Retinoblastoma: Abnormal Gadolinium Enhancement of Anterior Segment of Eyes at MR Imaging with Clinical and Histopathologic Correlation

Galluzzi, Paolo; Cerase, Alfonso; Hadjistilianou, Theodora; Francesco, Sonia De; Toti, Paolo; Vallone, Ignazio Maria; Filosomi, G.; Monti, Lucia; Bracco, Sandra; Gennari, Paola; Ginanneschi, Chiara; Venturi, Carlo

doi:10.1148/radiol.2283020466

Cited by 39 publications

(35 citation statements)

References 39 publications

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“…De Graaf et al 6 reported the clinical presence of IA, hyperemia, or inflammation as possible explanations for AES enhancement. Galluzzi et al 18 published a series of 16 eyes and found a correlation between histopathologic optic nerve and/or choroid invasion and AES enhancement on MR imaging; however, no correlation between clinical or histopathologic presence of IA and AES enhancement could be detected. On the other hand, Brisse et al 8 could not confirm this correlation between AES enhancement and optic nerve invasion in 10 eyes.…”

Section: Discussionmentioning

confidence: 98%

“…6,8,18 Authors of these studies correlated AES enhancement with clinical and histopathologic findings. De Graaf et al 6 reported the clinical presence of IA, hyperemia, or inflammation as possible explanations for AES enhancement.…”

Section: Discussionmentioning

confidence: 99%

“…This early enhancement has been attributed to leakage of contrast material into the extravascular space through regions of BOB disruption. 18,23 In newly formed capillaries during IA, the BOB is poorly developed from the outset and becomes further compromised under hypoxic conditions, with VEGF as an important mediator.…”

Section: Discussionmentioning

confidence: 99%

“…However, routine ophthalmoscopy has a low sensitivity for detecting early or subtle stages of IA, a finding confirmed in our study (2 eyes with IA detected clinically, compared with 14 eyes detected histopathologically). 18,28 The degree of AES enhancement might be a valuable diagnostic parameter in the choice between enucleation and conservative treatment strategies. Normal AES enhancement seems to be an indication for considering globe salvage rather than enucleation.…”

Section: Discussionmentioning

confidence: 99%

“…6,8,18 Surprisingly, this phenomenon is barely reported in the literature, and underlying pathophysiology and its histopathologic correlates are still unclarified. We postulated that AES enhancement may reflect the status of retinoblastoma-induced IA in vivo.…”

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confidence: 99%

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Contrast-Enhancement of the Anterior Eye Segment in Patients with Retinoblastoma: Correlation between Clinical, MR Imaging, and Histopathologic Findings

Graaf¹,

Valk²,

Moll³

et al. 2009

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Contrast-Enhancement of the Anterior Eye Segment in Patients with Retinoblastoma: Correlation between Clinical, MR Imaging, and Histopathologic Findings

Graaf¹,

Valk²,

Moll³

et al. 2009

AJNR Am J Neuroradiol

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Diagnosis of Postlaminar Optic Nerve Invasion in Retinoblastoma With MRI Features

