TriangleHEALTH PROFESSIONAL · SOURCE READING
Surveillance During and After Treatment
Source: Neuroblastoma Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: April 28, 2025 · Captured 2026-09-09.
Selected source text with whitespace normalised. This Triangle page is not an NCI PDQ summary.
Context: Treatment Option Overview for Neuroblastoma
Although the role of surveillance imaging for detection of neuroblastoma relapse has not been well studied, most patients will undergo regular imaging tests after completing therapy. Many patients who relapse are asymptomatic, and relapse is detected on surveillance evaluations. Factors such as risk stratification, disease sites, biomolecular markers, and cumulative radiation dose may be considered in surveillance after treatment.[31-33]
One series included 154 patients with high-risk neuroblastoma who had a complete or very good partial response and subsequently had relapsed disease. The study found that 113 of the patients (73%) had asymptomatic relapse, while only 41 (27%) presented with symptoms. Metaiodobenzylguanidine (MIBG) scans were the most reliable study to detect asymptomatic relapse.[32]
Source links and citations
In another series of 183 patients diagnosed with neuroblastoma, 50 patients experienced recurrence or progression. Relapsed disease was detected in most patients by symptoms/examination, MIBG scan, urinary catecholamines, and/or x-rays or ultrasonography.[33]
Source links and citations
Of the 50 patients, 37 had clinically evident or measurable disease detected by x-ray, ultrasonography, or urinary catecholamines. The addition of MIBG scanning identified eight additional recurrences.
The cross-sectional imaging (computed tomography [CT]/magnetic resonance imaging) was only required to identify 10% of cases (5 of 50).
Thirty-two of the 50 relapses (64%) were detected by scheduled surveillance investigations, and 18 of the 50 relapses (36%) were detected because of new symptoms and/or history.
Twenty-three of 50 relapses were associated with new concerning symptoms and/or examination. As a result, 18 of 50 patients had earlier-than-planned imaging performed, 17 of whom had new lesions that corresponded to the symptoms or examination. Seventeen of the 18 patients were high risk at diagnosis.
Cross-sectional imaging with CT scans is controversial because of the amount of radiation received and the low proportion of relapses detected with this modality.[33]
Source links and citations
Publication references
Read the original reference and check its publication notices.
Preserved source evidence · Not medical advice