title: Relevance of CT and MRI in retinoblastoma for the diagnosis of postlaminar invasion with normal-size optic nerve: a retrospective study of 150 patients with histological comparison.
abstract: BACKGROUND
  Detection of optic nerve invasion is mandatory in children primarily enucleated for retinoblastoma to ensure a free resection margin.
  
  
  OBJECTIVE
  To assess the accuracy of CT and MRI for the detection of postlaminar invasion in normal-size nerves.
  
  
  METHODS
  A total of 150 patients enucleated for retinoblastoma were included. Imaging data (119 CT and 46 MRI) were retrospectively reviewed and compared with histological findings. Abnormal contrast enhancement of the optic nerve was used as diagnostic criterion for invasion. The associations between postlaminar invasion and several indirect signs were also assessed. Statistical analysis was performed with the Kruskal-Wallis and Fisher exact tests.
  
  
  RESULTS
  Postlaminar invasion on histology was observed in 8% (12/150). The sensitivity, specificity, accuracy and negative and positive predictive values were 60%, 95%, 91%, 95% and 60% for MRI, and 0%, 100%, 94% and 94% (PPV not assessable) for CT, respectively. Tumour diameter was the only indirect radiological sign significantly associated with postlaminar optic nerve invasion (P=0.002).
  
  
  CONCLUSIONS
  Our results suggest that MRI is more relevant than CT for preoperative detection of optic nerve invasion in patients with retinoblastoma. Tumour diameter is the only indirect sign significantly associated with postlaminar invasion.
authors.affiliation: Department of Radiology, Institute Curie, 26 rue d'Ulm, Paris 75005, France. herve.brisse@curie.net
authors.forename: Hervé J
authors.initials: HJ
authors.lastname: Brisse
authors.forename: Myriam
authors.initials: M
authors.lastname: Guesmi
authors.forename: Isabelle
authors.initials: I
authors.lastname: Aerts
authors.forename: Xavier
authors.initials: X
authors.lastname: Sastre-Garau
authors.forename: Alexia
authors.initials: A
authors.lastname: Savignoni
authors.forename: Livia
authors.initials: L
authors.lastname: Lumbroso-Le Rouic
authors.forename: Laurence
authors.initials: L
authors.lastname: Desjardins
authors.forename: François
authors.initials: F
authors.lastname: Doz
authors.forename: Bernard
authors.initials: B
authors.lastname: Asselain
authors.forename: Danièle
authors.initials: D
authors.lastname: Bours
authors.forename: Sylvia
authors.initials: S
authors.lastname: Neuenschwander
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D009361:Neoplasm Invasiveness / Q000175:diagnosis; D009900:Optic Nerve / Q000473:pathology*; D011237:Predictive Value of Tests; D019572:Retinal Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D012175:Retinoblastoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed