scholarly journals Histopathological assessment of optic nerve invasion guided by radiological findings in enucleated globes with retinoblastoma.

2020 ◽  
Author(s):  
Mohammed Abusayf ◽  
Hind Manaa Alkatan ◽  
Sahar Elkhamary ◽  
Saleh Almesfer ◽  
Azza MY Maktabi
Keyword(s):  
Optic Nerve ◽  
High Risk ◽  
Predictive Value ◽  
Histopathological Examination ◽  
Demographic Data ◽  
Mri Findings ◽  
Level Of Invasion ◽  
Nerve Invasion ◽  
Unilateral Involvement ◽  
Magnetic Resonance Imaging Mri

Abstract Background: Optic nerve (ON) invasion is an important high-risk feature, and an indicator for neoadjuvant chemotherapy and prognosis. We aim through this study to correlate the detected-ON invasion by Magnetic resonance imaging (MRI) with the corresponding confirmed histopathological level of invasion. Methods: A retrospective study of enucleated globes with the diagnosis of retinoblastoma received in the histopathology department(s) from January 2015 to December 2016 (2 years). Slides were reviewed for ON invasion assessment, charts were reviewed for basic demographic data. All patients underwent MRI under sedation upon diagnosis and MRI findings were collected for the above correlation. Results: A total of 38 patients were included: 21 males and 17 females. 29 (77.3%) had unilateral involvement, 7 (18.4%) had bilateral involvement and 2 cases had trilateral disease. The overall mean age at diagnosis was 22.63 ±15.15 months. Histopathological examination revealed ON invasion in 28 cases (74%) distributed as follows: prelaminar (31.6%), laminar (18.4%), and post-laminar (23.7%). MRI confirmed post-laminar ON invasion in 8 cases (true positive) but failed to detect this in 1 case. Additionally, MRI detected another 8 cases of ON invasion that were false positive on histopathology (accuracy: 63.3%; sensitivity: 88.9%; specificity: 72.4%; Positive predictive value (PPV): 50%; Negative predictive value (NPV): 95.5%). Conclusions: MRI is found to be less sensitive in evaluating prelaminar and laminar ON invasion (0.0 and 42.9%) compared to post-laminar invasion (88.9%). MRI has generally better specificity in detecting ON invasion irrespective of the invasion level. In our study, obtaining deeper and/or additional histologic sections from the other surface of the tissue block in cases where a post-laminar ON invasion by MRI is found but not confirmed histopathologically in routine sections is essential to avoid missing such an important high-risk feature.

scholarly journals Histopathological assessment of optic nerve invasion guided by radiological findings in enucleated globes with retinoblastoma

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mohammed M. Abusayf ◽  
Hind M. Alkatan ◽  
Sahar Elkhamary ◽  
Saleh A. Almesfer ◽  
Azza M. Y. Maktabi
Keyword(s):  
Optic Nerve ◽  
High Risk ◽  
Predictive Value ◽  
Histopathological Examination ◽  
Demographic Data ◽  
Mri Findings ◽  
Level Of Invasion ◽  
Nerve Invasion ◽  
Unilateral Involvement ◽  
Magnetic Resonance Imaging Mri

