Functional neuroimaging to characterize visual system development in children with retinoblastoma.
OBJECTIVE
To use functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) to investigate visual system development in children being treated for retinoblastoma.


METHODS
Informed consent was obtained for all participants (N = 42) in this institutional review board-approved study. Participants were imaged with a 1.5-T scanner while under propofol sedation. Diagnostic brain and orbital imaging was followed by investigational functional neuroimaging, which included fMRI during photic stimulation through closed eyelids, to measure functional activation in the visual cortex, and DTI, to evaluate diffusion parameters of white matter tracts in the corpus callosum and the periventricular optic radiations. Analysis included 115 examinations of 39 patients with a median age of 16.4 months and age range from 1.5 to 101.5 months at first evaluation.


RESULTS
The blood oxygen level-dependent signal was predominantly negative and located in the anterior visual cortex. Activation was affected by tumor lateralization (unilateral or bilateral), macular involvement, and retinal detachment. Patients who had undergone unilateral enucleation showed cortical dominance corresponding to the projection from the nasal hemiretina in the unaffected eye. Diffusion parameters followed a normal developmental trajectory in the optic radiations and corpus callosum, but variability was greater in the splenium than in the genu of the corpus callosum.


CONCLUSIONS
Longitudinal functional neuroimaging demonstrated important effects of disease and treatment. Therefore, fMRI and DTI may be useful for characterizing the impact of retinoblastoma on the developing visual system and improving the prediction of visual outcome in survivors.
Department of Radiological Sciences, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105-2794, USA.
Scott M
SM
Barb
Carlos
C
Rodriguez-Galindo
Matthew W
MW
Wilson
Nicholas S
NS
Phillips
Ping
P
Zou
Matthew A
MA
Scoggins
Yimei
Y
Li
Ibrahim
I
Qaddoumi
Kathleen J
KJ
Helton
George
G
Bikhazi
Barrett G
BG
Haik
Robert J
RJ
Ogg
D000970:Antineoplastic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003337:Corpus Callosum; D056324:Diffusion Tensor Imaging; D015353:Eye Enucleation; D007839:Functional Laterality; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D009900:Optic Nerve / Q000503:physiopathology*; D010775:Photic Stimulation; D011446:Prospective Studies; D011878:Radiotherapy; D012160:Retina / Q000503:physiopathology*; D012163:Retinal Detachment / Q000503:physiopathology; D019572:Retinal Neoplasms / Q000503:physiopathology* / Q000628:therapy; D012175:Retinoblastoma / Q000503:physiopathology* / Q000628:therapy; D014793:Visual Cortex / Q000503:physiopathology*; D014795:Visual Pathways / Q000503:physiopathology*
D000970:Antineoplastic Agents
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