rare case of a traumatic fracture through the neurocentral synchondroses of L3 vertebra in a 5-year-old child.