What is the role of nuclear imaging in the workup of Wilms tumor?

Updated: Mar 04, 2019
  • Author: Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR; Chief Editor: Eugene C Lin, MD  more...
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Answer

Answer

Radionuclide studies may be indicated for assessing the volume of functioning renal tissues by using technetium-99m dimercaptosuccinic acid (DMSA). The findings may provide guidance as to what tissues may be preserved when nephron-sparing surgery of bilateral tumors is being contemplated. Isotope renography is a sensitive technique for assessing renal function.

Positron emission tomography (PET) may be important in the future. Bone scintigraphy is useful for evaluating only clear cell sarcoma, which tends to metastasize to bone.

This 6-year-old male child with hematuria was refe This 6-year-old male child with hematuria was referred for a renal ultrasound scan. The scan shows a 6 x 8 cm solid mass at the lower pole of the right kidney displacing part of the collecting system in a cephalad direction. The mass is of uniform echogenicity with a vague small central hypoechoic area suggestive of tumor necrosis.
An IVU shows a nonfunctioning left kidney with a s An IVU shows a nonfunctioning left kidney with a suggestion of ill-defined mass in the left loin due to a biopsy-proven Wilms tumor. Note the functioning right duplex renal collecting system. The chest radiograph in the same child shows a lung metastatic deposit (arrow). Images courtesy Dr. Pedro Daltro and Dr. Edson Marchiori, Port Allegre, Brazil. edmarchiori@gmail.com
Axial US image shows a solid 4.5-cm solid mass ant Axial US image shows a solid 4.5-cm solid mass anterior cortex, lower pole of the left kidney. Image courtesy of Dr. Pedro Daltro and Dr. Edson Marchiori, Port Allegre, Brazil. edmarchiori@gmail.com

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