title: Diagnostic Accuracy of Intraocular Tumor Size Measured with MR Imaging in the Prediction of Postlaminar Optic Nerve Invasion and Massive Choroidal Invasion of Retinoblastoma.
abstract: Purpose To assess the correlation of intraocular retinoblastoma tumor size measured with magnetic resonance (MR) imaging in the prediction of histopathologically determined metastatic risk factors (postlaminar optic nerve invasion and massive choroidal invasion). Materials and Methods The ethics committee approved this retrospective multicenter study with a waiver of informed consent. The study population included 370 consecutive patients with retinoblastoma (375 eyes) who underwent baseline MR imaging, followed by primary enucleation from 1993 through 2014. Tumor sizes (maximum diameter and volume) were measured independently by two observers and correlated with histopathologic risk factors. Receiver operating characteristic curves were used to analyze the diagnostic accuracy of tumor size, and areas under the curve were calculated. Logistic regression analysis was performed to evaluate potential confounders. Results Receiver operating characteristic analysis of volume and diameter, respectively, yielded areas under the curve of 0.77 (95% confidence interval [CI]: 0.70, 0.85; P < .0001) and 0.78 (95% CI: 0.71, 0.85; P < .0001) for postlaminar optic nerve invasion (n = 375) and 0.67 (95% CI: 0.57, 0.77; P = .0020) and 0.70 (95% CI: 0.59, 0.80; P = .0004) for massive choroidal tumor invasion (n = 219). For the detection of co-occurring massive choroidal invasion and postlaminar optic nerve invasion (n = 219), volume and diameter showed areas under the curve of 0.81 (95% CI: 0.70, 0.91; P = .0032) and 0.83 (95% CI: 0.73, 0.93; P = .0016), respectively. Conclusion Intraocular tumor size shows a strong association with postlaminar optic nerve invasion and a moderate association with massive choroidal invasion. These findings provide diagnostic accuracy measures at different size cutoff levels, which could potentially be useful in a clinical setting, especially within the scope of the increasing use of eye-salvage treatment strategies. (©) RSNA, 2015 Online supplemental material is available for this article.
authors.affiliation: From the Departments of Radiology and Nuclear Medicine (M.C.d.J., F.J.S.v.d.M., D.P.N., J.A.C., P.d.G.), Pathology (P.v.d.V.), and Ophthalmology (A.C.M.), VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands; Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany (S.L.G., S.S.); Departments of Radiology (H.J.B.) and Tumor Biology (X.S.G.), Institut Curie, Paris, France; Unit of Neuroimaging and Neurointervention, Department of Neurosciences, Siena University Hospital, Siena, Italy (P.G., A.C.); Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland (P.M.); Unit of Ophthalmology, University of Siena, Policlinico Santa Maria alle Scotte, Siena, Italy (S.D.F.); and Department of Pathology and Neuropathology, Institute of Pathology and Neuropathology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany (K.A.M.).
authors.forename: Marcus C
authors.initials: MC
authors.lastname: De Jong
authors.affiliation: From the Departments of Radiology and Nuclear Medicine (M.C.d.J., F.J.S.v.d.M., D.P.N., J.A.C., P.d.G.), Pathology (P.v.d.V.), and Ophthalmology (A.C.M.), VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands; Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany (S.L.G., S.S.); Departments of Radiology (H.J.B.) and Tumor Biology (X.S.G.), Institut Curie, Paris, France; Unit of Neuroimaging and Neurointervention, Department of Neurosciences, Siena University Hospital, Siena, Italy (P.G., A.C.); Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland (P.M.); Unit of Ophthalmology, University of Siena, Policlinico Santa Maria alle Scotte, Siena, Italy (S.D.F.); and Department of Pathology and Neuropathology, Institute of Pathology and Neuropathology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany (K.A.M.).
