Radiographic features and accuracy of CT in diagnosis and evaluation of the dissemination of retroperitoneal neuroblastoma in children

Le Thi Kim Ngoc1, Nguyen Duy Hue2,
1 Central Children's Hospital
2 Hanoi Medical University

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Abstract

SUMMARY


Purpose: This study aims to characterize radiographic features on CT of retroperitoneal neuroblastoma. Evaluate Se., Sp., PPV.,
NPV.,Ac., of CT in diagnosis of retroperitoneal neuroblastoma and dissemination of the disease.
Materials and Method: 111 children with 112 retroperitoneal tumors were enrolled in a prospective study. Abdominal CT findings of all the patients were analyzed, correlated with clinical, laboratory data, results of biopsy and surgical findings in order to assess sensitivity, specificity and accuracy values of CT in diagnosis and evaluation of tumor extent
Result: Radiographic features of retroperitoneal neuroblastoma on CT: lobulated, ill-defined, uncapsulated, calcified mass with mild or moderate heterogeneous enhancement and vessel encasement. Among these signs, “lobulated, ill-defined and vessel-encasement” are the most valuable (Ac. 72-81%). The other signs have low to medium Se., Sp., Ac in diagnostic value (52%-96%) and should be combined with the former. CT is good at evaluating the tumor extent: renal invasion (>94%), vessel encasement (100%), abdominalorgan invasion (>75%), retroperitoneal lymphadenopathy (>85%) except for detecting peritoneal fluid (Se. 36%)
Conclusion: Radiographic features of retroperitoneal neuroblastoma on CT: lobulated, ill-defined, uncapsulated, calcified, with mild or moderate heterogeneous enhancement and vessel-encased. Among them, “lobulated, ill-defined vesselencasement” are the most valuable signs. We should combine signs to increase accuracy of diagnosis. For evaluation of tumor
extent, CT have high sensitivity, specificity and accuracy except for detecting peritoneal fluid.
Abbreviation: CT: Computed Tomography, Se: Sensitive, Sp: Specificity, PPV: Positive Predictive Value, NPV: Negative Predictive Value, Ac: Accuracy

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References

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