Retinoblastoma MRI: Difference between revisions

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{{Retinoblastoma}}
{{Retinoblastoma}}
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==Overview==
==Overview==
On [[head]] and [[neck]] [[MRI]], retinoblastoma is characterized by isointense to hypointense mass on T1-weighted MRI and hyperintense mass on T2-weighted MRI.<ref name="radio">  Retinoblastoma. Radiopedia(2015) http://radiopaedia.org/articles/retinoblastoma Accessed on October 10, 2015</ref>
[[Magnetic resonance imaging|MRI]] findings of retinoblastoma include hyperintense [[mass]] on T1-weighted [[MRI]] and hypointense [[mass]] on T2-weighted [[MRI]].
 
==MRI==
==MRI==
*MRI imaging study of retinoblastoma first introduced in 1980.<ref name="Schueler2003">{{cite journal|last1=Schueler|first1=A O|title=High resolution magnetic resonance imaging of retinoblastoma|journal=British Journal of Ophthalmology|volume=87|issue=3|year=2003|pages=330–335|issn=00071161|doi=10.1136/bjo.87.3.330}}</ref>
*[[Magnetic resonance imaging|MRI imaging study]] of retinoblastoma was first introduced in1980.<ref name="Schueler2003">{{cite journal|last1=Schueler|first1=A O|title=High resolution magnetic resonance imaging of retinoblastoma|journal=British Journal of Ophthalmology|volume=87|issue=3|year=2003|pages=330–335|issn=00071161|doi=10.1136/bjo.87.3.330}}</ref>
*This method is used as an extra diagnostic method to CT scan in suspected retinoblastoma cases especially in those whose CT scan imaging is doubtful for the presence of extra-ocular extension.<ref name="pmid22988349">{{cite journal |vauthors=Meel R, Radhakrishnan V, Bakhshi S |title=Current therapy and recent advances in the management of retinoblastoma |journal=Indian J Med Paediatr Oncol |volume=33 |issue=2 |pages=80–8 |date=April 2012 |pmid=22988349 |pmc=3439795 |doi=10.4103/0971-5851.99731 |url=}}</ref>
*[[MRI]] is [[Accuracy|accurate]] for [[tumor]] [[Cancer staging|staging]] and evaluation of [[metastatic]] [[risk factors]].<ref name="de GraafBarkhof2005">{{cite journal|last1=de Graaf|first1=Pim|last2=Barkhof|first2=Frederik|last3=Moll|first3=Annette C.|last4=Imhof|first4=Saskia M.|last5=Knol|first5=Dirk L.|last6=van der Valk|first6=Paul|last7=Castelijns|first7=Jonas A.|title=Retinoblastoma: MR Imaging Parameters in Detection of Tumor Extent|journal=Radiology|volume=235|issue=1|year=2005|pages=197–207|issn=0033-8419|doi=10.1148/radiol.2351031301}}</ref>
*MRI diagnostic value in the diagnosis of advanced retinoblastoma is greater than CT scan.<ref name="de Jongde Graaf2014">{{cite journal|last1=de Jong|first1=Marcus C.|last2=de Graaf|first2=Pim|last3=Noij|first3=Daniel P.|last4=Göricke|first4=Sophia|last5=Maeder|first5=Philippe|last6=Galluzzi|first6=Paolo|last7=Brisse|first7=Hervé J.|last8=Moll|first8=Annette C.|last9=Castelijns|first9=Jonas A.|title=Diagnostic Performance of Magnetic Resonance Imaging and Computed Tomography for Advanced Retinoblastoma|journal=Ophthalmology|volume=121|issue=5|year=2014|pages=1109–1118|issn=01616420|doi=10.1016/j.ophtha.2013.11.021}}</ref>
