Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
European Radiology

13-12-2023 | Retinoblastoma | Paediatric

Optic nerve thickening on high-spatial-resolution MRI predicts early-stage postlaminar optic nerve invasion in retinoblastoma

Authors: Christiaan M. de Bloeme, Robin W. Jansen, Sophia Göricke, Steven T. L. Grauwels, Sabien van Elst, Petra Ketteler, Hervé J. Brisse, Paolo Galluzzi, Liesbeth Cardoen, Selma Sirin, Mériam Koob, Philippe Maeder, Paul van der Valk, Annette C. Moll, Pim de Graaf, Marcus C. de Jong, on behalf of the European Retinoblastoma Imaging Collaboration

Published in: European Radiology

Login to get access

Abstract

Objectives

To assess the diagnostic accuracy of nerve thickening on MRI to predict early-stage postlaminar optic nerve invasion (PLONI) in retinoblastoma. Furthermore, this study aimed to incorporate measurements into a multiparametric model for radiological determination of PLONI.

Methods

In this retrospective multicenter case–control study, high-spatial-resolution 3D T2-weighted MR images were used to measure the distal optic nerve. Histopathology was the reference standard for PLONI. Two neuroradiologists independently measured the optic nerve width, height, and surface at 0, 3, and 5 mm from the most distal part of the optic nerve. Subsequently, PLONI was scored on contrast-enhanced T1-weighted and 3D T2-weighted images, blinded for clinical data. Optic nerve measurements with the highest diagnostic accuracy for PLONI were incorporated into a prediction model for radiological determination of PLONI.

Results

One hundred twenty-four retinoblastoma patients (median age, 22 months [range, 0–113], 58 female) were included, resulting in 25 retinoblastoma eyes with histopathologically proven PLONI and 206 without PLONI. ROC analysis of axial optic nerve width measured at 0 mm yielded the best area under the curve of 0.88 (95% confidence interval: 0.79, 0.96; p < 0.001). The optimal width cutoff was ≥ 2.215 mm, with a sensitivity of 84% (95% CI: 64, 95%) and specificity of 83% (95% CI: 75, 89%) for detecting PLONI. Combining width measurements with the suspicion of PLONI on MRI sequences resulted in a prediction model with an improved sensitivity and specificity of respectively up to 88% and 92%.

Conclusion

Postlaminar optic nerve thickening can predict early-stage postlaminar optic nerve invasion in retinoblastoma.

Clinical relevance statement

This study provides an additional tool for clinicians to help determine postlaminar optic nerve invasion, which is a risk factor for developing metastatic disease in retinoblastoma patients.

