Sheba Medical Center’s team of specialists works tirelessly to ensure that each patient is treated with top-notch care from before diagnosis all the way through specialized treatment plans. Our oncologists, pediatric oncologists, radiation oncologists, pathologists, and other specialists work closely together to determine the diagnosis and stage of your child’s disease.
Our extensive facilities offer all testing and equipment necessary so that you can benefit from quick results and immediate action throughout each stage of diagnosis and treatment.
During your child’s diagnostic evaluation, we may perform the following procedures:
Blood and urine tests.
Sympathetic nerve cells release hormones called catecholamines into the bloodstream, which are then broken down and released from the body through the urine. Neuroblastoma cells can also produce these hormones, which would cause their blood levels to be much higher than the norm. Two main metabolites are: Homovanillic acid (HVA) and Vanillylmandelic acid (VMA). Blood and urine tests will pick up on abnormally high levels of these hormones.
Imaging tests used in the diagnostic evaluation help doctors to determine if an area in the body is cancerous and whether cancer has spread, and if so, how far. The most common imaging tests used in children with neuroblastomas include MIBG scan, magnetic resonance imaging (MRI) scan, Computed tomography (CT or CAT) scan, ultrasound, bone scintigraphy, positron emission tomography (PET) scan, and x-rays.
A biopsy is the most reliable test when it comes to diagnosing cancer. During a biopsy, the doctor removes a piece of the tumor. The sample is then sent to a lab where it is viewed by a pathologist who determines whether it is cancerous and what type of cancer it is.
Bone marrow aspiration and biopsy.
In many cases of neuroblastoma, cancer spreads to the bone marrow. A bone marrow aspiration is when bone marrow fluid and cells are taken through a needle placed in the bone. A bone marrow biopsy includes taking a small amount of bone, and it is performed at the same time as the bone marrow aspiration. Since they are very painful tests, the child is given either medication to reduce pain or put to sleep for the duration of the procedure.
After a neuroblastoma diagnosis is made, doctors try to figure out if the cancer has spread, and if so, how far. Our specialists gather all the information from diagnostic tests and may perform further tests for staging if necessary. The stage of the disease helps determine how serious the cancer is and provides information for prognosis.
Stages one through four indicate how much the cancer has spread. Stage 1 is when the cancer is still in the area in which it started, and stage 4 indicates that the cancer has spread to distant sites in the body such as the lymph nodes, bone, bone marrow, liver, skin, or other organs.
In addition to staging, specialists will also assign a risk group to the child — low-risk, intermediate-risk, or high-risk — based on many different diagnostic factors.