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Br J Ophthalmol doi:10.1136/bjophthalmol-2012-301502
  • Clinical science

The validity of routine brain MRI in detecting post-laminar optic nerve involvement in retinoblastoma

  1. Young Suk Yu1,2
  1. 1Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
  2. 2Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea
  3. 3Department of Radiology, College of Medicine, Chosun University, Gwangju, Korea
  4. 4Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
  1. Correspondence to Dr Young Suk Yu, Department of Ophthalmology, Seoul National University College of Medicine, 28 Yongon-Dong, Chongno-Gu, Seoul 110-744, Korea; ysyu{at}snu.ac.kr

  1. Contributors BJL: Contributed to the acquisition, analysis and interpretation of data and drafting the article. JHK: Contributed to the conception of ideas and design of the study and critical revision of contents. DHK and SHP: Contributed to the acquisition, analysis and interpretation of data and critical revision of contents. YSY: Contributed to the conception of ideas and design of the study and provided approval of the version to be published.

  • Accepted 19 June 2012
  • Published Online First 11 July 2012

Abstract

Objective To describe the diagnostic validity of a gadolinium-enhanced routine brain MRI scan with 5 mm section thickness for the detection of optic nerve involvement in patients with retinoblastoma.

Methods Medical records of primarily enucleated retinoblastoma patients who underwent routine preoperative brain MRI scan with section thickness of 5 mm were retrospectively reviewed. Preoperative magnetic resonance images were independently reviewed in a masked fashion by two radiologists and compared with histological findings.

Results 41 eyes of 41 patients were included and the mean age at enucleation was 23.1 months. Among 41 eyes, 14 eyes were diagnosed to have post-laminar optic nerve invasion on histopathology. The accuracy, sensitivity and specificity of MRI for the diagnosis of post-laminar invasion were 73.2%, 35.7% and 92.6%, respectively, by the first radiologist and 78.0%, 42.9% and 96.3%, respectively, by the second radiologist. Moderate agreement was found between two radiologists (κ =0.48, p<0.01).

Conclusions Compared with the results of previous studies using orbital MRI with less than 3 mm section thickness, routine brain MRI with section thickness of 5 mm showed comparable specificity but inferior sensitivity in detecting optic nerve involvement of retinoblastoma.

Footnotes

  • Funding This study was supported by a research fund from Seoul National University College of Medicine (800-20100049).

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Institutional Review Board for Clinical Research at the Seoul National University Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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