Learning objectives
-To produce an iconographic essay of Magnetic Resonance Imaging (MRI) of retinoblastoma through the database of a cancer referral service in Rio de Janeiro, where patients were submitted for treatment and follow up evaluation.
-To facilitate the imaging interpretation of retinoblastoma and its differential diagnosis, as well as demonstrating the decisive role of radiologists in the management of the patient.
Background
Retinoblastoma (RB) is the most common malignant intraocular tumor in childhood, with an incidence of one for each 17.000 live births¹. It originates in the retina and belongs to a group of neoplasms with embryonic neuroblastic elements. Most cases are diagnosed within the first four years of life, with a median age at clinical presentation of 2 years for unilateral forms, and 1 year for bilateral form. RB is non-hereditary in two-third of cases, as a result of spontaneous RB-1 mutation in just one single...
Findings and procedure details
Compared to the vitreous body, retinoblastoma is moderatelly hiperintensity on T1WI and quite hypointense on T2-WI. The calcified areas appear as markedly hypointense foci on gradienteecho T2WI. Also, the tumour shows moderate to marked contrast enhancement and restricted diffusion on DWI at high b values, with low ADC values. Fig. 3 Fig. 4
Three patterns of growth are recognized:
1) Endophytic: inwards to the vitreous chamber and may be associated with neoplastic seeding in this cavity.
2) Exophytic: outwards to the subretinal space, possibly associated...
Conclusion
Radiologists should be familiar with the MRI findings of retinoblastoma, both typical and atypical, and of main differential diagnosis. In this context, MRI imaging plays an important role and may determine prognosis with an accurate treatment management.
Personal information and conflict of interest
H. S. de Souza; Rio de Janeiro/BR - Radiology resident from INCA, Rio de Janeiro, Brazil. No conflict of interest. Email:
[email protected]
J. A. M. Silva; Rio de Janeiro/BR - Radiology resident from INCA, Rio de Janeiro, Brazil. No conflict of interest. Email:
[email protected]
V. R. F. Simonini; Rio de Janeiro/BR - Radiology resident from INCA, Rio de Janeiro, Brazil. No conflict of interest. Email:
[email protected]
R. Costa; Rio de Janeiro/BR - Radiology resident from INCA, Rio de Janeiro, Brazil. No conflict of interest. Email:...
References
Albader, Fahad & Fatani, Dalal. (2019). Uses of Radiological Imaging in Retinoblastoma. 10.5772/intechopen.86828.
de Graaf P, Göricke S, Rodjan F, et al. Guidelines for imaging retinoblastoma: imaging principles and MRI standardization.Pediatr Radiol. 2012;42(1):2–14.
A RAZEK, A A K; ELKHAMARY, S. MRI of retinoblastoma.The British Journal Of Radiology, [s.l.], v. 84, n. 1005, p.775-784, set. 2011. British Institute of Radiology.
Soliman SE, Dimaras H, Khetan V, Gardiner JA, Chan HS, Héon E, Gallie BL. Prenatal versus Postnatal Screening for Familial Retinoblastoma. Ophthalmology. 2016 Dec;123(12):2610-2617.
Soliman SE,...