Purpose
To assess the association between intraocular retinoblastoma tumour size measured with magnetic resonance imaging (MRI) and histopathologically determined metastatic risk factors (postlaminar optic nerve invasion [PLONI] and massive choroidal invasion).
Methods and materials
This study was performed according to the STARD (standards for reporting of diagnostic accuracy) statement.This retrospective study included 370 consecutive retinoblastoma patients (375 eyes) who underwent baseline MRI followed by primary enucleation.
Tumour sizes (maximum diameter and gross volume) were measured independently by two observers (figure 1).
Receiver operator curve (ROC) and logistic regression analysis were used to analyse the data and to evaluate potential confounders.
Results
For PLONI,
ROC analysis yielded areas under the curve (AUC) of 0.77 (95% CI 0.70–0.85) vs.
0.78 (0.71–0.85),
respectively for volume and diameter.
Massive choroidal tumour invasion showed AUCs of 0.67 (0.57–0.77) and 0.70 (0.59–0.80),
see figures 2 and 3.
Logistic regression analysis showed that tumour size was the main predictor of these metastatic risk factors.
The risk of PLONI was minimal (<1%) below 0.88 cm3 or 14 mm,
whereas the risk was substantial (>25%) above 1.8 cm3 or 17.2 mm.
Across the different tumour...
Conclusion
Tumour size is a good predictor of postlaminar optic nerve tumor invasion and to a lesser extent also of massive choroidal tumor invasion.
Across the tumour size categories the risk of massive choroidal invasion is more evenly distributed.
Tumour diameter and volume both performed similarly,
but volume can be obtained more reliably.
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Chantada GL,
Casco F,
Fandiño AC,
et al: Outcome of patients with retinoblastoma and postlaminar optic nerve invasion.
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