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Pai V, Muthusami P, Ertl-Wagner B, Shroff MM, Parra-Fariñas C, Sainani K, Kletke S, Brundler MA, Mallipatna A. Diagnostic Imaging for Retinoblastoma Cancer Staging: Guide for Providing Essential Insights for Ophthalmologists and Oncologists. Radiographics 2024; 44:e230125. [PMID: 38451848 DOI: 10.1148/rg.230125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Retinoblastoma is the most common cause of all intraocular pediatric malignancies. It is caused by the loss of RB1 tumor suppressor gene function, although some tumors occur due to MYCN oncogene amplification with normal RB1 genes. Nearly half of all retinoblastomas occur due to a hereditary germline RB1 pathogenic variant, most of which manifest with bilateral tumors. This germline RB1 mutation also predisposes to intracranial midline embryonal tumors. Accurate staging of retinoblastoma is crucial in providing optimal vision-, eye-, and life-saving treatment. The AJCC Cancer Staging Manual has undergone significant changes, resulting in a universally accepted system with a multidisciplinary approach for managing retinoblastoma. The authors discuss the role of MRI and other diagnostic imaging techniques in the pretreatment assessment and staging of retinoblastoma. A thorough overview of the prevailing imaging standards and evidence-based perspectives on the benefits and drawbacks of these techniques is provided. Published under a CC BY 4.0 license. Test Your Knowledge questions for this article are available in the supplemental material.
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Affiliation(s)
- Vivek Pai
- From the Divisions of Neuroradiology (V.P., P.M., B.E.W., M.M.S., C.P.F.) and Image Guided Therapy (P.M., M.M.S., C.P.F.), Department of Diagnostic Imaging, and Retinoblastoma Program, Department of Ophthalmology and Vision Sciences (K.S., S.K., A.M.), The Hospital for Sick Children (SickKids), University of Toronto, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Department of Pathology and Department of Laboratory Medicine and Pediatrics, Cumming School of Medicine, Calgary, Alberta, Canada (M.A.B.)
| | - Prakash Muthusami
- From the Divisions of Neuroradiology (V.P., P.M., B.E.W., M.M.S., C.P.F.) and Image Guided Therapy (P.M., M.M.S., C.P.F.), Department of Diagnostic Imaging, and Retinoblastoma Program, Department of Ophthalmology and Vision Sciences (K.S., S.K., A.M.), The Hospital for Sick Children (SickKids), University of Toronto, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Department of Pathology and Department of Laboratory Medicine and Pediatrics, Cumming School of Medicine, Calgary, Alberta, Canada (M.A.B.)
| | - Birgit Ertl-Wagner
- From the Divisions of Neuroradiology (V.P., P.M., B.E.W., M.M.S., C.P.F.) and Image Guided Therapy (P.M., M.M.S., C.P.F.), Department of Diagnostic Imaging, and Retinoblastoma Program, Department of Ophthalmology and Vision Sciences (K.S., S.K., A.M.), The Hospital for Sick Children (SickKids), University of Toronto, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Department of Pathology and Department of Laboratory Medicine and Pediatrics, Cumming School of Medicine, Calgary, Alberta, Canada (M.A.B.)
| | - Manohar M Shroff
- From the Divisions of Neuroradiology (V.P., P.M., B.E.W., M.M.S., C.P.F.) and Image Guided Therapy (P.M., M.M.S., C.P.F.), Department of Diagnostic Imaging, and Retinoblastoma Program, Department of Ophthalmology and Vision Sciences (K.S., S.K., A.M.), The Hospital for Sick Children (SickKids), University of Toronto, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Department of Pathology and Department of Laboratory Medicine and Pediatrics, Cumming School of Medicine, Calgary, Alberta, Canada (M.A.B.)
| | - Carmen Parra-Fariñas
- From the Divisions of Neuroradiology (V.P., P.M., B.E.W., M.M.S., C.P.F.) and Image Guided Therapy (P.M., M.M.S., C.P.F.), Department of Diagnostic Imaging, and Retinoblastoma Program, Department of Ophthalmology and Vision Sciences (K.S., S.K., A.M.), The Hospital for Sick Children (SickKids), University of Toronto, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Department of Pathology and Department of Laboratory Medicine and Pediatrics, Cumming School of Medicine, Calgary, Alberta, Canada (M.A.B.)
| | - Kanchan Sainani
- From the Divisions of Neuroradiology (V.P., P.M., B.E.W., M.M.S., C.P.F.) and Image Guided Therapy (P.M., M.M.S., C.P.F.), Department of Diagnostic Imaging, and Retinoblastoma Program, Department of Ophthalmology and Vision Sciences (K.S., S.K., A.M.), The Hospital for Sick Children (SickKids), University of Toronto, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Department of Pathology and Department of Laboratory Medicine and Pediatrics, Cumming School of Medicine, Calgary, Alberta, Canada (M.A.B.)
| | - Stephanie Kletke
- From the Divisions of Neuroradiology (V.P., P.M., B.E.W., M.M.S., C.P.F.) and Image Guided Therapy (P.M., M.M.S., C.P.F.), Department of Diagnostic Imaging, and Retinoblastoma Program, Department of Ophthalmology and Vision Sciences (K.S., S.K., A.M.), The Hospital for Sick Children (SickKids), University of Toronto, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Department of Pathology and Department of Laboratory Medicine and Pediatrics, Cumming School of Medicine, Calgary, Alberta, Canada (M.A.B.)
