Learning objectives
To explain the epidemiology and fisiopathology of neuroblastoma in order to provide a comprehensive basis for the radiological staging.
To outline the importance of risk factors in the diagnostic and therapeutic approach to neuroblastoma.
To discuss the most suitable imaging techniques for local and distant staging and their protocol.
To review the staging of neuroblastoma according to the International Neuroblastoma Risk Group Staging System (INRGSS).
Background
Neuroblastoma is an embrionary tumor and constitutes the second most common solid malignancy in children,
after CNS tumors,
and the third most common pediatric cancer.
It affects boys and girls in the same proportion,
with a median age at diagnosis is 16 months,
being 95% of cases diagnosed by 7 years of age.
Despite recent advances and different therapeutic options that include chemotherapy and stem cell trasplant,
it still represents 15% of cancer deaths in children.
Neuroblastoma derives from the primordial neural crest cells that...
Findings and procedure details
A-Imaging techniques
Neuroblastoma can be staged with either Magnetic Resonance Imaging (MRI) or contrast-enhanced computed tomography (CECT).
Each technique has its advantages and drawbacks,
and the use of each of them depends upon the availability of each imaging technique in the radiology Department (Fig.3) (Fig.4).
Ultrasonography (US) is usually performed as a first line in the setting of an abdominal mass in a children because of its wide availability and noninvasiveness.
However,
it is operator dependent,
does not provide an only image of the whole...
Conclusion
Neuroblastoma is a common tumor of childhood with very variable biological behaviour,
on which several prognostic factors predict whether the children will have fauvorable or unfauvorable course of the disease.
As complete surgical resection of the tumor is the most important of them,
the radiologists´ report becomes the most important tool that will determine the final management and prognosis of this malignancy.
References
1.
Brisse H,
McCarville M,
Granata C,
Krug K,
Wootton-Gorges S,
Kanegawa K et al.
Guidelines for Imaging and Staging of Neuroblastic Tumors: Consensus Report from the International Neuroblastoma Risk Group Project.
Radiology.
2011;261(1):243-257.
2.
Lonergan G,
Schwab C,
Suarez E,
Carlson C.
From the Archives of the AFIP.
RadioGraphics.
2002;22(4):911-934.
3.
Hallett A,
Traunecker H.
A review and update on neuroblastoma.
Paediatrics and Child Health.
2012;22(3):103-107.
4.
Swischuk L,
Fernández de Moya E,
Guillén J.
Radiología en el niño y en el recién nacido....