Imaging of abdominal neuroblastoma in children

Purpose: The aims of the study were: 1) to assess the efficacy of different imaging methods for use prior to treatment; 2) to compare the surgico-hist opathologically-based International Neuroblastoma Staging System (INSS) sta ging with the imaging results; and 3) to suggest a localisation scheme for abdominal neuroblastoma. Material and Methods. Thirty-one children with an abdominal neuroblastoma ( median age 2 years), underwent abdominal US, CT of chest and abdomen, MR im aging of abdomen and spine, chest radiography, skeletal survey, radionuclid e bone scintigraphy, MIBG scintigraphy, and bone marrow biopsy. Results. In the evaluation of local disease, CT and MR were superior to US. There was no significant difference between CT and MR in assessment of the location or size of the tumour. Evaluation of invasive growth and lymphade nopathy was uncertain irrespective of imaging modality. Intraspinal extensi on was more distinctly demonstrated with MR. Tissue characterization with C T and MR did not contribute in the assessment of the tumours. Contrast enha ncement at CT and MR examinations both improved demarcation between tumour and kidney, and was a necessity for evaluation of vessel encasement with CT . The local disease was best assessed by either CT or MR, while metastatic disease was best revealed by CT, MR, scintigraphy or bone marrow biopsy. Conclusion: Imaging may be a valuable basis for clinical assessment and pre treatment staging of abdominal neuroblastoma.