Imaging staging of neurobalstoms includes chest and abdominal radiographs to evaluate for the presence of a posterior mediastinal mass or calcifications. A CT scan of the primary site is essential to determine tumor extent. The main body of the tumor is usually indistinguishable from nodal masses. In cases of paraspinal masses, MRI aids in determining the presence of intraspinal tumor and cord compression. I123/131-methyliodobenzylguanadine (MIBG) accumulates in catecholaminergic cells and provides a specific way of identifying primary and metastatic disease if present. Increasing numbers of institutions have access to MIBG scanning.
A technetium-99 bone scan can also be used to evaluate bone metastases. Especially in patients with negative MIBG study findings. Skeletal surveys may also be useful, especially in patients with multiple metastatic lesions.
Positron emission tomography (PET) scan are under evaluation. There are only cse reprots and series to support its use. A clinical trial is looking at this question: http://www.muschealth.com/clintrials/Default.aspx?DocID=NCT00072488.xml
B. H. Kushner
Neuroblastoma: A Disease Requiring a Multitude of Imaging Studies
J. Nucl. Med., July 1, 2004; 45(7): 1172 – 1188.
Brian H. Kushner, Henry W.D. Yeung, Steven M. Larson, Kim Kramer, Nai-Kong V. Cheung Extending Positron Emission Tomography Scan Utility to High-Risk Neuroblastoma: Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography as Sole Imaging Modality in Follow-Up of Patients Journal of Clinical Oncology, Vol 19, Issue 14 (July), 2001: 3397-3405