How is neuroblastoma diagnosed?

Neuroblastoma is diagnosed using a combination of tests to confirm the diagnosis, identify where the tumour started, and understand how the cancer is behaving. Your child’s medical team will explain each test and what the results mean for your child. 

Tests and scans 

Most children need several tests, which may include: 

• Imaging scans: Scans such as an ultrasound, CT, or MRI are used to find the tumour, see its size, and understand which parts of the body are affected. 
  

• Urine and blood tests: Many children with neuroblastoma have raised levels of certain substances in their urine, called tumour markers (for example VMA or HVA). These tests can support the diagnosis and are also used to monitor response to treatment. 
  

• Biopsy: A biopsy involves taking a small sample of the tumour, usually under a general anaesthetic. This allows doctors to confirm that the tumour is neuroblastoma and to study its biological features, such as MYCN or ALK changes. 
  

• Bone marrow tests: Bone marrow samples may be taken to check whether the cancer has spread to the bone marrow. 
  

• mIBG scan: Most children have a special scan called an mIBG scan, which helps doctors see where neuroblastoma cells are in the body. Some children whose tumours do not take up mIBG may have a different type of scan instead. 
  

• PET scan: If the tumour does not take up mIBG then children will have a PET scan. This is another type of scan which can see where neuroblastoma cells are in the body.   

Understanding stage and risk group 

The results of these tests help doctors determine the stage and risk group of your child’s neuroblastoma. This information is essential for planning treatment. 

Every child’s diagnostic pathway is slightly different. Your child’s consultant will talk you through the results and answer any questions you have.

Read more about the risk groups for neuroblastoma.