Skip to main content

Advertisement

SpringerLink
Log in

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

  • Head and Neck
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

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 mm2). 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.

Conclusion

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.

Key Points

• 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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Abbreviations

HR-MRI:

High-resolution MRI

ON:

Optic nerve

IRSS:

International Retinoblastoma Staging System

References

  1. Doz F, Brisse H, Stoppa-Lyonnet D, Sastre X, Zucker J-M, Desjardins L (2004) Retinoblastoma. In: Pinkerton R, Plowman P, Pieters R (eds) Paediatric oncology. Arnold, London, pp 323–338

    Google Scholar 

  2. Shields CL, Meadows AT, Leahey AM, Shields JA (2004) Continuing challenges in the management of retinoblastoma with chemotherapy. Retina 24:849–862

    Article  PubMed  Google Scholar 

  3. Shields CL, Shields JA, Baez K, Cater JR, De Potter P (1994) Optic nerve invasion of retinoblastoma. Metastatic potential and clinical risk factors. Cancer 73:692–698

    Article  CAS  PubMed  Google Scholar 

  4. Sastre X, Chantada GL, Doz F et al (2009) Proceedings of the consensus meetings from the International Retinoblastoma Staging Working Group on the pathology guidelines for the examination of enucleated eyes and evaluation of prognostic risk factors in retinoblastoma. Arch Pathol Lab Med 133:1199–1202

    PubMed  Google Scholar 

  5. Khelfaoui F, Validire P, Auperin A et al (1996) Histopathologic risk factors in retinoblastoma: a retrospective study of 172 patients treated in a single institution. Cancer 77:1206–1213

    Article  CAS  PubMed  Google Scholar 

  6. Aerts I, Sastre-Garau X, Savignoni A et al (2013) Results of a multicenter prospective study on the postoperative treatment of unilateral retinoblastoma after primary enucleation. J Clin Oncol 31:1458–1463

    Article  CAS  PubMed  Google Scholar 

  7. Hungerford J (1993) Factors influencing metastasis in retinoblastoma. Br J Ophthalmol 77:541

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  8. Brisse HJ, Guesmi M, Aerts I et al (2007) Relevance of CT and MRI in retinoblastoma for the diagnosis of postlaminar invasion with normal-size optic nerve: a retrospective study of 150 patients with histological comparison. Pediatr Radiol 37:649–656

    Article  PubMed  Google Scholar 

  9. Magramm I, Abramson DH, Ellsworth RM (1989) Optic nerve involvement in retinoblastoma. Ophthalmology 96:217–222

    Article  CAS  PubMed  Google Scholar 

  10. Chantada G, Doz F, Antoneli CB et al (2006) A proposal for an international retinoblastoma staging system. Pediatr Blood Cancer 47:801–805

    Article  PubMed  Google Scholar 

  11. Freeman CR, Esseltine DL, Whitehead VM, Chevalier L, Little JM (1980) Retinoblastoma: the case for radiotherapy and for adjuvant chemotherapy. Cancer 46:1913–1918

    Article  CAS  PubMed  Google Scholar 

  12. Zelter M, Damel A, Gonzalez G, Schwartz L (1991) A prospective study on the treatment of retinoblastoma in 72 patients. Cancer 68:1685–1690

    Article  CAS  PubMed  Google Scholar 

  13. Schvartzman E, Chantada G, Fandino A, de Davila MT, Raslawski E, Manzitti J (1996) Results of a stage-based protocol for the treatment of retinoblastoma. J Clin Oncol 14:1532–1536

    CAS  PubMed  Google Scholar 

  14. Doz F, Khelfaoui F, Mosseri V et al (1994) The role of chemotherapy in orbital involvement of retinoblastoma. The experience of a single institution with 33 patients. Cancer 74:722–732

    Article  CAS  PubMed  Google Scholar 

  15. de Graaf P, Goricke S, Rodjan F et al (2012) Guidelines for imaging retinoblastoma: imaging principles and MRI standardization. Pediatr Radiol 42:2–14

    Article  PubMed Central  PubMed  Google Scholar 

  16. Bellaton E, Bertozzi AI, Behar C et al (2003) Neoadjuvant chemotherapy for extensive unilateral retinoblastoma. Br J Ophthalmol 87:327–329

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  17. Lumbroso-Le Rouic L, Aerts I, Levy-Gabriel C et al (2008) Conservative treatments of intraocular retinoblastoma. Ophthalmology 115:1405–1410

    Article  PubMed  Google Scholar 

  18. de Graaf P, Barkhof F, Moll AC et al (2005) Retinoblastoma: MR imaging parameters in detection of tumor extent. Radiology 235:197–207

    Article  PubMed  Google Scholar 

  19. Lemke AJ, Kazi I, Mergner U et al (2007) Retinoblastoma-MR appearance using a surface coil in comparison with histopathological results. Eur Radiol 17:49–60

    Article  PubMed  Google Scholar 

  20. Ainbinder DJ, Haik BG, Frei DF, Gupta KL, Mafee MF (1996) Gadolinium enhancement: improved MRI detection of retinoblastoma extension into the optic nerve. Neuroradiology 38:778–781

    Article  CAS  PubMed  Google Scholar 

  21. Schueler AO, Hosten N, Bechrakis NE et al (2003) High resolution magnetic resonance imaging of retinoblastoma. Br J Ophthalmol 87:330–335

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  22. Barkhof F, Smeets M, van der Valk P et al (1997) MR imaging in retinoblastoma. Eur Radiol 7:726–731

    Article  CAS  PubMed  Google Scholar 

  23. de Jong MC, de Graaf P, Noij DP et al (2014) Diagnostic performance of magnetic resonance imaging and computed tomography for advanced retinoblastoma: a systematic review and meta-analysis. Ophthalmology 121:1109–1118

