Pediatric Radiology

, Volume 49, Issue 11, pp 1441–1452 | Cite as

Imaging of Wilms tumor: an update

  • Sabah E. Servaes
  • Fredric A. Hoffer
  • Ethan A. Smith
  • Geetika KhannaEmail author
Pediatric oncologic imaging


Wilms tumor is the most common pediatric renal tumor, accounting for approximately 7% of all childhood cancers. Imaging plays an important role in the detection, staging, post-therapy evaluation and surveillance of Wilms tumor. Wilms tumor can be detected during surveillance of a known cancer predisposition or after a child presents with symptoms. In this manuscript we describe an evidence-based approach to the initial evaluation of Wilms tumor using current guidelines from the Children’s Oncology Group (COG). We illustrate the COG staging system for pediatric renal tumors and highlight key imaging findings that are critical for surgical management. We also discuss the controversies regarding detection and significance of <5-mm pulmonary nodules at initial staging. And finally, we present some thoughts regarding surveillance of Wilms tumor, where overall survival has now approached 90%.


Cancer Children Nephroblastoma Renal Wilms tumor 


Compliance with ethical standards

Conflicts of interest



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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of RadiologyChildren’s Hospital of PhiladelphiaPhiladelphiaUSA
  2. 2.Department of RadiologyUniversity of WashingtonSeattleUSA
  3. 3.Department of RadiologyUniversity of Cincinnati College of MedicineCincinnatiUSA
  4. 4.Mallinckrodt Institute of RadiologyWashington University School of MedicineSt. LouisUSA

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