Key Points

• The diagnostic accuracy of contrast-enhanced MRI for detecting postlaminar optic nerve invasion is limited in retinoblastoma patients.
• Optic nerve thickening can predict postlaminar optic nerve invasion.
• A prediction model combining MRI features has a high sensitivity and specificity for detecting postlaminar optic nerve invasion.
Appendix
Available only for authorised users
Literature
1.
2.
Finger PT, Harbour JW, Karcioglu ZA (2002) Risk factors for metastasis in retinoblastoma. Surv Ophthalmol 47:1–16CrossRefPubMed
3.
4.
Kaliki S, Shields CL, Rojanaporn D et al (2013) High-risk retinoblastoma based on international classification of retinoblastoma: analysis of 519 enucleated eyes. Ophthalmology 120:997–1003CrossRefPubMed
5.
Bosaleh A, Sampor C, Solernou V et al (2012) Outcome of children with retinoblastoma and isolated choroidal invasion. Arch Ophthalmol 130:724–729CrossRefPubMed
6.
7.
8.
Mallipatna ACGB, Chéves-Barrios P (2017) AJCC Cancer Staging Manual. In: Amin MB, Edge SB, Greene FL et al (eds) Springer, New York, pp 819–831
9.
Choucair ML, Brisse HJ, Fréneaux P et al (2020) Management of advanced uni- or bilateral retinoblastoma with macroscopic optic nerve invasion. Pediatr Blood Cancer 67:e27998CrossRefPubMed
10.
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 121:1109–1118CrossRefPubMed
11.
de Graaf P, Barkhof F, Moll AC et al (2005) Retinoblastoma: MR imaging parameters in detection of tumor extent. Radiology 235:197–207CrossRefPubMed
12.
Brisse HJ, de Graaf P, Galluzzi P et al (2015) 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 25:1443–1452CrossRefPubMed
13.
14.
De Jong MC, van der Meer FJ, Goricke SL et al (2016) Diagnostic accuracy of intraocular tumor size measured with MR imaging in the prediction of postlaminar optic nerve invasion and massive choroidal invasion of retinoblastoma. Radiology 279:817–826CrossRefPubMed
15.
16.
de Jong MC, Van Der Valk P, Jansen RW et al (2020) Full-width postlaminar optic nerve tumor invasion of retinoblastoma as risk-factor for leptomeningeal spread of retinoblastoma. A case report and review of the literature. Ophthalmic Genet 41:69–72CrossRefPubMed
17.
Bossuyt PM, Reitsma JB, Bruns DE et al (2003) The STARD statement for reporting studies of diagnostic accuracy: explanation and elaboration. Ann Intern Med 138:W1-12CrossRefPubMed
18.
de Graaf P, Goricke S, Rodjan F et al (2012) Guidelines for imaging retinoblastoma: imaging principles and MRI standardization. Pediatr Radiol 42:2–14CrossRefPubMed
19.
20.
Bohning D, Holling H, Patilea V (2011) A limitation of the diagnostic-odds ratio in determining an optimal cut-off value for a continuous diagnostic test. Stat Methods Med Res 20:541–550CrossRefPubMed
21.
de Jong MC, Kors WA, de Graaf P, Castelijns JA, Kivela T, Moll AC (2014) Trilateral retinoblastoma: a systematic review and meta-analysis. Lancet Oncol 15:1157–1167CrossRefPubMed
22.
Sirin S, Schlamann M, Metz KA et al (2015) High-resolution MRI using orbit surface coils for the evaluation of metastatic risk factors in 143 children with retinoblastoma: part 1: MRI vs. histopathology. Neuroradiology 57:805–814CrossRefPubMed
23.
Cho SJ, Kim JH, Baik SH, Sunwoo L, Bae YJ, Choi BS (2021) Diagnostic performance of MRI of post-laminar optic nerve invasion detection in retinoblastoma: a systematic review and meta-analysis. Neuroradiology 63:499–509CrossRefPubMed
24.
Gizewski ER, Wanke I, Jurklies C, Güngör AR, Forsting M (2005) T1 Gd-enhanced compared with CISS sequences in retinoblastoma: superiority of T1 sequences in evaluation of tumour extension. Neuroradiology 47:56–61CrossRefPubMed
25.
Grimes DA, Schulz KF (2005) Compared to what? Finding controls for case-control studies. Lancet 365:1429–1433CrossRefPubMed
26.
Moll AC, Kuik DJ, Bouter LM et al (1997) Incidence and survival of retinoblastoma in The Netherlands: a register based study 1862–1995. Br J Ophthalmol 81:559–562CrossRefPubMedPubMedCentral
27.
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 37:649–656CrossRefPubMed
28.
Abramson DH, Schefler AC, Almeida D, Folberg R (2003) Optic nerve tissue shrinkage during pathologic processing after enucleation for retinoblastoma. Arch Ophthalmol 121:73–75CrossRefPubMed
29.
Metadata
Title
Optic nerve thickening on high-spatial-resolution MRI predicts early-stage postlaminar optic nerve invasion in retinoblastoma
Authors
Christiaan M. de Bloeme
Robin W. Jansen
Sophia Göricke
Steven T. L. Grauwels
Sabien van Elst
Petra Ketteler
Hervé J. Brisse
Paolo Galluzzi
Liesbeth Cardoen
Selma Sirin
Mériam Koob
Philippe Maeder
Paul van der Valk
Annette C. Moll
Pim de Graaf
Marcus C. de Jong
on behalf of the European Retinoblastoma Imaging Collaboration
Publication date
13-12-2023
Publisher
Springer Berlin Heidelberg
Published in
European Radiology
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-023-10471-z