title: Assessment of early-stage optic nerve invasion in retinoblastoma using high-resolution 1.5 Tesla MRI with surface coils: a multicentre, prospective accuracy study with histopathological correlation.
abstract: OBJECTIVE
  To assess the accuracy of high-resolution (HR) magnetic resonance imaging (MRI) in diagnosing early-stage optic nerve (ON) invasion in a retinoblastoma cohort.
  
  
  METHODS
  This IRB-approved, prospective multicenter study included 95 patients (55 boys, 40 girls; mean age, 29 months). 1.5-T MRI was performed using surface coils before enucleation, including spin-echo unenhanced and contrast-enhanced (CE) T1-weighted sequences (slice thickness, 2 mm; pixel size <0.3 × 0.3 mm(2)). Images were read by five neuroradiologists blinded to histopathologic findings. ROC curves were constructed with AUC assessment using a bootstrap method.
  
  
  RESULTS
  Histopathology identified 41 eyes without ON invasion and 25 with prelaminar, 18 with intralaminar and 12 with postlaminar invasion. All but one were postoperatively classified as stage I by the International Retinoblastoma Staging System. The accuracy of CE-T1 sequences in identifying ON invasion was limited (AUC = 0.64; 95 % CI, 0.55 - 0.72) and not confirmed for postlaminar invasion diagnosis (AUC = 0.64; 95 % CI, 0.47 - 0.82); high specificities (range, 0.64 - 1) and negative predictive values (range, 0.81 - 0.97) were confirmed.
  
  
  CONCLUSIONS
  HR-MRI with surface coils is recommended to appropriately select retinoblastoma patients eligible for primary enucleation without the risk of IRSS stage II but cannot substitute for pathology in differentiating the first degrees of ON invasion.
  
  
  CONCLUSIONS
  • HR-MRI excludes advanced optic nerve invasion with high negative predictive value. • HR-MRI accurately selects patients eligible for primary enucleation. • Diagnosis of early stages of optic nerve invasion still relies on pathology. • Several physiological MR patterns may mimic optic nerve invasion.
authors.affiliation: Department of Radiology, Institut Curie, Paris, France, herve.brisse@curie.fr.
authors.forename: Hervé J
authors.initials: HJ
authors.lastname: Brisse
authors.forename: Pim
authors.initials: P
authors.lastname: de Graaf
authors.forename: Paolo
authors.initials: P
authors.lastname: Galluzzi
authors.forename: Kristel
authors.initials: K
authors.lastname: Cosker
authors.forename: Philippe
authors.initials: P
authors.lastname: Maeder
authors.forename: Sophia
authors.initials: S
authors.lastname: Göricke
authors.forename: Firazia
authors.initials: F
authors.lastname: Rodjan
authors.forename: Marcus C
authors.initials: MC
authors.lastname: de Jong
authors.forename: Alexia
authors.initials: A
authors.lastname: Savignoni
authors.forename: Isabelle
authors.initials: I
authors.lastname: Aerts
authors.forename: Laurence
authors.initials: L
authors.lastname: Desjardins
authors.forename: Annette C
authors.initials: AC
authors.lastname: Moll
authors.forename: Theodora
authors.initials: T
authors.lastname: Hadjistilianou
authors.forename: Paolo
authors.initials: P
authors.lastname: Toti
authors.forename: Paul
authors.initials: P
authors.lastname: van der Valk
authors.forename: Jonas A
authors.initials: JA
authors.lastname: Castelijns
authors.forename: Xavier
authors.initials: X
authors.lastname: Sastre-Garau
mesh_terms: D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008536:Meglumine; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D009900:Optic Nerve / Q000473:pathology*; D019574:Optic Nerve Neoplasms / Q000473:pathology*; D009942:Organometallic Compounds; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D019572:Retinal Neoplasms / Q000473:pathology* / Q000648:ultrastructure; D012175:Retinoblastoma / Q000473:pathology* / Q000648:ultrastructure; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D008536:Meglumine; C072417:gadoterate meglumine