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

Aman Khurana, Christina A. Eisenhut, Wenshuai Wan, Katayoon B. Ebrahimi, Chirag V Patel, Joan M. O'Brien, Kristen Yeom, Heike E. Daldrup-Link

Research output: Contribution to journalArticle

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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.

Original languageEnglish (US)
Pages (from-to)1271-1280
Number of pages10
JournalEuropean Radiology
Volume23
Issue number5
DOIs
StatePublished - May 2013

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Ophthalmoscopy
Retinoblastoma
Optic Nerve
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Neoplasms
Research Ethics Committees
Iris
Retinal Detachment
Growth
Seeds
Sensitivity and Specificity

Keywords

  • MR imaging
  • Ophthalmoscopy
  • Retinoblastoma
  • Retinoblastoma staging
  • Sensitivity and specificity

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Khurana, A., Eisenhut, C. A., Wan, W., Ebrahimi, K. B., Patel, C. V., O'Brien, J. M., ... Daldrup-Link, H. E. (2013). Comparison of the diagnostic value of MR imaging and ophthalmoscopy for the staging of retinoblastoma. European Radiology, 23(5), 1271-1280. https://doi.org/10.1007/s00330-012-2707-8

Comparison of the diagnostic value of MR imaging and ophthalmoscopy for the staging of retinoblastoma. / Khurana, Aman; Eisenhut, Christina A.; Wan, Wenshuai; Ebrahimi, Katayoon B.; Patel, Chirag V; O'Brien, Joan M.; Yeom, Kristen; Daldrup-Link, Heike E.

In: European Radiology, Vol. 23, No. 5, 05.2013, p. 1271-1280.

Research output: Contribution to journalArticle

Khurana, A, Eisenhut, CA, Wan, W, Ebrahimi, KB, Patel, CV, O'Brien, JM, Yeom, K & Daldrup-Link, HE 2013, 'Comparison of the diagnostic value of MR imaging and ophthalmoscopy for the staging of retinoblastoma', European Radiology, vol. 23, no. 5, pp. 1271-1280. https://doi.org/10.1007/s00330-012-2707-8
Khurana, Aman ; Eisenhut, Christina A. ; Wan, Wenshuai ; Ebrahimi, Katayoon B. ; Patel, Chirag V ; O'Brien, Joan M. ; Yeom, Kristen ; Daldrup-Link, Heike E. / Comparison of the diagnostic value of MR imaging and ophthalmoscopy for the staging of retinoblastoma. In: European Radiology. 2013 ; Vol. 23, No. 5. pp. 1271-1280.
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N2 - 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.

AB - 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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KW - Sensitivity and specificity

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