MRI helps depict clinically undetectable risk factors in advanced stage retinoblastomas.
This study compared high-resolution MRI with histology in advanced stage retinoblastomas in which ophthalmoscopy and ultrasonography did not give an exhaustive depiction of the tumour and/or its extension. MRI of orbits and head in 28 retinoblastoma patients (28 eyes) treated with primary enucleation were evaluated. Iris neoangiogenesis, infiltrations of optic nerve, choroid, anterior segment and sclera suspected at MR and histology were compared. Abnormal anterior segment enhancement (AASE) was also correlated with histologically proven infiltrations. Brain images were also evaluated. Significant values were obtained for: prelaminar optic nerve (ON) sensitivity (0.88), positive predictive value (PPV) (0.75) and negative predictive value (NPV) (0.71); post-laminar ON sensitivity (0.50), specificity (0.83), PPV (0.50) and NPV (0.83); overall choroid sensitivity (0.82), and massive choroid NPV (0.69); scleral specificity (1), and NPV (1). AASE correlated with iris neoangiogenesis in 14 out of 19 eyes, and showed significant values for: overall ON PPV (0.65), prelaminar ON sensitivity (0.65), and PPV (0.61), post-laminar ON NPV (0.64); overall choroid sensitivity (0.77), PPV (0.59) and NPV (0.73); scleral NPV (0.83); anterior segment sensitivity (1), and NPV (1). Odds ratios (OR) and accuracy were significant in scleral and prelaminar optic nerve infiltration. Brain examination was unremarkable in all cases. High-resolution MRI may add important findings to clinical evaluation of advanced stage retinoblastomas.
Neuroimaging and Neurointerventional (NINT) Unit galluzzip@libero.it.
Paolo
P
Galluzzi
Unit of Ophthalmology and Retinoblastoma Referral Centre, Department of Surgery.
Theodora
T
Hadjistilianou
Neuroimaging and Neurointerventional (NINT) Unit.
Alfonso
A
Cerase
Section of Pathology, Department of Medical Biotechnologies.
Paolo
P
Toti
Neuroimaging and Neurointerventional (NINT) Unit.
Sara
S
Leonini
Neuroimaging and Neurointerventional (NINT) Unit.
Sandra
S
Bracco
Unit of Ophthalmology and Retinoblastoma Referral Centre, Department of Surgery.
Sonia
S
de Francesco
Unit of Paediatrics, Department of Maternal, Newborn and Child Health, University of Siena, "Santa Maria alle Scotte" Hospital; Siena, Italy.
Daniela
D
Galimberti
Unit of Anaesthesiology, Siena University Hospital Trust; Siena, Italy.
Donatella
D
Balducci
Department of Medicine, Surgery and Neuroscience, University of Siena; Siena, Italy.
Pietro
P
Piu
Neuroimaging and Neurointerventional (NINT) Unit.
Lucia
L
Monti
Neuroimaging and Neurointerventional (NINT) Unit.
Matteo
M
Bellini
Unit of Paediatrics, Department of Maternal, Newborn and Child Health, University of Siena, "Santa Maria alle Scotte" Hospital; Siena, Italy.
Mauro
M
Caini
Neuroimaging and Neurointerventional (NINT) Unit.
Alessandro
A
Rossi
D002675:Child, Preschool; D005123:Eye / Q000473:pathology*; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009915:Orbit / Q000473:pathology*; D019572:Retinal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D012175:Retinoblastoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D012307:Risk Factors
magnetic resonance imaging; retinoblastoma