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Jabbarli L, Göricke S, Stumbaum P, Rating P, Lever M, Kiefer T, Ting S, Junker A, Bornfeld N, Schoenberger S, Bechrakis NE, Ketteler P, Biewald E. Preoperative Detection of Local Tumor Extent in Patients with Advanced Retinoblastoma: Predictive Value of MRI and Clinical Findings. Klin Monbl Augenheilkd 2023. [PMID: 38134910 DOI: 10.1055/a-2198-7630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Abstract
OBJECTIVE Before planned enucleation, local tumor extension in advanced retinoblastoma is routinely assessed preoperatively using high-resolution magnetic resonance imaging (MRI). The aim of our study was to analyse the predictive value of MRI and clinical characteristics for predicting tumor extent, as confirmed by histopathology postoperatively. PATIENTS AND METHODS All consecutive patients were included who underwent primary enucleation for advanced retinoblastoma after high-resolution MRI examination in our hospital between January 2011 and December 2021. The primary study endpoint was the evaluation of the predictability of histopathological risk factors on preoperative MRI examination. The sensitivity and specificity of the MRI examination with respect to clinically relevant optic nerve infiltration and choroidal infiltration were determined. RESULTS The mean age of the 209 included patients was 1.6 years (range 1 month to 4.7 years). MRI indicated optic nerve infiltration in 46 (22%) patients, extensive choroidal infiltration in 78 (40.2%) patients, and scleral infiltration in one patient (2.6%). Histopathological examination demonstrated postlaminar optic infiltration in 25 (12%) patients and extensive choroidal infiltration in 17 (8.1%) cases. Scleral infiltration was evident in 8 (3.8%) patients. In the final multivariate analysis, MRI findings of tumor infiltration and a preoperative intraocular pressure ≥ 20 mmHg were independently associated with histopathological evidence of clinically relevant optic nerve (p = 0.033/p = 0.011) and choroidal infiltration (p = 0.005/p = 0.029). The diagnostic accuracy of the prediction models based on the multivariate analysis for the identification of the clinically relevant optic nerve (AUC = 0.755) and choroidal infiltration (AUC = 0.798) was greater than that of purely MRI-based prediction (respectively 0.659 and 0.742). The sensitivity and specificity of MRI examination for determining histopathological risk factors in our cohort were 64% and 65% for clinically relevant optic infiltration and 87% and 64% for clinically relevant choroidal infiltration. CONCLUSION The local tumor extent of retinoblastoma with infiltration of the optic nerve and choroid can be well estimated based on radiological and clinical characteristics before treatment initiation. The combination of clinical and radiological risk factors supports the possibility of early treatment stratification in retinoblastoma patients.
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Affiliation(s)
- Leyla Jabbarli
- Klinik für Augenheilkunde, Universitätsklinikum Essen, Deutschland
| | - Sophia Göricke
- Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Essen, Deutschland
| | - Paulina Stumbaum
- Klinik für Augenheilkunde, Universitätsklinikum Essen, Deutschland
| | - Philipp Rating
- Klinik für Augenheilkunde, Universitätsklinikum Essen, Deutschland
| | - Mael Lever
- Klinik für Augenheilkunde, Universitätsklinikum Essen, Deutschland
| | - Tobias Kiefer
- Klinik für Augenheilkunde, Universitätsklinikum Essen, Deutschland
| | - Saskia Ting
- Institut für Pathologie Nordhessen, Gesundheit Nordhessen Holding AG, Kassel, Deutschland
| | - Andreas Junker
- Institut für Neuropathologie, Universitätsklinikum Essen, Deutschland
| | - Norbert Bornfeld
- Facharztzentrum für Augenheilkunde, Düsseldorf, Universität Duisburg-Essen, Duisburg, Deutschland
| | | | | | - Petra Ketteler
- Klinik für pädiatrische Hämatologie und Onkologie, Universitätsklinikum Essen, Deutschland
| | - Eva Biewald
- Klinik für Augenheilkunde, Universitätsklinikum Essen, Deutschland
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Zhang Y, Sheng R, Yang C, Dai Y, Zeng M. Higher field reduced FOV diffusion-weighted imaging for abdominal imaging at 5.0 Tesla: image quality evaluation compared with 3.0 Tesla. Insights Imaging 2023; 14:171. [PMID: 37840062 PMCID: PMC10577120 DOI: 10.1186/s13244-023-01513-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 08/27/2023] [Indexed: 10/17/2023] Open
Abstract