Guo

et al. 2019

Magnetic Resonance Imaging

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Background Retinoblastomas (RBs) with postlaminar optic nerve invasion (PLONI) increases the risk of local recurrence or systemic metastasis. Most MRI studies on PLONI focused on optic nerve enhancement and tumor size, with reported relatively high specificity (84–98%) but low sensitivity (37–78%), which shows room for improvement, especially with regard to sensitivity. Purpose To evaluate the diagnostic performance for detecting PLONI with RB using MRI features. Study Type Retrospective. Population Fifty patients with histopathologic PLONI and 70 patients without PLONI of RB. Field Strength/Sequence 1.5T and 3.0T, precontrast axial T1‐weighted and T2‐weighted, postcontrast axial, coronal and oblique‐sagittal T1‐weighted. Assessment The eyes were histopathologically analyzed and the preoperative MRI features of the eyes were independently evaluated by three observers. Statistical Tests MRI features suggesting the presence of PLONI were identified by univariate and multivariable analysis. Receiver operating characteristic curve (ROC) and the area under the curve (AUC) were used to analyze diagnostic performance. Results Significant independent diagnostic factors for PLONI include: 1: Bilateral tumor (odds ratio [OR], 15.32; 95% confidence interval [CI]: 1.63–143.51); 2: Tumor with total coverage of the optic disk (OR, 6.43; 95% CI: 1.04–39.79); and 3: Optic nerve enhancement (OR, 8.43; 95% CI: 3.50–20.31). On the other hand, isointense signal of tumor on T2WI (OR, 0.30; 95% CI: 0.12–0.75) was an independent diagnostic factor in excluding PLONI. ROC analysis showed AUC of 0.84 (95% CI: 0.77–0.91, P < 0.0001) for PLONI. Based on the cutoff of maximum Youden index, the sensitivity, specificity, and accuracy were 82%, 73%, and 77%, respectively. Data Conclusion MRI features of RB showed a strong association with PLONI. The model of MRI features demonstrated promising diagnostic performance in detecting PLONI. Level of Evidence: 4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:1045–1052.

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Diffusion‐Weighted MR Imaging of the Optic Nerve Can Improve the Detection of Post‐Laminar Optic Nerve Invasion from Retinoblastoma

Liu

Yan

et al. 2022

Magnetic Resonance Imaging

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BackgroundPost‐laminar optic nerve invasion (PLONI) is a high‐risk factor for the metastasis of retinoblastoma (RB). Unlike conventional MRI, diffusion‐weighted imaging (DWI) reflects histopathological features, and may aid the assessment of PLONI.PurposeTo determine the value of conventional MRI plus DWI in detecting PLONI in RB patients.Study TypeRetrospective.PopulationEighty‐three RB patients, including 28 with histopathologically proven PLONI and 55 without PLONI.Field Strength/Sequence3.0 T, precontrast axial T1‐weighted and T2‐weighted imaging, DWI, and postcontrast axial, coronal, and oblique‐sagittal T1‐weighted imaging.AssessmentPLONI was assessed using post‐enucleation histology and preoperative MRI features (optic nerve signal intensity, enlargement, and enhancement on conventional MRI, and apparent diffusion coefficient [ADC] of the optic nerve on DWI) evaluated by three observers.Statistical TestsMRI features suggesting the presence of PLONI were identified using univariable and multivariable analyses. Receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to analyze diagnostic performance.ResultsOptic nerve enhancement and low ADC of the optic nerve were significant indicators of PLONI. ROC curve analysis showed that the AUC of the combination of these two features for detecting PLONI was 0.87 (95% confidence interval [CI]: 0.78–0.93). The diagnostic performance of this model was significantly superior to that of optic nerve enhancement alone (0.76, 95% CI: 0.65–0.85) and marginally superior to that of the ADC of the affected optic nerve (0.78, 95% CI: 0.68–0.87, P = 0.051).Data ConclusionConventional MRI combined with DWI can improve the detection of PLONI in RB patients over conventional MRI alone.Evidence Level: 3Technical Efficacy: Stage 2

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Retinoblastoma: Abnormal Gadolinium Enhancement of Anterior Segment of Eyes at MR Imaging with Clinical and Histopathologic Correlation

Abstract: Abnormal gadolinium enhancement of the anterior segments of eyes harboring retinoblastoma seems to indicate more aggressive tumor behavior.

Cited by 39 publications

References 39 publications

Contrast-Enhancement of the Anterior Eye Segment in Patients with Retinoblastoma: Correlation between Clinical, MR Imaging, and Histopathologic Findings

Contrast-Enhancement of the Anterior Eye Segment in Patients with Retinoblastoma: Correlation between Clinical, MR Imaging, and Histopathologic Findings

Diagnosis of Postlaminar Optic Nerve Invasion in Retinoblastoma With MRI Features

Diffusion‐Weighted MR Imaging of the Optic Nerve Can Improve the Detection of Post‐Laminar Optic Nerve Invasion from Retinoblastoma

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