| | - Marie-Anne Brundler
- From the Divisions of Neuroradiology (V.P., P.M., B.E.W., M.M.S., C.P.F.) and Image Guided Therapy (P.M., M.M.S., C.P.F.), Department of Diagnostic Imaging, and Retinoblastoma Program, Department of Ophthalmology and Vision Sciences (K.S., S.K., A.M.), The Hospital for Sick Children (SickKids), University of Toronto, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Department of Pathology and Department of Laboratory Medicine and Pediatrics, Cumming School of Medicine, Calgary, Alberta, Canada (M.A.B.)
| | - Ashwin Mallipatna
- From the Divisions of Neuroradiology (V.P., P.M., B.E.W., M.M.S., C.P.F.) and Image Guided Therapy (P.M., M.M.S., C.P.F.), Department of Diagnostic Imaging, and Retinoblastoma Program, Department of Ophthalmology and Vision Sciences (K.S., S.K., A.M.), The Hospital for Sick Children (SickKids), University of Toronto, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Department of Pathology and Department of Laboratory Medicine and Pediatrics, Cumming School of Medicine, Calgary, Alberta, Canada (M.A.B.)
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Sharma M, Gupta A, Jana M, Kashyap S, Bakhshi S, Sharma S. Comparison of HASTE versus EPI-Based DWI for Retinoblastoma and Correlation with Prognostic Histopathologic Parameters. AJNR Am J Neuroradiol 2024; 45:198-204. [PMID: 38176729 DOI: 10.3174/ajnr.a8084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/29/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND AND PURPOSE Non-EPI-based DWI has shown better performance in head and neck pathologies owing to lesser susceptibility artifacts compared with EPI-DWI. However, only sporadic studies have investigated the feasibility of non-EPI-based DWI in retinoblastoma (RB). We qualitatively and quantitively compared EPI-DWI and HASTE-DWI in RB and correlated the tumor ADC values obtained from these 2 techniques with histopathologic markers. MATERIALS AND METHODS Twenty-one treatment-naive patients with RB underwent 1.5T orbital MR imaging. EPI-DWI and HASTE-DWI were acquired at 3 b-values (0, 500, and 1000 s/mm2). All patients subsequently underwent surgical enucleation. For qualitative image assessment, scoring of overall image quality, artifacts, tumor sharpness, and tumor conspicuity was done by using a 5-point Likert scale. Quantitative assessment included calculations of SNR, contrast-to-noise ratio (CNR), geometric distortion, and ADC. Qualitative scores were compared by using the Wilcoxon signed-rank test, and quantitative parameters were analyzed with a t test. RESULTS All 21 patients had unilateral RB; 15 were male and 6 were female with a median age of 36 months (range, 9-72 months). On histopathology, patients had either poorly differentiated (n = 13/21) or moderately differentiated (n = 8/21) RB. Other poor prognostic markers evaluated were optic nerve invasion (n = 10/21), choroidal invasion (n = 12/21), and anterior eye segment enhancement on MRI (n = 6/21). HASTE-DWI demonstrated higher image quality scores than EPI-DWI (P < .01), except for tumor conspicuity score, which was higher for EPI-DWI (P < .001). HASTE-DWI showed lower SNR, CNR, and geometric distortion than EPI-DWI (P < .001). The average acquisition times of EPI-DWI and HASTE-DWI were ∼1 and 14 minutes, respectively. The mean tumor ADC value on EPI-DWI was 0.62 ± 0.14 × 10-3 mm2/s and on HASTE-DWI was 0.83 ± 0.17 × 10-3 mm2/s. A significant correlation between EPI-DWI and HASTE-DWI ADC values (r = 0.8; P = .01) was found. Lower ADC values were found in tumors with poor prognostic markers, but none reached a statistically significant difference. CONCLUSIONS HASTE-DWI shows improved overall image quality; however, it lacks in terms of tumor conspicuity, SNR, CNR, and longer acquisition time compared with EPI-DWI. ADC values derived from HASTE-DWI show no advantage over EPI-DWI in correlation with histopathologic prognostic markers.
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Affiliation(s)
- Manish Sharma
- From the Department of Radiodiagnosis and Interventional Radiology (M.S., A.G., M.J., S.S.), All India Institute of Medical Sciences, New Delhi, India
| | - Amit Gupta
- From the Department of Radiodiagnosis and Interventional Radiology (M.S., A.G., M.J., S.S.), All India Institute of Medical Sciences, New Delhi, India
| | - Manisha Jana
- From the Department of Radiodiagnosis and Interventional Radiology (M.S., A.G., M.J., S.S.), All India Institute of Medical Sciences, New Delhi, India
| | - Seema Kashyap
- Department of Pathology (S.K.), All India Institute of Medical Sciences, New Delhi, India
| | - Sameer Bakhshi
- Department of Medical Oncology (S.B.), Institute of Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay Sharma
- From the Department of Radiodiagnosis and Interventional Radiology (M.S., A.G., M.J., S.S.), All India Institute of Medical Sciences, New Delhi, India
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