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N.A. Sharara, R.M. Conway, C. Sonne, J. Barckovick, J.M. O'Brian; The role of high resolution magnetic resonance imaging in predicting ocular tissue involvement in retinoblastoma . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4633.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: Our aim was to study the significance of high resolution magnetic resonance imaging (MRI) in predicting invasion of the optic nerve and other ocular structures by tumor cells in correlation with clinical and histopathological findings in retinoblastoma patients. Methods: Records of 57 retiboblastoma patients (79 eyes) from the Ocular Oncology service at UCSF were reviewed for clinical and histopathological data. The parameters evaluated were optic nerve and choroidal invasion, vitreous seeds, anterior chamber involvement, tumor calcification, and extrascleral extension. Pre and postoperative imaging data were evaluated by 2 neuroradiologists (DCS, AJB). Both were masked for the clinical and histopathological findings. Imaging data included CT scan, 3D FSE T2– weighted, T1–weighted with fat saturation and T1 weighted gadelinium enhanced MRI. Imaging data were subsequently correlated with clinical examination and histopathology. Results: MRI predicted optic nerve invasion in 23% of eyes in correlation with clinical and/or histopathological evidence while CT scan failed in 100% of eyes studied by CT. MRI showed choroidal invasion in 33% of eyes while CT scan failed in 100% of eyes. Vitreous seeds were identified by MRI and correlated with clinical examination in 85% of eyes and in 65% of eyes studied by CT scan. Tumor presence in the anterior chamber was noted on either MRI or CT scan in 100% of eyes involved. Calcification was noted by CT in 100% of eyes and correlated with the clinicopathologic data. None of our cases had extrascleral extension. Conclusions: MRI with 3D–FSE T2–weighted sequence and CT scan can not predict optic nerve invasion in most cases. Vitreous seeds were more reliably predicted on MRI than CT scan. Choroidal invasion is more likely to be missed on MRI and CT scan while anterior chamber extension was detected with either modalities in all eyes involved.
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