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
Male
Retinal Neoplasms
Infant, Newborn
Retinoblastoma
Infant
Optic Nerve
Magnetic Resonance Imaging
Sensitivity and Specificity
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Child, Preschool
Humans
Female
Neoplasm Invasiveness
Child
Tomography, X-Ray Computed
Retrospective Studies
DOI:
10.1007/s00247-007-0491-4
Publication Date:
2007-05-03T17:11:20Z
AUTHORS (11)
ABSTRACT
Detection of optic nerve invasion is mandatory in children primarily enucleated for retinoblastoma to ensure a free resection margin.To assess the accuracy of CT and MRI for the detection of postlaminar invasion in normal-size nerves.A total of 150 patients enucleated for retinoblastoma were included. Imaging data (119 CT and 46 MRI) were retrospectively reviewed and compared with histological findings. Abnormal contrast enhancement of the optic nerve was used as diagnostic criterion for invasion. The associations between postlaminar invasion and several indirect signs were also assessed. Statistical analysis was performed with the Kruskal-Wallis and Fisher exact tests.Postlaminar invasion on histology was observed in 8% (12/150). The sensitivity, specificity, accuracy and negative and positive predictive values were 60%, 95%, 91%, 95% and 60% for MRI, and 0%, 100%, 94% and 94% (PPV not assessable) for CT, respectively. Tumour diameter was the only indirect radiological sign significantly associated with postlaminar optic nerve invasion (P=0.002).Our results suggest that MRI is more relevant than CT for preoperative detection of optic nerve invasion in patients with retinoblastoma. Tumour diameter is the only indirect sign significantly associated with postlaminar invasion.
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