Pediatric abdominal tumors: Neuroblastoma

Key Points: □ The clinical presentation of neuroblastoma can be nonspecific and sometimes confusing (strong evidence). □ The features that need to be evaluated on imaging studies for surgical planning or staging in neuroblastoma are tumor location, regional tumor extent (including vascular encasement, midline extension, regional lymph node involvement), and skeletal or liver metastases (strong evidence). □ Ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) have high sensitivity for tumor detection and moderate specificity (strong evidence). □ CT and MRI have moderate sensitivity for detection of regional tumor extent and are superior to sonography for this determination (limited to moderate evidence). □ MRI, bone scintigraphy, metaiodobenzylguanidine (MIBG) scintigraphy and fluoro-2-deoxy-d-glucose positron emission (FDG-PET) imaging have high sensitivity for detecting bone/bone marrow metastases (moderate to strong evidence). □ MRI, MIBG scintigraphy, and FDG-PET imaging have high sensitivity for detecting non-skeletal metastases (moderate to strong evidence). □ No data were found in the medical literature that evaluate the cost-effectiveness of the different imaging modalities in the evaluation of these tumors.