Imaging in neuroblastoma

Abstract

Neuroblastoma is the most common extracranial solid malignancy of childhood. The prognosis is highly variable ranging from spontaneous involution in infants to fatal outcome, despite aggressive treatment, in disseminated high-risk neuroblastoma. This paper provides a comprehensive review of the crucial role of imaging during the extensive treatment course.

Keywords: Children; Imaging; Magnetic resonance imaging; Neuroblastoma; Nuclear medicine.

Fig. 1

A 5-month-old boy with raccoon eyes (periorbital ecchymosis) due to extensive bone marrow metastasis from abdominal neuroblastoma. An axial T2-weighted image (a) and a coronal short tau inversion recovery (STIR) image (b) of the skull base show extensive bone marrow metastases around both orbits (arrows). c A coronal T2-weighted image shows the primary tumour arising from the left adrenal gland with vascular encasement of the renal pedicle (Image Defined Risk Factors positive). d A sagittal STIR image illustrates diffuse bone marrow metastasis of the spine

Fig. 2

A 1-month-old girl with enlarged abdominal girth, thrombocytopenia and anaemia. A sagittal short tau inversion recovery (STIR) image (a) shows the relatively small primary tumour arising from the right adrenal gland (arrow) with diffuse liver metastases. b A coronal T2-weighted image illustrates enlargement of the liver due to diffuse liver metastases. Treatment was started due to respiratory compromise. The liver metastases show impeded diffusion (c: axial b1,000 diffusion-weighted image; d: axial apparent diffusion coefficient map)