Abstract Background Optic nerve (ON) invasion is an important high-risk feature, and an indicator for neoadjuvant chemotherapy and prognosis. We aim through this study to correlate the detected-ON invasion by Magnetic resonance imaging (MRI) with the corresponding confirmed histopathological level of invasion. Methods A retrospective study of enucleated globes with the diagnosis of retinoblastoma received in the histopathology department(s) from January 2015 to December 2016 (2 years). Slides were reviewed for ON invasion assessment, charts were reviewed for basic demographic data. All patients underwent MRI under sedation upon diagnosis and MRI findings were collected for the above correlation. Results A total of 38 patients were included: 21 males and 17 females. 29 (77.3%) had unilateral involvement, 7 (18.4%) had bilateral involvement and 2 cases had trilateral disease. The overall mean age at diagnosis was 22.63 ± 15.15 months. Histopathological examination revealed ON invasion in 28 cases (74%) distributed as follows: prelaminar (31.6%), laminar (18.4%), and post-laminar (23.7%). MRI confirmed post-laminar ON invasion in 8 cases (true positive) but failed to detect this in 1 case. Additionally, MRI detected another 8 cases of ON invasion that were false positive on histopathology (accuracy: 63.3%; sensitivity: 88.9%; specificity: 72.4%; Positive predictive value (PPV): 50%; Negative predictive value (NPV): 95.5%). Conclusions MRI is found to be less sensitive in evaluating prelaminar and laminar ON invasion (0.0 and 42.9%) compared to post-laminar invasion (88.9%). MRI has generally better specificity in detecting ON invasion irrespective of the invasion level. In our study, obtaining deeper and/or additional histologic sections from the other surface of the tissue block in cases where a post-laminar ON invasion by MRI is found but not confirmed histopathologically in routine sections is essential to avoid missing such an important high-risk feature.

scholarly journals Histopathological assessment of optic nerve invasion guided by radiological findings in enucleated globes with retinoblastoma.

2020 ◽  
Author(s):  
Mohammed Abusayf ◽  
Hind Manaa Alkatan ◽  
Sahar Elkhamary ◽  
Saleh Almesfer ◽  
Azza MY Maktabi
Keyword(s):  
Optic Nerve ◽  
High Risk ◽  
Predictive Value ◽  
Histopathological Examination ◽  
Demographic Data ◽  
Mri Findings ◽  
Level Of Invasion ◽  
Nerve Invasion ◽  
Unilateral Involvement ◽  
Magnetic Resonance Imaging Mri

Abstract Background: Optic nerve (ON) invasion is an important high-risk feature, and an indicator for neoadjuvant chemotherapy and prognosis. We aim through this study to correlate the detected-ON invasion by Magnetic resonance imaging (MRI) with the corresponding confirmed histopathological level of invasion. Methods: A retrospective study of enucleated globes with the diagnosis of retinoblastoma received in the histopathology department(s) from January 2015 to December 2016 (2 years). Slides were reviewed for ON invasion assessment, charts were reviewed for basic demographic data. All patients underwent MRI under sedation upon diagnosis and MRI findings were collected for the above correlation. Results: A total of 38 patients were included: 21 males and 17 females. 29 (77.3%) had unilateral involvement, 7 (18.4%) had bilateral involvement and 2 cases had trilateral disease. The overall mean age at diagnosis was 22.63 ±15.15 months. Histopathological examination revealed ON invasion in 28 cases (74%) distributed as follows: prelaminar (31.6%), laminar (18.4%), and post-laminar (23.7%). MRI confirmed post-laminar ON invasion in 8 cases (true positive) but failed to detect this in 1 case. Additionally, MRI detected another 8 cases of ON invasion that were false positive on histopathology (accuracy: 63.3%; sensitivity: 88.9%; specificity: 72.4%; Positive predictive value (PPV): 50%; Negative predictive value (NPV): 95.5%). Conclusions: MRI is found to be less sensitive in evaluating prelaminar and laminar ON invasion (0.0 and 42.9%) compared to post-laminar invasion (88.9%). MRI has generally better specificity in detecting ON invasion irrespective of the invasion level. In our study, obtaining deeper and/or additional histologic sections from the other surface of the tissue block in cases where a post-laminar ON invasion by MRI is found but not confirmed histopathologically in routine sections is essential to avoid missing such an important high-risk feature.

scholarly journals Histopathological assessment of optic nerve invasion guided by radiological findings in enucleated globes with retinoblastoma.