authors.forename: Fenna J S
authors.initials: FJ
authors.lastname: van der Meer
authors.affiliation: From the Departments of Radiology and Nuclear Medicine (M.C.d.J., F.J.S.v.d.M., D.P.N., J.A.C., P.d.G.), Pathology (P.v.d.V.), and Ophthalmology (A.C.M.), VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands; Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany (S.L.G., S.S.); Departments of Radiology (H.J.B.) and Tumor Biology (X.S.G.), Institut Curie, Paris, France; Unit of Neuroimaging and Neurointervention, Department of Neurosciences, Siena University Hospital, Siena, Italy (P.G., A.C.); Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland (P.M.); Unit of Ophthalmology, University of Siena, Policlinico Santa Maria alle Scotte, Siena, Italy (S.D.F.); and Department of Pathology and Neuropathology, Institute of Pathology and Neuropathology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany (K.A.M.).
authors.forename: Sophia L
authors.initials: SL
authors.lastname: Göricke
authors.affiliation: From the Departments of Radiology and Nuclear Medicine (M.C.d.J., F.J.S.v.d.M., D.P.N., J.A.C., P.d.G.), Pathology (P.v.d.V.), and Ophthalmology (A.C.M.), VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands; Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany (S.L.G., S.S.); Departments of Radiology (H.J.B.) and Tumor Biology (X.S.G.), Institut Curie, Paris, France; Unit of Neuroimaging and Neurointervention, Department of Neurosciences, Siena University Hospital, Siena, Italy (P.G., A.C.); Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland (P.M.); Unit of Ophthalmology, University of Siena, Policlinico Santa Maria alle Scotte, Siena, Italy (S.D.F.); and Department of Pathology and Neuropathology, Institute of Pathology and Neuropathology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany (K.A.M.).
authors.forename: Hervé J
authors.initials: HJ
authors.lastname: Brisse
authors.affiliation: From the Departments of Radiology and Nuclear Medicine (M.C.d.J., F.J.S.v.d.M., D.P.N., J.A.C., P.d.G.), Pathology (P.v.d.V.), and Ophthalmology (A.C.M.), VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands; Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany (S.L.G., S.S.); Departments of Radiology (H.J.B.) and Tumor Biology (X.S.G.), Institut Curie, Paris, France; Unit of Neuroimaging and Neurointervention, Department of Neurosciences, Siena University Hospital, Siena, Italy (P.G., A.C.); Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland (P.M.); Unit of Ophthalmology, University of Siena, Policlinico Santa Maria alle Scotte, Siena, Italy (S.D.F.); and Department of Pathology and Neuropathology, Institute of Pathology and Neuropathology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany (K.A.M.).
authors.forename: Paolo
authors.initials: P
authors.lastname: Galluzzi
authors.affiliation: From the Departments of Radiology and Nuclear Medicine (M.C.d.J., F.J.S.v.d.M., D.P.N., J.A.C., P.d.G.), Pathology (P.v.d.V.), and Ophthalmology (A.C.M.), VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands; Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany (S.L.G., S.S.); Departments of Radiology (H.J.B.) and Tumor Biology (X.S.G.), Institut Curie, Paris, France; Unit of Neuroimaging and Neurointervention, Department of Neurosciences, Siena University Hospital, Siena, Italy (P.G., A.C.); Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland (P.M.); Unit of Ophthalmology, University of Siena, Policlinico Santa Maria alle Scotte, Siena, Italy (S.D.F.); and Department of Pathology and Neuropathology, Institute of Pathology and Neuropathology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany (K.A.M.).
authors.forename: Philippe
authors.initials: P
authors.lastname: Maeder
authors.affiliation: From the Departments of Radiology and Nuclear Medicine (M.C.d.J., F.J.S.v.d.M., D.P.N., J.A.C., P.d.G.), Pathology (P.v.d.V.), and Ophthalmology (A.C.M.), VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands; Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany (S.L.G., S.S.); Departments of Radiology (H.J.B.) and Tumor Biology (X.S.G.), Institut Curie, Paris, France; Unit of Neuroimaging and Neurointervention, Department of Neurosciences, Siena University Hospital, Siena, Italy (P.G., A.C.); Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland (P.M.); Unit of Ophthalmology, University of Siena, Policlinico Santa Maria alle Scotte, Siena, Italy (S.D.F.); and Department of Pathology and Neuropathology, Institute of Pathology and Neuropathology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany (K.A.M.).
