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Neuroblastoma

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Atlas of PET/CT in Pediatric Patients

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Abstract

Neuroblastoma (NB) is a malignant neoplasm that originates from neuroectodermal cells of the neural crest. During embryonic life, these cells migrate, giving rise to the sympathetic ganglia and adrenal medulla. The mean age at NB diagnosis is around 2 years, with 90 % of the cases diagnosed in children under the age of 6 years but only exceptionally in adolescents and in adults. In 40 % of the cases, the NB is localized to the adrenal glands, although it can develop anywhere in the sympathetic nervous system: neck (1 %), chest (19 %), other sites in the abdomen (30 %), or in the pelvis (1 %). The degree of malignancy of the tumor is determined by the proportion of cellular and extracellular maturation. The most aggressive and undifferentiated forms occur in young children (average 2 years of age), while the more mature forms, represented by ganglioneuroma, are usually seen in older children. 18F-fluorodeoxyglucose is the principal PET tracer in oncology, and its role in NB has also been investigated. However, thus far its use is limited to those cases in which the 123I-MIBG scan is negative or inconclusive. In this setting, the superior performance of 18F-FDG–PET has been demonstrated, based on a sensitivity and specificity of 78 and 92 %, respectively, and, compared to 123I-MIBG scintigraphy, 50 and 75 %, respectively.

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Authors and Affiliations

  1. Nuclear Medicine Unit, Humanitas Cancer Center, IRCCS Humanitas, Via Manzoni 56, Rozzano (MI), 20089, Italy

    Egesta Lopci MD

  2. Nuclear Medicine Unit, La Maddalena Hospital, Via San Lorenzo Colli 312, Palermo, 90146, Italy

    Umberto Ficola MD

  3. Department of Nuclear Medicine, Positron Emission Tomography Center IRMET S.p.A., Euromedic Inc., Via Onorato Vigliani 89, Turin, 10100, Italy

    Angelina Cistaro MD

  4. Institute of Cognitive Sciences and Technologies, National Research Council, Rome, Italy

    Angelina Cistaro MD

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  1. Egesta Lopci MD
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  2. Umberto Ficola MD
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  3. Angelina Cistaro MD
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Correspondence to Angelina Cistaro MD .

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  1. Nuclear Medicine, Positron Emission Tomography Centre, Torino, Italy

    Angelina Cistaro

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Lopci, E., Ficola, U., Cistaro, A. (2014). Neuroblastoma. In: Cistaro, A. (eds) Atlas of PET/CT in Pediatric Patients. Springer, Milano. https://doi.org/10.1007/978-88-470-5358-8_12

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  • DOI: https://doi.org/10.1007/978-88-470-5358-8_12

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