Thirteen patients with neural crest tumors were each studied with a radionuclide skeletal survey, a radiographic skeletal survey, and an iliac crest bone marrow aspiration. The RN skeletal survey proved to be more accurate than the radiographic skeletal survey in: 1) detecting the primary tumor; 2) demonstrating bony metastatic disease; and 3) evaluating response to therapy. The overall accuracy of the RN skeletal survey in detecting metastatic disease correlated with the results of bone marrow aspiration both in the initial detection of metastatic disease and the evaluation of response during therapy.