Clinical Research Directory

Construction and Validation of an Intelligent Ultrasound Diagnostic System for the Spectrum of Neuroblastoma in Children

The goal of this observational study is to build an intelligent ultrasound diagnostic system that integrates pathological typing, risk stratification and prognosis assessment. The main question it aims to answer is: 1. Can the prediction model of neuroblastoma tumors (NTs) in children based on ultrasound images distinguish each pathological subtype? 2. Can the multimodal fusion model established based on clinical and pathological features identify high-risk patients, predict bone marrow metastasis, and estimate the therapeutic effect? 3. Can this ultrasound diagnostic system achieve a systematic and intelligent assessment of NTs patients to assist in clinical risk stratification and individualized treatment decisions?

Interest of Preoperative Arteriography to Identify the Adamkiewicz Artery Before Surgery for Basi-thoracic Neuroblastic Tumors

Neuroblastic tumors (NBTs) develop from neural crest cells that give rise to the sympathetic nervous system. They include neuroblastomas, ganglioneuroblastomas, and ganglioneuromas. They represent approximately 10% of solid tumors in children under 15 years of age. In 15 to 20% of cases, NBTs are located in the thoracic region. These paravertebral tumors have an extracanal component and some also have an intraspinal component (dumbbell tumors) that can cause spinal cord compression. Surgery for these tumors also exposes the patient to neurological complications. In the thorax, the basi-thoracic location (T9-T12) may be particularly at risk due to the presence of the artery of Adamkiewicz (AKA), which supplies blood to the spinal cord; damage to this artery can result in spinal cord ischemia. To avoid this scenario, some teams recommend performing spinal cord arteriography to identify AKA. However, many centers do not perform arteriography and do not report more postoperative complications. Currently, there is no consensus on the indications for performing preoperative spinal arteriography in patients undergoing surgery for basi-thoracic NBT. This study evaluates the practice in France of preoperative arteriography to identify the AKA among patients undergoing surgery for basi-thoracic neuroblastic tumors and analyzes the incidence of postoperative neurological complications in these patients.

Prospective Study Registry of Peripheral Neuroblastic Tumours Presenting With Spinal Canal Involvement (SCI)

To describe the natural history of peripheral neuroblastic tumour presenting with SCI and evaluate the combined effects of different risk factors on the eventual neurologic and orthopaedic outcomes