Wilms' tumour: pre- and post-chemotherapy CT appearances.
Pre-operative chemotherapy is used in our institution for patients with Wilms' Tumours (WT) when surgical 'operability' is in doubt. To date, the computed tomographic (CT) appearances of chemotherapy-induced changes in WT have not been described. We have analysed CT examinations of 18 children undergoing pre-operative chemotherapy to assess the effects of treatment on size, extent and qualitative changes of the tumour. Clinical response to chemotherapy was associated with a reduction in tumour size of at least 50%. Cystic changes were commonly seen within tumours following chemotherapy. CT did not reliably differentiate lymph nodes involved by tumour from those showing only reactive change. Pre-chemotherapy CT scans were incorrect in predicting liver invasion in 4/18 (22%) cases: of these, two were right-sided tumours, and two were bilateral.
Ng
Y Y
YY
Department of Radiology, Hospital for Sick Children, London.
Hall-Craggs
M A
MA
Dicks-Mireaux
C
C
Pritchard
J
J
D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003609:Dactinomycin / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007223:Infant; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014750:Vincristine / Q000627:therapeutic use; D009396:Wilms Tumor / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology / Q000556:secondary / Q000601:surgery
D003609:Dactinomycin; D014750:Vincristine; D004317:Doxorubicin