title: High-resolution MRI using orbit surface coils for the evaluation of metastatic risk factors in 143 children with retinoblastoma: Part 2: new vs. old imaging concept.
abstract: BACKGROUND
  High-resolution magnetic resonance imaging (MRI) is recommended for the evaluation of metastatic risk factors in children with retinoblastoma according to recent guidelines. The aim of this study was to compare diagnostic accuracy of a new imaging concept with two orbit surface coils to that of an old imaging concept with one orbit surface coil.
  
  
  METHODS
  One hundred forty-three patients (148 eyes, 64 girls, 79 boys) underwent high-resolution MRI on 1.5 T scanners using orbit surface coils. The old imaging concept (one orbit surface coil focusing on the (most) effected eye additionally to the standard head coil) was used in 100 patients/103 eye; the new imaging concept (two orbit surface coils (each focusing on one eye) additionally to the standard head coil) in 43 patients/45 eyes. Image analysis was performed by two neuroradiologists in consensus. Histopathology served as gold standard.
  
  
  RESULTS
  Detection rate for choroidal invasion was higher for the new compared to that for the old imaging concept (sensitivity/specificity 87.5/94.6 % vs. 57.1/96.1 % for choroidal invasion and 100/97.5 % vs. 58.3/97.7 % for massive choroidal invasion, respectively). Sensitivity and specificity for the detection of postlaminar optic nerve infiltration, peribulbar fat, and scleral invasion were comparable in both imaging concepts; however positive predictive value was higher in the new imaging concept (new vs. old imaging concept: 60 vs. 31.6 % for postlaminar and deep postlaminar optic nerve infiltration, respectively, and 100 vs. 66.7 % for scleral invasion).
  
  
  CONCLUSIONS
  The new imaging concept shows a trend towards improving the accuracy of detecting metastatic risk factors in children with retinoblastoma and is therefore recommended for pretherapeutic imaging and follow-up.
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany, selma.sirin@uk-essen.de.
authors.forename: Selma
authors.initials: S
authors.lastname: Sirin
authors.forename: Marc
authors.initials: M
authors.lastname: Schlamann
authors.forename: Klaus A
authors.initials: KA
authors.lastname: Metz
authors.forename: Norbert
authors.initials: N
authors.lastname: Bornfeld
authors.forename: Bernd
authors.initials: B
authors.lastname: Schweiger
authors.forename: Markus
authors.initials: M
authors.lastname: Holdt
authors.forename: Petra
authors.initials: P
authors.lastname: Temming
authors.forename: Michael M
authors.initials: MM
authors.lastname: Schuendeln
authors.forename: Sophia L
authors.initials: SL
authors.lastname: Goericke
mesh_terms: D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000295:instrumentation*; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000295:instrumentation*; D008297:Male; D015203:Reproducibility of Results; D019572:Retinal Neoplasms / Q000473:pathology*; D012175:Retinoblastoma / Q000473:pathology* / Q000556:secondary*; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D014159:Transducers