2019 ◽  
Author(s):  
Mohammed Abusayf ◽  
Hind Manaa Alkatan ◽  
Azza MY Maktabi ◽  
Sahar Elkhamary ◽  
Saleh Almesfer
Keyword(s):  
Magnetic Resonance Imaging ◽  
Optic Nerve ◽  
High Risk ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Resonance Imaging ◽  
Important Indicator ◽  
Histopathological Features ◽  
Level Of Invasion ◽  
Nerve Invasion

Abstract Purpose: High-risk histopathological features in primary enucleated retinoblastoma globes affect the indication for neoadjuvant chemotherapy to avoid the increased risk of metastasis and to improve survival in such children. Optic nerve (ON) invasion is an important indicator of prognosis and we aim through this study to correlate the detected-ON invasion by imaging with the corresponding confirmed histopathological level of invasion. Methods: This is an approved retrospective study with collaborative agreement between the 2 centres. All enucleated globes with the diagnosis of retinoblastoma received in the histopathology department(s) from January 2015 to December 2016 (2 years) were collected for review by 2 pathologists and the charts were reviewed for basic demographic data. All patients underwent Magnetic resonance imaging (MRI) under sedation upon diagnosis and MRI reading was done by an experienced single neuroradiologist. Results: A total of 38 patients were included: 21 males and 17 females. 29 (77.3%) had unilateral involvement, 7 (18.4%) had bilateral involvement and 2 cases had trilateral disease. The overall mean age at diagnosis was 22.63 ±15.15 months. 28 cases (74%) had pathologically-proven ON invasion: prelaminar (31.6%), laminar (18.4%), and post-laminar (23.7%). Post-laminar ON invasion was identified in 8 cases (true positive), while another 8 were false positive. Only 1 case was missed on MRI (accuracy: 63.3%; sensitivity: 88.9%; specificity: 72.4%; Positive predictive value (PPV): 50%; Negative predictive value (NPV): 95.5%). Conclusions: MRI was found to be less sensitive in evaluating pre-laminar and laminar ON invasion (0.0 and 42.9%) compared to post-laminar invasion (88.9%) but had better specificity in detecting various levels of invasion (72.4 to 83.9%). Obtaining deeper histologic sections in some cases where there are mismatching ON level of invasion between MRI and histopathological examination is recommended to avoid misleading assessment of the high-risk histopathological features. There are no solid international protocols of how many sections should be obtained to evaluate the optic nerve invasion in these globes and this should be established for universal use especially in less developed countries where experienced pathologists might be lacking. Key words: Retinoblastoma; High-risk, Histopathology; Optic nerve invasion; Lamina cribrosa; Radiology; Magnetic resonance imaging; Chemotherapy.

The predictive value of magnetic resonance imaging of retinoblastoma for the likelihood of high-risk pathologic features

2018 ◽  
Vol 29 (2) ◽  
pp. 262-268 ◽  
Author(s):  
Jamila G Hiasat ◽  
Alaa Saleh ◽  
Maysa Al-Hussaini ◽  
Ibrahim Al Nawaiseh ◽  
Mustafa Mehyar ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Optic Nerve ◽  
High Risk ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Resonance Imaging ◽  
Cut Edge ◽  
Pathologic Features ◽  
Nerve Invasion ◽  
Choroidal Invasion

Purpose: To evaluate the predictive value of magnetic resonance imaging in retinoblastoma for the likelihood of high-risk pathologic features. Methods: A retrospective study of 64 eyes enucleated from 60 retinoblastoma patients. Contrast-enhanced magnetic resonance imaging was performed before enucleation. Main outcome measures included demographics, laterality, accuracy, sensitivity, and specificity of magnetic resonance imaging in detecting high-risk pathologic features. Results: Optic nerve invasion and choroidal invasion were seen microscopically in 34 (53%) and 28 (44%) eyes, respectively, while they were detected in magnetic resonance imaging in 22 (34%) and 15 (23%) eyes, respectively. The accuracy of magnetic resonance imaging in detecting prelaminar invasion was 77% (sensitivity 89%, specificity 98%), 56% for laminar invasion (sensitivity 27%, specificity 94%), 84% for postlaminar invasion (sensitivity 42%, specificity 98%), and 100% for optic cut edge invasion (sensitivity100%, specificity 100%). The accuracy of magnetic resonance imaging in detecting focal choroidal invasion was 48% (sensitivity 33%, specificity 97%), and 84% for massive choroidal invasion (sensitivity 53%, specificity 98%), and the accuracy in detecting extrascleral extension was 96% (sensitivity 67%, specificity 98%). Conclusions and relevance: Magnetic resonance imaging should not be the only method to stratify patients at high risk from those who are not, eventhough it can predict with high accuracy extensive postlaminar optic nerve invasion, massive choroidal invasion, and extrascleral tumor extension.