authors.forename: Selma
authors.initials: S
authors.lastname: Sirin
authors.affiliation: From the Departments of Radiology and Nuclear Medicine (M.C.d.J., F.J.S.v.d.M., D.P.N., J.A.C., P.d.G.), Pathology (P.v.d.V.), and Ophthalmology (A.C.M.), VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands; Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany (S.L.G., S.S.); Departments of Radiology (H.J.B.) and Tumor Biology (X.S.G.), Institut Curie, Paris, France; Unit of Neuroimaging and Neurointervention, Department of Neurosciences, Siena University Hospital, Siena, Italy (P.G., A.C.); Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland (P.M.); Unit of Ophthalmology, University of Siena, Policlinico Santa Maria alle Scotte, Siena, Italy (S.D.F.); and Department of Pathology and Neuropathology, Institute of Pathology and Neuropathology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany (K.A.M.).
authors.forename: Sonia
authors.initials: S
authors.lastname: De Francesco
authors.affiliation: From the Departments of Radiology and Nuclear Medicine (M.C.d.J., F.J.S.v.d.M., D.P.N., J.A.C., P.d.G.), Pathology (P.v.d.V.), and Ophthalmology (A.C.M.), VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands; Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany (S.L.G., S.S.); Departments of Radiology (H.J.B.) and Tumor Biology (X.S.G.), Institut Curie, Paris, France; Unit of Neuroimaging and Neurointervention, Department of Neurosciences, Siena University Hospital, Siena, Italy (P.G., A.C.); Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland (P.M.); Unit of Ophthalmology, University of Siena, Policlinico Santa Maria alle Scotte, Siena, Italy (S.D.F.); and Department of Pathology and Neuropathology, Institute of Pathology and Neuropathology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany (K.A.M.).
authors.forename: Xavier
authors.initials: X
authors.lastname: Sastre-Garau
authors.affiliation: From the Departments of Radiology and Nuclear Medicine (M.C.d.J., F.J.S.v.d.M., D.P.N., J.A.C., P.d.G.), Pathology (P.v.d.V.), and Ophthalmology (A.C.M.), VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands; Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany (S.L.G., S.S.); Departments of Radiology (H.J.B.) and Tumor Biology (X.S.G.), Institut Curie, Paris, France; Unit of Neuroimaging and Neurointervention, Department of Neurosciences, Siena University Hospital, Siena, Italy (P.G., A.C.); Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland (P.M.); Unit of Ophthalmology, University of Siena, Policlinico Santa Maria alle Scotte, Siena, Italy (S.D.F.); and Department of Pathology and Neuropathology, Institute of Pathology and Neuropathology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany (K.A.M.).
authors.forename: Klaus A
authors.initials: KA
authors.lastname: Metz
authors.affiliation: From the Departments of Radiology and Nuclear Medicine (M.C.d.J., F.J.S.v.d.M., D.P.N., J.A.C., P.d.G.), Pathology (P.v.d.V.), and Ophthalmology (A.C.M.), VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands; Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany (S.L.G., S.S.); Departments of Radiology (H.J.B.) and Tumor Biology (X.S.G.), Institut Curie, Paris, France; Unit of Neuroimaging and Neurointervention, Department of Neurosciences, Siena University Hospital, Siena, Italy (P.G., A.C.); Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland (P.M.); Unit of Ophthalmology, University of Siena, Policlinico Santa Maria alle Scotte, Siena, Italy (S.D.F.); and Department of Pathology and Neuropathology, Institute of Pathology and Neuropathology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany (K.A.M.).
authors.forename: Alfonso
authors.initials: A
authors.lastname: Cerase
authors.affiliation: From the Departments of Radiology and Nuclear Medicine (M.C.d.J., F.J.S.v.d.M., D.P.N., J.A.C., P.d.G.), Pathology (P.v.d.V.), and Ophthalmology (A.C.M.), VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands; Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany (S.L.G., S.S.); Departments of Radiology (H.J.B.) and Tumor Biology (X.S.G.), Institut Curie, Paris, France; Unit of Neuroimaging and Neurointervention, Department of Neurosciences, Siena University Hospital, Siena, Italy (P.G., A.C.); Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland (P.M.); Unit of Ophthalmology, University of Siena, Policlinico Santa Maria alle Scotte, Siena, Italy (S.D.F.); and Department of Pathology and Neuropathology, Institute of Pathology and Neuropathology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany (K.A.M.).