OBJECTIVE To evaluate the image quality of reduced field-of-view (rFOV) DWI for abdominal imaging at 5.0 Tesla (T) compared with 3.0 T. METHODS Fifteen volunteers were included into this prospective study. All the subjects underwent the 3.0 T and 5.0 T MR examinations (time interval: 2 ± 1.9 days). Free-breathing (FB), respiratory-triggered (RT), and navigator-triggered (NT) spin-echo echo-planner imaging-based rFOV-DWI examinations were conducted at 3.0 T and 5.0 T (FB3.0 T, NT3.0 T, RT3.0 T, FB5.0 T, NT5.0 T, and RT5.0 T) with two b values (b = 0 and 800 s/mm2), respectively. The signal-to-noise ratio (SNR) of different acquisition approaches were determined and statistically compared. The image quality was assessed and statistically compared with a 5-point scoring system. RESULTS The SNRs of any 5.0 T DWI images were significantly higher than those of any 3.0 T DWI images for same anatomic locations. Moreover, 5.0 T rFOV-DWIs had the significantly higher sharpness scores than 3.0 T rFOV-DWIs. Similar distortion scores were observed at both 3.0 T and 5.0 T. Finally, RT5.0 T displayed the best overall image quality followed by NT5.0 T, FB5.0 T, RT3.0 T, NT3.0 T and FB3.0 T (RT5.0 T = 3.9 ± 0.3, NT5.0 T = 3.8 ± 0.3, FB5.0 T = 3.4 ± 0.3, RT3.0 T = 3.2 ± 0.4, NT3.0 T = 3.1 ± 0.4, and FB3.0 T = 2.7 ± 0.4, p < 0.001). CONCLUSION The 5.0 T rFOV-DWI showed better overall image quality and improved SNR compared to 3.0 T rFOV-DWI, which holds clinical potential for identifying the abdominal abnormalities in routine practice. CRITICAL RELEVANCE STATEMENT This study provided evidence that abdominal 5.0 Tesla reduced field of view diffusion-weighted imaging (5.0 T rFOV-DWI) exhibited enhanced image quality and higher SNR compared to its 3.0 Tesla counterparts, holding clinical promise for accurately visualizing abdominal abnormalities. KEY POINTS • rFOV-DWI was firstly integrated with high-field-MRI for visualizing various abdominal organs. • This study indicated the feasibility of abdominal 5.0 T-rFOV-DWI. • Better image quality was identified for 5.0 T rFOV-DWI.
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Affiliation(s)
- Yunfei Zhang
- Shanghai Institute of Medical Imaging, Fudan University, Shanghai, 200032, China
- Central Research Institute, United Imaging Healthcare, Shanghai, 201800, China
| | - Ruofan Sheng
- Shanghai Institute of Medical Imaging, Fudan University, Shanghai, 200032, China
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Chun Yang
- Shanghai Institute of Medical Imaging, Fudan University, Shanghai, 200032, China
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Yongming Dai
- School of Biomedical Engineering, ShanghaiTech Univerisity, Shanghai, 200032, China.
| | - Mengsu Zeng
- Shanghai Institute of Medical Imaging, Fudan University, Shanghai, 200032, China.
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
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Histopathologic and MR Imaging Appearance of Spontaneous and Radiation-Induced Necrosis in Uveal Melanomas: Initial Results. Cancers (Basel) 2022; 14:cancers14010215. [PMID: 35008378 PMCID: PMC8750257 DOI: 10.3390/cancers14010215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 02/01/2023] Open
Abstract
Simple Summary Uveal melanomas may undergo necrosis, both spontaneously or following radiotherapy. Nowadays radiotherapy is the preferred treatment, whereas enucleation of the eye is used in selected cases. In order to differentiate the effects of radiotherapy from spontaneous degenerative changes in uveal melanomas, we compared the appearance of necrosis, both from a histopathological point of view and from the perspective of MR imaging, in two groups of patients with uveal melanoma: a group who had undergone previous proton beam radiotherapy (secondary enucleation); a control group who had undergone enucleation without any previous radiotherapy treatment (primary enucleation). Irradiated and nonirradiated uveal melanomas differ on the basis of the histological appearance, the MR imaging appearance and the distribution of necrosis. We hope that the findings we observed could be extended to all patients with uveal melanomas treated with radiotherapy, and may enhance the accuracy of radiologists in evaluating MR examinations after radiotherapy. Abstract Necrosis in uveal melanomas can be spontaneous or induced by radiotherapy. The purpose of our study was to compare the histopathologic and MRI findings of radiation-induced necrosis of a group of proton beam-irradiated uveal melanomas with those of spontaneous necrosis of a control group of patients undergoing primary enucleation. 11 uveal melanomas who had undergone proton beam radiotherapy, MRI and secondary enucleation, and a control group of 15 untreated uveal melanomas who had undergone MRI and primary enucleation were retrospectively identified. Within the irradiated and nonirradiated group, 7 and 6 eyes with histological evidence of necrosis respectively, were furtherly selected for the final analysis; the appearance of necrosis was assessed at histopathologic examination and MRI. Irradiated melanomas showed a higher degree of necrosis as compared with nonirradiated tumors. Irradiated and nonirradiated lesions differed based on the appearance and distribution of necrosis. Irradiated tumors showed large necrotic foci, sharply demarcated from the viable neoplastic tissue; nonirradiated tumors demonstrated small, distinct foci of necrosis. Radiation-induced necrosis, more pigmented than surrounding viable tumor, displayed high signal intensity on T1-weighted and low signal intensity on T2-weighted images. The hemorrhagic/coagulative necrosis, more prevalent in nonirradiated tumors (4 out of 6 vs. 1 out of 7 cases), appeared hyperintense on T2-weighted and hypointense on T1-weighted images. Our study boosts the capability to recognize radiation-induced alterations in uveal melanomas at MRI and may improve the accuracy of radiologists in the evaluation of follow-up MR examination after radiotherapy.
