plain abdominal radiology - typical microcalcification of tumour noted in 50% of cases
chest radiology - for evidence of metastases
abdominal CT with intravenous contrast - helps to distinguish neuroblastoma from Wilm's tumour
chest CT should be performed to look for metastases
isotope bone scan for metastases
Biochemistry: (2)
urinary excretion of catecholamine metabolites - levels of vanillylmandelic acid, homovanillic acid raised in 75% of cases
the ratio of a spot VMA concentration to urinary creatinine may be helpful where a 24 hour collection is impractical
Reference
Whittle SB, Smith V, Doherty E, et al; Overview and recent advances in the treatment of neuroblastoma. Expert Rev Anticancer Ther. 2017 Apr;17(4):369-386
Barco S, Gennai I, Reggiardo G, et al. Urinary homovanillic and vanillylmandelic acid in the diagnosis of neuroblastoma: report from the Italian Cooperative Group for Neuroblastoma. Clin Biochem. 2014 Jun;47(9):848-52.
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