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Noij
authors.affiliation: From the Departments of Radiology and Nuclear Medicine (M.C.d.J., F.J.S.v.d.M., D.P.N., J.A.C., P.d.G.), Pathology (P.v.d.V.), and Ophthalmology (A.C.M.), VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands; Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany (S.L.G., S.S.); Departments of Radiology (H.J.B.) and Tumor Biology (X.S.G.), Institut Curie, Paris, France; Unit of Neuroimaging and Neurointervention, Department of Neurosciences, Siena University Hospital, Siena, Italy (P.G., A.C.); Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland (P.M.); Unit of Ophthalmology, University of Siena, Policlinico Santa Maria alle Scotte, Siena, Italy (S.D.F.); and Department of Pathology and Neuropathology, Institute of Pathology and Neuropathology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany (K.A.M.).
authors.forename: Paul
authors.initials: P
authors.lastname: van der Valk
authors.affiliation: From the Departments of Radiology and Nuclear Medicine (M.C.d.J., F.J.S.v.d.M., D.P.N., J.A.C., P.d.G.), Pathology (P.v.d.V.), and Ophthalmology (A.C.M.), VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands; Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany (S.L.G., S.S.); Departments of Radiology (H.J.B.) and Tumor Biology (X.S.G.), Institut Curie, Paris, France; Unit of Neuroimaging and Neurointervention, Department of Neurosciences, Siena University Hospital, Siena, Italy (P.G., A.C.); Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland (P.M.); Unit of Ophthalmology, University of Siena, Policlinico Santa Maria alle Scotte, Siena, Italy (S.D.F.); and Department of Pathology and Neuropathology, Institute of Pathology and Neuropathology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany (K.A.M.).
authors.forename: Annette C
authors.initials: AC
authors.lastname: Moll
authors.affiliation: From the Departments of Radiology and Nuclear Medicine (M.C.d.J., F.J.S.v.d.M., D.P.N., J.A.C., P.d.G.), Pathology (P.v.d.V.), and Ophthalmology (A.C.M.), VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands; Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany (S.L.G., S.S.); Departments of Radiology (H.J.B.) and Tumor Biology (X.S.G.), Institut Curie, Paris, France; Unit of Neuroimaging and Neurointervention, Department of Neurosciences, Siena University Hospital, Siena, Italy (P.G., A.C.); Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland (P.M.); Unit of Ophthalmology, University of Siena, Policlinico Santa Maria alle Scotte, Siena, Italy (S.D.F.); and Department of Pathology and Neuropathology, Institute of Pathology and Neuropathology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany (K.A.M.).
authors.forename: Jonas A
authors.initials: JA
authors.lastname: Castelijns
authors.affiliation: From the Departments of Radiology and Nuclear Medicine (M.C.d.J., F.J.S.v.d.M., D.P.N., J.A.C., P.d.G.), Pathology (P.v.d.V.), and Ophthalmology (A.C.M.), VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands; Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany (S.L.G., S.S.); Departments of Radiology (H.J.B.) and Tumor Biology (X.S.G.), Institut Curie, Paris, France; Unit of Neuroimaging and Neurointervention, Department of Neurosciences, Siena University Hospital, Siena, Italy (P.G., A.C.); Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland (P.M.); Unit of Ophthalmology, University of Siena, Policlinico Santa Maria alle Scotte, Siena, Italy (S.D.F.); and Department of Pathology and Neuropathology, Institute of Pathology and Neuropathology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany (K.A.M.).
authors.forename: Pim
authors.initials: P
authors.lastname: de Graaf
mesh_terms: D002830:Choroid Neoplasms / Q000556:secondary*; D005260:Female; D005544:Forecasting; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009361:Neoplasm Invasiveness; D019574:Optic Nerve Neoplasms / Q000556:secondary*; D012044:Regression Analysis; D019572:Retinal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D012175:Retinoblastoma / Q000000981:diagnostic imaging* / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors