Guidelines for imaging retinoblastoma: imaging principles and MRI standardization

Abstract

Retinoblastoma is the most common intraocular tumor in children. The diagnosis is usually established by the ophthalmologist on the basis of fundoscopy and US. Together with US, high-resolution MRI has emerged as an important imaging modality for pretreatment assessment, i.e. for diagnostic confirmation, detection of local tumor extent, detection of associated developmental malformation of the brain and detection of associated intracranial primitive neuroectodermal tumor (trilateral retinoblastoma). Minimum requirements for pretreatment diagnostic evaluation of retinoblastoma or mimicking lesions are presented, based on consensus among members of the European Retinoblastoma Imaging Collaboration (ERIC). The most appropriate techniques for imaging in a child with leukocoria are reviewed. CT is no longer recommended. Implementation of a standardized MRI protocol for retinoblastoma in clinical practice may benefit children worldwide, especially those with hereditary retinoblastoma, since a decreased use of CT reduces the exposure to ionizing radiation.

Ocular MR Imaging: Evaluation of Different Coil Setups in a Phantom Study

“…Thisˆnding suggests that the head coil should be turned oŠ when images of the eye are acquired with small surface coils, such as in children with retinoblastoma when the head coil is necessary for acquiring images of the entire brain to depict trilateral retinoblastoma. 1 The lowest SNR was measured using the head coil only, suggesting that unilateral imaging of the eye and orbit using only the head coil should be discouraged based on our phantom results. The head coil is certainly useful in acquiring images of both orbits for comparison, 10 such as in diseases aŠect-ing the eye muscles, like Grave's disease, and it may also be useful in patients who are very sensitive to and may not tolerate well the direct contact of the surface coil with the face.…”

“…Its particular utility for assessing retinoblastoma before therapy has been reported. 1 Some institutions use ocular MR imaging to plan proton-beam therapy in uveal melanoma, 2 the most common primary intraocular tumor in adults. 3 Rare diseases of the eye bulb, such as staphyloma/coloboma, may also require ocular MR imaging.…”

3D turbo field echo with diffusion-sensitized driven-equilibrium preparation technique (DSDE-TFE) versus echo planar imaging in evaluation of diffusivity of retinoblastoma

“…1,2 However, MRI is recommended to evaluate extraocular extension and the presence of intracranial lesions. 2,5 Diffusion-weighted imaging (DWI) is widely used to diagnose tumours, inflammation and vascular disease in both intracranial and extracranial lesions. 3,4,[6][7][8][9][10][11][12][13][14][15][16] Previous studies also revealed the efficacy of DWI to evaluate orbital lesions including orbital tumours of adults 8,9 and children, 10 ocular adnexal lymphomas, 9,11 immunoglobulin G4 (IgG4)-related disease, 9 endophthalmitis 12 and optic nerve lesions.…”

“…[1][2][3][4][5] Diagnoses of retinoblastoma are usually made by fundoscopy and ultrasound. 1,2 However, MRI is recommended to evaluate extraocular extension and the presence of intracranial lesions. 2,5 Diffusion-weighted imaging (DWI) is widely used to diagnose tumours, inflammation and vascular disease in both intracranial and extracranial lesions.…”

Retinoblastoma: Value of Dynamic Contrast-Enhanced MR Imaging and Correlation with Tumor Angiogenesis

“…These characteristics can be well-detected on histopathology, but detection by conventional MR imaging is not optimal so far. [5][6][7][8][9][10][11][12][13] Therefore, it is important to assess the prospects of other MR imaging methods that could further optimize the tumor tissue characterization in vivo.…”