MRI Helps Depict Clinically Undetectable Risk Factors in Advanced Stage Retinoblastomas

Galluzzi, Paolo; Hadjistilianou, Theodora; Cerase, Alfonso; Toti, Paolo; Leonini, Sara; Bracco, Sandra; Francesco, Sonia De; Galimberti, Daniela; Balducci, D; Piu, Pietro; Monti, Lucia; Bellini, Matteo; Caini, Mauro; Rossi, Alessandro

doi:10.15274/nrj-2014-10103

Cited by 6 publications

(8 citation statements)

References 51 publications

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“…A high rate of false-positive findings was observed (13/58), because partial-volume effects hinder differentiation between the intraocular tumor and the ciliary body. Our results were similar to previous studies [8,12]. Cui Y. et al [9] concluded higher specificity (98%) and NPV than that reported in previous studies to exclude ciliary body invasion.…”

Section: Discussionsupporting

confidence: 93%

“…Low specificity might be attributed to the large mean tumor size included in our study that might hinder the delineation between the intraocular tumor and the underlying ocular wall. Our results are similar to previous reports (accuracy, 60-88%; sensitivity, 35-82%; and specificity, 40-99%) [8,12,13]. Cui Y. et al [9] reported an accuracy of 61.9% with very low specificity (34%) compared to previous reports attributed to image parameter factors.…”

Section: Discussionsupporting

confidence: 91%

“…Risk factors include tumor extension into the choroid, sclera, optic nerve, and anterior eye segment. With the expanding options of nonsurgical treatment of retinoblastoma and shifting to the chemotherapeutic agents, more children have been managed without pathological staging and evaluation of metastatic risk factors [8]. Preoperative ocular MRI is becoming the primary noninvasive technique used upon deciding to treat an eye conservatively or to enucleate as funduscopy and ultrasound have limitations.…”

Section: Introductionmentioning

confidence: 99%

“…Although several studies have reported the diagnostic accuracy of MRI in detecting intraocular tumor extent and metastasis [3,[6][7][8][9][10][11][12][13][14][15], our study provides a comprehensive evaluation of the diagnostic accuracy of 3 T ocular MRI, diagnostic role of DWIs, sensitivity, and specificity of different tumor diameter cut off values of postlaminar optic nerve invasion (PLONI) and ocular coat invasion as well as the relationship of the abnormal anterior eye segment enhancement in MRI examinations of retinoblastoma and different MRI and histopathological findings which, to our knowledge, are grouped in few studies. This prospective study aims to evaluate the preoperative MR imaging diagnostic value in pathologically proved retinoblastoma patients.…”

Section: Introductionmentioning

confidence: 99%

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High Resolution MR Imaging guidelines in retinoblastoma: prospective study correlated with histopathological results

