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Pediatric Radiology

, Volume 38, Issue 1, pp 18–29 | Cite as

Imaging in unilateral Wilms tumour

  • Hervé J. BrisseEmail author
  • Anne M. Smets
  • Sue C. Kaste
  • Catherine M. Owens
Minisymposium

Abstract

Wilms tumour is one of the most common malignancies in children, with an excellent prognosis after therapy. There is a very diverse approach to treatment according to geographical location. This variation in therapeutic attitude toward Wilms tumour, particularly between the United States and Europe, has consequences for the choice of imaging modality at diagnosis. In Europe, the International Society of Paediatric Oncology (SIOP) treatment protocol is based on chemotherapy followed by surgery. Imaging (US, CT and MRI), clinical history and examination will help predict whether the findings are consistent with Wilms tumour. Furthermore, in the UK preoperative image-guided biopsy is advised to help identify the small group of patients who, despite typical imaging features of Wilms tumour, have other types of neoplasia that require alternative management. In the United States, the National Wilms Tumor Study (NWTS) advises surgery prior to chemo- and radiotherapy. Hence imaging must provide detailed anatomical information for surgical planning. This article discusses the role of imaging at diagnosis and the relative strengths and weaknesses of the available radiological techniques. We also focus on imaging the lung for metastatic disease and the consequences (to the patient’s ultimate outcome) of CT-diagnosed small pulmonary nodules and discuss the radiological diagnosis and consequences of tumour rupture present at diagnosis.

Keywords

Wilms tumour Diagnostic imaging Neoplasm staging Children 

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Hervé J. Brisse
    • 1
    Email author
  • Anne M. Smets
    • 2
  • Sue C. Kaste
    • 3
  • Catherine M. Owens
    • 4
  1. 1.Service de RadiodiagnosticInstitut CurieParisFrance
  2. 2.Academic Medical Center AmsterdamAmsterdamThe Netherlands
  3. 3.Department of Radiological SciencesSt. Jude Children’s Research HospitalMemphisUSA
  4. 4.Great Ormond Street Hospital for ChildrenLondonUK

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