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Sims JR, Chen AM, Sun Z, Deng W, Colwell NA, Colbert MK, Zhu J, Sainulabdeen A, Faiq MA, Bang JW, Chan KC. Role of Structural, Metabolic, and Functional MRI in Monitoring Visual System Impairment and Recovery. J Magn Reson Imaging 2021; 54:1706-1729. [PMID: 33009710 PMCID: PMC8099039 DOI: 10.1002/jmri.27367] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/24/2020] [Accepted: 08/27/2020] [Indexed: 12/13/2022] Open
Abstract
The visual system, consisting of the eyes and the visual pathways of the brain, receives and interprets light from the environment so that we can perceive the world around us. A wide variety of disorders can affect human vision, ranging from ocular to neurologic to systemic in nature. While other noninvasive imaging techniques such as optical coherence tomography and ultrasound can image particular sections of the visual system, magnetic resonance imaging (MRI) offers high resolution without depth limitations. MRI also gives superior soft-tissue contrast throughout the entire pathway compared to computed tomography. By leveraging different imaging sequences, MRI is uniquely capable of unveiling the intricate processes of ocular anatomy, tissue physiology, and neurological function in the human visual system from the microscopic to macroscopic levels. In this review we discuss how structural, metabolic, and functional MRI can be used in the clinical assessment of normal and pathologic states in the anatomic structures of the visual system, including the eyes, optic nerves, optic chiasm, optic tracts, visual brain nuclei, optic radiations, and visual cortical areas. We detail a selection of recent clinical applications of MRI at each position along the visual pathways, including the evaluation of pathology, plasticity, and the potential for restoration, as well as its limitations and key areas of ongoing exploration. Our discussion of the current and future developments in MR ocular and neuroimaging highlights its potential impact on our ability to understand visual function in new detail and to improve our protection and treatment of anatomic structures that are integral to this fundamental sensory system. LEVEL OF EVIDENCE 3: TECHNICAL EFFICACY STAGE 3: .
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Affiliation(s)
- Jeffrey R. Sims
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
| | - Anna M. Chen
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
- Sackler Institute of Graduate Biomedical Sciences, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
| | - Zhe Sun
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
- Sackler Institute of Graduate Biomedical Sciences, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
| | - Wenyu Deng
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
| | - Nicole A. Colwell
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
| | - Max K. Colbert
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
| | - Jingyuan Zhu
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Anoop Sainulabdeen
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
- Department of Surgery and Radiology, College of Veterinary and Animal Sciences, Kerala Veterinary and Animal Sciences University, Thrissur, India
| | - Muneeb A. Faiq
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
| | - Ji Won Bang
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
| | - Kevin C. Chan
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
- Sackler Institute of Graduate Biomedical Sciences, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
- Department of Radiology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
- Neuroscience Institute, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
- Center for Neural Science, College of Arts and Science, New York University, New York, New York, USA
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Niendorf T, Beenakker JWM, Langner S, Erb-Eigner K, Bach Cuadra M, Beller E, Millward JM, Niendorf TM, Stachs O. Ophthalmic Magnetic Resonance Imaging: Where Are We (Heading To)? Curr Eye Res 2021; 46:1251-1270. [PMID: 33535828 DOI: 10.1080/02713683.2021.1874021] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Magnetic resonance imaging of the eye and orbit (MReye) is a cross-domain research field, combining (bio)physics, (bio)engineering, physiology, data sciences and ophthalmology. A growing number of reports document technical innovations of MReye and promote their application in preclinical research and clinical science. Realizing the progress and promises, this review outlines current trends in MReye. Examples of MReye strategies and their clinical relevance are demonstrated. Frontier applications in ocular oncology, refractive surgery, ocular muscle disorders and orbital inflammation are presented and their implications for explorations into ophthalmic diseases are provided. Substantial progress in anatomically detailed, high-spatial resolution MReye of the eye, orbit and optic nerve is demonstrated. Recent developments in MReye of ocular tumors are explored, and its value for personalized eye models derived from machine learning in the treatment planning of uveal melanoma and evaluation of retinoblastoma is highlighted. The potential of MReye for monitoring drug distribution and for improving treatment management and the assessment of individual responses is discussed. To open a window into the eye and into (patho)physiological processes that in the past have been largely inaccessible, advances in MReye at ultrahigh magnetic field strengths are discussed. A concluding section ventures a glance beyond the horizon and explores future directions of MReye across multiple scales, including in vivo electrolyte mapping of sodium and other nuclei. This review underscores the need for the (bio)medical imaging and ophthalmic communities to expand efforts to find solutions to the remaining unsolved problems and technical obstacles of MReye, with the objective to transfer methodological advancements driven by MR physics into genuine clinical value.
