Staging

To assess the prevalence of the disease and exclude metastases, you need:

• bone marrow aspiration and biopsy from multiple sites (usually the two posterior iliac crests);
• Skeleton scintigraphy;
• bone scan or metaiodobenzylguanidine (MIBG) scan;
• CT or MRI of the abdomen, pelvis, and chest.

CT or MRI of the skull indicated if symptoms or signs suggest brain metastases.

The results of these tests determine the stage of the disease. The International Neuroblastoma Staging System requires surgical results to determine the stage. The International Neuroblastoma Risk Group Staging System uses imaging of specific risk factors rather than surgery to determine the stage of neuroblastoma.

Neuroblastoma also has a single-stage, termed 4S or MS, which often regresses spontaneously without treatment. This stage includes infants younger than 12 months (4S) or 18 months (MS) who have a localized primary tumor whose spread is limited to the skin, liver, or bone marrow. Bone marrow involvement should be minimal and limited, a maximum of 10% of the total nuclear cell count, and may not involve compact bone marrow involvement.

The leading medical center Tel Aviv Medical Clinic, is studying the problem of neuroblastoma in children. Experts carry out high-precision diagnostics using innovative new generation equipment. Based on the research results, a therapeutic program formed. During the treatment, medical experts use the latest, high-tech equipment.