*It is also used as an additional [[diagnostic]] tool in suspected retinoblastoma cases.<ref name="pmid22988349">{{cite journal |vauthors=Meel R, Radhakrishnan V, Bakhshi S |title=Current therapy and recent advances in the management of retinoblastoma |journal=Indian J Med Paediatr Oncol |volume=33 |issue=2 |pages=80–8 |date=April 2012 |pmid=22988349 |pmc=3439795 |doi=10.4103/0971-5851.99731 |url=}}</ref>
MRI findings diagnostic of retinoblastoma are:
*[[MRI|MRI's]] [[Diagnosis|diagnostic]] value in the [[diagnosis]] of advanced retinoblastoma is greater than [[CT scan]].<ref name="de Jongde Graaf2014">{{cite journal|last1=de Jong|first1=Marcus C.|last2=de Graaf|first2=Pim|last3=Noij|first3=Daniel P.|last4=Göricke|first4=Sophia|last5=Maeder|first5=Philippe|last6=Galluzzi|first6=Paolo|last7=Brisse|first7=Hervé J.|last8=Moll|first8=Annette C.|last9=Castelijns|first9=Jonas A.|title=Diagnostic Performance of Magnetic Resonance Imaging and Computed Tomography for Advanced Retinoblastoma|journal=Ophthalmology|volume=121|issue=5|year=2014|pages=1109–1118|issn=01616420|doi=10.1016/j.ophtha.2013.11.021}}</ref>
*On T1 image:Hyperintense mass compared to vitrous body
*[[MRI]] findings [[diagnostic]] of retinoblastoma are:
*On T2 image:Hypointense mass compared to vitrous body
**'''On T1 image:''' Hyperintense [[mass]] compared to [[vitreous body]]
*It should be mentined that MRI is accurate for tumor staging and evaluation of metastatic risk factors.<ref name="de GraafBarkhof2005">{{cite journal|last1=de Graaf|first1=Pim|last2=Barkhof|first2=Frederik|last3=Moll|first3=Annette C.|last4=Imhof|first4=Saskia M.|last5=Knol|first5=Dirk L.|last6=van der Valk|first6=Paul|last7=Castelijns|first7=Jonas A.|title=Retinoblastoma: MR Imaging Parameters in Detection of Tumor Extent|journal=Radiology|volume=235|issue=1|year=2005|pages=197–207|issn=0033-8419|doi=10.1148/radiol.2351031301}}</ref>
**'''On T2 image:''' Hypointense [[mass]] compared to [[vitreous body]]
*This imaging study is capable to discreminate the tumor with secondary retinal detachment from other causes of subretinal effusion or detachment, such as coat's disease, primary hyperplastic vitreous and retinopathy of prematurity.
*[[Magnetic resonance imaging|MRI]] can differentiate the [[tumor]] with secondary [[retinal detachment]] from other [[causes]] of subretinal effusion or [[Retinal detachment|detachment]], such as [[Coats disease|Coats' disease]], primary hyperplastic [[vitreous]], and [[retinopathy of prematurity]].
*Also, some expert argue that CT imaging studies in bilateral retinoblastoma individuals will increase the risk of individuals for future malignancies. MRI is not associated with such risk.
*Also, some experts argue that [[CT-scans|CT imaging studies]] in [[bilateral]] retinoblastoma will increase the risk of future [[malignancies]]. [[MRI]] is not associated with such risk.
*Currently, MRI is the imaging study of choice for
*[[MRI]] is also the study of choice to rule out extra-[[ocular]] extension of the [[tumor]].<ref name="pmid22988349">{{cite journal |vauthors=Meel R, Radhakrishnan V, Bakhshi S |title=Current therapy and recent advances in the management of retinoblastoma |journal=Indian J Med Paediatr Oncol |volume=33 |issue=2 |pages=80–8 |date=April 2012 |pmid=22988349 |doi=10.4103/0971-5851.99731 |url=}}</ref>
 
