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. 2015 Feb;28(1):53-61.
doi: 10.15274/NRJ-2014-10103.

MRI helps depict clinically undetectable risk factors in advanced stage retinoblastomas

Paolo Galluzzi  1 , Theodora Hadjistilianou  2 , Alfonso Cerase  3 , Paolo Toti  4 , Sara Leonini  3 , Sandra Bracco  3 , Sonia de Francesco  2 , Daniela Galimberti  5 , Donatella Balducci  6 , Pietro Piu  7 , Lucia Monti  3 , Matteo Bellini  3 , Mauro Caini  5 , Alessandro Rossi  3
Affiliations

MRI helps depict clinically undetectable risk factors in advanced stage retinoblastomas

Paolo Galluzzi et al. Neuroradiol J. 2015 Feb.

Abstract

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.

Keywords: magnetic resonance imaging; retinoblastoma.

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Figures

Figure 1.
Figure 1.
A) T1-weighted axial contrast-enhanced image shows a large intravitreal mass with total retinal detachment; LEICR at the optic disc (encircled). B) Prelaminar tumour infiltration at histology.
Figure 2.
Figure 2.
T1-weighted axial contrast-enhanced image shows abnormal enhancement reaching the post-laminar part of the optic nerve (arrow).
Figure 3.
Figure 3.
T1-weighted axial contrast-enhanced image shows thinning of the choroid with extensive choroidoretinal enhancement interruption (encircled).
Figure 4.
Figure 4.
A) T1-weighted sagittal contrast-enhanced image shows invasion of locally thickened choroid (arrow). B) Choroid massively infiltrated by neoplastic cells that also infiltrate the inner part of the sclera.
Figure 5.
Figure 5.
T1-weighted axial (A) and sagittal (B) contrast-enhanced images shows high grade AASE (arrow).
Figure 6.
Figure 6.
T1-weighted axial contrast-enhanced image shows a moderate AASE on the right side (arrow).
See this image and copyright information in PMC

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