    Article  PubMed  Google Scholar 

  24. Wilson MW, Rodriguez-Galindo C, Billups C, Haik BG, Laningham F, Patay Z (2009) Lack of correlation between the histologic and magnetic resonance imaging results of optic nerve involvement in eyes primarily enucleated for retinoblastoma. Ophthalmology 116:1558–1563

    Article  PubMed  Google Scholar 

  25. Song KD, Eo H, Kim JH, Yoo SY, Jeon TY (2012) Can preoperative MR imaging predict optic nerve invasion of retinoblastoma? Eur J Radiol 81:4041–4045

    Article  PubMed  Google Scholar 

  26. Lee BJ, Kim JH, Kim DH, Park SH, Yu YS (2012) The validity of routine brain MRI in detecting post-laminar optic nerve involvement in retinoblastoma. Br J Ophthalmol 96:1237–1241

    Article  PubMed  Google Scholar 

  27. Chawla B, Sharma S, Sen S et al (2012) Correlation between clinical features, magnetic resonance imaging, and histopathologic findings in retinoblastoma: a prospective study. Ophthalmology 119:850–856

    Article  PubMed  Google Scholar 

  28. Reese AB, Ellsworth RM (1963) The evaluation and current concept of retinoblastoma therapy. Trans Am Acad Opthalmol Otolaryngol 67:164–172

    CAS  Google Scholar 

  29. Shields CL, Mashayekhi A, Au AK et al (2006) The international classification of retinoblastoma predicts chemoreduction success. Ophthalmology 113:2276–2280

    Article  PubMed  Google Scholar 

  30. Ruskell GL (1997) Peripapillary venous drainage from the choroid: a variable feature in human eyes. Br J Ophthalmol 81:76–79

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  31. Sirin S, Schlamann M, Metz KA et al (2013) Diagnostic image quality of gadolinium-enhanced T1-weighted MRI with and without fat saturation in children with retinoblastoma. Pediatr Radiol 43:716–724

    Article  PubMed  Google Scholar 

  32. Shields CL, Pellegrini M, Ferenczy SR, Shields JA (2014) Enhanced depth imaging optical coherence tomography of intraocular tumors: from placid to seasick to rock and rolling topography: the 2013 Francesco Orzalesi Lecture. Retina 34:1495–1512

    Article  PubMed  Google Scholar 

  33. Rootman DB, Gonzalez E, Mallipatna A et al (2013) Hand-held high-resolution spectral domain optical coherence tomography in retinoblastoma: clinical and morphologic considerations. Br J Ophthalmol 97:59–65

    Article  PubMed  Google Scholar 

  34. Yousef YA, Shroff M, Halliday W, Gallie BL, Heon E (2012) Detection of optic nerve disease in retinoblastoma by use of spectral domain optical coherence tomography. J AAPOS 16:481–483

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The scientific guarantor of this publication is Dr Hervé J. Brisse. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. Ophthalmologists: C Levy, L Lumbroso-Le Rouic, N Cassoux, M.I. Bosscha; Paediatricians: F Doz, W.A. Kors; Radiographer: S Lasalle; Biostatistics technicians: N Algret.

This study received funding from: The ODAS Foundation, Delft, The Netherlands (mailing, traveling costs, data management); and The RETINOSTOP foundation, Paris, France (data management, statistical analysis). Two of the authors (KC, AS) have significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: prospective, diagnostic, multicentre study.

Author information

Authors and Affiliations

  1. Department of Radiology, Institut Curie, Paris, France

    Hervé J. Brisse

  2. Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands

    Pim de Graaf, Firazia Rodjan, Marcus C. de Jong & Jonas A. Castelijns

  3. Neuroimaging and Neurointerventional Unit (NINT) Azienda Ospedaliera e Universitaria Senese, Siena, Italy

    Paolo Galluzzi

  4. Department of Biostatistics, Institut Curie, Paris, France

    Kristel Cosker & Alexia Savignoni

  5. Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland

    Philippe Maeder

  6. Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany

    Sophia Göricke

  7. Department of Pediatric Oncology, Institut Curie, Paris, France

    Isabelle Aerts

  8. Department of Ophthalmology, Institut Curie, Paris, France

    Laurence Desjardins

  9. Department of Ophthalmology, VU University Medical Center, Amsterdam, The Netherlands

    Annette C. Moll

  10. Department of Ophthalmology, Azienda Ospedaliera Universitaria Senese, Siena, Italy

    Theodora Hadjistilianou

  11. Department of Medical Biotechnologies, Pathology Unit, University of Siena, Siena, Italy

    Paolo Toti

  12. Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands

    Paul van der Valk

  13. Department of Biopathology, Institut Curie, Paris, France

    Xavier Sastre-Garau

  14. Imaging Department, Institut CURIE, 26 rue d’Ulm, 75005, Paris, France

    Hervé J. Brisse

Authors
  1. Hervé J. Brisse
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pim de Graaf
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paolo Galluzzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kristel Cosker
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Philippe Maeder
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sophia Göricke
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Firazia Rodjan
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Marcus C. de Jong
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Alexia Savignoni
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Isabelle Aerts
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Laurence Desjardins
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Annette C. Moll
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Theodora Hadjistilianou
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Paolo Toti
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Paul van der Valk
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Jonas A. Castelijns
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Xavier Sastre-Garau
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

on behalf of the European Retinoblastoma Imaging Collaboration (ERIC)

Corresponding author

Correspondence to Hervé J. Brisse.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Brisse, H.J., de Graaf, P., Galluzzi, P. et al. 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. Eur Radiol 25, 1443–1452 (2015). https://doi.org/10.1007/s00330-014-3514-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-014-3514-1

Keywords

Search

Navigation