title: Diagnostic image quality of gadolinium-enhanced T1-weighted MRI with and without fat saturation in children with retinoblastoma.
abstract: BACKGROUND
  Gadolinium-enhanced T1-weighted MRI without fat saturation has been recommended for assessment of retinoblastoma.
  
  
  OBJECTIVE
  The purpose of this study was to compare diagnostic image quality without and with fat saturation following gadolinium administration.
  
  
  METHODS
  High-resolution gadolinium-enhanced T1-weighted sequences with and without fat saturation performed in children with subsequently histopathologically confirmed retinoblastoma were included. Image analysis (image quality [1 = poor, 2 = moderate, 3 = good], anatomical detail depiction, tumour extension) was performed by two neuroradiologists in consensus. Enhancement was scored and measured. Signal- and contrast-to-noise ratios were calculated. Image-assessed tumour invasiveness was compared to histopathological findings. Paired sample t-test was used for statistical analysis.
  
  
  RESULTS
  Thirty-six children (mean age, 19.0 ± 16.8 [SD] months) were included. Image quality and anatomical detail depiction were significantly better without fat saturation (P < 0.001). Tumour enhancement was rated higher with fat saturation (P < 0.001). Fat saturation improved detection of (post-)laminar optic nerve infiltration. Detection of choroidal invasion was improved without fat saturation. Combining both sequences was best in the assessment of tumour extension (sensitivity/specificity for (post-)laminar optic nerve infiltration, 75.0%/100.0%, and for choroidal invasion, 87.5%/85.7%).
  
  
  CONCLUSIONS
  Combined T1-weighted spin-echo imaging with and without fat saturation improved the image quality for assessment of invasiveness of retinoblastoma.
authors: Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany. selma.sirin@uk-essen.de
authors: Selma
authors: S
authors: Sirin
authors: Marc
authors: M
authors: Schlamann
authors: Klaus A
authors: KA
authors: Metz
authors: Norbert
authors: N
authors: Bornfeld
authors: Bernd
authors: B
authors: Schweiger
authors: Markus
authors: M
authors: Holdt
authors: Michael M
authors: MM
authors: Schuendeln
authors: Simone
authors: S
authors: Lohbeck
authors: Andrej
authors: A
authors: Krasny
authors: Sophia L
authors: SL
authors: Goericke
mesh_terms: D000273:Adipose Tissue / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D019572:Retinal Neoplasms / Q000473:pathology*; D012175:Retinoblastoma / Q000473:pathology*; D012680:Sensitivity and Specificity; D013382:Subtraction Technique
chemical_list: D003287:Contrast Media; D005682:Gadolinium