Accuracy of Rotator Cuff Tears and Tendinosis Diagnoses on Shoulder Ultrasound Performed by a Short-experienced Operator

2018 ◽  
Vol 1 ◽  
pp. 9
Author(s):  
Harshad Arvind Vanjare ◽  
Jyoti Panwar
Keyword(s):  
Rotator Cuff ◽  
Negative Predictive Value ◽  
Rotator Cuff Tear ◽  
Predictive Value ◽  
Rotator Cuff Tears ◽  
Mri Findings ◽  
Cuff Tear ◽  
Experienced Operator ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Objective The objective of the study was to assess the accuracy of ultrasound examination for the diagnosis of rotator cuff tear and tendinosis performed by a short experienced operator, compared to magnetic resonance imaging (MRI) results. Method A total of 70 subjects suspected to have rotator cuff tear or tendinosis and planned for shoulder MRI were included in the study. Shoulder ultrasound was performed either before or after the MRI scan on the same day. Ultrasound operator had a short experience in performing an ultrasound of the shoulder. Ultrasound findings were correlated to MRI findings. Results Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the diagnosis of tendinosis were 58%, 84%, 63%, 80%, and 75%, respectively, and it was 68%, 91%, 73%, 88%, and 85%, respectively, for the diagnosis of rotator cuff tear. Conclusions Sensitivity for diagnosing rotator cuff tear or tendinosis was moderate but had a higher negative predictive value. Thus, the ultrasound operator with a short experience in performing shoulder ultrasound had moderate sensitivity in diagnosing tendinosis or tears; however, could exclude them with confidence.

scholarly journals Negative MRI findings in a case of degenerative myelopathy in a dog : clinical communication

2009 ◽  
Vol 80 (4) ◽  
Author(s):  
M. Okada ◽  
M. Kitagawa ◽  
K. Kanayama ◽  
H. Yamamura ◽  
T. Sakai
Keyword(s):  
Magnetic Resonance Imaging ◽  
Histopathological Examination ◽  
Clinical Signs ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Clinical Communication ◽  
Bladder Control ◽  
Blood Tests ◽  
Degenerative Myelopathy ◽  
Magnetic Resonance Imaging Mri

An 11-year-old male Rough collie was submitted with paraparesis, but did not respond to medical treatment. Clinical signs worsened and the dog displayed paralysis, inability to stand and loss of voluntary bladder control, whereupon magnetic resonance imaging (MRI) was performed. No significant abnormalities were identified from MRI, blood tests, cerebrospinal fluid tests or radiography. After MRI, the dog developed dyspnoea and died. Autopsy and subsequent histopathological examination led to a diagnosis of degenerative myelopathy.

Imaging Features of Idiopathic Intracranial Hypertension in Children

2016 ◽  
Vol 32 (1) ◽  
pp. 120-126 ◽  
Author(s):  
Alexander J. P. W. Hartmann ◽  
Bruno P. Soares ◽  
Beau B. Bruce ◽  
Amit M. Saindane ◽  
Nancy J. Newman ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Optic Nerve ◽  
Intracranial Hypertension ◽  
Optic Nerve Head ◽  
Idiopathic Intracranial Hypertension ◽  
Empty Sella ◽  
Imaging Features ◽  
Mri Findings ◽  
Sinus Stenosis ◽  
Magnetic Resonance Imaging Mri