{|
[[MRI]] is the modality of choice for pre-treatment staging on retinoblastoma.
|[[image:Retinoblastoma-edited.jpg|thumb|400px|T2 image, Case courtesy of Dr Jeremy Jones, Radiopaedia.org, rID: 22114]]
*The MRI features of retinoblastoma include:<ref name="radio"> Retinoblastoma. Radiopedia(2015) http://radiopaedia.org/articles/retinoblastoma Accessed on October 10, 2015</ref>
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! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Features}}
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:T1
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|[[image:Retinoblastoma-5 edited.jpg|thumb|400px|T1 image, Case courtesy of Dr Jeremy Jones, Radiopaedia.org, rID: 22114]]
*Intermediate signal intensity, hyperintense c.f. vitreous
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:T2
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*Hypointense c.f. vitreous
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:T1 contrast with gadolinium
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*The mass usually enhances relatively homogeneously when small
*Larger tumors often have areas of necrosis, rendering it heterogeneous
*Linear enhancement of the choroid beyond the margins of the tumour should raise the possibility of choroidal involvement, although inflammation may lead to similar appearance
*Enhancement of the anterior chamber need not represent tumour involvement, with hyperaemia, uveitis and iris neovascularisation all leading to asymmetric enhancement
*Careful assessment of the optic disc and optic nerve should be carried out to assess for involvement
*Extra-ocular extension through the sclera will be visible as interruption of the otherwise hypointense non-enhancing sclera by enhancing tumour
|-
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:Diffusion Weighted Imaging
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*The tumour shows restricted diffusion on DWI at high b values. It exhibits low ADC values in contrast to the high intensity of the vitreous in the ADC maps
*ADC map can be used to differentiate viable and necrotic tumour
*DWI is valuable in evaluating the response to eye-preservation treatment
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[[File:Axial MRI scan.jpg|thumb|none|200px|Axial MRI showing retinoblastoma<ref name="radio1">Image courtesy of Radswiki [http://www.radiopaedia.org Radiopaedia] (original file [http://radiopaedia.org/cases/retinoblastoma-3]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC</ref>]]
[[File:T1 MRI of retinoblastoma.jpg|thumb|none|200px|T1 MRI showing retinoblastoma<ref name="radio1">Image courtesy of Dr. Vinay Shah [http://www.radiopaedia.org Radiopaedia] (original file [http://radiopaedia.org/cases/retinoblastoma-9]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC</ref>]]
[[File:T2 MRI of retinoblastoma.jpg|thumb|none|200px|T2 MRI showing retinoblastoma<ref name="radio1">Image courtesy of Dr. Vinay Shah [http://www.radiopaedia.org Radiopaedia] (original file [http://radiopaedia.org/cases/retinoblastoma-9]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC</ref>]]


==References==
==References==
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{{reflist|2}}
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Latest revision as of 23:59, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2] Simrat Sarai, M.D. [3]

Overview

MRI findings of retinoblastoma include hyperintense mass on T1-weighted MRI and hypointense mass on T2-weighted MRI.

MRI

T2 image, Case courtesy of Dr Jeremy Jones, Radiopaedia.org, rID: 22114


T1 image, Case courtesy of Dr Jeremy Jones, Radiopaedia.org, rID: 22114


References

  1. Schueler, A O (2003). "High resolution magnetic resonance imaging of retinoblastoma". British Journal of Ophthalmology. 87 (3): 330–335. doi:10.1136/bjo.87.3.330. ISSN 0007-1161.
  2. de Graaf, Pim; Barkhof, Frederik; Moll, Annette C.; Imhof, Saskia M.; Knol, Dirk L.; van der Valk, Paul; Castelijns, Jonas A. (2005). "Retinoblastoma: MR Imaging Parameters in Detection of Tumor Extent". Radiology. 235 (1): 197–207. doi:10.1148/radiol.2351031301. ISSN 0033-8419.
  3. 3.0 3.1 Meel R, Radhakrishnan V, Bakhshi S (April 2012). "Current therapy and recent advances in the management of retinoblastoma". Indian J Med Paediatr Oncol. 33 (2): 80–8. doi:10.4103/0971-5851.99731. PMC 3439795. PMID 22988349.
  4. de Jong, Marcus C.; de Graaf, Pim; Noij, Daniel P.; Göricke, Sophia; Maeder, Philippe; Galluzzi, Paolo; Brisse, Hervé J.; Moll, Annette C.; Castelijns, Jonas A. (2014). "Diagnostic Performance of Magnetic Resonance Imaging and Computed Tomography for Advanced Retinoblastoma". Ophthalmology. 121 (5): 1109–1118. doi:10.1016/j.ophtha.2013.11.021. ISSN 0161-6420.