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Jansen RW, Roohollahi K, Uner OE, de Jong Y, de Bloeme CM, Göricke S, Sirin S, Maeder P, Galluzzi P, Brisse HJ, Cardoen L, Castelijns JA, van der Valk P, Moll AC, Grossniklaus H, Hubbard GB, de Jong MC, Dorsman J, de Graaf P. Correlation of gene expression with magnetic resonance imaging features of retinoblastoma: a multi-center radiogenomics validation study. Eur Radiol 2024; 34:863-872. [PMID: 37615761 PMCID: PMC10853293 DOI: 10.1007/s00330-023-10054-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 04/30/2023] [Accepted: 06/22/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVES To validate associations between MRI features and gene expression profiles in retinoblastoma, thereby evaluating the repeatability of radiogenomics in retinoblastoma. METHODS In this retrospective multicenter cohort study, retinoblastoma patients with gene expression data and MRI were included. MRI features (scored blinded for clinical data) and matched genome-wide gene expression data were used to perform radiogenomic analysis. Expression data from each center were first separately processed and analyzed. The end product normalized expression values from different sites were subsequently merged by their Z-score to permit cross-sites validation analysis. The MRI features were non-parametrically correlated with expression of photoreceptorness (radiogenomic analysis), a gene expression signature informing on disease progression. Outcomes were compared to outcomes in a previous described cohort. RESULTS Thirty-six retinoblastoma patients were included, 15 were female (42%), and mean age was 24 (SD 18) months. Similar to the prior evaluation, this validation study showed that low photoreceptorness gene expression was associated with advanced stage imaging features. Validated imaging features associated with low photoreceptorness were multifocality, a tumor encompassing the entire retina or entire globe, and a diffuse growth pattern (all p < 0.05). There were a number of radiogenomic associations that were also not validated. CONCLUSIONS A part of the radiogenomic associations could not be validated, underlining the importance of validation studies. Nevertheless, cross-center validation of imaging features associated with photoreceptorness gene expression highlighted the capability radiogenomics to non-invasively inform on molecular subtypes in retinoblastoma. CLINICAL RELEVANCE STATEMENT Radiogenomics may serve as a surrogate for molecular subtyping based on histopathology material in an era of eye-sparing retinoblastoma treatment strategies. KEY POINTS • Since retinoblastoma is increasingly treated using eye-sparing methods, MRI features informing on molecular subtypes that do not rely on histopathology material are important. • A part of the associations between retinoblastoma MRI features and gene expression profiles (radiogenomics) were validated. • Radiogenomics could be a non-invasive technique providing information on the molecular make-up of retinoblastoma.
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Affiliation(s)
- Robin W Jansen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
- Cancer Center Amsterdam, Amsterdam, The Netherlands.
| | - Khashayar Roohollahi
- Cancer Center Amsterdam, Amsterdam, The Netherlands
- Department of Oncogenetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ogul E Uner
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, USA
- Emory Eye Center, Ocular Oncology Service, Atlanta, USA
| | - Yvonne de Jong
- Cancer Center Amsterdam, Amsterdam, The Netherlands
- Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Christiaan M de Bloeme
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Sophia Göricke
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Selma Sirin
- Department of Diagnostic Imaging, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Philippe Maeder
- Department of Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | | | | | | | - Jonas A Castelijns
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Paul van der Valk
- Department of Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Annette C Moll
- Cancer Center Amsterdam, Amsterdam, The Netherlands
- Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | | | - Marcus C de Jong
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Josephine Dorsman
- Cancer Center Amsterdam, Amsterdam, The Netherlands
- Department of Oncogenetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Pim de Graaf
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Amsterdam, The Netherlands
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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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Schweiger B, Göricke S, Ketteler P, Biewald E, Kottke R, Sirin S. [Imaging of retinoblastoma : Current state-of-the-art and future prospects]. RADIOLOGIE (HEIDELBERG, GERMANY) 2022; 62:1067-1074. [PMID: 35969246 PMCID: PMC9712334 DOI: 10.1007/s00117-022-01052-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/11/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Retinoblastoma is the most common malignant eye tumor in children and is associated with tumor predisposition syndrome (RB1 mutation) in up to 40% of cases. Imaging is an important part of the diagnostic workup of children with retinoblastoma both during the initial diagnosis and follow-up. OBJECTIVES The goal of this review is to present the current state-of-the-art regarding imaging of children with retinoblastoma, including technical background and diagnostic clues with a brief discussion of future prospects. In addition, we summarize the general clinical diagnostic workup and therapeutic options. MATERIALS AND METHODS Review of the literature and our own experience in the imaging of retinoblastoma. CONCLUSION High-resolution magnetic resonance imaging (MRI) is the imaging modality of choice in children with retinoblastoma for diagnosis (estimation of diagnosis/differential diagnosis, evaluation of local and intracranial tumor extension) and during follow-up. Despite the characteristic calcifications, computed tomography (CT) examinations are no longer indicated in these patients. Due to the high association with tumor predisposition syndrome, genetic counselling is recommended.
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Affiliation(s)
- Bernd Schweiger
- Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Essen, Essen, Deutschland
| | - Sophia Göricke
- Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Essen, Essen, Deutschland
| | - Petra Ketteler
- Klinik für Pädiatrische Hämatologie und Onkologie, Universitätsklinikum Essen, Essen, Deutschland
| | - Eva Biewald
- Klinik für Augenheilkunde, Universitätsklinikum Essen, Essen, Deutschland
| | - Raimund Kottke
- Abteilung für Bilddiagnostik, Universitäts-Kinderspital Zürich, Zürich, Schweiz
| | - Selma Sirin
- Abteilung für Bilddiagnostik, Universitäts-Kinderspital Zürich, Zürich, Schweiz.
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