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Comparison of the diagnostic value of MR imaging and ophthalmoscopy for the staging of retinoblastoma

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Abstract

Purpose

To compare the diagnostic value of magnetic resonance (MR) imaging and ophthalmoscopy for staging of retinoblastoma.

Methods

MR and ophthalmoscopic images of 36 patients who underwent enucleation were evaluated retrospectively following institutional review board approval. Histopathology being the standard of reference, the sensitivity and specificity of both diagnostic modalities were compared regarding growth pattern, iris neoangiogenesis, retinal detachment, vitreous seeds and optic nerve invasion. Data were analysed via McNemar’s test.

Results

Both investigations showed no significant difference in accuracy for the detection of different tumour growth patterns (P = 0.80). Vitreous seeding detection was superior by ophthalmoscopy (P < 0.001). For prelaminar optic nerve invasion, MR imaging showed similar sensitivity as ophthalmoscopy but increased specificity of 40 % (CI 0.12–0.74) vs. 20 % (0.03–0.56). MR detected optic nerve involvement past the lamina cribrosa with a sensitivity of 80 % (0.28–0.99) and a specificity of 74 % (0.55–0.88). The absence of optic nerve enhancement excluded histopathological infiltration, but the presence of optic nerve enhancement included a high number of false positives (22–24 %).

Conclusions

Ophthalmoscopy remains the method of choice for determining extent within the globe while MR imaging is useful for evaluating extraocular tumour extension. Thus, both have their own strengths and contribute uniquely to the staging of retinoblastoma.

Key Points

• Ophthalmoscopy: method of choice for determining extent of retinoblastoma within the globe.

• MR imaging provides optimal evaluation of extrascleral and extraocular tumour extension.

• Positive enhancement of the optic nerve on MRI does not necessarily indicate involvement.

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Abbreviations

PPV:

Positive predictive value

NPV:

Negative predictive value

FSE:

Fast spin echo

ICRB:

International Classification of Retinoblastoma

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Author information

Authors and Affiliations

  1. Department of Radiology, Stanford University, Stanford, CA, USA

    Aman Khurana, Wenshuai Wan, Kristen Yeom & Heike E. Daldrup-Link

  2. Department of Radiology, Technical University of Munich, Munich, Germany

    Christina A. Eisenhut

  3. Department of Ocular Oncology, Johns Hopkins University, Baltimore, MD, USA

    Katayoon B. Ebrahimi

  4. Department of Radiology, University of California Davis, Davis, CA, USA

    Chirag Patel

  5. Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA, USA

    Joan M. O’Brien

  6. Department of Radiology, Pediatric Radiology Section, Lucile Packard Children’s Hospital, Stanford University, Stanford, CA, USA

    Heike E. Daldrup-Link

Authors
  1. Aman Khurana
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  2. Christina A. Eisenhut
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  3. Wenshuai Wan
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  4. Katayoon B. Ebrahimi
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  6. Joan M. O’Brien
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  8. Heike E. Daldrup-Link
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Correspondence to Heike E. Daldrup-Link.

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Khurana, A., Eisenhut, C.A., Wan, W. et al. Comparison of the diagnostic value of MR imaging and ophthalmoscopy for the staging of retinoblastoma. Eur Radiol 23, 1271–1280 (2013). https://doi.org/10.1007/s00330-012-2707-8

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  • DOI: https://doi.org/10.1007/s00330-012-2707-8

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