title: Retinoblastoma: value of dynamic contrast-enhanced MR imaging and correlation with tumor angiogenesis.
abstract: OBJECTIVE
  Noninvasive evaluation of retinoblastoma treatment response has become more important due to increased use of eye-sparing treatments. We evaluated the relation between DCE-MR imaging and histopathologic parameters to determine the value of DCE-MR imaging in assessing tumor angiogenesis and prognostic features.
  
  
  METHODS
  Fifteen consecutive patients with retinoblastoma (mean age, 24 months; range, 2-70 months) undergoing enucleation as the primary treatment (15 eyes) were scanned at 1.5T by using dedicated surface coils. Pretreatment DCE-MR imaging of the most affected eye was evaluated by 2 observers by using curve-pattern analysis, with the first 5 minutes of each curve and the full time-series described as κ(5min) and κ(17min), respectively. Assessed histopathologic and immunologic parameters included optic nerve invasion, choroid invasion, MVD, tumor necrosis, and expression of VEGF and Flt-1.
  
  
  RESULTS
  The median value of κ(5min) was 1.28 (range, 0.87-2.07) and correlated positively with MVD (P = .008). The median value of κ(17min) was 1.33 (range, 0.35-3.08) and correlated negatively with tumor necrosis (P = .002). Other histopathologic and immunohistopathologic parameters did not correlate with DCE-MR imaging parameters. Interobserver agreement was 0.53 for κ(5min) and 0.91 for κ(17min).
  
  
  CONCLUSIONS
  In retinoblastoma, the early phase of the DCE time curve positively correlates with MVD, while the presence of late enhancement is correlated with necrosis. Thus, the potential for DCE-MR imaging to noninvasively assess tumor angiogenesis and necrosis in retinoblastoma is promising and warrants further investigation.
authors.affiliation: Departments of Radiology, VU University Medical Center, Amsterdam, the Netherlands. f.rodjan@vumc.nl
authors.forename: F
authors.initials: F
authors.lastname: Rodjan
authors.forename: P
authors.initials: P
authors.lastname: de Graaf
authors.forename: P
authors.initials: P
authors.lastname: van der Valk
authors.forename: A C
authors.initials: AC
authors.lastname: Moll
authors.forename: J P A
authors.initials: JP
authors.lastname: Kuijer
authors.forename: D L
authors.initials: DL
authors.lastname: Knol
authors.forename: J A
authors.initials: JA
authors.lastname: Castelijns
authors.forename: P J W
authors.initials: PJ
authors.lastname: Pouwels
mesh_terms: D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009389:Neovascularization, Pathologic / Q000150:complications* / Q000473:pathology*; D015203:Reproducibility of Results; D019572:Retinal Neoplasms / Q000150:complications* / Q000473:pathology*; D012175:Retinoblastoma / Q000150:complications* / Q000473:pathology*; D012680:Sensitivity and Specificity; D013223:Statistics as Topic
chemical_list: D003287:Contrast Media