Magnetic resonance imaging (MRI) signs of elevated intracranial pressure and idiopathic intracranial hypertension have been well characterized in adults but not in children. The MRIs of 50 children with idiopathic intracranial hypertension and 46 adults with idiopathic intracranial hypertension were reviewed for optic nerve head protrusion, optic nerve head enhancement, posterior scleral flattening, increased perioptic cerebrospinal fluid, optic nerve tortuosity, empty or partially empty sella, tonsillar herniation, enlargement of Meckel’s cave meningoceles, and transverse venous sinus stenosis(TSS). Compared to adolescents (11-17 years, n = 40) and adults (>17 years, n = 46), prepubescent children (<11 years, n = 10) had lower frequencies of scleral flattening (50% vs 89% and 85%, P = .02), increased perioptic cerebrospinal fluid (60% vs 84% and 89%, P = .08), optic nerve tortuosity (20% vs 46% and 59%, P = .07), empty or partially empty sella (56% vs 78% and 93%, P = .007), and TSS (67% vs 93% and 96%, P = .04). Children with idiopathic intracranial hypertension have similar MRI findings as adults, but they are less frequent in prepubescent children.

scholarly journals Retinoblastoma: An institutional experience

2015 ◽  
Vol 5 (9) ◽  
pp. 723-726
Author(s):  
S Karki ◽  
P Upadhyaya ◽  
M Agarwal ◽  
KK Maharjan ◽  
P Lavaju
Keyword(s):  
Optic Nerve ◽  
High Risk ◽  
Tumor Staging ◽  
Tertiary Care ◽  
Prognostic Significance ◽  
Routine Practice ◽  
Ocular Involvement ◽  
Department Of Ophthalmology ◽  
Nerve Invasion ◽  
Choroidal Invasion

Background: This article aims to describe histopathologic high risk tumor characteristics in our patient population of retinoblastoma. It is based on consensus criteria for definitions of choroidal and optic nerve invasion as outlined in The International RetinoblastomaStaging Working Group (IRSWG) 2009.Materials and Methods: Fifty histopathologically diagnosed cases of retinoblastoma were archived from records of Pathology department during years 2004 to 2014. Re-evaluation of slides to identify choroidal and optic nerve invasion as per IRSWG along with Pathologic tumor staging was done. Data were entered into Microsoft excel sheets and results expressed in percentages. Department of Ophthalmology was consulted for recurrence of Retinoblastoma.Results: Among fifty cases, Choroidal invasion was absent in 62% cases. Minimal invasion (<3mm) was seen in 18% cases, massive (>3mm) in 14% cases and extra ocular involvement in 6% cases. The optic nerve was free of tumor in more than three forth of the cases (78%). Prelaminar and retro laminar involvement of optic nerve was observed in 6% and 10% cases respectively. Intraocular spread of tumor was observed in 6% of cases. The cut margin of optic nerve was involved in 42% while it was free of tumor in 58% of cases. Significant number of tumours were pathologically classified as pT1 (58%) followed by pT2a (22%). pT3a and pT4b were found in 6% each and pT3b and pT4a were found in 4% each. Recurrence was observed in two cases of PT3a and one of pT4b.Conclusion: We conclude identifying low percentages of high risk charateristics in a retrospective histologic experience with Retinoblastoma. Recurrence observed in two tumours staged pT3a sheds light on prognostic significance of reporting massive choroidal invasion despite free cut margin. These observations call for routine practice of standardized histopathologic reporting and processing of enucleated eye samples at our tertiary care centre.Journal of Pathology of Nepal (2015) Vol. 5, 723-726

scholarly journals Clinical and histopathological correlation: A study on 334 eyes with retinoblastoma from Vietnam

2016 ◽  
Vol 16 (1) ◽  
pp. 23-34
Author(s):  
Ha Ngan Nguyen ◽  
Van Trong Pham ◽  
Tuan Anh Hoang ◽  
Van Hong Pham ◽  
Chung Ngoc Nguyen ◽  
...  
Keyword(s):  
Optic Nerve ◽  
High Risk ◽  
Clinical Features ◽  
Risk Group ◽  
Clinical Signs ◽  
Group Versus ◽  
High Risk Group ◽  
Iris Neovascularization ◽  
Nerve Invasion ◽  
Vitreous Seeding