Habib

Youssef

AlKiki

et al. 2020

Egypt J Radiol Nucl Med

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Background: Retinoblastoma is the commonest intraocular pediatric neoplasm. With the recent scope of shifting to eye preserving therapies, preoperative MRI is becoming the primary noninvasive diagnostic method to confirm the diagnosis, assess the ocular coats and optic nerve, and detect extraocular tumor extension and intracranial primitive neuroectodermal tumor associated with retinoblastoma as funduscopy and ultrasound have limitations. Diffusion-weighted images (DWIs) detect abnormalities based on differences in tissue cellularity. Echoplanar-based (EP) DWI results in susceptibility artifacts and geometric distortions, which make DWI of the orbit a challenging technique. The purpose of our study is to evaluate preoperative magnetic resonance (MR) imaging diagnostic merits and indices in patients with retinoblastoma. Results: Fifty-eight eyes were prospectively reviewed in 30 girls and 27 boys (mean age at diagnosis was 23 months ± 18.9) with retinoblastoma by two radiologists on T1-weighted images, fat saturated T2-weighted images, DWIs, ADC, and postcontrast T1-weighted MR images with and without fat suppression. All patients included were primarily treated by surgical enucleation; one girl had bilateral enucleation. MRI shows accuracy, sensitivity, specificity, NPV, and PPV; 86.2%, 95.3%, 60%, 81.8%, and 87.2% respectively for choroidal invasion; 75.8%, 58.8%, 82.9%, 83%, and 58.8% in prelaminar optic nerve invasion; and 86.2%, 85.2%, 87%, 87%, and 85% in postlaminar optic nerve invasion (PLONI) respectively. For sclera and extrascleral tumor invasion, MRI show accuracy, sensitivity, specificity, NPV, and PPV of 93%, 55.6%, 100%, 92.5%, 100%, and 98.3%, 100%, 98%,100%, 80% respectively. On DWIs, the vital solid tumor shows hyperintense signal compared to the vitreous. The difference between the mean ADC value of the solid enhancing tumor (0.3[0.12-0.8] × 10 −3 s/mm 2) and nonenhancing necrotic parts (1.4[1.0-1.8] × 10 −3 s/mm 2) was statistically significant (p < 0.001). No correlation was found between the ADC values and high risk features for metastasis. Abnormal anterior chamber enhancement shows no statistically significant correlation with main MRI and histopathology findings. Maximum tumor diameter in mm show statistically significant correlation with postlaminar optic nerve invasion (ρ = .002) and choroidal invasion (ρ = .007). Sensitivity and specificity of different tumor size cutoff values are calculated using the ROC analysis. Conclusion: High-resolution ocular MR imaging can reliably detect postlaminar optic nerve invasion, choroid, and extrascleral invasion; meanwhile, it shows low sensitivity in prelaminar optic nerve, ciliary body, and sclera invasion. Significantly lower ADC values in viable tumor than necrotic parts are recorded.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

High Resolution MR Imaging guidelines in retinoblastoma: prospective study correlated with histopathological results

Habib

Youssef

AlKiki

et al. 2020

Egypt J Radiol Nucl Med

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“…With conservative treatment options significantly improved in the last decades, the main aims in the management of retinoblastoma are globe salvage and reduced systemic toxicity [20]. IAC shows improved tumor control, and is both an effective and safe treatment for retinoblastoma, but it does cause some complications [8–10, 12, 21].…”

Section: Discussionmentioning

confidence: 99%

The value of MRI in evaluating the efficacy and complications with the treatment of intra-arterial chemotherapy for retinoblastoma

Chen

Liu

et al. 2017

Oncotarget

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Retinoblastoma is the most common intraocular malignant tumor of childhood. Intra-arterial chemotherapy (IAC) is a recently popularized technique used for the treatment of retinoblastoma, to decrease mortality, increase preservation of the eye, and prevent blindness. Along with the extensive use of IAC, it is important to apply noninvasive examination methods to assess the activity of the tumor and the risk factors for disease dissemination without histopathological confirmation. There are few studies that have assessed the value of magnetic resonance imaging (MRI) in evaluating the efficacy and complications of IAC for retinoblastoma. We retrospectively analyzed the MRI features of 60 patients with unilateral retinoblastoma given the primary treatment of IAC from January 2014 to February 2016 in our hospital. Our study showed that MRI could well assess the decreased activity of the tumor after IAC, presenting with diminished tumor size, increased apparent diffusion coefficient (ADC) values (from 0.94 ± 0.24 × 10−3 mm2/s to 2.24 ± 0.40 × 10−3 mm2/s), and a reduced degree of enhancement of the tumor. Our study also showed that MRI can monitor the risk factors of abnormal enhancement of the postlaminar optic nerve, to avoid unnecessary enucleation. Meanwhile, the results showed that the main late complications after IAC included affected eyeball volume reduction, subretinal hemorrhage, vitreous hemorrhage, vitreous opacity, cataractous len, and choroidal vascular ischemia.

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Diagnostic performance of MRI of post-laminar optic nerve invasion detection in retinoblastoma: A systematic review and meta-analysis

et al. 2020

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MRI Helps Depict Clinically Undetectable Risk Factors in Advanced Stage Retinoblastomas

Cited by 6 publications

References 51 publications

High Resolution MR Imaging guidelines in retinoblastoma: prospective study correlated with histopathological results

High Resolution MR Imaging guidelines in retinoblastoma: prospective study correlated with histopathological results

The value of MRI in evaluating the efficacy and complications with the treatment of intra-arterial chemotherapy for retinoblastoma

Diagnostic performance of MRI of post-laminar optic nerve invasion detection in retinoblastoma: A systematic review and meta-analysis

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