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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

European Radiology volume 25, pages 1443–1452 (2015)Cite this article

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.

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Abbreviations

HR-MRI:

High-resolution MRI

ON:

Optic nerve

IRSS:

International Retinoblastoma Staging System

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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

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
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  2. Pim de Graaf
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  3. Paolo Galluzzi
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  4. Kristel Cosker
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  5. Philippe Maeder
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  6. Sophia Göricke
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  7. Firazia Rodjan
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  8. Marcus C. de Jong
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  9. Alexia Savignoni
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  10. Isabelle Aerts
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  11. Laurence Desjardins
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  12. Annette C. Moll
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  13. Theodora Hadjistilianou
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  14. Paolo Toti
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  15. Paul van der Valk
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  16. Jonas A. Castelijns
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  17. Xavier Sastre-Garau
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Consortia

on behalf of the European Retinoblastoma Imaging Collaboration (ERIC)

Corresponding author

Correspondence to Hervé J. Brisse.

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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

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

Keywords

  • Retinoblastoma
  • Optic nerve
  • Neoplasm staging
  • Magnetic resonance imaging
  • Subtraction technique