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Affiliation(s)
- Thoralf Niendorf
- MRI.TOOLS GmbH, Berlin, Germany.,Berlin Ultrahigh Field Facility, Max Delbrueck Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Jan-Willem M Beenakker
- Department of Ophthalmology and Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Sönke Langner
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, Rostock University Medical Center, Rostock, Germany
| | - Katharina Erb-Eigner
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Meritxell Bach Cuadra
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland.,Department of Radiology, Lausanne University and University Hospital, Lausanne, Switzerland
| | - Ebba Beller
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, Rostock University Medical Center, Rostock, Germany
| | - Jason M Millward
- Berlin Ultrahigh Field Facility, Max Delbrueck Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | | | - Oliver Stachs
- Department Life, Light & Matter, University Rostock, Rostock, Germany.,Department of Ophthalmology, Rostock University Medical Center, Rostock, Germany
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Cho SJ, Kim JH, Baik SH, Sunwoo L, Bae YJ, Choi BS. Diagnostic performance of MRI of post-laminar optic nerve invasion detection in retinoblastoma: A systematic review and meta-analysis. Neuroradiology 2020; 63:499-509. [PMID: 32865636 DOI: 10.1007/s00234-020-02538-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/20/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Preoperative MRI detection of post-laminar optic nerve invasion (PLONI) offers guidance in assessing the probability of total tumor resection, an estimation of the extent of surgery, and screening of candidates for eye-preserving therapies or neoadjuvant chemotherapies in the patients with retinoblastoma (RB). The purpose of this systematic review and meta-analysis was to evaluate the diagnostic performance of MRI for detecting PLONI in patients with RB and to demonstrate the factors that may influence the diagnostic performance. METHODS Ovid-MEDLINE and EMBASE databases were searched up to January 11, 2020, for studies identifying the diagnostic performance of MRI for detecting PLONI in patients with RB. The pooled sensitivity and specificity of all studies were calculated followed by meta-regression analysis. RESULTS Twelve (1240 patients, 1255 enucleated globes) studies were included. The pooled sensitivity was 61%, and the pooled specificity was 88%. Higgins I2 statistic demonstrated moderate heterogeneity in the sensitivity (I2 = 72.23%) and specificity (I2 = 78.11%). Spearman correlation coefficient indicated the presence of a threshold effect. In the meta-regression, higher magnetic field strength (3 T than 1.5 T), performing fat suppression, and thinner slice thickness (< 3 mm) were factors causing heterogeneity and enhancing diagnostic power across the included studies. CONCLUSIONS MR imaging was demonstrated to have acceptable diagnostic performance in detecting PLONI in patients with RB. The variation in the magnetic field strength and protocols was the main factor behind the heterogeneity across the included studies. Therefore, there is room for developing and optimizing the MR protocols for patients with RB.
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Affiliation(s)
- Se Jin Cho
- Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi, 13620, Republic of Korea
| | - Jae Hyoung Kim
- Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi, 13620, Republic of Korea.
| | - Sung Hyun Baik
- Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi, 13620, Republic of Korea
| | - Leonard Sunwoo
- Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi, 13620, Republic of Korea
| | - Yun Jung Bae
- Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi, 13620, Republic of Korea
| | - Byung Se Choi
- Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi, 13620, Republic of Korea
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