Purpose: To elucidate the clinical features which predict high-risk histopathological factors for subsequent metastatic disease as well as to report the incidence of these high-risk histopathological factors in a cohort of Asian patients with retinoblastoma. Design: A retrospective and non-randomized sequential cases series. Methods: A retrospective study was done on 334 eyes with retinoblastoma at Vietnam National Institute of Ophthalmology during a 10 year period (January 2004 – December 2013). All pathology specimens and medical records were reviewed and assessed for invasion and clinical signs. Results: Among 334 eyes, 225 (67.4%) had high-risk retinoblastoma and 109 (22.6%) had non-high-risk features on histopathology. The high-risk histopathological features included anterior chamber seeding (48.2%), iris infiltration (14.7%), ciliary body involvement (14.1%), massive choroidal invasion (29.9 %), post-laminar optic nerve invasion (21.2%), invasion of optic nerve transection (9.6 %), combined choroidal and optic nerve invasion (9.6 %), scleral invasion (3.3%), and extra-scleral infiltration (11.4%). The significant clinical features in high-risk group versus non-high-risk group included hyphema (19.6% vs 3.7%, p < 0.001), pseudohypopyon (19.1% vs 6.4%, p = 0.001), iris neovascularization  (25.3% vs 5.5%, p < 0.001), vitreous seeding (72.4% vs 37.6%, p < 0.001), staphyloma (24% vs 4.6%, p < 0.001) and scleritis (20% vs 3.7%, p < 0.001). Conclusions: Clinical signs including hyphema, pseudohypopyon, iris neovascularization, vitreous seeding, staphyloma, and scleritis were significantly associated with high-risk features on histopathology. Globe preserving methods should be used with caution in patients with these signs.  

Extensively Necrotic Retinoblastoma Is Associated With High-Risk Prognostic Factors

2006 ◽  
Vol 130 (11) ◽  
pp. 1669-1672 ◽  
Author(s):  
Eva-Marie Chong ◽  
Robert E. Coffee ◽  
Murali Chintagumpala ◽  
Richard L. Hurwitz ◽  
Mary Y. Hurwitz ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Optic Nerve ◽  
High Risk ◽  
Metastatic Disease ◽  
Tumor Necrosis ◽  
Patient Survival ◽  
Nerve Invasion ◽  
Choroidal Invasion ◽  
Extensive Necrosis ◽  
Histopathologic Features

Abstract Context.—Retinoblastoma is the most common malignant intraocular tumor in children. It has been shown that adjuvant therapy following enucleation in patients with high-risk histopathologic features significantly decreases the mortality. We describe the association of extensive necrosis of tumor and intraocular structures with 2 of the major risk factors: optic nerve invasion and choroidal invasion. This may alert the pathologist who makes the observation of extensive necrosis to carefully search for histologic features associated with adverse outcome. Objective.—To determine whether extensively necrotic retinoblastoma is associated with high-risk histologic prognostic factors for metastatic disease and patient survival. Design.—Retrospective case series. Forty-three eyes of 43 patients with retinoblastoma who underwent enucleation between 1990 and 2001 were evaluated. Medical records, histopathology specimens, pathology reports, and clinical photographs were reviewed. Tumors were designated as exhibiting extensive necrosis if more than 95% of tumor cells and intraocular tissues were necrotic. The main outcome measure was the association of extensive tumor necrosis with 3 high-risk histopathologic features: extraocular extension, optic nerve invasion, or choroidal invasion. Metastatic disease, patient survival, and associations with pathologic findings were also analyzed. Results.—Optic nerve head invasion (P &lt; .001), post-lamina-cribrosal invasion (P &lt; .001), and choroidal invasion by tumor (P = .004) were observed more frequently in eyes with extensive necrosis compared with eyes without extensive necrosis. Two of the 11 patients with extensively necrotic intraocular retinoblastoma died from metastatic disease (P = .06). None of the 32 patients without extensive necrosis developed metastatic disease or died. Conclusions.—Extensive ocular tissue and tumor necrosis is associated with histologic high-risk prognostic factors for tumor metastasis and mortality.

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