Primary neuroblastoma (NB) tumors may develop anywhere along the sympathetic chain or in the adrenal medulla. Although the majority of tumors are found in the retroperitoneum, primary sites in the posterior mediastinum, pelvis, and neck also occur but are less common (Abramson 1997). Neuroblas-tomas are often locally invasive and may encase surrounding vascular structures and extend into local lymph nodes. More than 50% of children with NB present with distant disease. Common sites of metastases include bone, bone marrow, liver, skin, and lymph nodes. Occasionally, patients may also present with lung and central nervous system metastases. Treatment strategies are based, in part, on the results of imaging studies that are used to evaluate the stage of disease at the time of diagnosis as well as disease response following therapy. This chapter reviews the imaging modalities that have been shown to be useful for clinical staging, assessing potential resectabil-ity, and examining response to therapy.

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